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Lytvyak E, Zarrinpar A, Dalle Ore C, Lee E, Yazdani-Boset K, Horgan S, Grunvald E. Control of Eating Attributes and Weight Loss Outcomes over One Year After Sleeve Gastrectomy. Obes Surg 2024; 34:1618-1629. [PMID: 38502520 DOI: 10.1007/s11695-024-07158-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 03/05/2024] [Accepted: 03/06/2024] [Indexed: 03/21/2024]
Abstract
PURPOSE Sleeve gastrectomy (SG) is a commonly performed metabolic-bariatric surgery, but its effectiveness is variable and difficult to predict. Our study aimed to compare control of eating (CoE) attributes pre- and post-SG depending on the achievement of optimal weight loss target at 1 year post-SG. MATERIALS AND METHODS A prospective longitudinal cohort study using the CoE Questionnaire, pre-SG, and postoperatively at 3, 6, and 12 months was conducted. Total weight loss (TWL) ≥ 25% at 12 months post-SG was set as an optimal weight loss target. RESULTS Forty-one patients (80.5% females, mean age 41.7 ± 10.6) were included. Sex, age, baseline weight, BMI, and smoking status were all comparable. At 3 months post-SG, "difficulty to control eating" score became significantly different between ≥ 25%TWL and < 25%TWL groups (7 [0-50] vs. 17 [5-63], p = 0.042). At 6 months, it was followed by "feeling of fullness," "frequency of food cravings," and "difficulty to resist cravings" demonstrating significant differences between ≥ 25%TWL and < 25%TWL groups. At 12 months, significant differences between groups were observed in "feeling hungry," "difficulty to resist cravings," "eating in response to cravings," and difficulty to control eating scores. CONCLUSION Individuals with obesity who achieved a target of ≥ 25%TWL at 1 year post-SG have an early improvement in overall eating control at 3 months that steadily persists at 6 and 12 months. Improvements in other aspects tend to follow later, at 6 and 12 months. These findings may assist in identifying individuals with inadequate response to help attain optimal weight loss targets and developing a prognostic model to identify predictors of successful weight loss.
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Affiliation(s)
- Ellina Lytvyak
- Division of Preventive Medicine, Department of Medicine, University of Alberta, 5-30 University Terrace, 8303 112 Street, Edmonton, AB, T6G 2T4, Canada.
| | - Amir Zarrinpar
- Division of Gastroenterology, University of California San Diego, 9500 Gilman Dr, La Jolla, San Diego, CA, 92093, USA
- School of Medicine, University of California San Diego, 9500 Gilman Dr, La Jolla, San Diego, CA, 92093, USA
| | - Cecilia Dalle Ore
- School of Medicine, University of California San Diego, 9500 Gilman Dr, La Jolla, San Diego, CA, 92093, USA
| | - Euyhyun Lee
- Altman Clinical and Translational Research Institute, University of California San Diego, 9452 Medical Ctr Dr, La Jolla, San Diego, CA, 92037, USA
| | - Keila Yazdani-Boset
- University of California San Diego, 9500 Gilman Dr, La Jolla, San Diego, CA, 92093, USA
| | - Santiago Horgan
- Division of Minimally Invasive Surgery, Bariatric and Metabolic Institute, University of California San Diego, 4303 La Jolla Village Drive, Suite 2110, San Diego, CA, 92122, USA
| | - Eduardo Grunvald
- School of Medicine, University of California San Diego, 9500 Gilman Dr, La Jolla, San Diego, CA, 92093, USA
- Division of General Internal Medicine, University of California San Diego, 9500 Gilman Dr, La Jolla, San Diego, CA, 92093, USA
- Division of Minimally Invasive Surgery, Bariatric and Metabolic Institute, University of California San Diego, 4303 La Jolla Village Drive, Suite 2110, San Diego, CA, 92122, USA
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Nicanor-Carreón JG, Rowitz B, Pepino MY. Taste and odor interactions after metabolic surgery. Chem Senses 2024; 49:bjae034. [PMID: 39292252 DOI: 10.1093/chemse/bjae034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2024] [Indexed: 09/19/2024] Open
Abstract
Most patients report "taste" changes after undergoing metabolic surgeries. Yet, most studies that used validated sensory evaluation techniques, including ours, found no changes in perceived taste intensity from before to after surgery. However, we assessed participants with pure gustatory stimuli and after an overnight fast, which raises questions about whether patients' self-reported "taste" changes are due to conflating changes in retronasal smell/"flavor" with taste changes or whether they only manifest during the fed state. To investigate this, we conducted a cross-sectional study comparing sensory responses in women who underwent metabolic surgery 2 to 6 yr ago (n = 15) with 2 nonoperated control groups: one with a body mass index (BMI) equivalent (n = 15) and one with a healthy BMI (n = 15). Participants attended 2 sessions, one fed and one fasted. Using a sip-and-spit method, women tasted liquid samples containing gustatory and olfactory stimuli and puddings with varying fat content with and without nose clips. They used separate general labeled magnitude scales to rate their perceived intensity of taste, smell, flavor, and liking. Mixed ANOVAs indicated that the surgery and BMI equivalent groups rated retronasal smell intensity of coffee stronger than the healthy BMI group (P ≤ 0.015). However, there were no differences in taste/flavor intensity or liking ratings among groups. Additionally, feeding conditions did not significantly affect perceived intensity ratings. Our findings suggest that changes in the sensory-discriminatory component of taste or taste-odor interactions are not significant contributors to dietary modifications following metabolic surgery.
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Affiliation(s)
- Jessica G Nicanor-Carreón
- Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, United States
| | - Blair Rowitz
- Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, United States
- Carle Illinois College of Medicine, University of Illinois at Urbana-Champaign, Urbana, IL, United States
- Department of Surgery, Carle Foundation Hospital, Urbana, IL, United States
| | - Marta Yanina Pepino
- Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, United States
- Carle Illinois College of Medicine, University of Illinois at Urbana-Champaign, Urbana, IL, United States
- Food Science and Human Nutrition, University of Illinois at Urbana-Champaign, Urbana, IL, United States
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Matiashova L, Hoogkamer AL, Timper K. The Role of the Olfactory System in Obesity and Metabolism in Humans: A Systematic Review and Meta-Analysis. Metabolites 2023; 14:16. [PMID: 38248819 PMCID: PMC10821293 DOI: 10.3390/metabo14010016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 12/16/2023] [Accepted: 12/20/2023] [Indexed: 01/23/2024] Open
Abstract
Obesity, linked to chronic diseases, poses a global health challenge. While the role of the olfactory system in energy homeostasis is well-documented in rodents, its role in metabolism regulation and obesity in humans remains understudied. This review examines the interplay between olfactory function and metabolic alterations in human obesity and the effects of bariatric surgery on olfactory capabilities in humans. Adhering to PRISMA guidelines, a systematic review and meta-analysis was conducted, focusing exclusively on original human studies. From 51 articles, 14 were selected for the meta-analysis. It was found that variations in olfactory receptor genes influence the susceptibility to odors and predisposition to weight gain and poor eating habits. Bariatric surgery, particularly sleeve gastrectomy, shows significant improvements in olfactory function (SMD 2.37, 95% CI [0.96, 3.77], I = 92%, p = 0.001), especially regarding the olfactory threshold (SMD -1.65, 95% CI [-3.03, -0.27], I = 81%, p = 0.02). There is a bidirectional relationship between olfactory function and metabolism in humans. Bariatric surgery improves olfactory perception in obese patients, but it is still unclear if impacting the olfactory system directly affects eating behavior and the energy balance. However, these findings open novel avenues for future studies addressing the olfactory system as a novel target to alter systemic metabolism in humans.
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Affiliation(s)
- Lolita Matiashova
- Clinic of Endocrinology, Diabetes and Metabolism, University Hospital Basel, 4031 Basel, Switzerland; (A.L.H.); or (K.T.)
| | - Anouk Lisa Hoogkamer
- Clinic of Endocrinology, Diabetes and Metabolism, University Hospital Basel, 4031 Basel, Switzerland; (A.L.H.); or (K.T.)
| | - Katharina Timper
- Clinic of Endocrinology, Diabetes and Metabolism, University Hospital Basel, 4031 Basel, Switzerland; (A.L.H.); or (K.T.)
- Department of Biomedicine, University of Basel, 4031 Basel, Switzerland
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4
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Phan A, Hage M, Zaharia R, Vigan M, Coursault S, Wilson S, Gabali E, Foussier L, Vychnevskaia K, Raffin-Sanson ML, Bretault M. Nutritional Status of Vegetarian Patients Before and After Bariatric Surgery: a Monocentric Retrospective Observational Case-Control Study. Obes Surg 2023; 33:1356-1365. [PMID: 36991254 DOI: 10.1007/s11695-023-06538-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 03/01/2023] [Accepted: 03/07/2023] [Indexed: 03/31/2023]
Abstract
The obesity pandemic is associated with an increasing number of bariatric surgeries which allow improvement in obesity-related comorbidities and life expectancy but potentially induce nutritional deficiencies. Vegetarianism becomes more and more popular and exposes as well to vitamin and micronutrient deficiencies. Only one study has explored the impact of vegetarianism on the preoperative nutritional status of eligible patients for bariatric surgery, but none in postoperative care. MATERIALS AND METHODS We conducted a retrospective case-control study in our cohort of bariatric patients, matching 5 omnivores for each vegetarian. We compared their biological profile regarding vitamin and micronutrient blood levels before and 3, 6, 12, and 30 months after surgery. RESULTS We included 7 vegetarians including 4 lacto-ovo-vegetarians (57%), 2 lacto-vegetarians (29%), and one lacto-ovo-pesco-vegetarian (14%). Three years after surgery with equivalent daily standard vitamin supplementation, the two groups showed a similar biological profile including blood levels of ferritin (p = 0.6), vitamin B1 (p = 0.1), and B12 (p = 0.7), while the total median weight loss at 3 years was comparable (39.1% [27.0-46.6] in vegetarians vs 35.7% [10.5-46.5] in omnivores, p = 0.8). We observed no significant difference between vegetarians and omnivores before surgery regarding comorbidities and nutritional status. CONCLUSION It seems that, after bariatric surgery, vegetarian patients taking a standard vitamin supplementation do not show an increased risk of nutritional deficiencies compared to omnivores. However, a larger study with a longer follow-up is needed to confirm these data, including an evaluation of different types of vegetarianism such as veganism.
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Affiliation(s)
- Aurélie Phan
- Department of Nutrition, European Georges Pompidou Hospital, APHP, Paris, France
| | - Mirella Hage
- Department of Endocrinology-Nutrition, Ambroise Paré Hospital, AP-HP, EA4340 Research Unit, Université de Versailles Saint-Quentin-en-Yvelines, University Paris-Saclay, 92100, Boulogne-Billancourt, France
| | - Ramona Zaharia
- Department of Endocrinology-Nutrition, Ambroise Paré Hospital, AP-HP, EA4340 Research Unit, Université de Versailles Saint-Quentin-en-Yvelines, University Paris-Saclay, 92100, Boulogne-Billancourt, France
| | - Marie Vigan
- Clinical Research Unit, AP-HP, Paris-Saclay, Hôpital Ambroise Pare, Boulogne-Billancourt, France
| | - Séverine Coursault
- Department of Endocrinology-Nutrition, Ambroise Paré Hospital, AP-HP, EA4340 Research Unit, Université de Versailles Saint-Quentin-en-Yvelines, University Paris-Saclay, 92100, Boulogne-Billancourt, France
| | - Sandy Wilson
- Department of Endocrinology-Nutrition, Ambroise Paré Hospital, AP-HP, EA4340 Research Unit, Université de Versailles Saint-Quentin-en-Yvelines, University Paris-Saclay, 92100, Boulogne-Billancourt, France
| | - Elodie Gabali
- Department of Endocrinology-Nutrition, Ambroise Paré Hospital, AP-HP, EA4340 Research Unit, Université de Versailles Saint-Quentin-en-Yvelines, University Paris-Saclay, 92100, Boulogne-Billancourt, France
| | - Loic Foussier
- Department of Endocrinology-Nutrition, Ambroise Paré Hospital, AP-HP, EA4340 Research Unit, Université de Versailles Saint-Quentin-en-Yvelines, University Paris-Saclay, 92100, Boulogne-Billancourt, France
| | - Karina Vychnevskaia
- Department of Surgery and Oncology, Ambroise Paré Hospital, AP-HP, Boulogne-Billancourt, France
| | - Marie-Laure Raffin-Sanson
- Department of Endocrinology-Nutrition, Ambroise Paré Hospital, AP-HP, EA4340 Research Unit, Université de Versailles Saint-Quentin-en-Yvelines, University Paris-Saclay, 92100, Boulogne-Billancourt, France
| | - Marion Bretault
- Department of Endocrinology-Nutrition, Ambroise Paré Hospital, AP-HP, EA4340 Research Unit, Université de Versailles Saint-Quentin-en-Yvelines, University Paris-Saclay, 92100, Boulogne-Billancourt, France.
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5
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Sherf-Dagan S, Biton R, Ribeiro R, Kessler Y, Raziel A, Rossoni C, Kais H, Bragança R, Santos Z, Goitein D, Viveiros O, Graham Y, Mahawar K, Sakran N, Ben-Porat T. Nutritional and Lifestyle Behaviors Reported Following One Anastomosis Gastric Bypass Based on a Multicenter Study. Nutrients 2023; 15:nu15061515. [PMID: 36986245 PMCID: PMC10053792 DOI: 10.3390/nu15061515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 03/13/2023] [Accepted: 03/15/2023] [Indexed: 03/30/2023] Open
Abstract
This study aimed to describe nutritional and lifestyle parameters following one-anastomosis gastric bypass (OAGB). A multicenter study among OAGB patients across Israel (n = 277) and Portugal (n = 111) was performed. Patients were approached according to the time elapsed since surgery. An online survey with information regarding demographics, anthropometrics, and nutritional and lifestyle aspects was administered in both countries simultaneously. Respondents from Israel (pre-surgery age of 41.6 ± 11.0 years, 75.8% females) and Portugal (pre-surgery age of 45.6 ± 12.3 years, 79.3% females) reported changes in their appetite (≤94.0% and ≤94.6%), changes in their taste (≤51.0 and ≤51.4%), and intolerance to specific foods (i.e., red meat, pasta, bread, and rice). Bariatric surgery-related eating recommendations were generally followed well, but a trend toward lower adherence was evident in groups with longer time elapsed since surgery in both countries. Most respondents from Israel and Portugal reported participation in follow-up meetings with a surgeon (≤94.0% and 100%) and a dietitian (≤92.6% and ≤100%), while far fewer reported participation in any follow-up meeting with a psychologist/social worker (≤37.9% and ≤56.1%). Patients following OAGB might experience changes in appetite, taste, and intolerance to specific foods. Adherence to bariatric surgery-related eating recommendations is not always satisfying, especially in the longer term post-surgery.
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Affiliation(s)
- Shiri Sherf-Dagan
- Department of Nutrition Sciences, School of Health Sciences, Ariel University, Ariel 40700, Israel
- Department of Nutrition, Assuta Medical Center, Tel Aviv 6971028, Israel
| | - Reut Biton
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 6997801, Israel
| | - Rui Ribeiro
- Multidisciplinary Center for Obesity Treatment, Hospital Lusíadas Amadora, 2724-002 Amadora, Portugal
- General Surgery Department Coordinator, Hospital Lusíadas Amadora, 2724-002 Amadora, Portugal
| | - Yafit Kessler
- Department of Nutrition Sciences, School of Health Sciences, Ariel University, Ariel 40700, Israel
- Assia Medical Group, Assuta Medical Center, Tel Aviv 6971028, Israel
| | - Asnat Raziel
- Assia Medical Group, Assuta Medical Center, Tel Aviv 6971028, Israel
| | - Carina Rossoni
- Multidisciplinary Center for Obesity Treatment, Hospital Lusíadas Amadora, 2724-002 Amadora, Portugal
- Institute of Environmental Health, Faculty Medicine, University of Lisbon, 1649-028 Lisbon, Portugal
| | - Hasan Kais
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 6997801, Israel
- Division of Surgery, Shamir Medical Center, Zerifin 70300, Israel
| | - Rossela Bragança
- Multidisciplinary Center for Obesity Treatment, Hospital Lusíadas Amadora, 2724-002 Amadora, Portugal
| | - Zélia Santos
- Multidisciplinary Center for Obesity Treatment, Hospital Lusíadas Amadora, 2724-002 Amadora, Portugal
- H&TRC-Health & Technology Research Center, (ESTeSL) Escola Superior de Tecnologia da Saúde de Lisboa, 1990-096 Lisbon, Portugal
| | - David Goitein
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 6997801, Israel
- Assia Medical Group, Assuta Medical Center, Tel Aviv 6971028, Israel
- Department of Surgery C, Sheba Medical Center, Tel Hashomer, Ramat Gan 5266202, Israel
| | - Octávio Viveiros
- Multidisciplinary Center for Obesity Treatment, Hospital Lusíadas Amadora, 2724-002 Amadora, Portugal
| | - Yitka Graham
- Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland SR1 3SD, UK
- Bariatric Surgical Unit, Sunderland Royal Hospital, Sunderland SR4 7TP, UK
| | - Kamal Mahawar
- Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland SR1 3SD, UK
- Bariatric Surgical Unit, Sunderland Royal Hospital, Sunderland SR4 7TP, UK
| | - Nasser Sakran
- Assia Medical Group, Assuta Medical Center, Tel Aviv 6971028, Israel
- Department of Surgery, Holy Family Hospital, Nazareth 1600100, Israel
- The Azrieli Faculty of Medicine Safed, Bar-Ilan University, Ramat Gan 5290002, Israel
| | - Tair Ben-Porat
- Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montréal, QC H4B 1R6, Canada
- Montreal Behavioural Medicine Centre (MBMC), Centre Intégré Universitaire de Santé et de Services Sociaux du Nord-de-l'Île-de-Montréal (CIUSSS-NIM), Montréal, QC H4J 1C5, Canada
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Mozaffar B, Idris I. A Literature Review of Taste Change and Zinc Deficiency After Bariatric Surgery: Could There Be a Causal Link? Obes Surg 2023; 33:313-331. [PMID: 36401097 PMCID: PMC9834104 DOI: 10.1007/s11695-022-06197-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 06/30/2022] [Accepted: 06/30/2022] [Indexed: 11/21/2022]
Abstract
In this review, we collated evidence relating to taste change and zinc deficiency in relation to bariatric surgery (BS) and effects of zinc replacement on taste perception and speculate on the possible role of zinc deficiency to induce taste change after BS. A literature search was conducted (33 studies, N = 3264). We showed that taste change and zinc deficiency are frequent complications after BS, which both typically occurred at 6 months post-surgery. Our analysis did not support a causal link between the two, but similar onset of incidences indirectly indicates a link. Supplementation with 45-50 mg of zinc sulphate, higher than current recommendation, was effective in improving taste. Further studies are required to establish the causal link between the two in the context of BS.
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Affiliation(s)
- Boshra Mozaffar
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, National Institute for Health Research Nottingham Biomedical Research Centre, Clinical, Metabolic and Molecular Physiology, University of Nottingham, Royal Derby Hospital, Uttoxeter Road, Derby, DE22 3DT, UK
- Applied Medical Sciences, Clinical Nutrition Department, Jazan University, Jazan, Kingdom of Saudi Arabia
| | - Iskandar Idris
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, National Institute for Health Research Nottingham Biomedical Research Centre, Clinical, Metabolic and Molecular Physiology, University of Nottingham, Royal Derby Hospital, Uttoxeter Road, Derby, DE22 3DT, UK.
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7
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Lopes KG, Dos Santos GP, Romagna EC, Mattos DMF, Braga TG, Cunha CB, Maranhão PA, Kraemer-Aguiar LG. Changes in appetite, taste, smell, and food aversion in post-bariatric patients and their relations with surgery time, weight loss and regain. Eat Weight Disord 2022; 27:1679-1686. [PMID: 34554440 DOI: 10.1007/s40519-021-01304-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 09/13/2021] [Indexed: 12/12/2022] Open
Abstract
PURPOSE We aimed to study the occurrence of long-term changes in appetite, taste, smell perceptions, and food aversion in patients following bariatric surgery. Additionally, we compared two surgery types, excess weight loss, rate of weight regain, and time since surgery. METHODS This cross-sectional study included 146 post-bariatric patients who were without regular medical follow-up (126 post-Roux-en-Y gastric bypass [RYGB] and 20 post-sleeve gastrectomy [SG]), aged 42 ± 8 years, BMI of 32.6 ± 6.3 kg/m2, with excess weight loss of 87.5 ± 20.2%, rate of weight regain (RWR) of 15.4 [3.9-30.9]% and time since surgery of 5.0 ± 4.0 years. They answered a questionnaire about sensory and food perceptions at their first medical appointment at our unit. RESULTS Changes in appetite (76%), taste (48.6%), and an increased sensation for sweet taste (60.2%) frequently occurred in our sample. Sensory and food aversion perceptions, taste changes to specific foods, and loss level of taste and smell were similar between RYGB and SG. No differences between patients with or without changes in appetite, taste, smell, and food aversion perceptions concerning excess weight loss were observed. The RWR in post-RYGB was lower in those with changes in taste and smell (P = 0.05). Sensory changes were noted in those with shorter time since surgery for both surgeries (P ≤ 0.05). CONCLUSION Changes in appetite and taste occurred frequently in our patients even in the long term. Post-RYGB patients with lower RWR had more changes in taste and smell while a shorter time since surgery showed more frequent changes in appetite, taste, and smell. LEVEL OF EVIDENCE Level V, cross-sectional study. TRIAL REGISTRATION NUMBER ClinicalTrials.gov (NCT04193384).
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Affiliation(s)
- Karynne Grutter Lopes
- Postgraduate Program in Clinical and Experimental Physiopathology, Faculty of Medical Sciences, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Gabriel Pires Dos Santos
- Graduate Program in Medical Sciences, Faculty of Medical Sciences, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Eline Coan Romagna
- Postgraduate Program in Clinical and Experimental Physiopathology, Faculty of Medical Sciences, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Diogo Menezes Ferrazani Mattos
- MídiaCom/Postgraduate Program On Electrical and Telecommunications Engineering (PPGEET), Fluminense Federal University, Niterói, RJ, Brazil
| | - Tassia Gomide Braga
- Postgraduate Program in Clinical and Experimental Physiopathology, Faculty of Medical Sciences, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Carolina Bastos Cunha
- Postgraduate Program in Clinical and Experimental Physiopathology, Faculty of Medical Sciences, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Priscila Alves Maranhão
- Faculty of Medicine, Center for Research in Health Technologies and Information Systems (CINESIS), University of Porto, Porto, Portugal
| | - Luiz Guilherme Kraemer-Aguiar
- Postgraduate Program in Clinical and Experimental Physiopathology, Faculty of Medical Sciences, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil. .,Obesity Unit, Department of Internal Medicine, Faculty of Medical Sciences, State University of Rio de Janeiro, Rua São Francisco Xavier, 524, Pavilhão Reitor Haroldo Lisboa da Cunha, sala 104, Maracanã, Rio de Janeiro, RJ, CEP 20550-013, Brazil.
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8
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The Effects of Roux-en-Y Gastric Bypass on Glucose- vs. Fructose-Associated Conditioned Flavor Preference. Physiol Behav 2022; 248:113730. [PMID: 35149056 PMCID: PMC8901435 DOI: 10.1016/j.physbeh.2022.113730] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 02/04/2022] [Accepted: 02/05/2022] [Indexed: 11/23/2022]
Abstract
In rodents, repeated single-bottle exposures to distinctly flavored isocaloric glucose and fructose solutions, two sugars with different metabolic pathways, eventually lead to a preference for the former. Because Roux-en-Y gastric bypass (RYGB) surgery decreases preference for and intake of sugar solutions in rats, we tested whether RYGB would curtail the conditioning of a preference for a glucose-paired vs. fructose-paired flavor. RYGB (♂ n=11; ♀ n=10) and sham-operated (SHAM; ♂ n=9; ♀ n=10) rats were trained with a single bottle (30 min/day) containing 8% glucose solution flavored with either 0.05% grape or cherry Kool-Aid (Glu/CSG) or 8% fructose solution with the alternative Kool-Aid flavor (Fru/CSF) in an alternating fashion for 8 days. To determine baseline preferences, a 4-day 30-min two-bottle test was used to assess preference for Glu/CSG vs. Fru/CSF before training. After training, 2-day 30-min two-bottle tests assessed preference for the a) Glu/CSG (CSG-flavored 8% glucose solution) vs Fru/CSF (CSF-flavored 8% fructose solution), b) CSG- vs. CSF-flavored mixture of 4% glucose & 4% fructose (isocaloric), c) CSG- vs. CSF-flavored 0.2% saccharin ("sweet", no calories), and d) CSG- vs. CSF-flavored water. During training, only male SHAM rats demonstrated progressively increased intake of Glu/CSG over Fru/CSF, and female SHAM rats displayed a trend. RYGB eliminated any difference in single-bottle intake of these solutions during training, regardless of sex. Like their male and female SHAM counterparts, male RYGB rats displayed a conditioned preference for the CSG-associated stimulus in Tests 1-3. Although female RYGB rats displayed acquisition of the conditioned flavor preference in Test 1, unlike the other groups, when the differential sugar cue between the two solutions was removed in Tests 2 and 3, female rats did not display a CSG preference. When the sugar and sweetener cues were both removed on Test 4, all groups displayed some generalization decrement. Thus, RYGB does not compromise the ability of rats to learn and express a glucose- vs. fructose-associated conditioned flavor preference when the exact CS used in training is presented in testing. The mechanistic basis for the sex difference in the effect of RYGB on the generalization decrement observed in this type of flavor preference learning warrants further study.
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Abstract
Objective: To systematically review the problem of appetite loss after major abdominal surgery. Summary of Background Data: Appetite loss is a common problem after major abdominal surgery. Understanding of etiology and treatment options is limited. Methods: We searched Medline, Cochrane Central Register of Controlled Trials, and Web of Science for studies describing postoperative appetite loss. Data were extracted to clarify definition, etiology, measurement, surgical influence, pharmacological, and nonpharmacological treatment. PROSPERO registration ID: CRD42021224489. Results: Out of 6144 articles, we included 165 studies, 121 of which were also analyzed quantitatively. A total of 19.8% were randomized, controlled trials (n = 24) and 80.2% were nonrandomized studies (n = 97). The studies included 20,506 patients undergoing the following surgeries: esophageal (n = 33 studies), gastric (n = 48), small bowel (n = 6), colon (n = 27), rectal (n = 20), hepatobiliary (n = 6), and pancreatic (n = 13). Appetite was mostly measured with the Quality of Life Questionnaire of the European Organization for Research and Treatment of Cancer (EORTC QLQ C30, n = 54). In a meta-analysis of 4 randomized controlled trials gum chewing reduced time to first hunger by 21.2 hours among patients who had bowel surgery. Other reported treatment options with positive effects on appetite but lower levels of evidence include, among others, intravenous ghrelin administration, the oral Japanese herbal medicine Rikkunshito, oral mosapride citrate, multidisciplin-ary-counseling, and watching cooking shows. No studies investigated the effect of well-known appetite stimulants such as cannabinoids, steroids, or megestrol acetate on surgical patients. Conclusions: Appetite loss after major abdominal surgery is common and associated with increased morbidity and reduced quality of life. Recent studies demonstrate the influence of reduced gastric volume and ghrelin secretion, and increased satiety hormone secretion. There are various treatment options available including level IA evidence for postoperative gum chewing. In the future, surgical trials should include the assessment of appetite loss as a relevant outcome measure.
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10
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Faour M, Magnan C, Gurden H, Martin C. Olfaction in the context of obesity and diabetes: Insights from animal models to humans. Neuropharmacology 2021; 206:108923. [PMID: 34919903 DOI: 10.1016/j.neuropharm.2021.108923] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 12/07/2021] [Accepted: 12/10/2021] [Indexed: 12/12/2022]
Abstract
The olfactory system is at the crossroad between sensory processing and metabolic sensing. In addition to being the center of detection and identification of food odors, it is a sensor for most of the hormones and nutrients responsible for feeding behavior regulation. The consequences of modifications in body homeostasis, nutrient overload and alteration of this brain network in the pathological condition of food-induced obesity and type 2 diabetes are still not elucidated. The aim of this review was first to use both humans and animal studies to report on the current knowledge of the consequences of obesity and type 2 diabetes on odorant threshold and olfactory perception including identification discrimination and memory. We then discuss how olfactory processing can be modified by an alteration of the metabolic homeostasis of the organism and available elements on pharmacological treatments that regulate olfaction. We focus on data within the olfactory system but also on the interactions between the olfactory system and other brain networks impacted by metabolic diseases.
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Affiliation(s)
- Maya Faour
- Université de Paris, BFA, UMR 8251, CNRS, F-75013, Paris, France
| | | | - Hirac Gurden
- Université de Paris, BFA, UMR 8251, CNRS, F-75013, Paris, France
| | - Claire Martin
- Université de Paris, BFA, UMR 8251, CNRS, F-75013, Paris, France.
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11
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Yang C, Hammer FJ, Reissfelder C, Otto M, Vassilev G. Dental Erosion in Obese Patients before and after Bariatric Surgery: A Cross-Sectional Study. J Clin Med 2021; 10:4902. [PMID: 34768422 PMCID: PMC8584300 DOI: 10.3390/jcm10214902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 10/17/2021] [Accepted: 10/21/2021] [Indexed: 11/24/2022] Open
Abstract
Obese patients are at risk of dental erosion due to micronutrient deficiency, consumption of soft drinks, gastric reflux disease and vomiting. The present study evaluates the presence of dental erosion in obese patients before and after bariatric surgery using the BEWE (basic erosive wear examination) scoring system. A total of 62 patients with severe obesity were included in the analysis, 31 in the control group (without bariatric surgery) and 31 in the surgery group (after bariatric surgery). BEWE scores did not vary between groups. Vitamin D deficiency was detected in 19 patients in the control group and three in the surgery group (p < 0.001). The serum calcium and vitamin D values were significantly higher in the surgery group (p = 0.003, p < 0.001 consecutively). All patients after bariatric surgery showed compliance with supplements, including vitamin D and calcium daily. Patients after bariatric surgery were less likely to drink soft drinks regularly (p = 0.026). Obese patients, before or after bariatric surgery, are at risk for erosive dental wear. However, with sufficient education prior to surgery and consistent intake of vitamin and mineral supplements, significant erosive dental wear after bariatric surgery could be avoided. Regular dental examination should be included in the check-up and follow-up program.
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Affiliation(s)
- Cui Yang
- Department of Surgery, Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany; (F.J.H.); (C.R.); (M.O.); (G.V.)
| | - Frederik Johannes Hammer
- Department of Surgery, Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany; (F.J.H.); (C.R.); (M.O.); (G.V.)
- Faculty of Dentistry, University of Heidelberg, 68167 Mannheim, Germany
| | - Christoph Reissfelder
- Department of Surgery, Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany; (F.J.H.); (C.R.); (M.O.); (G.V.)
| | - Mirko Otto
- Department of Surgery, Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany; (F.J.H.); (C.R.); (M.O.); (G.V.)
| | - Georgi Vassilev
- Department of Surgery, Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany; (F.J.H.); (C.R.); (M.O.); (G.V.)
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12
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Redpath TL, Livingstone MBE, Dunne AA, Boyd A, le Roux CW, Spector AC, Price RK. Methodological issues in assessing change in dietary intake and appetite following gastric bypass surgery: A systematic review. Obes Rev 2021; 22:e13202. [PMID: 33527664 PMCID: PMC8244068 DOI: 10.1111/obr.13202] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Revised: 11/20/2020] [Accepted: 12/13/2020] [Indexed: 12/23/2022]
Abstract
Gastric bypass surgery is an effective long-term treatment for individuals with severe obesity. Changes in appetite, dietary intake, and food preferences have all been postulated to contribute to postoperative body weight regulation, however, findings are inconsistent. The aim of this systematic review was to evaluate the current literature on changes in dietary intake and appetite following gastric bypass surgery, in the context of the methodology used and the analysis, interpretation, and presentation of results. Four databases were systematically searched with terms related to "gastric bypass surgery," "appetite," and "dietary intake," and 49 papers (n = 2384 patients after gastric bypass) were eligible for inclusion. The evidence indicated that only a reduction in overall energy intake and an increase in postprandial satiety are maintained beyond 6-month post-surgery, whereas relative macronutrient intake and premeal hunger remain unchanged. However, available data were limited by inconsistencies in the methods, analysis, presentation, and interpretation of results. In particular, there was a reliance on data collected by subjective methods with minimal acknowledgment of the limitations, such as misreporting of food intake. There is a need for further work employing objective measurement of appetite and dietary intake following gastric bypass surgery to determine how these mechanisms may contribute to weight regulation in the longer term.
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Affiliation(s)
- Tamsyn L Redpath
- Nutrition Innovation Centre for Food and Health, Ulster University, Coleraine, UK
| | | | - Aoibheann A Dunne
- Nutrition Innovation Centre for Food and Health, Ulster University, Coleraine, UK
| | - Adele Boyd
- Nutrition Innovation Centre for Food and Health, Ulster University, Coleraine, UK
| | - Carel W le Roux
- Diabetes Complications Research Centre, University College Dublin, Dublin, Ireland
| | - Alan C Spector
- Department of Psychology and Program in Neuroscience, Florida State University, Tallahassee, Florida, USA
| | - Ruth K Price
- Nutrition Innovation Centre for Food and Health, Ulster University, Coleraine, UK
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13
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Lewis KH, Ji M, Bai Y, Arterburn DE, Bhakta BB, Cornejo M, Crawford CL, Drewnowski A, Gray MF, Moore DD, Murali SB, Paz SR, Taylor B, Yoon TK, Young DR, Coleman KJ. Bariatric Surgical Alterations in Tolerability, Enjoyment and Cravings in the Diet (BSATED) instrument: A new scale to measure food preferences following bariatric surgery. Appetite 2021; 162:105151. [PMID: 33549835 DOI: 10.1016/j.appet.2021.105151] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 01/24/2021] [Accepted: 01/30/2021] [Indexed: 11/28/2022]
Abstract
Bariatric surgery is associated with changing food preferences, but it is not known whether these changes differ by type of operation or are associated with weight loss. The current study presents validation results for a new 27-item scale, Bariatric Surgical Alterations in Tolerability, Enjoyment and Cravings in the Diet (BSATED). This scale measured enjoyment, craving, and intolerance changes for nine food and beverage categories common to dietary habits in the Southern California region of the U.S. one year following bariatric surgery in the Bariatric Experience Long Term (BELONG) study. Validation of BSATED was done using exploratory factor analyses, construct validity with other conceptually related survey instruments, and criterion validity using hypothesized differences for operation type and percent total weight loss (%TWL) at 12-18 months after surgery. Participants (n = 999) were 86% female, 41% non-Hispanic White, with a mean age of 43.1 ± 11.3 years and a body mass index (BMI) of 43.4 ± 6.8 kg/m2 at the time of surgery. Participants reported less enjoyment and craving for high-fat meats (62%), grains (54%), candy and other desserts (e.g. candy bars, chocolate, ice cream) (52%), and sweet baked goods (48%) 12 months after surgery. These changes were more common among participants undergoing Roux-en-Y gastric bypass (RYGB) compared to those receiving sleeve gastrectomy (SG). Participants who reported decreased enjoyment and craving for foods and beverages that post-bariatric patients are counseled to reduce or avoid had greater %TWL at 12-18 months following surgery (p < .001 and p = .003 respectively). The foods and beverages in BSATED that post-bariatric patients are counseled to reduce or avoid could be used to understand how changes in enjoyment, craving and tolerability of these foods/beverages contribute to weight loss following surgery.
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Affiliation(s)
- Kristina H Lewis
- SM Division of Public Health Sciences, Department of Epidemiology & Prevention, Wake Forest University Health Sciences, Winston-Salem, NC, USA
| | - Ming Ji
- College of Nursing, University of South Florida, Tampa, FL, USA
| | - Yun Bai
- College of Nursing, University of South Florida, Tampa, FL, USA
| | - David E Arterburn
- Health Research Institute, Kaiser Permanente Washington, Seattle, WA, USA
| | - Bhumi B Bhakta
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - Melissa Cornejo
- Kaiser Permanente Southern California, Department of Research and Evaluation, Pasadena, CA, USA
| | - Cecelia L Crawford
- Regional Nursing Research Program, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - Adam Drewnowski
- Center for Public Health Nutrition, University of Washington, Seattle, WA, USA
| | | | - Darren D Moore
- Marriage and Family Therapy Program, Touro University Worldwide, Los Alamitos, CA, USA
| | - Sameer B Murali
- Center for Healthy Living, San Bernardino Medical Center, Kaiser Permanente Southern California, Fontana, CA, USA
| | - Silvia R Paz
- Kaiser Permanente Southern California, Department of Research and Evaluation, Pasadena, CA, USA
| | - Brianna Taylor
- Kaiser Permanente Southern California, Department of Research and Evaluation, Pasadena, CA, USA
| | - Tae K Yoon
- Kaiser Permanente Southern California, Department of Research and Evaluation, Pasadena, CA, USA
| | - Deborah Rohm Young
- Kaiser Permanente Southern California, Department of Research and Evaluation, Pasadena, CA, USA
| | - Karen J Coleman
- Kaiser Permanente Southern California, Department of Research and Evaluation, Pasadena, CA, USA.
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14
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Melis M, Pintus S, Mastinu M, Fantola G, Moroni R, Pepino MY, Tomassini Barbarossa I. Changes of Taste, Smell and Eating Behavior in Patients Undergoing Bariatric Surgery: Associations with PROP Phenotypes and Polymorphisms in the Odorant-Binding Protein OBPIIa and CD36 Receptor Genes. Nutrients 2021; 13:nu13010250. [PMID: 33467165 PMCID: PMC7830302 DOI: 10.3390/nu13010250] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 01/08/2021] [Accepted: 01/13/2021] [Indexed: 02/08/2023] Open
Abstract
Bariatric surgery is the most effective long-term treatment for severe obesity and related comorbidities. Although patients who underwent bariatric surgery report changes of taste and smell perception, results from sensory studies are discrepant and limited. Here, we assessed taste and smell functions in 51 patients before, one month, and six months after undergoing bariatric surgery. We used taste strip tests to assess gustatory function (including sweetness, saltiness, sourness, umaminess, bitterness and oleic acid, a fatty stimulus), the “Sniffin’ Sticks” test to assess olfactory identification and the 3-Factor Eating Questionnaire to assess eating behavior. We also explored associations between these phenotypes and flavor-related genes. Results showed an overall improvement in taste function (including increased sensitivity to oleic acid and the bitterness of 6-n-propylthiouracil (PROP)) and in olfactory function (which could be related to the increase in PROP and oleic acid sensitivity), an increase in cognitive restraint, and a decrease in disinhibition and hunger after bariatric surgery. These findings indicate that bariatric surgery can have a positive impact on olfactory and gustatory functions and eating behavior (with an important role of genetic factors, such PROP tasting), which in turn might contribute to the success of the intervention.
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Affiliation(s)
- Melania Melis
- Department of Biomedical Sciences, University of Cagliari, 09042 Monserrato, Italy; (M.M.); (I.T.B.)
- Correspondence: ; Tel.: +39-070-675-4142
| | - Stefano Pintus
- Obesity Surgical Unit ARNAS G. Brotzu, 09121 Cagliari, Italy; (S.P.); (G.F.); (R.M.)
| | - Mariano Mastinu
- Department of Biomedical Sciences, University of Cagliari, 09042 Monserrato, Italy; (M.M.); (I.T.B.)
| | - Giovanni Fantola
- Obesity Surgical Unit ARNAS G. Brotzu, 09121 Cagliari, Italy; (S.P.); (G.F.); (R.M.)
| | - Roberto Moroni
- Obesity Surgical Unit ARNAS G. Brotzu, 09121 Cagliari, Italy; (S.P.); (G.F.); (R.M.)
| | - Marta Yanina Pepino
- Department of Food Science and Human Nutrition, University of Illinois, Urbana Champaign, Urbana, IL 61801, USA;
| | - Iole Tomassini Barbarossa
- Department of Biomedical Sciences, University of Cagliari, 09042 Monserrato, Italy; (M.M.); (I.T.B.)
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15
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Taste alteration after gastrectomy in patients with gastric cancer. Surg Today 2021; 51:777-784. [PMID: 33387026 DOI: 10.1007/s00595-020-02194-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 09/05/2020] [Indexed: 12/24/2022]
Abstract
PURPOSE To investigate the relationship between changes in taste due to surgical procedures and other clinical factors, we performed a detailed investigation of taste alteration in patients who underwent gastrectomy. METHODS Questionnaires on taste alteration were distributed to patients who visited our outpatient clinic from July 2018 to January 2019 for the postoperative evaluation of gastric cancer. Associations of clinical characteristics with changes in sensitivity to the four major taste types (sweet, sour, salty, and bitter) were examined. RESULTS Of the 243 eligible patients, 42 (17.3%) experienced taste alteration after gastrectomy; taste sensitivity decreased in 21 (8.6%) patients and increased in 31 (12.7%) patients. The frequency of a decreased sensitivity to sweet was significantly higher in patients who underwent total gastrectomy than in those who underwent distal gastrectomy (18.8% vs. 3.3%, P = 0.001). Patients who underwent total gastrectomy were significantly more likely than those who received distal gastrectomy to experience increased sensitivity to sour (12.5% vs. 2.2%, respectively; P = 0.004) and bitter (15.6% vs. 3.8%, respectively; P = 0.007) tastes. A multivariate analysis revealed that total gastrectomy was an independent risk factor for total taste alteration. CONCLUSIONS Patients who underwent total gastrectomy showed a high likelihood of both loss and gain of taste sensitivity.
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16
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Westerink F, Beijderwellen H, Huibregtse IL, De Hoog MLA, De Brauw LM, Brandjes DPM, Gerdes VEA. Lactose after Roux-en-Y gastric bypass for morbid obesity, is it a problem? Scand J Gastroenterol 2020; 55:1398-1404. [PMID: 33096008 DOI: 10.1080/00365521.2020.1837927] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Roux-en-Y gastric bypass (RYGB) can cause multiple food intolerances and gastrointestinal complaints are frequently reported after dairy consumption. We aimed to determine the prevalence of lactose malabsorption and intolerance, and complaints associated with dairy consumption in daily life, before and after RYGB. METHOD The lactose breath test (LBT) and lactose tolerance test (LTT) was performed in 84 patients awaiting RYGB surgery and 84 patients after surgery. Gastrointestinal symptoms at baseline and after testing were recorded. Lactose malabsorption was defined as a positive LBT and/or LTT. Lactose intolerance as a positive test combined with an increase of gastrointestinal complains. Dairy consumption in daily life and successive gastrointestinal complaints were registered via a questionnaire. Results of preoperative and postoperative patients were compared. RESULTS Lactose malabsorption was present in 15 (17.9%) of the preoperative patients and in 25 (29.8%) of the postoperative patients (OR 2.46; 95%CI: 1.08-5.59; p = .03). Of the preoperative patients 6 (7.1%) patients met the criteria for lactose intolerance, compared to 8 (9.5%) patients in the postoperative group (OR 1.48; 95%CI 0.48-4.57; p = .50). Twelve (14.3%) preoperative patients indicated to have gastrointestinal complaints after dairy consumption in daily life versus 45 (53.6%) postoperative patients (p < .01). CONCLUSION This study shows no increase in patients with proven lactose intolerance after RYGB compared to preoperative patients. Gastrointestinal complaints after dairy consumption in daily life were far more frequently reported by RYGB patients. It is unlikely that all reported gastrointestinal complaints are actually caused by lactose. Other ingredients in dairy, like fat, are possibly contributory.
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Affiliation(s)
- F Westerink
- Department of Vascular Medicine, Amsterdam University Medical Centre, Amsterdam, The Netherlands.,Department of Internal Medicine, Spaarne Gasthuis, Hoofddorp, The Netherlands
| | - H Beijderwellen
- Department of Vascular Medicine, Amsterdam University Medical Centre, Amsterdam, The Netherlands
| | - I L Huibregtse
- Department of Gastroenterology, Netherlands Cancer Institute, Antoni van Leeuwenhoek, Amsterdam, The Netherlands
| | - M L A De Hoog
- Spaarne Gasthuis Academy, Hoofddorp, The Netherlands
| | - L M De Brauw
- Department of Surgery, Spaarne Gasthuis, Hoofddorp, The Netherlands
| | - D P M Brandjes
- Department of Vascular Medicine, Amsterdam University Medical Centre, Amsterdam, The Netherlands
| | - V E A Gerdes
- Department of Vascular Medicine, Amsterdam University Medical Centre, Amsterdam, The Netherlands.,Department of Internal Medicine, Spaarne Gasthuis, Hoofddorp, The Netherlands
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17
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Missing Something? Comparisons of Effectiveness and Outcomes of Bariatric Surgery Procedures and Their Preferred Reporting: Refining the Evidence Base. Obes Surg 2020; 30:3167-3177. [PMID: 32415632 PMCID: PMC7305092 DOI: 10.1007/s11695-020-04659-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Comparisons of effectiveness of bariatric surgery (BS) procedures encompass weight loss, metabolic/clinical outcomes, and improvements or worsening of comorbidities. Post-operative physical activity (PA) and diet influence such outcomes but are frequently not included in comparisons of effectiveness. We assessed the value and necessity of including post-operative PA/diet data when comparing effectiveness of BS. Including post-operative PA/diet data has significant benefits for BS and patients. The paper proposes an explicit preferred reporting system (Preferred REporting of post-operative PHYsical activity and Diet data in comparisons of BS effectiveness: PRE-PHYD Bariatric). Including post-operative PA/diet data could result in more accurate appraisals of effectiveness of BS procedures. This could translate into better 'individualized' BS by achieving a better 'fit' between patient and procedure.
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18
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Shoar S, Naderan M, Shoar N, Modukuru VR, Mahmoodzadeh H. Alteration Pattern of Taste Perception After Bariatric Surgery: a Systematic Review of Four Taste Domains. Obes Surg 2020; 29:1542-1550. [PMID: 30712168 DOI: 10.1007/s11695-019-03730-w] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Efforts continue to understand the underlying mechanism of weight loss after bariatric surgery. Taste perception has shown to be a contributing factor. However, the alteration pattern in different taste domains and among bariatric procedures has not been sufficiently investigated. OBJECTIVES To study the alteration pattern in the perception of four taste domains after different bariatric procedures. SETTINGS Private Research Institute, USA. METHODS A systematic review was conducted to pool available data in the literature on post-operative changes in the perception of sensitivity to four taste domains after Roux-en-Y gastric bypass (RYGB), laparoscopic sleeve gastrectomy (LSG), and adjustable gastric banding (AGB). RESULTS Our study showed that bariatric surgery is associated with significant change in sensitivity to all four taste domains especially salt taste, sweetness, and sourness. LSG patients showed an increased sensitivity to all four taste domains. However, RYGB patients had a variable alteration pattern of taste perception but more commonly a decreased sensitivity to sweetness and an increased sensitivity to salt taste and sourness. Additionally, AGB patients had a decreased sensitivity to sweetness, salt taste, and sourness. CONCLUSION Bariatric surgery is associated with taste change in a way which results in less preference for high-calorie food and possibly reduced calorie intake. This may explain one of the mechanisms by which bariatric surgery produces weight loss. However, data are heterogeneous, the potential effect dilutes over time, and the alteration varies significantly between different procedures.
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Affiliation(s)
- Saeed Shoar
- Department of ScientificWriting, Division of Surgical Research, Shoar Research Institute, Houston, TX, USA. .,Cancer Institute, Imam Khomeini Hospital Complex, Division of Surgical Oncology, Department of Surgery, Tehran University of Medical Science, Tehran, Iran.
| | - Mohammad Naderan
- Cancer Institute, Imam Khomeini Hospital Complex, Division of Surgical Oncology, Department of Surgery, Tehran University of Medical Science, Tehran, Iran
| | - Nasrin Shoar
- Department of ScientificWriting, Division of Surgical Research, Shoar Research Institute, Houston, TX, USA.,Faculty of Medicine, Kashan University of Medical Science, Kashan, Iran
| | - Venkat R Modukuru
- Department of ScientificWriting, Division of Surgical Research, Shoar Research Institute, Houston, TX, USA.,Faculty Surgeon, Department of Surgery, NYMC at Metropolitan Hospital Program, New York City, NY, USA
| | - Habibollah Mahmoodzadeh
- Cancer Institute, Imam Khomeini Hospital Complex, Division of Surgical Oncology, Department of Surgery, Tehran University of Medical Science, Tehran, Iran
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19
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Lopes Pinto S, da Silva DCG, Bressan J. Absolute and Relative Changes in Ultra-processed Food Consumption and Dietary Antioxidants in Severely Obese Adults 3 Months After Roux-en-Y Gastric Bypass. Obes Surg 2020; 29:1810-1815. [PMID: 30719649 DOI: 10.1007/s11695-019-03749-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
INTRODUCTION Patients that undergo Roux-en-Y gastric bypass (RYGB) experience a dramatic change in food consumption; however, it is unknown whether food consumption changes in relation to the level of food processing. OBJECTIVE The aim of this work was to evaluate the relationship between ultra-processed food intake, dietary antioxidant capacity, and cardiometabolic risk factors in patients who underwent RYGB. METHODS This study included 58 obese patients who underwent RYGB bariatric surgery. Data collection was done pre-operatively and at 3 months post-surgery. The foods consumed were documented using a 3-day 24-h dietary recall, and food intake was classified based on NOVA and dietary total antioxidant capacity (TAC). Anthropometric and biochemical data as well as information on body composition were also collected. Metabolic syndrome (MS) was classified in accordance with the International Diabetes Federation. RESULTS Ultra-processed foods amounted to 27.2% and 19.7% of the total calories consumed during pre- and post-surgery periods, respectively. Regarding post-surgery, the caloric contribution of unprocessed or minimally processed foods increased, from 55.7 to 70.2% (p = 0.000). The TAC of foods consumed is inversely proportional to that of ultra-processed foods. Obvious changes were observed in all the anthropometric variables, lipid profile, glycemia, insulin resistance, and MS. CONCLUSION Our results indicate that bariatric surgery is able to promote improvement in the diet quality of patients, reducing the consumption of ultra-processed foods and increasing the intake of unprocessed foods. The TAC of foods consumed is inversely proportional to that of ultra-processed ones.
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Affiliation(s)
- Sônia Lopes Pinto
- Federal University of Tocantins, Quadra 806 South, Alameda 02, HM 1, Apt 202, Block C, Palmas, Tocantins, Brazil. .,Department of Nutrition and Health, Federal University of Viçosa, University Campus, Viçosa, Minas Gerais, 36570-900, Brazil.
| | - Danielle Cristina Guimarães da Silva
- Department of Nutrition and Health, Federal University of Viçosa, University Campus, Viçosa, Minas Gerais, 36570-900, Brazil.,Federal University of the West of Bahia, Rua Professor José Seabra de Lemos, 316, Recanto dos Pássaros, Barreiras, Bahia, 47808-021, Brazil
| | - Josefina Bressan
- Department of Nutrition and Health, Federal University of Viçosa, University Campus, Viçosa, Minas Gerais, 36570-900, Brazil
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20
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Osland E, Powlesland H, Guthrie T, Lewis CA, Memon MA. Micronutrient management following bariatric surgery: the role of the dietitian in the postoperative period. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:S9. [PMID: 32309413 PMCID: PMC7154332 DOI: 10.21037/atm.2019.06.04] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Bariatric surgery is increasingly being utilized to manage obesity and obesity related comorbidities, but may lead to the development of micronutrient deficiencies postoperatively. The anatomical, physiological, nutritional and behavioral reasons for micronutrient vulnerabilities are reviewed, along with recommendations for routine monitoring and replacement following surgery. The role the dietitian and their contribution in the postoperative identification, prevention and management of micronutrient vulnerabilities in bariatric patients is described. Specific considerations such as the nutritional and dietetic management of pregnant and lactating women post-bariatric surgery is also discussed.
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Affiliation(s)
- Emma Osland
- Department of Nutrition and Dietetics, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia.,School of Human Movement and Nutrition Science, University of Queensland, Brisbane, Australia
| | - Hilary Powlesland
- Department of Nutrition and Dietetics, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
| | - Taylor Guthrie
- Department of Nutrition and Dietetics, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
| | - Carrie-Anne Lewis
- Department of Nutrition and Dietetics, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia.,Mayne Medical School, School of Medicine, University of Queensland, Brisbane, Queensland, Australia
| | - Muhammed Ashraf Memon
- Sunnybank Obesity Centre, McCullough Centre, Sunnybank, Queensland, Australia.,Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia.,School of Agricultural, Computational and Environmental Sciences, International Centre for Applied Climate Sciences and Centre for Health Sciences Research, University of Southern Queensland, Toowoomba, Queensland, Australia.,Faculty of Health and Social Science, Bolton University, Bolton, Lancashire, UK
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21
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Mencia-Huerta M, Lindenmeyer C. Chirurgie bariatrique et fantasmes de métamorphose. ANNALES MEDICO-PSYCHOLOGIQUES 2020. [DOI: 10.1016/j.amp.2018.10.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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22
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Asarian L, Geary N. RYGB and flavor-consequence learning. Appetite 2019; 146:104467. [PMID: 31557496 DOI: 10.1016/j.appet.2019.104467] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 09/19/2019] [Accepted: 09/20/2019] [Indexed: 02/07/2023]
Abstract
Flavor-consequence learning refers to learned associations between flavor stimuli and post-oral consequences of food that affect food selection, amount eaten and affect. Forms of flavor-consequence learning include flavor aversions, flavor avoidance, conditioned satiety, expected satiety and appetition. Roux-en-Y gastric bypass surgery (RYGB) and other bariatric procedures alter gastrointestinal processing of food in a number of ways. Thus, it is plausible that these procedures alter post-oral unconditioned stimuli that support flavor-consequence learning, leading to altered food selection, amount eaten, and affect. Surprisingly, however, there is almost no research on the role of flavor-consequence learning in the effects of bariatric surgery on appetite. This issue urgently warrants investigation.
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Affiliation(s)
- Lori Asarian
- Department of Medicine, Larner College of Medicine, University of Vermont, Burlington, VT, 05405, USA.
| | - Nori Geary
- Department of Psychiatry, Weill Medical College of Cornell University, New York, NY, 10025, USA
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23
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Nielsen MS, Schmidt JB, le Roux CW, Sjödin A. Effects of Roux-en-Y Gastric Bypass and Sleeve Gastrectomy on Food Preferences and Potential Mechanisms Involved. Curr Obes Rep 2019; 8:292-300. [PMID: 31222526 DOI: 10.1007/s13679-019-00354-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE OF REVIEW Bariatric surgery leads to a substantial decrease in energy intake. It is unclear whether this decrease in energy intake is simply due to eating smaller portions of the same food items or a shift in food preference towards less energy-dense foods. This review evaluates the existing literature on changes in food preferences after bariatric surgery and the potential mechanisms involved. RECENT FINDINGS Changes in food preferences have been reported; however, the evidence is mainly based on indirect measurements, such as self-reporting. When changes in food preferences are directly assessed, results contradict previous findings, indicating that results based on self-reporting must be interpreted with caution as they do not necessarily reflect actual behaviour. However, it seems that there could be inter-individual differences in the response to surgery. Future studies investigating changes in food preferences should not only focus on direct measured of behaviour but should also consider the heterogeneity of the response after bariatric surgery.
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Affiliation(s)
- Mette S Nielsen
- Department of Nutrition, Exercise and Sports, Faculty of Science (Obesity research), University of Copenhagen, Rolighedsvej 26, 1958, Frederiksberg C, Denmark.
- The Danish Diabetes Academy, Odense University Hospital, Odense, Denmark.
| | - Julie B Schmidt
- Department of Nutrition, Exercise and Sports, Faculty of Science (Obesity research), University of Copenhagen, Rolighedsvej 26, 1958, Frederiksberg C, Denmark
| | - Carel W le Roux
- Investigative Science, Imperial College London, London, UK
- Diabetes Complications Research Centre, Conway Institute, University College Dublin, Dublin, Ireland
| | - Anders Sjödin
- Department of Nutrition, Exercise and Sports, Faculty of Science (Obesity research), University of Copenhagen, Rolighedsvej 26, 1958, Frederiksberg C, Denmark
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24
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Nance K, Acevedo MB, Pepino MY. Changes in taste function and ingestive behavior following bariatric surgery. Appetite 2019; 146:104423. [PMID: 31473274 DOI: 10.1016/j.appet.2019.104423] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 07/22/2019] [Accepted: 08/23/2019] [Indexed: 02/06/2023]
Abstract
Bariatric surgery is the most effective treatment for severe obesity and its related comorbidities. Roux-en-Y Gastric Bypass (RYGB) and Sleeve Gastrectomy (SG) are currently the most popular weight-loss surgeries used worldwide. Following these surgeries, many patients self-report changes in taste perception and decreased preference for unhealthy foods. These reported changes might account for increased adherence to healthier diets and successful weight loss after surgeries. However, researchers have used a variety of methodologies to assess patients' reported changes andresults are discrepant. The goal of this review is to summarize the literature regarding changes to taste function and ingestive behavior following RYGB and SG to examine differences in findings by methodology (indirect vs. direct measurements). We focused our review around changes in sweets, fats, and alcohol because most of the documented changes in ingestive behavior post-surgery are related to changes in these dietary items. We found that studies using surveys and questionnaires generally find that subjects self-report changes in taste and decrease their preference and cravings for energy-dense foods (particularly, sweets and high-fats). However, studies using validated sensory techniques that include oral sampling or by using direct food intake measurements find little to no change in subjects' ability to perceive taste or their preference for energy-dense foods. Therefore, reported changes in taste and food preferences are unlikely to be explained by alterations in taste intensity and diet selection, and are rather related to changes in the rewarding value of food. Further, that RYGB, and likely SG, is associated with increased alcohol consumption and arisk to develop an alcohol use disorder) supports the notion that these surgeries alter central circuits of reward that are critical in the regulation of ingestive behavior.
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Affiliation(s)
- Katie Nance
- Department of Food Science and Human Nutrition, College of Agricultural, Consumer and Environmental Sciences, University of Illinois, 905 South Goodwin Avenue, Urbana, IL, 61801, USA.
| | - M Belén Acevedo
- Department of Food Science and Human Nutrition, College of Agricultural, Consumer and Environmental Sciences, University of Illinois, 905 South Goodwin Avenue, Urbana, IL, 61801, USA.
| | - M Yanina Pepino
- Department of Food Science and Human Nutrition, College of Agricultural, Consumer and Environmental Sciences, University of Illinois, 905 South Goodwin Avenue, Urbana, IL, 61801, USA; Division of Nutritional Sciences, College of Agricultural, Consumer and Environmental Sciences, University of Illinois, 905 South Goodwin Avenue, Urbana, IL, 61801, USA.
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25
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Associations between Weight Loss, Food Likes, Dietary Behaviors, and Chemosensory Function in Bariatric Surgery: A Case-Control Analysis in Women. Nutrients 2019; 11:nu11040804. [PMID: 30970617 PMCID: PMC6521240 DOI: 10.3390/nu11040804] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 03/27/2019] [Accepted: 04/04/2019] [Indexed: 12/16/2022] Open
Abstract
We tested the hypothesis that successful weight loss post-bariatric surgery would be associated with healthier chemosensory function, food likes, and dietary behaviors than either unsuccessful weight loss or pre-surgery morbid obesity. In a case-control design, pre-surgical women with morbid obesity (n = 49) were compared with those 1-year post-surgery (24 Roux-en-Y Bypass, 24 Sleeve Gastrectomy) and defined by excess or percent weight loss as successful/unsuccessful. For self-reported smell/taste perception, more post-surgery than pre-surgery reported improved/distorted perception, especially if weight loss successful. Measured taste function (perceived quinine and NaCl intensity) was lower among weight loss unsuccessful versus pre-surgery patients, yet a genetic variation in taste probe (propylthiouracil bitterness) matched expected frequencies without significant pre/post-surgery difference. Regarding survey-reported liking, higher diet quality was seen in the weight loss successful (independent of surgery type) versus pre-surgical patients, with differences driven by lower sweet and refined carbohydrate liking. The post versus pre-surgical patients had greater restraint but less hunger and disinhibition. Patients reporting both higher diet quality and lower hunger showed greater % weight loss, independent of surgery type. Thus, successful weight loss 1-year post-bariatric surgery was associated with improved or distorted chemosensation and patterns of liking associated with healthier diets, especially if coupled with less hunger.
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26
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Spector AC, Kapoor N, Price RK, Pepino MY, Livingstone MBE, Le Roux CW. Proceedings from the 2018 Association for Chemoreception Annual Meeting Symposium: Bariatric Surgery and Its Effects on Taste and Food Selection. Chem Senses 2019; 44:155-163. [PMID: 30517609 PMCID: PMC6410396 DOI: 10.1093/chemse/bjy076] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
This article provides a summary of the topics discussed at the symposium titled "Bariatric Surgery and Its Effects on Taste and Food Selection," which was held at the Fortieth Annual Meeting of the Association for Chemoreception Sciences. Bariatric surgery such as Roux-en-Y gastric bypass (RYGB) is currently one of the most effective treatments available for weight loss and Type 2 diabetes. For this reason, it is of great interest to clinicians as well as to basic scientists studying the controls of feeding and energy balance. Despite the commonly held view by clinicians that RYGB patients change their food preferences away from fats and sugars in favor of less energy dense alternatives such as vegetables, the empirical support for this claim is equivocal. It is currently thought that the taste and palatability of fats and sugars are affected by the surgery. Some key preclinical and clinical findings addressing these issues were evaluated in this symposium.
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Affiliation(s)
- Alan C Spector
- Department of Psychology and Program in Neuroscience, Florida State University, Tallahassee, FL, USA
| | - Natasha Kapoor
- Diabetes Complications Research Centre, University College Dublin, Dublin, Ireland
| | - Ruth K Price
- The Nutrition Innovation Centre for Food and Health, Ulster University, Coleraine, Northern Ireland
| | - M Yanina Pepino
- Department of Food Science and Human Nutrition and Division of Nutritional Sciences, College of ACES, University of Illinois at Urbana–Champaign, Urbana, IL, USA
| | - M Barbara E Livingstone
- The Nutrition Innovation Centre for Food and Health, Ulster University, Coleraine, Northern Ireland
| | - Carel W Le Roux
- Diabetes Complications Research Centre, University College Dublin, Dublin, Ireland
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27
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Peng M, Coutts D, Wang T, Cakmak YO. Systematic review of olfactory shifts related to obesity. Obes Rev 2019; 20:325-338. [PMID: 30450791 DOI: 10.1111/obr.12800] [Citation(s) in RCA: 70] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 10/07/2018] [Indexed: 02/01/2023]
Abstract
OBJECTIVE The modern food environment is a key driver of rising levels of obesity. While olfaction is known to play a major role in food choice; however, its relationship to obesity is yet to be understood. This review assesses current knowledge of the interaction between obesity and olfaction. METHODS This review is based on observational studies comparing olfactory abilities across weight groups (N = 10) and clinical studies evaluating olfactory changes following bariatric surgery (N = 9). Meta-analyses were performed on data collected by a standard olfactory assessment tool (Sniffin΄ Sticks), to test whether olfaction has any association with body weight or bariatric surgery. RESULTS This review synthesizes findings derived from 38 datasets, with a total of 1432 individual olfactory assessments. The meta-analyses suggest that olfactory function is negatively correlated with body weight. In addition, Roux-en-Y gastric bypass patients frequently report olfactory changes, yet more pronounced and immediate shifts have been observed among sleeve gastrectomy recipients. CONCLUSIONS Our review finds strong evidence for the link between olfaction and obesity and indicates that bariatric surgery (particularly the sleeve gastrectomy) is effective in reversing olfactory decline associated with obesity. In conclusion, we present mechanistic models to underpin the observed relationship between olfaction and obesity.
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Affiliation(s)
- Mei Peng
- Sensory Neuroscience Laboratory, Department of Food Science, University of Otago, Dunedin, New Zealand
| | - Duncan Coutts
- Sensory Neuroscience Laboratory, Department of Food Science, University of Otago, Dunedin, New Zealand
| | - Ting Wang
- Department of Mathematics and Statistics, University of Otago, Dunedin, New Zealand
| | - Yusuf O Cakmak
- Department of Anatomy, University of Otago, Dunedin, New Zealand.,Brain Health Research Centre, Dunedin, New Zealand.,Medical Technologies Centre of Research Excellence, Auckland, New Zealand
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28
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Abstract
Pancreatic alpha cells are generally considered the only source of glucagon secretion in humans. In the 1970s several groups investigating totally pancreatectomised animals reported that glucagon-like immunoreactive material could be detected in the gastrointestinal tract and reopened the question of an extrapancreatic source of glucagon proposed in 1948 when a hyperglycaemic substance was found in the gastrointestinal tract of dogs and rabbits. Nevertheless, over the years, controversy about the existence of extrapancreatic glucagon has flourished as it proved difficult to accurately measure fully processed 29-amino acid glucagon. Recent advances in analytical methods have increased sensitivity and specificity of glucagon assays and, furthermore, technical advances in mass spectrometry-based proteomics have made the detection of low-abundant peptides, such as glucagon, in human plasma more accurate. Here we review new data on extrapancreatic glucagon secretion in the context of historical data and recent analytical breakthroughs. Furthermore, the source, regulation and potential physiological role of extrapancreatic glucagon are discussed and ongoing challenges and knowledge-gaps are outlined.
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Affiliation(s)
- Asger Lund
- Clinical Metabolic Physiology, Steno Diabetes Center Copenhagen, Gentofte Hospital, Hellerup, Denmark; Department of Medicine, Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark.
| | - Filip K Knop
- Clinical Metabolic Physiology, Steno Diabetes Center Copenhagen, Gentofte Hospital, Hellerup, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
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29
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Abstract
BACKGROUND Alterations in taste perception and preferences may contribute to dietary changes and subsequent weight loss following bariatric surgery. METHODS A systematic search was performed to identify all articles investigating gustation, olfaction, and sensory perception in both animal and human studies following bariatric procedures. RESULTS Two hundred fifty-five articles were identified after database searches, bibliography inclusions and deduplication. Sixty-one articles were included. These articles provide evidence supporting changes in taste perception and hedonic taste following bariatric procedures. Taste sensitivity to sweet and fatty stimuli appears to increase post-operatively. Additionally, patients also have a reduced hedonic response to these stimuli. CONCLUSIONS Available evidence suggests that there is a change in taste perception following bariatric procedures, which may contribute to long-term maintenance of weight loss following surgery.
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Affiliation(s)
- Kasim Ahmed
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Nicholas Penney
- Department of Surgery and Cancer, Imperial College London, London, UK.
| | - Ara Darzi
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Sanjay Purkayastha
- Department of Surgery and Cancer, Imperial College London, London, UK
- Imperial Weight Centre, St Mary's Hospital, London, UK
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30
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Kittrell H, Graber W, Mariani E, Czaja K, Hajnal A, Di Lorenzo PM. Taste and odor preferences following Roux-en-Y surgery in humans. PLoS One 2018; 13:e0199508. [PMID: 29975712 PMCID: PMC6033408 DOI: 10.1371/journal.pone.0199508] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Accepted: 06/09/2018] [Indexed: 11/21/2022] Open
Abstract
It is well established that bariatric surgery, the most effective method to achieve long-term weight loss in obese subjects, reverses enhanced preference and intake of sweet/fatty foods. Although taste and odor preference changes following bariatric surgery have been previously described, their time course and relationship to weight loss remains an issue. The aim of this study was to determine the relationship between taste and odor preference changes and successful weight loss following bariatric surgery. A cross-sectional study was performed on 195 human subjects with body mass index (BMI) above 30 (at least class I obesity), who were scheduled to receive (n = 54) or had previously received (n = 141) Roux-en-Y gastric bypass (RYGB). A Self-Assessment Manikin test was used to measure each participant’s affective reaction (ranging from pleasure to displeasure) to a variety of food-related and odor-related pictures. Results confirmed earlier reports about changes in sweet/fatty foods preference after surgery and revealed a shift in preference toward less calorie-dense foods. Relatedly, endorsements of “favorite” foods were mostly sweet/fatty foods in subjects awaiting surgery but were shifted toward more healthy choices, particularly vegetables, in subjects post-RYGB surgery. However, food preference ratings trended toward pre-surgical levels as the time since surgery increased. Answers to open-ended questions about why their diet changed post-surgery revealed that changes in cravings, rather than changes in taste per se, were the major factor. Surprisingly, patients rating a coffee taste as more pleasing after surgery had a lower post-surgical BMI. No associations of odors with change in BMI were apparent. Results showed that following bariatric surgery taste preferences are significantly altered and that these changes correlate with lowered BMI. However, these changes fade as time since surgery lengthens. These results may suggest diagnostic criteria to identify people at risk for less than optimal changes in BMI following bariatric surgery.
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Affiliation(s)
- Hannah Kittrell
- Department of Psychology, Binghamton University, Binghamton, New York, United States of America
| | - William Graber
- Metabolic Surgery, St. Joseph Hospital Health Center, Syracuse, New York, United States of America
| | - Evelyn Mariani
- Metabolic Surgery, St. Joseph Hospital Health Center, Syracuse, New York, United States of America
| | - Krzysztof Czaja
- Veterinary Biosciences and Diagnostic Imaging, University of Georgia, Athens, Georgia, United States of America
| | - Andras Hajnal
- Department of Neural and Behavioral Sciences, Penn State University, College of Medicine, Hershey, Pennsylvania, United States of America
| | - Patricia M. Di Lorenzo
- Department of Psychology, Binghamton University, Binghamton, New York, United States of America
- * E-mail:
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31
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Zerrweck C, Gallardo VC, Calleja C, Sepúlveda E, Guilber L. Gross Olfaction Before and After Laparoscopic Gastric Bypass. Obes Surg 2018; 27:2988-2992. [PMID: 28508275 DOI: 10.1007/s11695-017-2733-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Obesity leads to olfaction alterations, and this can further impact food choices, appetite, and nutritional status. Bariatric procedures induce weight loss and change in taste and smell perception, but more information is needed, especially using objective olfaction tests. METHODS A prospective study was conducted during 6 months, with candidates to laparoscopic gastric bypass at a single institution. A preoperative nasofibroscopy and gross smell identification test (The Pocket Smell Test ®) were performed in those meeting the inclusion criteria. After 6 months, a new test was performed, and the primary objective was to determine if there was an improvement in the olfaction score. Weight loss and comorbidities improvement were also analyzed. RESULTS From the 30 patients with morbid obesity enrolled, 21 met the inclusion criteria and ENT evaluation. At baseline, 42.8% of patients scored 3 points, 53.3% scored 2 points, and 4.7% scored 1 point. After 6 months, there was a -81.1% of change. Seventeen patients scored 3 points (p = 0.002 vs initial) and two scored 2 points (p = 0.006 vs initial). There were no patients with less than 2 points. Weight and comorbidities had a significant improvement as well. CONCLUSION Laparoscopic gastric bypass improves the olfaction scores of the Pocket Smell Test in morbidly obese patients 6 months after their procedure. More complex tests can be used in candidates to bariatric surgery if low scores are detected initially. Other causes of olfaction dysfunctions should be determined if there is no improvement after weight loss.
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Affiliation(s)
- Carlos Zerrweck
- The Obesity Clinic at Hospital General Tláhuac, Villa Centroamericana y del Caribe, Delegación Tláhuac, Avenida la Turba # 655, Col, 13250, Mexico City, Mexico.
| | | | - Carmen Calleja
- Bariatric Nutrition Department at Hospital Angeles Tijuana. BCN, Mexico City, Mexico
| | - Elisa Sepúlveda
- The Obesity Clinic at Hospital General Tláhuac, Villa Centroamericana y del Caribe, Delegación Tláhuac, Avenida la Turba # 655, Col, 13250, Mexico City, Mexico
| | - Lizbeth Guilber
- The Obesity Clinic at Hospital General Tláhuac, Villa Centroamericana y del Caribe, Delegación Tláhuac, Avenida la Turba # 655, Col, 13250, Mexico City, Mexico
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32
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Makaronidis JM, Batterham RL. Obesity, body weight regulation and the brain: insights from fMRI. Br J Radiol 2018; 91:20170910. [PMID: 29365284 DOI: 10.1259/bjr.20170910] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Obesity constitutes a major global health threat. Despite the success of bariatric surgery in delivering sustainable weight loss and improvement in obesity-related morbidity, effective non-surgical treatments are urgently needed, necessitating an increased understanding of body weight regulation. Neuroimaging studies undertaken in people with healthy weight, overweight, obesity and following bariatric surgery have contributed to identifying the neurophysiological changes seen in obesity and help increase our understanding of the mechanisms driving the favourable eating behaviour changes and sustained weight loss engendered by bariatric surgery. These studies have revealed a key interplay between peripheral metabolic signals, homeostatic and hedonic brain regions and genetics. Findings from brain functional magnetic resonance imaging (fMRI) studies have consistently associated obesity with an increased motivational drive to eat, increased reward responses to food cues and impaired food-related self-control processes. Interestingly, new data link these obesity-associated changes with structural and connectivity changes within the central nervous system. Moreover, emerging data suggest that bariatric surgery leads to neuroplastic recovery. A greater understanding of the interactions between peripheral signals of energy balance, the neural substrates that regulate eating behaviour, the environment and genetics will be key for the development of novel therapeutic strategies for obesity. This review provides an overview of our current understanding of the pathoaetiology of obesity with a focus upon the role that fMRI studies have played in enhancing our understanding of the central regulation of eating behaviour and energy homeostasis.
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Affiliation(s)
- Janine M Makaronidis
- 1 Department of Medicine, Centre for Obesity Research, Rayne Institute, University College London , London , UK.,2 Bariatric Centre for Weight Management and Metabolic Surgery, University College London Hospital (UCLH) Bariatric Centre for Weight Management and Metabolic Surgery, University College London Hospital , London , UK.,3 Bariatric Centre for Weight Management and Metabolic Surgery, National Institute of Health Research, UCLH Biomedical Research Centre , London , UK
| | - Rachel L Batterham
- 1 Department of Medicine, Centre for Obesity Research, Rayne Institute, University College London , London , UK.,2 Bariatric Centre for Weight Management and Metabolic Surgery, University College London Hospital (UCLH) Bariatric Centre for Weight Management and Metabolic Surgery, University College London Hospital , London , UK.,3 Bariatric Centre for Weight Management and Metabolic Surgery, National Institute of Health Research, UCLH Biomedical Research Centre , London , UK
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33
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Zerrweck C, Zurita L, Álvarez G, Maydón HG, Sepúlveda EM, Campos F, Caviedes A, Guilbert L. Taste and Olfactory Changes Following Laparoscopic Gastric Bypass and Sleeve Gastrectomy. Obes Surg 2018; 26:1296-302. [PMID: 26475030 DOI: 10.1007/s11695-015-1944-8] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Alterations in taste/smell after bariatric surgery have been observed, but few data is available. Some authors documented these changes and their role on weight loss but there is no evidence after laparoscopic sleeve gastrectomy (LSG). METHODS Cohort study with patients submitted to laparoscopic gastric bypass (LGBP) and LSG that were asked to participate in a validated survey. The primary objective was to determinate the differences between procedures for taste and smell changes; a demographic and anthropometric analysis were also performed. Secondarily, the relation between food aversion and weight loss was also obtained. RESULTS Final analysis was based on 154 patients (104 LGBP and 50 LSG). The overall mean time between surgery and questionnaire was 10 ± 6.7 months. Most of the patients (87.6 %) experienced some taste/smell change. There were no differences between procedures for any change, taste or smell change. More patients submitted to LGBP referred that food smelled different (51.9 vs 34 % for the LSG group; p = 0.040). Higher %EWL was observed for patients presenting food aversion (73.3 ± 19.7 vs 65.8 ± 19.4 % for those without aversion; p = 0.046). Based on type of surgery, the LGBP group had the same trend (%EWL of 78.2 ± 17.3 vs 70.4 ± 18.6 % for those without aversion; p = 0.044). CONCLUSION The majority of patients presented taste and olfactory changes soon after surgery independently of type of procedure. Patients submitted to LGBP referred more often a different smell in food. Higher %EWL was observed in patients presenting any food aversion, especially in the LGBP group.
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Affiliation(s)
- Carlos Zerrweck
- The Obesity Clinic at "Hospital General Tláhuac", Avenida La Turba #655, Col. Villa Centroamericana y del Caribe, Del. Tláhuac, 13278, Mexico City, Mexico.
| | - Luis Zurita
- The Obesity Clinic at "Hospital General Dr. Rubén Leñero", Mexico City, Mexico
| | - Guillermo Álvarez
- The Obesity Clinic at "Hospital General Tláhuac", Avenida La Turba #655, Col. Villa Centroamericana y del Caribe, Del. Tláhuac, 13278, Mexico City, Mexico
| | - Hernán G Maydón
- The Obesity Clinic at "Hospital General Tláhuac", Avenida La Turba #655, Col. Villa Centroamericana y del Caribe, Del. Tláhuac, 13278, Mexico City, Mexico
| | - Elisa M Sepúlveda
- The Obesity Clinic at "Hospital General Tláhuac", Avenida La Turba #655, Col. Villa Centroamericana y del Caribe, Del. Tláhuac, 13278, Mexico City, Mexico
| | - Francisco Campos
- The Obesity Clinic at "Hospital General Dr. Rubén Leñero", Mexico City, Mexico
| | - Amaya Caviedes
- The Obesity Clinic at "Hospital General Tláhuac", Avenida La Turba #655, Col. Villa Centroamericana y del Caribe, Del. Tláhuac, 13278, Mexico City, Mexico
| | - Lizbeth Guilbert
- The Obesity Clinic at "Hospital General Tláhuac", Avenida La Turba #655, Col. Villa Centroamericana y del Caribe, Del. Tláhuac, 13278, Mexico City, Mexico
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34
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Abstract
The obesity epidemic continues to escalate each year in the United States more than anywhere else in the world. The existing pharmaceutical and other nonsurgical treatments for morbid obesity produce suboptimal physiologic outcomes compared with those of Roux-en-Y gastric bypass (RYGB) surgery. RYGB has been the gold standard of bariatric surgery because the beneficial long-term outcomes, which include sustainable weight loss and type 2 diabetes mellitus (T2DM) resolution, are far superior to those obtained with other bariatric surgeries. However, the current understanding of RYGB's mechanisms of actions remains limited and incomplete. There is an urgent need to understand these mechanisms as gaining this knowledge may lead to the development of innovative and less invasive procedures and/or medical devices, which can mirror the favorable outcomes of RYGB surgery. In this review, we highlight current observations of the metabolic and physiologic events following RYGB, with a particular focus on the role of the anatomical reconfiguration of the gastrointestinal tract after RYGB.
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Affiliation(s)
- Martin L Yarmush
- Center for Engineering in Medicine, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, and Shriners Burn Hospital for Children, Boston, Massachusetts 02114;
| | - Matthew D'Alessandro
- Center for Engineering in Medicine, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, and Shriners Burn Hospital for Children, Boston, Massachusetts 02114;
| | - Nima Saeidi
- Center for Engineering in Medicine, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, and Shriners Burn Hospital for Children, Boston, Massachusetts 02114;
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35
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Fysekidis M, Bouchoucha M, Mary F, Airinei G, Bon C, Benamouzig R. Change of appetite in patients with functional digestive disorder. Association with psychological disorders: A cross-sectional study. J Gastroenterol Hepatol 2018; 33:195-202. [PMID: 28556178 DOI: 10.1111/jgh.13836] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Revised: 05/19/2017] [Accepted: 05/22/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND AIMS Changes in appetite are a frequent complaint in patients with functional gastrointestinal disorders (FGIDs). The aims of this study are to evaluate whether the changes in appetite are associated with specific FGIDs and to explore associations of these changes with symptoms of anxiety or depression. METHODS This study included 1009 consecutive FGID patients (71% female), aged 48.9 years who all filled out a Rome III questionnaire for the evaluation of FGIDs, submitted to a psychological evaluation of symptoms of anxiety, and completed the Beck Depression Inventory questionnaire. The patients were classified according to their appetite change using a 7-point grading scale and split into three groups: those with appetite loss, those with no change in appetite, and those with increased appetite. RESULTS Among the 1009, 496 patients (49%) reported a change in appetite, of which 332 (33%) patients reported a decrease in appetite and 164 (16%) patients reported an increase in appetite. Appetite was not affected in 51% of patients. Changes in appetite depended on gender, body mass index and psychometric evaluation scores. Increased appetite did not have specific FGIDs associations, while decreased appetite was associated with esophageal, gastroduodenal, bowel, and anorectal symptoms. The presence of depressive symptoms was also a predictor for the majority of FGIDs in decreased appetite, while anxiety trait was significant for globus and dysphagia. CONCLUSIONS Decreased appetite was associated with FGIDs, especially in the presence of depressive symptoms. A reduced appetite would help to predict psychological disorders associated with FGIDs. FINANCIAL DISCLOSURE None declared. LEGAL REGISTRATION This study was a registered study in the French National Drug Agency (ANSM, Agence Nationale de Securité du Medicamentet des produits de santé, Study Number 2016-A01120-51). COMPETING INTERESTS Michel Bouchoucha, Marinos Fysekidis, Florence Mary, Gheorghe Airinei, Cyriaque Bon, and Robert Benamouzig have no competitive interests.
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Affiliation(s)
- Marinos Fysekidis
- Service de Nutrition et Diabétologie, Hôpital Avicenne, Paris, France
| | - Michel Bouchoucha
- Université Paris V René Descartes, Paris, France.,Service de Gastroentérologie, Hôpital Avicenne, Paris, France
| | - Florence Mary
- Service de Gastroentérologie, Hôpital Avicenne, Paris, France
| | | | - Cyriaque Bon
- Service de Gastroentérologie, Hôpital Avicenne, Paris, France
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Steinert RE, Feinle-Bisset C, Asarian L, Horowitz M, Beglinger C, Geary N. Ghrelin, CCK, GLP-1, and PYY(3-36): Secretory Controls and Physiological Roles in Eating and Glycemia in Health, Obesity, and After RYGB. Physiol Rev 2017; 97:411-463. [PMID: 28003328 PMCID: PMC6151490 DOI: 10.1152/physrev.00031.2014] [Citation(s) in RCA: 367] [Impact Index Per Article: 52.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The efficacy of Roux-en-Y gastric-bypass (RYGB) and other bariatric surgeries in the management of obesity and type 2 diabetes mellitus and novel developments in gastrointestinal (GI) endocrinology have renewed interest in the roles of GI hormones in the control of eating, meal-related glycemia, and obesity. Here we review the nutrient-sensing mechanisms that control the secretion of four of these hormones, ghrelin, cholecystokinin (CCK), glucagon-like peptide-1 (GLP-1), and peptide tyrosine tyrosine [PYY(3-36)], and their contributions to the controls of GI motor function, food intake, and meal-related increases in glycemia in healthy-weight and obese persons, as well as in RYGB patients. Their physiological roles as classical endocrine and as locally acting signals are discussed. Gastric emptying, the detection of specific digestive products by small intestinal enteroendocrine cells, and synergistic interactions among different GI loci all contribute to the secretion of ghrelin, CCK, GLP-1, and PYY(3-36). While CCK has been fully established as an endogenous endocrine control of eating in healthy-weight persons, the roles of all four hormones in eating in obese persons and following RYGB are uncertain. Similarly, only GLP-1 clearly contributes to the endocrine control of meal-related glycemia. It is likely that local signaling is involved in these hormones' actions, but methods to determine the physiological status of local signaling effects are lacking. Further research and fresh approaches are required to better understand ghrelin, CCK, GLP-1, and PYY(3-36) physiology; their roles in obesity and bariatric surgery; and their therapeutic potentials.
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Affiliation(s)
- Robert E Steinert
- University of Adelaide Discipline of Medicine and National Health and Medical Research Council of Australia Centre of Research Excellence in Translating Nutritional Science to Good Health, Adelaide, Australia; DSM Nutritional Products, R&D Human Nutrition and Health, Basel, Switzerland; Institute of Veterinary Physiology, University of Zurich, Zurich, Switzerland; Department of Biomedicine and Division of Gastroenterology, University Hospital Basel, Basel, Switzerland; and Department of Psychiatry, Weill Medical College of Cornell University, New York, New York
| | - Christine Feinle-Bisset
- University of Adelaide Discipline of Medicine and National Health and Medical Research Council of Australia Centre of Research Excellence in Translating Nutritional Science to Good Health, Adelaide, Australia; DSM Nutritional Products, R&D Human Nutrition and Health, Basel, Switzerland; Institute of Veterinary Physiology, University of Zurich, Zurich, Switzerland; Department of Biomedicine and Division of Gastroenterology, University Hospital Basel, Basel, Switzerland; and Department of Psychiatry, Weill Medical College of Cornell University, New York, New York
| | - Lori Asarian
- University of Adelaide Discipline of Medicine and National Health and Medical Research Council of Australia Centre of Research Excellence in Translating Nutritional Science to Good Health, Adelaide, Australia; DSM Nutritional Products, R&D Human Nutrition and Health, Basel, Switzerland; Institute of Veterinary Physiology, University of Zurich, Zurich, Switzerland; Department of Biomedicine and Division of Gastroenterology, University Hospital Basel, Basel, Switzerland; and Department of Psychiatry, Weill Medical College of Cornell University, New York, New York
| | - Michael Horowitz
- University of Adelaide Discipline of Medicine and National Health and Medical Research Council of Australia Centre of Research Excellence in Translating Nutritional Science to Good Health, Adelaide, Australia; DSM Nutritional Products, R&D Human Nutrition and Health, Basel, Switzerland; Institute of Veterinary Physiology, University of Zurich, Zurich, Switzerland; Department of Biomedicine and Division of Gastroenterology, University Hospital Basel, Basel, Switzerland; and Department of Psychiatry, Weill Medical College of Cornell University, New York, New York
| | - Christoph Beglinger
- University of Adelaide Discipline of Medicine and National Health and Medical Research Council of Australia Centre of Research Excellence in Translating Nutritional Science to Good Health, Adelaide, Australia; DSM Nutritional Products, R&D Human Nutrition and Health, Basel, Switzerland; Institute of Veterinary Physiology, University of Zurich, Zurich, Switzerland; Department of Biomedicine and Division of Gastroenterology, University Hospital Basel, Basel, Switzerland; and Department of Psychiatry, Weill Medical College of Cornell University, New York, New York
| | - Nori Geary
- University of Adelaide Discipline of Medicine and National Health and Medical Research Council of Australia Centre of Research Excellence in Translating Nutritional Science to Good Health, Adelaide, Australia; DSM Nutritional Products, R&D Human Nutrition and Health, Basel, Switzerland; Institute of Veterinary Physiology, University of Zurich, Zurich, Switzerland; Department of Biomedicine and Division of Gastroenterology, University Hospital Basel, Basel, Switzerland; and Department of Psychiatry, Weill Medical College of Cornell University, New York, New York
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Boerlage TCC, van de Laar AWJM, Westerlaken S, Gerdes VEA, Brandjes DPM. Gastrointestinal symptoms and food intolerance 2 years after laparoscopic Roux-en-Y gastric bypass for morbid obesity. Br J Surg 2016; 104:393-400. [PMID: 27990637 PMCID: PMC5324533 DOI: 10.1002/bjs.10419] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Revised: 06/09/2016] [Accepted: 10/03/2016] [Indexed: 12/14/2022]
Abstract
BACKGROUND Laparoscopic Roux-en-Y gastric bypass (LRYGB) is an effective treatment for morbid obesity, but might aggravate gastrointestinal complaints and food intolerance. The long-term prevalence of these symptoms has not been well studied. METHODS In a cross-sectional study, all patients who underwent primary LRYGB from May to October 2012 were approached 2 years after surgery to complete a general health questionnaire, the Gastrointestinal Symptom Rating Scale (GSRS), and a food intolerance questionnaire. The results were compared with those for a control group of morbidly obese patients. RESULTS A total of 249 patients were included for analysis, representing a response rate of 93·9 per cent. Mean(s.d.) total weight loss was 30·8(8·7) per cent. The total mean GSRS score was higher in patients who had LRYGB (median 2·19 versus 1·75 in unoperated patients; P < 0·001); the difference in symptoms of indigestion was most notable (P < 0·001). Food intolerance for specific products was reported by 70·7 (95 per cent c.i. 64·8 to 76·0) per cent of the postoperative patients, for a median of 4 foods. There was a positive correlation between food intolerance and score on the GSRS. There was no correlation between either food intolerance or the total mean GSRS score and weight loss, but there was a correlation between weight loss and abdominal pain. CONCLUSION At 2 years after surgery, patients undergoing LRYGB for morbid obesity have more gastrointestinal complaints than obese controls. Food intolerance is a common side-effect of LRYGB independent of degree of weight loss or the presence of other abdominal symptoms.
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Affiliation(s)
- T C C Boerlage
- Departments of Internal Medicine, Academic Medical Centre, Amsterdam, The Netherlands
| | | | - S Westerlaken
- Departments of Dietetics, MC Slotervaart, Academic Medical Centre, Amsterdam, The Netherlands
| | - V E A Gerdes
- Departments of Internal Medicine, Academic Medical Centre, Amsterdam, The Netherlands
| | - D P M Brandjes
- Departments of Internal Medicine, Academic Medical Centre, Amsterdam, The Netherlands.,Department of Vascular Medicine, Academic Medical Centre, Amsterdam, The Netherlands
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Taste, Enjoyment, and Desire of Flavors Change After Sleeve Gastrectomy-Short Term Results. Obes Surg 2016; 27:1466-1473. [DOI: 10.1007/s11695-016-2497-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Jahn U, Schubert T, Schlepp S, Deuber HJ. [Metabolic surgery or conservative measures as therapy of obese type 2 diabetics?]. Wien Med Wochenschr 2016; 167:234-244. [PMID: 27921198 DOI: 10.1007/s10354-016-0532-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Accepted: 11/08/2016] [Indexed: 11/30/2022]
Abstract
After bariatric surgery there are some favourable effects on comorbidities of obesity as glucose and lipid metabolism besides weight loss. Therefore surgical measures targeting at improvement of such metabolic disorders especially diabetes type 2 has been called "metabolic surgery". The complexity of its underlying metabolic mechanisms is not yet clear, but restriction of energy and weight loss (maintenance) seem to be the cornerstones.Risks of these procedures which are drawn of the established methods of bariatric surgery are reported to be relatively low in qualified centers. Being an elective operation special focus has to be set on mortality and morbidity, numbers of therapeutic failure and redo-surgery. Multiple irreversible and not seldom severe, potentially life-threatening consequences of bariatric surgery require consequent interdisciplinary postsurgery care and therapy throughout the whole life, especially substitution therapy of deficiencies due to post-operative malassimilation, if necessary. Little is known about long term consequences of modified anatomy and function of digestive system caused by surgery, and there may be a delay of (many) years until manifestation of clinical problems.Obese diabetics (BMI ≥ 35 kg/m2) should primarily be treated conservatively in an "individualized" way. Metabolic surgery should not be considered earlier than failure of the conservative approach has to be stated (in this case as an "ultima ratio" in well defined trials). A broader use of metabolic surgery beyond this narrow frame is not yet supported by long-term evidence-based data showing its value and safety.
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Hancı D, Altun H, Altun H, Batman B, Karip AB, Serin KR. Laparoscopic Sleeve Gastrectomy Improves Olfaction Sensitivity in Morbidly Obese Patients. Obes Surg 2016; 26:558-62. [PMID: 26138692 DOI: 10.1007/s11695-015-1784-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Olfactory abilities of the patients are known to be altered by eating and metabolic disorders, including obesity. There are only a number of studies investigating the effect of obesity on olfaction, and there is limited data on the changes in olfactory abilities of morbidly obese patients after surgical treatment. Here we investigated the changes in olfactory abilities of 54 morbidly obese patients (M/F, 22/32; age range 19-57 years; body mass index (BMI) range 30.5-63.0 kg/m(2)) after laparoscopic sleeve gastrectomy. METHOD A laparoscopic sleeve gastrectomy was performed by the same surgeon using five-port technique. Olfactory abilities were tested preoperatively and 1, 3, and 6 months after the surgery using a standardized Sniffin' Sticks Extended Test kit. RESULTS Analyses of variance indicated statistically significant improvement in T, D, and I scores of morbidly obese patients within time factors (preoperative vs. 1, 3, and 6 months; 1 vs. 3 and 6 months; and 3 vs. 6 months; p < 0.001 for all). There was a statistically significant improvement in overall TDI scores with an increase from 25 to 41 during the 6 months follow-up period (p < 0.001 for all). CONCLUSIONS Here, for the first time in literature, we were able to show the significant improvement in olfactory abilities of morbidly obese patients after laparoscopic sleeve gastrectomy.
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Affiliation(s)
- Deniz Hancı
- Ear Nose and Throat Clinic, Liv Hospital, Ulus, Istanbul, Turkey
| | - Huseyin Altun
- Ear Nose and Throat Clinic, Yunus Emre Hospital, Uskudar, Istanbul, Turkey
| | - Hasan Altun
- General Surgery Clinic, Liv Hospital, Ulus, Istanbul, Turkey.
| | - Burcin Batman
- General Surgery Clinic, Liv Hospital, Ulus, Istanbul, Turkey
| | - Aziz Bora Karip
- General Surgery Clinic, Fatih Sultan Mehmet Education and Research Hospital, Atasehir, Istanbul, Turkey
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Reported appetite, taste and smell changes following Roux-en-Y gastric bypass and sleeve gastrectomy: Effect of gender, type 2 diabetes and relationship to post-operative weight loss. Appetite 2016; 107:93-105. [PMID: 27453553 DOI: 10.1016/j.appet.2016.07.029] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Revised: 07/16/2016] [Accepted: 07/20/2016] [Indexed: 12/11/2022]
Abstract
Reduced energy intake drives weight loss following Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) procedures. Post-operative changes in subjective appetite, taste, and smell and food preferences are reported and suggested to contribute to reduced energy intake. We aimed to investigate the prevalence of these changes following RYGB and SG and to evaluate their relationship with weight loss. 98 patients post-RYGB and 155 post-SG from a single bariatric centre were recruited to a cross-sectional study. Participants completed a questionnaire, previously utilised in post-operative bariatric patients, to assess the prevalence of post-operative food aversions and subjective changes in appetite, taste and smell. Anthropometric data were collected and percentage weight loss (%WL) was calculated. The relationship between food aversions, changes in appetite, taste and smell and %WL was assessed. The influence of time post-surgery, gender and type 2 diabetes (T2D) were evaluated. Following RYGB and SG the majority of patients reported food aversions (RYGB = 62%, SG = 59%), appetite changes (RYGB = 91%, SG = 91%) and taste changes (RYGB = 64%, SG = 59%). Smell changes were more common post-RYGB than post-SG (RYGB = 41%, SG = 28%, p = 0.039). No temporal effect was observed post-RYGB. In contrast, the prevalence of appetite changes decreased significantly with time following SG. Post-operative appetite changes associated with and predicted higher %WL post-SG but not post-RYGB. Taste changes associated with and predicted higher %WL following RYGB but not post-SG. There was no gender effect post-RYGB. Post-SG taste changes were less common in males (female = 65%, males = 40%, p = 0.008). T2D status in females did not influence post-operative subjective changes. However, in males with T2D, taste changes were less common post-SG than post-RYGB together with lower %WL (RYGB = 27.5 ± 2.7, SG = 14.6 ± 2.1, p = 0.003). Further research is warranted to define the biology underlying these differences and to individualise treatments.
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Primeaux SD, de Silva T, Tzeng TH, Chiang MC, Hsia DS. Recent advances in the modification of taste and food preferences following bariatric surgery. Rev Endocr Metab Disord 2016; 17:195-207. [PMID: 27245858 DOI: 10.1007/s11154-016-9365-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
There is a large body of evidence indicating that bariatric surgery provides durable weight loss and health benefits to patients who are obese and have comorbidities such as type 2 diabetes (T2D). However, there are still many questions related to mechanisms of metabolic improvement, predictors of success/failure, and long term consequences, which need to be answered. More recently, there has been a particular interest in the modulation of taste and food preferences that occurs after bariatric surgery and how this affects weight loss in different individuals. Animal models as well as human studies have shed some light on the role of taste in changing food preferences and how these changes may affect weight loss after surgery. The goal of this review is to discuss the physiological and behavioral consequences of bariatric surgery as a treatment for obesity and T2D, with particular emphasis on recent studies describing bariatric surgery-induced modifications in taste perception and food preferences.
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Affiliation(s)
- Stefany D Primeaux
- Department of Physiology, LSU Health Sciences Center, 1901 Perdido Street, MEB 7159D, New Orleans, LA, 70112, USA.
- Joint Diabetes, Endocrinology & Metabolism Program, Pennington Biomedical Research Center, Baton Rouge, LA, 70808, USA.
| | - Taniya de Silva
- Department of Internal Medicine-Endocrinology, LSU Health Sciences Center, New Orleans, LA, 70112, USA
| | - Tony H Tzeng
- Department of Physiology, LSU Health Sciences Center, 1901 Perdido Street, MEB 7159D, New Orleans, LA, 70112, USA
| | - Monica C Chiang
- Department of Internal Medicine-Endocrinology, LSU Health Sciences Center, New Orleans, LA, 70112, USA
| | - Daniel S Hsia
- Joint Diabetes, Endocrinology & Metabolism Program, Pennington Biomedical Research Center, Baton Rouge, LA, 70808, USA
- Department of Internal Medicine-Endocrinology, LSU Health Sciences Center, New Orleans, LA, 70112, USA
- Pennington Biomedical Research Center, Baton Rouge, LA, 70808, USA
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European Obesity Summit (EOS) - Joint Congress of EASOand IFSO-EC, Gothenburg, Sweden, June 1 - 4, 2016: Abstracts. Obes Facts 2016; 9 Suppl 1:1-376. [PMID: 27238363 PMCID: PMC5672850 DOI: 10.1159/000446744] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
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Altun H, Hanci D, Altun H, Batman B, Serin RK, Karip AB, Akyuz U. Improved Gustatory Sensitivity in Morbidly Obese Patients After Laparoscopic Sleeve Gastrectomy. Ann Otol Rhinol Laryngol 2016; 125:536-40. [DOI: 10.1177/0003489416629162] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Introduction: The reduction in the preferences for sweet and fat containing tastes in obese patients who underwent bariatric surgery was relatively well shown; however, there are only limited data on the changes in the sensitivity of other tastes like sour, salty, and bitter. Methods: We investigated the changes in gustatory sensitivity of 52 morbidly obese patients (M/F, 22/30; age range, 19-60 years; BMI range, 32.5-63.0 kg/m2) after laparoscopic sleeve gastrectomy. The surgery was performed by the same surgeon using 5 ports technique. Gustatory sensitivity was tested preoperatively and 1 and 3 months after the surgery using standardized Taste Strips test. Results: There was a statistically significant improvement in the taste acuity to sweet, sour, salty, and bitter tastants in morbidly obese patients after the laparoscopic sleeve gastrectomy during the follow-up period of 3 months. Median whole test scores of the patients were increased from 11.5 preoperatively to 14 in the first and third months. Conclusion: In this study, we were able to show the significant improvement in gustatory sensitivity of morbidly obese patients after laparoscopic sleeve gastrectomy for the first time in literature.
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Affiliation(s)
- Huseyin Altun
- Yunus Emre Hospital, Istanbul, ENT clinic, ENT surgeon
| | - Deniz Hanci
- Okmeydani Education and Research Hospital, Istanbul, ENT Department; ENT surgeon
| | - Hasan Altun
- Liv Hospital, Istanbul, General Surgery clinic, General Surgeon
| | - Burcin Batman
- Liv Hospital, Istanbul, General Surgery clinic, General Surgeon
| | | | - Aziz Bora Karip
- FSM Education and Research Hospital, Istanbul, General surgery Clinic, General Surgeon
| | - Umit Akyuz
- FSM Education and Research Hospital, Istanbul, Gastroenterology Clinic, Gastroenterologist
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RYGB progressively increases avidity for a low-energy, artificially sweetened diet in female rats. Appetite 2015; 98:133-41. [PMID: 26707654 DOI: 10.1016/j.appet.2015.11.029] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2015] [Revised: 11/18/2015] [Accepted: 11/24/2015] [Indexed: 02/06/2023]
Abstract
Weight re-gain within 2 y after Roux-en-Y gastric bypass (RYGB) is significantly associated with increased intake of and cravings for sweet foods. Here we describe a novel model of this late increase in sweet appetite. Ovariectomized RYGB and Sham-operated rats, with or without estradiol treatment, were maintained on Ensure liquid diet and offered a low-energy, artificially sweetened diet (ASD) 2 h/d. First, we tested rats more than six months after RYGB. ASD meals were larger in RYGB than Sham rats, whereas Ensure meals were smaller. General physical activity increased during ASD meals in RYGB rats, but not during Ensure meals. Second, new rats were adapted to ASD before surgery, and were then offered ASD again during 4-10 wk following surgery. Estradiol-treated RYGB rats lost the most weight and progressively increased ASD intake to >20 g/2 h in wk 9-10 vs. ∼3 g/2 h in Sham rats. Finally, the same rats were then treated with leptin or saline for 8 d. Leptin did not affect body weight, Ensure intake, or activity during meals, but slightly reduced ASD intake in estradiol-treated RYGB rats. Food-anticipatory activity was increased in estradiol-treated RYGB rats during the saline-injection tests. Because increased meal-related physical activity together with larger meals is evidence of hunger in rats, these data suggest that (1) RYGB can increase hunger for a low-energy sweet food in rats and (2) low leptin levels contribute to this hunger, but are not its only cause. This provides a unique rat model for the increased avidity for sweets that is significantly associated with weight recidivism late after RYGB.
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Abstract
Bariatric surgery leads to significant long-term weight loss, particularly Roux-en-Y gastric bypass (RYGB). The mechanisms underlying weight loss have not been fully uncovered. The aim of this review is to explore the changes in food preferences, as a novel mechanism contributing to weight loss, and also focus on the underlying processes modulating eating behaviour after bariatric surgery. Patients after gastric bypass are less hungry and prefer healthier food options. They develop an increased acuity to sweet taste, which is perceived as more intense. The appeal of sweet fatty food decreases, with functional MRI studies showing a corresponding reduction in activation of the brain reward centres to high-energy food cues. Patients experiencing post-ingestive symptoms with sweet and fatty food develop conditioned aversive behaviours towards the triggers. Gut hormones are elevated in RYGB and have the potential to influence the taste system and food hedonics. Current evidence supports a beneficial switch in food preferences after RYGB. Changes within the sensory and reward domain of taste and the development of post-ingestive symptoms appear to be implicated. Gut hormones may be the mediators of these alterations and therefore exploiting this property might prove beneficial for designing future obesity treatment.
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Forde CG, Almiron-Roig E, Brunstrom JM. Expected Satiety: Application to Weight Management and Understanding Energy Selection in Humans. Curr Obes Rep 2015; 4:131-40. [PMID: 26627096 PMCID: PMC4881812 DOI: 10.1007/s13679-015-0144-0] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Recent advances in the approaches used to quantify expectations of satiation and satiety have led to a better understanding of how humans select and consume food, and the associated links to energy intake regulation. When compared calorie for calorie some foods are expected to deliver several times more satiety than others, and multiple studies have demonstrated that people are able to discriminate between similar foods reliably and with considerable sensitivity. These findings have implications for the control of meal size and the design of foods that can be used to lower the energy density of diets. These methods and findings are discussed in terms of their implications for weight management. The current paper also highlights why expected satiety may also play an important role beyond energy selection, in moderating appetite sensations after a meal has been consumed, through memory for recent eating and the selection of foods across future meals.
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Affiliation(s)
- Ciarán G Forde
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, 14 Medical Drive, #07-02, Singapore, 117599, Singapore.
| | | | - Jeffrey M Brunstrom
- Nutrition and Behaviour Unit, School of Experimental Psychology, University of Bristol, Bristol, UK.
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le Roux CW, Bueter M. The physiology of altered eating behaviour after Roux-en-Y gastric bypass. Exp Physiol 2014; 99:1128-32. [DOI: 10.1113/expphysiol.2014.078378] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Carel W. le Roux
- Diabetes Complications Research Centre; Conway Institute; School of Medicine and Medical Sciences; University College Dublin; Dublin Ireland
- Gastrosurgical Laboratory; University of Gothenburg; Gothenburg Sweden
- Investigative Science; Imperial College London; London UK
| | - Marco Bueter
- Department of Surgery; Division of Visceral and Transplantation Surgery; University Hospital Zurich; Zurich Switzerland
- Center of Integrative Human Physiology; University of Zurich; Zurich Switzerland
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