Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, 84081 Baronissi, Italy.
NBFC-National Biodiversity Future Center, 90133 Palermo, Italy.
Nutrients. 2024 May 11;16(10):1448. doi: 10.3390/nu16101448.
Sleeve gastrectomy (SG) is one of the most commonly performed weight loss (WL) bariatric procedures. The main goal of WL is reducing total body weight (TBW) and fat mass (FM). However, TBW loss is systematically accompanied by a decline in fat-free mass (FFM), predominantly in the first post-surgical month, despite protein supplementation. Branched-chain amino acids (BCAAs) and vitamin D seem to attenuate loss of FFM and, thus, reduce the decline in muscle strength (MS). However, data on the role of an integrated supplementation with whey protein plus BCAAs plus vitamin D (P+BCAAs+Vit.D) vs. protein alone on total weight loss (TWL), fat mass (FM), fat-free mass (FFM), and (MS) in the first month after SG are lacking. Therefore, the present study aims to evaluate the impact of P+BCAAs+Vit.D vs. protein alone supplementation on TWL, FM, FFM, and MS in the first month after SG.
Before SG and at 1 month afterward, we prospectively measured and compared TBW, FM, FFM, and MS in 57 patients who received either a supplementation with P+BCAAs+Vit.D (n = 31) or protein alone (n = 26). The impact of P+BCAAs+Vit.D and protein alone supplementation on clinical status was also evaluated.
Despite non-significant variation in TBW, FM decreased more significantly (18.5% vs. 13.2%, = 0.023) with the P+BCAA+Vit.D supplementation compared to protein alone. Furthermore, the P+BCAA+Vit.D group showed a significantly lower decrease in FFM (4.1% vs. 11.4%, < 0.001) and MS (3.8% vs. 18.5%, < 0.001) compared to the protein alone group. No significant alterations in clinical status were seen in either group.
P+BCAA+Vit.D supplementation is more effective than protein alone in determining FM loss and is associated with a lower decrease in FFM and MS, without interfering with clinical status in patients 1 month after SG.
袖状胃切除术（SG）是最常进行的减重（WL）减肥手术之一。减肥的主要目标是减轻体重（TBW）和脂肪量（FM）。然而，尽管进行了蛋白质补充，TBW 的损失总是伴随着去脂体重（FFM）的下降，主要发生在术后第一个月。支链氨基酸（BCAAs）和维生素 D 似乎可以减轻 FFM 的损失，从而降低肌肉力量（MS）的下降。然而，关于乳清蛋白加 BCAAs 加维生素 D（P+BCAAs+Vit.D）与单独蛋白质补充对 SG 后第一个月总减重（TWL）、脂肪量（FM）、去脂体重（FFM）和（MS）的作用的数据尚缺乏。因此，本研究旨在评估 P+BCAAs+Vit.D 与单独蛋白质补充对 SG 后第一个月 TWL、FM、FFM 和 MS 的影响。
在 SG 前和术后 1 个月，我们前瞻性地测量并比较了 57 例接受 P+BCAAs+Vit.D（n=31）或单独蛋白质（n=26）补充的患者的 TBW、FM、FFM 和 MS。还评估了 P+BCAAs+Vit.D 和单独蛋白质补充对临床状况的影响。
尽管 TBW 无显著变化，但 P+BCAAs+Vit.D 补充组的 FM 减少更明显（18.5% vs. 13.2%， = 0.023）。此外，与单独蛋白质组相比，P+BCAAs+Vit.D 组的 FFM（4.1% vs. 11.4%， < 0.001）和 MS（3.8% vs. 18.5%， < 0.001）的下降幅度显著降低。两组的临床状况均无显著变化。
P+BCAAs+Vit.D 补充比单独蛋白质更有效，可确定 FM 丢失，并与 FFM 和 MS 下降幅度较低相关，而不会干扰 SG 后 1 个月患者的临床状况。
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