Nutrition Course, Federal University of Tocantins, Quadra 109 North, NS-15 Avenue, ALCNO-14, Block Bala2, North Director Plan, Palmas, Tocantins, 77001-090, Brazil.
Federal University of Viçosa, Viçosa, Minas Gerais, Brazil.
Obes Surg. 2019 Dec;29(12):3780-3785. doi: 10.1007/s11695-019-04124-8.
Although bariatric surgery promotes dietary changes, many questions regarding their effect on weight loss remain unanswered.
The aim of this study was to evaluate changes in dietary intake and predictive factors of obesity remission in the first 12 months after RYGB.
Fifty-one patients (mean 39.34 ± 9.38 years, 68.7% women) who underwent RYGB were included in this study. Dietary intake was evaluated through a 24-h dietary recall and subsequently classified by NOVA, macronutrients and calories. The predictive factors for obesity remission within 12 months after RYGB were evaluated by Cox regression.
At baseline, 62.7% of the patients presented severe obesity; mean excess weight loss was greater than 80% after 1 year of surgery and about 70% of the patients were no longer diagnosed with obesity. An increase in percentage of calories from protein was observed at 3 and 12 months after surgery. The caloric contribution of ultra-processed foods was low at 3 months after surgery while that of unprocessed or minimally processed foods was high at 3 and 12 months after surgery. From the Cox regression analysis, preoperative BMI (HR, 0.78; 95% CI, 0.69-0.88) and age (HR, 0.94; 95% CI, 0.89-0.99) showed an inverse association with obesity remission. Also, Δ protein (at 3 months-baseline) showed a positive association with obesity remission (HR, 1.06; 95% CI, 1.01-1.12).
Lower preoperative BMI, lower age, and higher protein intake at 3 months after surgery may favor remission of obesity in up to 12 months compared with baseline.
尽管减重手术可促进饮食改变，但有关其对体重减轻影响的许多问题仍未得到解答。
本研究旨在评估 RYGB 术后 12 个月内饮食摄入的变化及其对肥胖缓解的预测因素。
本研究纳入了 51 例（平均年龄 39.34±9.38 岁，68.7%为女性）接受 RYGB 的患者。通过 24 小时膳食回顾评估饮食摄入，并根据 NOVA、宏量营养素和卡路里进行分类。通过 Cox 回归评估 RYGB 术后 12 个月内肥胖缓解的预测因素。
基线时，62.7%的患者患有严重肥胖症；术后 1 年时，平均超重减轻量超过 80%，约 70%的患者不再被诊断为肥胖症。术后 3 个月和 12 个月时观察到蛋白质卡路里百分比增加。术后 3 个月时，超加工食品的卡路里贡献较低，而未加工或轻度加工食品的卡路里贡献较高。Cox 回归分析显示，术前 BMI（HR，0.78；95%CI，0.69-0.88）和年龄（HR，0.94；95%CI，0.89-0.99）与肥胖缓解呈负相关。此外，术后 3 个月时的Δ蛋白（3 个月-基线）与肥胖缓解呈正相关（HR，1.06；95%CI，1.01-1.12）。
与基线相比，术前 BMI 较低、年龄较小、术后 3 个月时蛋白质摄入较高可能有利于 12 个月内肥胖的缓解。
