Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania; Department of Minimally Invasive Surgery, Penn State College of Medicine, Hershey, Pennsylvania.
Department of Psychology, University of South Alabama, Mobile, Alabama.
Surg Obes Relat Dis. 2021 Feb;17(2):263-270. doi: 10.1016/j.soard.2020.10.013. Epub 2020 Oct 17.
Research exploring dietary quality patterns within bariatric populations is limited, despite the significance of eating behaviors for postoperative outcomes. Recent studies revealed associations between food insecurity and disordered eating behavior in bariatric patients; however, the relationship between food insecurity and dietary quality is not known.
To examine the association between dietary quality and levels of food security within a sample of presurgical bariatric patients.
One academic medical center in central Pennsylvania, United States of America.
Patients completed three self-report measures as part of their presurgical psychological assessment process. Food security status was measured by the United States Department of Agriculture's Food Security Module, modified for self-reports. Participants also completed the Rapid Eating Assessment for Participants, short version, which is a measure of dietary quality with scores ranging from 13-39, and the Adult Eating Behavior Questionnaire. Hierarchical multiple regressions were used to assess relationships between dietary quality and food security levels, and mediation models were built to explore associations between variables.
Of the 197 participants, 35.5% reported high food security, while 35.0% and 29.5% reported marginal food security and food insecurity, respectively. Compared with patients with high food security, the dietary quality scores of food-insecure patients were 1.3 points lower (95% confidence interval [CI], -3.3 to .7; P = .2) of and marginally food-secure patients were 1.2 points lower (95% CI, -2.9 to .5) than those reporting high food security (P = .2).
Our findings indicate a need for further exploration into the barriers that prebariatric patients may face when attempting to adhere to pre- and postoperative dietary requirements, particularly for those reporting marginal food security and food insecurity. Future research should target postoperative outcomes, including weight gain, weight regain, and dietary adherence, among the most economically vulnerable bariatric patients.
尽管饮食行为对术后结果很重要，但探索肥胖人群饮食质量模式的研究有限。最近的研究表明，在肥胖症患者中，食物不安全与饮食行为障碍之间存在关联；然而，食物不安全与饮食质量之间的关系尚不清楚。
在美国宾夕法尼亚州中部的一家学术医疗中心，研究了术前肥胖患者样本中饮食质量与食物安全水平之间的关系。
美国宾夕法尼亚州中部的一家学术医疗中心。
患者在术前心理评估过程中完成了三项自我报告措施。食物安全状况通过美国农业部的食物安全模块进行衡量，该模块经过修改后可用于自我报告。参与者还完成了快速进食评估参与者，短版，这是一个衡量饮食质量的指标，分数范围为 13-39，以及成人饮食行为问卷。分层多元回归用于评估饮食质量与食物安全水平之间的关系，并建立中介模型来探索变量之间的关联。
在 197 名参与者中，35.5%报告了高食物安全，而 35.0%和 29.5%分别报告了边缘食物安全和食物不安全。与高食物安全的患者相比，食物不安全患者的饮食质量评分低 1.3 分（95%置信区间[CI]，-3.3 至 0.7；P=0.2），边缘食物安全患者低 1.2 分（95% CI，-2.9 至 0.5）比报告高食物安全的患者（P=0.2）。
我们的研究结果表明，需要进一步探讨术前肥胖患者在试图遵守术前和术后饮食要求时可能面临的障碍，特别是对于那些报告边缘性食物安全和食物不安全的患者。未来的研究应针对术后结果，包括体重增加、体重反弹和饮食依从性，针对最经济弱势群体的肥胖症患者。
