Clinical Nutrition and Dietetics Unit, Department of Endocrinology and Nutrition, Complejo Asistencial Universitario de León, Altos de Nava S/N, 24071, León, Spain.
Obes Surg. 2023 May;33(5):1401-1410. doi: 10.1007/s11695-023-06540-3. Epub 2023 Mar 21.
Bariatric surgery (BS) is a very effective treatment regarding body weight loss but might affect food tolerance and energy and protein intake. The aim of this study was to compare three BS techniques (biliopancreactic diversion (BPD), gastric bypass (GB), and sleeve gastrectomy (SG)) and their effect on food tolerance.
Prospective study conducted between April 2016 and April 2019. Visits included were 1 before and 6, 12, and 24 months after BS. Food tolerance test (FTT), 24-h recall, and bioelectrical impedance (TANITA MC780) were performed at all visits.
Sixty-six patients were included (74.2% women). FTT showed a better self-perception of the intake after surgery in BPD at 6 months (p = 0.013), and at 12 months (p = 0.006). BPD had a better tolerance of 8 food groups at 6 months (red meat p = 0.017, white meat p = 0.026, salad p = 0.017, bread p < 0.001, rice p = 0.047, pasta p = 0.014, fish p = 0.027) and at 12 months, but only red meat (p = 0.002), bread (p < 0.001), rice (p = 0.025), and pasta (p = 0.025) remained statistically different. Twenty-four months after surgery, only the red meat food group (p = 0.007) showed differences. BPD had the lowest incidence of vomiting at 6 months (p < 0.001), 12 months (p = 0.008), and 24 months (p = 0.002). The total score of FTT was better in BPD at 6 months [25.6 (SD 1.5), p < 0.001], 12 months [25.6 (SD 2.4), p < 0.001], and 24 months [25.7 (SD 1.3), p = 0.001]. BPD showed the best intake in energy and proteins at 6 months [1214.8 (SD 342.4) kcal and 67.1 (SD 18.4) g] and 12 months [1199.6 (SD 289.7) kcal and 73.5 (SD 24.3) g]. % FML was higher in GB both at 6 and 12 months being statistically different (p < 0.050).
Biliopancreatic diversion appears to be the technique with a better food tolerance and protein and energy intake in the first year of follow-up after BS.
减重手术（BS）在减轻体重方面非常有效，但可能会影响食物耐受性和能量及蛋白质摄入。本研究旨在比较三种 BS 技术（胆胰分流术（BPD）、胃旁路术（GB）和袖状胃切除术（SG））及其对食物耐受性的影响。
2016 年 4 月至 2019 年 4 月进行前瞻性研究。随访包括手术前和手术后 6、12 和 24 个月的 3 次就诊。所有就诊时均进行食物耐受性测试（FTT）、24 小时回顾和生物电阻抗（TANITA MC780）。
共纳入 66 例患者（74.2%为女性）。FTT 显示，BPD 在术后 6 个月（p=0.013）和 12 个月（p=0.006）时自我感知的术后摄入情况更好。BPD 在术后 6 个月时（红肉 p=0.017，白肉 p=0.026，沙拉 p=0.017，面包 p<0.001，米饭 p=0.047，意大利面 p=0.014，鱼 p=0.027）和 12 个月时（但仅包括红肉、面包、米饭和意大利面）对 8 种食物的耐受性更好，统计学差异仍有意义。术后 24 个月时，仅红肉食物组（p=0.007）仍有差异。BPD 在术后 6 个月（p<0.001）、12 个月（p=0.008）和 24 个月（p=0.002）时呕吐发生率最低。FTT 的总评分在 BPD 术后 6 个月[25.6（SD 1.5），p<0.001]、12 个月[25.6（SD 2.4），p<0.001]和 24 个月[25.7（SD 1.3），p=0.001]时更好。BPD 在术后 6 个月[1214.8（SD 342.4）kcal 和 67.1（SD 18.4）g]和 12 个月[1199.6（SD 289.7）kcal 和 73.5（SD 24.3）g]时能量和蛋白质摄入最佳。GB 在术后 6 和 12 个月时的 FML%均更高，差异有统计学意义（p<0.050）。
胆胰分流术在 BS 术后随访的第一年似乎具有更好的食物耐受性和蛋白质及能量摄入。
