Department of Nutritional Sciences, School of Health Sciences, Ariel University, Ariel, Israel.
Department of Nutrition, Assuta Medical Center, Tel Aviv, Israel.
Adv Nutr. 2021 Jun 1;12(3):1020-1031. doi: 10.1093/advances/nmaa121.
Bariatric surgery (BS) has proven to be highly efficacious in the treatment of obesity and its comorbidities. However, careful patient selection is critical for its success. Thus, patients should undergo medical, behavioral, and nutritional assessment by a multidisciplinary team. From the nutritional point of view, BS candidates should undergo nutritional assessment, preparation, and education by a registered dietitian in the preoperative period. Currently, detailed specified and comprehensive information on these topics is lacking. The present narrative review aimed to summarize the available literature concerning both the preoperative nutritional assessment components and the preoperative nutritional preparation and education components of patients planning to undergo BS. Current literature indicates that proper management before BS should include a comprehensive nutritional assessment, in which it is advisable to perform a clinical interview to assess patients' medical background, weight management history, eating patterns and pathologies, oral health, physical activity habits, nutritional status, supplementation usage, BS knowledge, surgery expectations and anthropometric measurements. Nutritional preparation and educational strategies should include an individualized preoperative weight-loss nutrition program, improvement of glycemic control, micronutrients deficiencies correction, eating and lifestyle habits adaptation, physical activity initiation, and strengthening knowledge on obesity and BS. At this stage, more well-designed intervention and long-term cohort studies are needed in order to formulate uniform evidence-based nutritional guidelines for patients who plan to undergo BS, including populations at higher nutritional risk. Moreover, postoperative outcomes of presurgical nutritional intervention programs should be studied.
减重手术（BS）已被证明在治疗肥胖及其合并症方面非常有效。然而，仔细选择患者对于手术的成功至关重要。因此，患者应由多学科团队进行医学、行为和营养评估。从营养角度来看，BS 患者应在术前接受注册营养师的营养评估、准备和教育。目前，这些主题的详细具体和综合信息尚缺乏。本综述性叙述旨在总结有关计划接受 BS 的患者的术前营养评估和术前营养准备和教育两部分的现有文献。目前的文献表明，BS 前的适当管理应包括全面的营养评估，其中建议进行临床访谈，以评估患者的医疗背景、体重管理史、饮食模式和病理、口腔健康、身体活动习惯、营养状况、补充剂使用、BS 知识、手术预期和人体测量。营养准备和教育策略应包括个体化的术前减重营养计划、改善血糖控制、纠正微量营养素缺乏、饮食和生活方式习惯的适应、开始进行身体活动以及加强对肥胖和 BS 的认识。在现阶段，需要进行更多设计良好的干预和长期队列研究，以便为计划接受 BS 的患者制定统一的基于证据的营养指南，包括营养风险较高的人群。此外，还应研究术前营养干预计划的术后结果。
