Laboratory of Energy Metabolism and Body Composition (LAMECC), Department of Nutrition and Health, Universidade Federal de Viçosa, Av. PH Rolfs S/N, Viçosa, Minas Gerais, 36570‑900, Brazil.
Nutrition Course, Universidade Federal de Tocantins, Palmas, Tocantins, 77001-090, Brazil.
Obes Surg. 2023 May;33(5):1382-1389. doi: 10.1007/s11695-023-06539-w. Epub 2023 Mar 28.
Some patients do not have the expected weight loss, and the post-surgical diet may partially explain these differences.
To estimate the impact of macronutrient substitution on obesity remission after RYGB, considering the protein source.
This study included 58 patients undergoing RYGB. Data collection was performed preoperatively, 3 and 12 months after surgery. Eight participants dropped out of the study at 3 months, and the others remained for 12 months. The foods consumed were registered using a 24-h, 3-day food recall. For the isocaloric substitution analysis, foods were classified according to the protein source. The groups were compared using hypothesis tests, and Cox proportional hazard ratio regression was used to analyze isocaloric substitution.
At three months after surgery, every 5% energy from plant protein replaced by animal protein increased by 3.50 [CI 1.204 - 10.205; p = 0.021] the probability of obesity remission. Stratified analysis by protein groups indicated that replacing vegetable protein with white meat was positively associated with remission of obesity. Every 5% vegetable protein replaced with white meat increased by 3.20 [CI 1.026 - 9.981; p = 0.045] the probability of obesity remission. Both results were independent of age, body mass index (BMI), and the presence of comorbidities.
The results suggest that the consumption of animal proteins after RYGB, mainly white meat, favors weight loss.
部分患者未达到预期的体重减轻效果，术后饮食可能部分解释了这些差异。
估计在考虑蛋白质来源的情况下，宏量营养素替代对 RYGB 后肥胖缓解的影响。
这项研究纳入了 58 例行 RYGB 的患者。数据采集在术前、术后 3 个月和 12 个月进行。8 名参与者在 3 个月时退出研究，其余参与者持续了 12 个月。通过 24 小时、3 天的食物回忆来记录所消耗的食物。对于等热量替代分析，根据蛋白质来源对食物进行分类。使用假设检验比较组间差异，并使用 Cox 比例风险回归分析等热量替代。
术后 3 个月时，植物蛋白的能量每替代 5%为动物蛋白，肥胖缓解的概率增加 3.50 [CI 1.204-10.205；p=0.021]。按蛋白质组进行分层分析表明，用白肉替代植物蛋白与肥胖缓解呈正相关。每替代 5%的植物蛋白为白肉，肥胖缓解的概率增加 3.20 [CI 1.026-9.981；p=0.045]。这两个结果均独立于年龄、体重指数（BMI）和合并症的存在。
结果表明，RYGB 后食用动物蛋白，主要是白肉，有利于体重减轻。
