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肥胖患者行 Roux-en-Y 胃旁路手术后 2 年食物不耐受与咀嚼效率和蛋白质摄入的关系。

Relationship of Food Intolerance 2 Years After Roux-en-Y Gastric Bypass Surgery for Obesity with Masticatory Efficiency and Protein Consumption.

机构信息

Speech Therapy Department, Hospital Universitário Onofre Lopes, Av. Nilo Peçanha 620, Petrópolis, Natal, RN, 59012-300, Brazil.

Departamento de Fonoaudiologia, Hospital Universitário Onofre Lopes, Av. Nilo Peçanha 620, Petrópolis, Natal, RN, 59012-300, Brazil.

出版信息

Obes Surg. 2020 Aug;30(8):3093-3098. doi: 10.1007/s11695-020-04669-z.

Abstract

BACKGROUND

Roux-en-Y gastric bypass (RYGB) is among the most performed bariatric surgery techniques. One known complication of RYGB surgery is food intolerance, which may limit the intake of protein.

OBJECTIVE

To investigate the relationship of food intolerance after RYGB surgery with masticatory efficiency, chewing time and cycles, and consumption of protein and red meat.

METHODS

A case-control study in subjects with and without food intolerance (regurgitation and/or vomiting more than once a week) aged over 18 years old who had undergone RYGB more than 2 years prior, with an absence of no more than 2 dental units and normal oral motor system evaluation. Masticatory efficiency was evaluated by the granulometry of red meat chewed by the study subject according to a predefined protocol using a sieving technique and classified from very poor to excellent. Protein and red meat consumption were evaluated by usual food recall and a 3-day dietary diary.

RESULTS

The study population consisted of 24 cases (37.7 ± 7.57 years old, 79.2% females) and 68 controls (38.0 ± 8.75 years old, 61.8% females). There was a statistically significant association (p = 0.001 by the ranksum test) between food intolerance and masticatory efficiency, with 58.3% of cases and 23.5% of controls showing very poor masticatory efficiency. No evidence was found of an association of food intolerance with chewing time, chewing cycles, low protein or red meat consumption.

CONCLUSION

Masticatory inefficiency is a contributing factor to food intolerance after RYGB, regardless of time and chewing cycles. No relationship was found between food intolerance and consumption of red meat and protein.

摘要

背景

Roux-en-Y 胃旁路术(RYGB)是最常施行的减重手术之一。RYGB 手术后的一种已知并发症是食物不耐受,这可能会限制蛋白质的摄入。

目的

研究 RYGB 手术后食物不耐受与咀嚼效率、咀嚼时间和咀嚼周期以及蛋白质和红肉的摄入之间的关系。

方法

这是一项病例对照研究,纳入了年龄大于 18 岁且 RYGB 手术时间超过 2 年的病例和对照组,病例组存在每周多于 1 次的反流和/或呕吐,对照组不存在食物不耐受且无超过 2 个牙缺失,口腔运动系统评估正常。咀嚼效率根据预定方案,使用筛分技术,通过评估研究对象咀嚼的红肉颗粒度进行评估,结果分为很差到很好。通过常规食物回忆和 3 天饮食日记评估蛋白质和红肉的摄入。

结果

研究人群包括 24 例病例(37.7±7.57 岁,79.2%为女性)和 68 例对照组(38.0±8.75 岁,61.8%为女性)。病例组和对照组在食物不耐受和咀嚼效率之间存在统计学显著关联(秩和检验,p=0.001),58.3%的病例组和 23.5%的对照组存在很差的咀嚼效率。未发现食物不耐受与咀嚼时间、咀嚼周期、低蛋白或低红肉摄入之间存在关联。

结论

RYGB 术后咀嚼效率差是导致食物不耐受的一个因素,与时间和咀嚼周期无关。未发现食物不耐受与红肉和蛋白质摄入之间存在关联。

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