Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, 1985717413, Iran.
Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, 1981619573, Iran.
Eur J Med Res. 2024 Aug 13;29(1):417. doi: 10.1186/s40001-024-02009-w.
Food intakes 1-2 years following bariatric surgery depend more on patients than the surgery's gastrointestinal tract changes. This study aimed to determine the major dietary patterns of patients after the first two years of sleeve gastrectomy and to investigate their associations with total weight loss (TWL) and the proportion of TWL as fat mass (FM) and fat-free mass (FFM) loss.
This cross-sectional study included 146 patients undergoing sleeve gastrectomy 2-4 years after surgery. Dietary patterns were determined using principal component analysis based on the 19 food groups. The percentage of FM loss relative to TWL (%FML) and FFM loss relative to TWL (%FFML) were calculated. A suboptimal clinical response was defined as a TWL of less than 25%. High FM loss and excessive FFM loss were defined based on the highest tertiles. Linear and logistic regression models were used to derive unstandardized (B) coefficients and odds ratios (OR), with dietary pattern scores serving as both a continuous and a binary variable (higher vs. lower adherence groups based on median).
Two predominant dietary patterns were retained. Each 1-unit increase in the first dietary pattern score characterized by high intakes of fast foods, soft drinks, processed meats, sugar confectionary, salty snacks, grains, and organ meats was associated with higher %FFML (B = 1.99; 95% confidence interval (CI) 0.34, 3.66), lower %FML (B = - 1.84; 95% CI - 3.49, - 0.20), and higher odds of excessive FFM loss (OR = 1.84; 95% CI 1.09, 3.11). Participants with higher adherence to the first dietary pattern had lower %TWL, and greater odds of suboptimal clinical response and excessive FFM loss than those with lower adherence. Each 1-unit increase in score for the second dietary pattern characterized by a high intake of fruits, dairy, vegetables, legumes, eggs, nuts, red meats, poultry, and fish was associated with lower odds of suboptimal clinical response (OR = 0.51; 95% CI 0.31, 0.86).
Patients should be encouraged to modify their diet by reducing the consumption of ultra-processed foods and increasing their intake of high-quality protein sources, fruits, and vegetables to achieve the best postoperative outcome.
减重手术后 1-2 年内的食物摄入量更多地取决于患者，而不是手术引起的胃肠道变化。本研究旨在确定袖状胃切除术后两年内患者的主要饮食模式，并探讨其与总减重（TWL）以及 TWL 中脂肪质量（FM）和去脂体重（FFM）损失的比例之间的关系。
本横断面研究纳入了 146 名接受袖状胃切除术后 2-4 年的患者。采用基于 19 种食物组的主成分分析来确定饮食模式。计算 FM 损失相对于 TWL 的百分比（%FML）和 FFM 损失相对于 TWL 的百分比（%FFML）。将 TWL 小于 25%定义为临床疗效不佳。根据最高三分位数将高 FM 损失和过度 FFM 损失定义为高 FM 损失和过度 FFM 损失。线性和逻辑回归模型用于获得未标准化（B）系数和比值比（OR），饮食模式评分既作为连续变量，也作为分类变量（中位数为高和低依从性组）。
保留了两种主要的饮食模式。第一种饮食模式的评分每增加 1 个单位，特点是大量摄入快餐、软饮料、加工肉类、糖食、咸零食、谷物和动物内脏，与较高的 %FFML（B=1.99；95%置信区间（CI）0.34，3.66）、较低的 %FML（B=-1.84；95%CI -3.49，-0.20）和较高的过度 FFM 损失的可能性（OR=1.84；95%CI 1.09，3.11）相关。与低饮食模式评分者相比，高饮食模式评分者的 TWL 百分比较低，临床疗效不佳和过度 FFM 损失的可能性较高。第二种饮食模式的评分每增加 1 个单位，特点是大量摄入水果、奶制品、蔬菜、豆类、鸡蛋、坚果、红色肉类、家禽和鱼类，与临床疗效不佳的可能性较低（OR=0.51；95%CI 0.31，0.86）相关。
应鼓励患者通过减少食用超加工食品和增加高质量蛋白质来源、水果和蔬菜的摄入量来调整饮食，以获得最佳的术后效果。
