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Boppre G, Diniz-Sousa F, Veras L, Bezerra A, Devezas V, Preto J, Santos-Sousa H, Oliveira J, Fonseca H. Impact of a Multicomponent Exercise Training Program on Muscle Strength After Bariatric Surgery: A Randomized Controlled Trial. Obes Surg 2024; 34:1704-1716. [PMID: 38532144 PMCID: PMC11031478 DOI: 10.1007/s11695-024-07173-w] [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: 12/22/2023] [Revised: 03/11/2024] [Accepted: 03/13/2024] [Indexed: 03/28/2024]
Abstract
PURPOSE This study examined the benefits of an 11-months multicomponent exercise program (MEP) on muscular strength (MS) after bariatric surgery. METHODS Of the 84 randomized patients, 41 participants from the exercise group (EG) and 20 participants from the control group (CG) were included in the analysis. The EG received supervised MEP for 11 months, starting 1-month post-bariatric surgery (BS) in addition to standard medical care, while the CG received medical care recommendations only. Knee and trunk MS was assessed by isokinetic dynamometry pre-surgery, 1-, 6-, and 12-month post-surgery, while body composition was assessed by dual-energy X-ray absorptiometry. RESULTS The MEP did not significantly impact absolute MS in the dominant knee and trunk regions at 6- and 12-month post-BS. However, relative MS showed significant improvements. At 6-month post-BS, knee flexion at 60°/s relative to body weight (BW) increased significantly (p = 0.047), as did knee extension at 180°/s relative to BW (p = 0.009), and knee extension at 60°/s relative to total lean mass (p=0.040). At 12-month post-BS, knee flexion at 60°/s relative to BW also significantly improved (p=0.038). CONCLUSION While absolute MS was not significantly improved with MEP, this study found significant enhancements in relative MS, particularly in dominant knee flexion post-MEP participation. Further research should explore different exercise intensities and frequencies to optimize postoperative MS recovery post-BS. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov (NCT02843048).
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Affiliation(s)
- Giorjines Boppre
- Research Centre in Physical Activity, Health, and Leisure (CIAFEL), Faculty of Sport, University of Porto, Rua Dr. Plácido Costa, 91, 4200-450, Porto, Portugal.
- Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal.
| | - Florêncio Diniz-Sousa
- Research Centre in Physical Activity, Health, and Leisure (CIAFEL), Faculty of Sport, University of Porto, Rua Dr. Plácido Costa, 91, 4200-450, Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
| | - Lucas Veras
- Research Centre in Physical Activity, Health, and Leisure (CIAFEL), Faculty of Sport, University of Porto, Rua Dr. Plácido Costa, 91, 4200-450, Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
| | - Andrea Bezerra
- Research Centre in Physical Activity, Health, and Leisure (CIAFEL), Faculty of Sport, University of Porto, Rua Dr. Plácido Costa, 91, 4200-450, Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
| | - Vitor Devezas
- General Surgery Department, São João Medical Center, Porto, Portugal
| | - John Preto
- General Surgery Department, São João Medical Center, Porto, Portugal
| | - Hugo Santos-Sousa
- General Surgery Department, São João Medical Center, Porto, Portugal
| | - José Oliveira
- Research Centre in Physical Activity, Health, and Leisure (CIAFEL), Faculty of Sport, University of Porto, Rua Dr. Plácido Costa, 91, 4200-450, Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
| | - Hélder Fonseca
- Research Centre in Physical Activity, Health, and Leisure (CIAFEL), Faculty of Sport, University of Porto, Rua Dr. Plácido Costa, 91, 4200-450, Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
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Stults-Kolehmainen MA, Bond DS, Richardson LA, Herring LY, Mulone B, Garber CE, Morton J, Ghiassi S, Duffy AJ, Balk E, Abolt CJ, Howard MC, Ash GI, Williamson S, Marcon ER, De Los Santos M, Bond S, Huehls J, Alowaish O, Heyman NB, Gualano B. Role of the exercise professional in metabolic and bariatric surgery. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.04.20.23288698. [PMID: 37645986 PMCID: PMC10462198 DOI: 10.1101/2023.04.20.23288698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
Background Physical activity (PA) is important for the long-term health and weight management of patients who undergo metabolic and bariatric surgery (MBS). However, the roles of exercise professionals in MBS settings have not been systematically determined. Objectives To investigate: (1) who are the professionals implementing PA programming in MBS clinical settings; and (2) what patient-centric tasks do they perform? Setting Clinical and academic exercise settings worldwide. Methods This multimethod study included a scoping review of PA programs in MBS described in the research literature. Data about job tasks were extracted and provided to 10 experts to sort into categories. Cluster analysis was utilized to find the hierarchical structure of tasks. A Delphi process was used to agree on a final model. Results The majority of PA professionals were exercise physiologists in the USA and physiotherapists or other types of exercise professionals elsewhere. Forty-three tasks were identified, the most reported being: supervision of exercise, fitness testing, and exercise prescription. Seven higher-order categories were determined: (1) Exercise-related health assessment, (2) Body composition and physical fitness assessment, (3) Lifestyle physical activity and sedentary behavior assessment, (4) Education, instruction, and prescription, (5) Exercise monitoring, (6) Behavioral counseling and psychosocial support, and (7) Dietary support. The following statements were rated an average of 9.0, classifying them as "imperative": 1) "Pre- and post-operative PA/exercise guidelines for MBS patients are needed", 2) "MBS programs need to include PA/exercise as part of multidisciplinary care". Conclusions The expert group reached a consensus on 7 major classifications of job tasks for the exercise professional. It is important for governing medical associations across the world to formally recognize experienced exercise professionals as playing pivotal roles in continuing, multidisciplinary care for MBS patients. These findings also provide evidence-based information in the effort to solidify these positions within the greater context of healthcare.
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Affiliation(s)
- Matthew A. Stults-Kolehmainen
- Center for Weight Management, Division of Digestive Health, Yale New Haven Hospital, New Haven, CT, United States
- Department of Biobehavioral Sciences, Teachers College – Columbia University, New York, NY, United States
| | - Dale S. Bond
- Departments of Surgery and Research, Hartford Hospital/HealthCare, Hartford, CT, United States
| | | | - Louisa Y. Herring
- University Hospitals of Leicester NHS Trust, Infirmary Square, Leicester, England, United Kingdom
- NIHR Leicester Biomedical Research Centre, Leicester Diabetes Centre, Leicester General Hospital, Leicester, England, United Kingdom
| | - Bethany Mulone
- Center for Weight Management, Division of Digestive Health, Yale New Haven Hospital, New Haven, CT, United States
| | - Carol Ewing Garber
- Department of Biobehavioral Sciences, Teachers College – Columbia University, New York, NY, United States
| | - John Morton
- Division of Bariatric and Minimally Invasive Surgery, Department of Surgery, Yale University School of Medicine, New Haven, CT, United States
| | - Saber Ghiassi
- Division of Bariatric and Minimally Invasive Surgery, Department of Surgery, Yale University School of Medicine, New Haven, CT, United States
| | - Andrew J. Duffy
- Division of Bariatric and Minimally Invasive Surgery, Department of Surgery, Yale University School of Medicine, New Haven, CT, United States
| | - Ethan Balk
- Center for Weight Management, Division of Digestive Health, Yale New Haven Hospital, New Haven, CT, United States
- Department of Nutrition and Food Studies, New York University, New York, NY, United States
| | - Charles J. Abolt
- Earth and Environmental Sciences Division, Los Alamos National Laboratory, Los Alamos, NM, United States
| | - Matt C. Howard
- Department of Marketing & Quantitative Methods, University of South Alabama, Mobile, AL, United States
| | - Garrett I. Ash
- Center for Medical Informatics, Yale School of Medicine, New Haven, CT, United States
- Center for Pain, Research, Informatics, Medical Comorbidities and Education Center (PRIME), VA Connecticut Healthcare System, West Haven, CT, United States
| | - Susannah Williamson
- Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research (WRAIR), Silver Spring, MD, United States
- Army Educational Outreach Program, Rochester Institute of Technology, United States
| | - Emilian Rejane Marcon
- Department of Bariatric Surgery, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Melissa De Los Santos
- Department of Biobehavioral Sciences, Teachers College – Columbia University, New York, NY, United States
| | - Samantha Bond
- College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, United States
| | - Janet Huehls
- UMass Memorial Weight Center, UMASS Memorial Medical Center, Worchester, MA, United States
| | - Osama Alowaish
- Department of Biobehavioral Sciences, Teachers College – Columbia University, New York, NY, United States
| | - Nina Brojan Heyman
- Department of Biobehavioral Sciences, Teachers College – Columbia University, New York, NY, United States
| | - Bruno Gualano
- Applied Physiology & Nutrition Research Group, School of Medicine, University of São Paulo, São Paulo, Brazil
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Bond DS, Manuel KM, Wu Y, Livingston J, Papasavas PK, Baillot A, Pescatello LS. Exercise for counteracting weight recurrence after bariatric surgery: a systematic review and meta-analysis of randomized controlled trials. Surg Obes Relat Dis 2023; 19:641-650. [PMID: 36624025 PMCID: PMC10219840 DOI: 10.1016/j.soard.2022.12.029] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Revised: 11/14/2022] [Accepted: 12/10/2022] [Indexed: 12/23/2022]
Abstract
Exercise is recommended to prevent post-surgical weight recurrence. Yet, whether exercise interventions are efficacious in this regard has not been systematically evaluated. Moreover, clinicians lack evidence-based information to advise patients on appropriate exercise frequency, intensity, time, and type (FITT) for preventing weight recurrence. Thus, we conducted a meta-analysis of randomized controlled trials (RCTs) involving exercise interventions specifying FITT and weight measurement ≥12 months post-surgery. We reviewed scientific databases up through February 2022 for RCTs comparing exercise interventions reporting FITT and a nonexercise control group on weight ≥12 months post-surgery. Procedures following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses were registered at the international prospective register of systematic reviews (PROSPERO: CRD42022342337). Of 1368 studies reviewed, 5 met inclusion criteria (n = 189; 47.8 ± 4.2 yr, 36.1 6 ± 3.8 kg·m2, 83.2 ± 9.5% female; 61.7% underwent Roux-en-Y gastric bypass). Exercise interventions were largely supervised, lasted 12-26 weeks, and prescribed 80-210 minutes/week of moderate-to-vigorous intensity combined aerobic and resistance exercise over ≤5 days. Within-group effects showed non-statistically significant weight loss for exercise (d = - .15, 95% confidence interval [CI]: -1.96, 1.65; -1.4 kg; P = .87) and weight gain for control (d = .11, 95% CI: -1.70,1.92; +1.0 kg; P = .90), with no difference between these groups (d = -2.26, 95% CI: -2.07, 1.55; -2.4 kg; P = .78). Exercise elicited an additional 2.4 kg weight loss versus control, although this effect was small and statistically non-significant. Ability to draw definitive conclusions regarding efficacy of exercise interventions for counteracting post-surgical weight recurrence was limited by the small number of trials and methodological issues. Findings highlight the need for more rigorous RCTs of exercise interventions specifically designed to reduce post-surgical weight recurrence.
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Affiliation(s)
- Dale S Bond
- Department of Surgery, Hartford Hospital/HealthCare, Hartford, Connecticut; Department of Research, Hartford Hospital/HealthCare, Hartford, Connecticut.
| | - Katherine M Manuel
- Department of Nutritional Sciences, Howard University, Washington, District of Columbia
| | - Yin Wu
- Department of Research, Hartford Hospital/HealthCare, Hartford, Connecticut; Department of Kinesiology, University of Connecticut, Storrs, Connecticut; Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, Connecticut
| | - Jill Livingston
- Wesleyan Library, Wesleyan University, Middletown, Connecticut
| | - Pavlos K Papasavas
- Department of Surgery, Hartford Hospital/HealthCare, Hartford, Connecticut
| | - Aurélie Baillot
- Department of Nursing, University of Québec en Outaouais, Gatineau, Quebec, Canada; Institut du Savoir Montfort-Recherche, Ottawa, Ontario, Canada
| | - Linda S Pescatello
- Department of Kinesiology, University of Connecticut, Storrs, Connecticut; Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, Connecticut
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Physical Exercise to Improve Functional Capacity: Randomized Clinical Trial in Bariatric Surgery Population. J Clin Med 2022; 11:jcm11154621. [PMID: 35956235 PMCID: PMC9369494 DOI: 10.3390/jcm11154621] [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: 07/05/2022] [Revised: 07/31/2022] [Accepted: 08/05/2022] [Indexed: 11/17/2022] Open
Abstract
Background: Bariatric surgery is a safe and effective method to lose weight over time. However, some patients fail to achieve healthy weight losses. We aimed to determine if a moderate-intensity physical exercise intervention in patients who underwent bariatric surgery increases their functional capacity thus improving bariatric surgery results. Methods: We conducted a parallel-group non-blinded randomized controlled trial at a surgery clinic in Talca, Chile. A total of 43 participants with obesity and scheduled bariatric surgery completed the six months follow-up. A physical exercise program was conducted in exercise group participants one month after bariatric surgery. Walked distance in the six-minute walk test, BMI, Borg scale of perceptive exertion results and cardiovascular variables were evaluated. Results: Patients’ weight significantly decreased after bariatric surgery but there was no difference between the groups of study. The exercise group progressed from a base value of 550 ± 75 m walked in the six-minute walk test to a sixth-month value of 649.6 ± 68.5 m (p < 0.05), whilst the control group yielded base values of 554.4 ± 35.1 and a sixth-month walked distance of 591.1 ± 75.34 (p > 0.05). Conclusions: Physical exercise in obese patients undergoing bariatric surgery increased functional capacity independently of weight losses resulting from bariatric surgery.
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Vieira FT, de Oliveira GS, Gonçalves VSS, Neri SGR, de Carvalho KMB, Dutra ES. Effect of physical exercise on muscle strength in adults following bariatric surgery: A systematic review and meta-analysis of different muscle strength assessment tests. PLoS One 2022; 17:e0269699. [PMID: 35687555 PMCID: PMC9187088 DOI: 10.1371/journal.pone.0269699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 05/25/2022] [Indexed: 11/18/2022] Open
Abstract
Individuals following bariatric surgery are considered at high risk for the development of sarcopenic obesity (excess fat mass, low muscle mass and low physical function), and exercise may play an important role in its prevention and treatment. We systematically reviewed 5 scientific databases (Embase, Medline, Scopus, SPORTDiscus, and Web of Science) and 2 grey literature databases (ProQuest and Google Scholar) for clinical trials that evaluated the effect of exercise on muscle strength in adults following bariatric surgery and conducted a separate meta-analysis for studies that used different muscle strength tests. Random-effect models, restricted maximum likelihood method and Hedges' g were used. The review protocol was registered at the International Prospective Register of Systematic Reviews (PROSPERO) database (CRD42020152142). Fifteen studies were included (638 patients), none had a low risk of bias, and all were included in at least 1 of the 5 meta-analyses (repetition maximum [lower and upper limbs], sit-to-stand, dynamometer, and handgrip tests). Exercise interventions improved both upper (effect size, 0.71; 95% CI, 0.41-1.01; I2 = 0%) and lower (effect size, 1.37; 95% CI, 0.84-1.91; I2 = 46.14) limb muscle strength, as measured by repetition maximum tests. Results were similar for the sit-to-stand (effect size, 0.60; 95% CI, 0.20-1.01; I2 = 68.89%) and dynamometer (effect size, 0.46; 95% CI, 0.06-0.87; I2 = 31.03%), but not for the handgrip test (effect size, 0.11; 95% CI, -0.42-0.63; I2 = 73.27%). However, the certainty level of the meta-analyses was very low. Exercise with a resistance training component performed post bariatric surgery may improve muscle strength, which is related to sarcopenic obesity, functional capacity, and mortality risk, therefore should be included in the follow-up.
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Affiliation(s)
| | | | | | - Silvia G. R. Neri
- Graduate Program in Physical Education of the University of Brasilia, Brasilia, Brazil
| | | | - Eliane Said Dutra
- Graduate Program in Human Nutrition of the University of Brasilia, Brasilia, Brazil
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James JD, Hardeman W, Goodall M, Eborall H, Sprung VS, Bonnett LJ, Wilding JP. A systematic review of interventions to increase physical activity and reduce sedentary behaviour following bariatric surgery. Physiotherapy 2022; 115:1-17. [PMID: 35091180 PMCID: PMC9153984 DOI: 10.1016/j.physio.2021.10.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 09/30/2021] [Accepted: 10/11/2021] [Indexed: 12/23/2022]
Abstract
Background Objectives Eligibility Study appraisal and synthesis methods Results Limitations Conclusion and implications of key findings Systematic review registration number
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Hayotte M, Gioda J, d'Arripe-Longueville F. Effects and Acceptability of Technology-Based Physical Activity Interventions in Bariatric Surgery: a Scoping Review. Obes Surg 2022; 32:2445-2456. [PMID: 35501637 DOI: 10.1007/s11695-022-06049-1] [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: 09/07/2021] [Revised: 04/05/2022] [Accepted: 04/07/2022] [Indexed: 11/28/2022]
Abstract
The aim of this scoping review is to highlight current trends in the emerging field of technology-based physical activity interventions (TbPAI) in pre- and post-bariatric surgery. Original articles published between 2000 and 2020 on eHealth, bariatric surgery, and physical activity were identified through electronic searches of eight databases. Screening, data extraction, and charting were performed independently by two authors and disagreements were resolved by consensus. Nine full-text articles were included in this review. The studies reported that the physical activity outcomes had improved and the interventions were positively perceived by the target population. We highlight some consistent findings, as well as knowledge gaps, and suggest how future studies could be improved.
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Flore G, Preti A, Carta MG, Deledda A, Fosci M, Nardi AE, Loviselli A, Velluzzi F. Weight Maintenance after Dietary Weight Loss: Systematic Review and Meta-Analysis on the Effectiveness of Behavioural Intensive Intervention. Nutrients 2022; 14:nu14061259. [PMID: 35334917 PMCID: PMC8953094 DOI: 10.3390/nu14061259] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 03/07/2022] [Accepted: 03/14/2022] [Indexed: 02/04/2023] Open
Abstract
After a low-calorie diet, only 25% of patients succeed in maintaining the result of weight loss for a long time. This systematic review and meta-analysis aims to explore whether patients undergoing intensive intervention during the maintenance phase have a greater preservation of the weight achieved during the previous slimming phase than controls. A bibliographic search was conducted using PubMed, Scopus, and Cochrane databases for clinical trials and randomised, controlled trials investigating the role of choice in weight-loss-maintenance strategies. Only studies with a follow-up of at least 12 months were considered. A total of eight studies, for a total of 1454 patients, was identified, each comparing a group that followed a more intensive protocol to a control group. Our metanalysis highlighted that an intensive approach even in the maintenance phase could be important to ensure greater success in the phase following the weight-loss period. However, it should be pointed out that the improvement was not so different from the trend of the respective controls, with a non-statistically significant mean difference of the effect size (0.087; 95% CI −0.016 to 0.190 p = 0.098). This finding, along with the observation of a weight regain in half of the selected studies, suggests this is a long work that has to be started within the weight-loss phase and reinforced during the maintenance phase. The problem of weight control in patients with obesity should be understood as a process of education to a healthy lifestyle and a balanced diet to be integrated in the context of a multidisciplinary approach.
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Affiliation(s)
- Giovanna Flore
- Obesity Unit, Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy; (A.D.); (M.F.); (A.L.); (F.V.)
- Correspondence: ; Tel.: +39-070-6754230
| | - Antonio Preti
- Department of Neuroscience, University of Turin, 10124 Torino, Italy;
| | - Mauro Giovanni Carta
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy;
| | - Andrea Deledda
- Obesity Unit, Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy; (A.D.); (M.F.); (A.L.); (F.V.)
| | - Michele Fosci
- Obesity Unit, Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy; (A.D.); (M.F.); (A.L.); (F.V.)
| | - Antonio Egidio Nardi
- Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-901, Brazil;
| | - Andrea Loviselli
- Obesity Unit, Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy; (A.D.); (M.F.); (A.L.); (F.V.)
| | - Fernanda Velluzzi
- Obesity Unit, Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy; (A.D.); (M.F.); (A.L.); (F.V.)
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Boppre G, Diniz‐Sousa F, Veras L, Oliveira J, Fonseca H. Can exercise promote additional benefits on body composition in patients with obesity after bariatric surgery? A systematic review and meta-analysis of randomized controlled trials. Obes Sci Pract 2022; 8:112-123. [PMID: 35127127 PMCID: PMC8804945 DOI: 10.1002/osp4.542] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 06/04/2021] [Accepted: 06/15/2021] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Bariatric surgery is the most effective treatment for patients with severe obesity, but success rates vary substantially. Exercise is recommended after bariatric surgery to reduce weight regain but the effectiveness remains undetermined on weight loss due to conflicting results. It is also unclear what should be the optimal exercise prescription for these patients. A systematic review and meta-analysis of randomized controlled trials on the effects of exercise on body weight (BW), anthropometric measures, and body composition after bariatric surgery was performed. METHODS PubMed/MEDLINE®, EBSCO®, Web of Science® and Scopus® databases were searched to identify studies evaluating exercise effectiveness. RESULTS The analysis comprised 10 studies (n = 487 participants). Exercise favored BW (-2.51kg; p = 0.02), waist circumference (-4.14cm; p = 0.04) and body mass index (-0.84kg·m-2; p = 0.02) reduction but no improvements in body composition. Combined exercise interventions were the most effective in reducing BW (-5.50kg; p < 0.01) and body mass index (-1.86kg·m-2; p < 0.01). Interventions starting >6-months after bariatric surgery were more successful in reducing BW (-5.02kg; p < 0.01) and body mass index (-1.62kg·m-2; p < 0.01). CONCLUSION Exercise, combined exercise regimens and interventions starting >6-months after bariatric surgery were effective in promoting BW, waist circumference and body mass index reduction. Exercise following bariatric surgery does not seem to favor body composition improvements.
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Affiliation(s)
- Giorjines Boppre
- Research Center in Physical ActivityHealth and Leisure (CIAFEL)Faculty of SportUniversity of PortoPortoPortugal
- Laboratory for Integrative and Translational Research in Population Health (ITR)PortoPortugal
| | - Florêncio Diniz‐Sousa
- Research Center in Physical ActivityHealth and Leisure (CIAFEL)Faculty of SportUniversity of PortoPortoPortugal
- Laboratory for Integrative and Translational Research in Population Health (ITR)PortoPortugal
| | - Lucas Veras
- Research Center in Physical ActivityHealth and Leisure (CIAFEL)Faculty of SportUniversity of PortoPortoPortugal
- Laboratory for Integrative and Translational Research in Population Health (ITR)PortoPortugal
| | - José Oliveira
- Research Center in Physical ActivityHealth and Leisure (CIAFEL)Faculty of SportUniversity of PortoPortoPortugal
- Laboratory for Integrative and Translational Research in Population Health (ITR)PortoPortugal
| | - Hélder Fonseca
- Research Center in Physical ActivityHealth and Leisure (CIAFEL)Faculty of SportUniversity of PortoPortoPortugal
- Laboratory for Integrative and Translational Research in Population Health (ITR)PortoPortugal
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Schurmans G, Caty G, Reychler G. Is the Peri-Bariatric Surgery Exercise Program Effective in Adults with Obesity: a Systematic Review. Obes Surg 2022; 32:512-535. [PMID: 34981321 DOI: 10.1007/s11695-021-05693-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 08/25/2021] [Accepted: 08/29/2021] [Indexed: 11/30/2022]
Abstract
The number of people with obesity continues to increase. Bariatric surgery is the most effective treatment for severe obesity. However, this surgery also has disadvantages, such as an increased risk of excessive loss of fat-free mass, lean body mass, and muscle mass compared to other weight loss interventions. PubMed and Cochrane Library database including articles in English, Dutch, French, and German were used. From the 3609 retrieved references, 20 articles were selected. Compared with the control group, physical exercise improved body mass index (5 of 13 articles), weight loss (7 of 17 articles), functional capacity (2 of 5 articles), muscle strength (1 of 1 article), fat-free mass (3 of 5 articles), cardiorespiratory endurance (4 of 6 articles), and quality of life (2 of 4 articles) in obese patients undergoing BS. Current data is suggestive of positive effects of exercise on body mass index, weight loss, functional capacity, muscle strength, fat-free mass, cardiorespiratory endurance, and quality of life in obese patients undergoing bariatric surgery. However, our conclusions are limited because of the heterogeneity of programs and short studies. Further research is needed to determine the most effective physical exercise program in peri-bariatric surgery.
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Affiliation(s)
- Gaëlle Schurmans
- Institut de Recherche Expérimentale et Clinique (IREC), Groupe de Recherche en Kinésithérapie Respiratoire, Université Catholique de Louvain, 1200, Brussels, Belgium.
| | - Gilles Caty
- Service de Médecine Physique, Centre Hospitalier Wallonie Picarde (CHWAPI), Avenue Delmée 9, 7500, Tournai, Belgium
| | - Gregory Reychler
- Institut de Recherche Expérimentale et Clinique (IREC), Groupe de Recherche en Kinésithérapie Respiratoire, Université Catholique de Louvain, 1200, Brussels, Belgium.,Service de Pneumologie, Cliniques Universitaires Saint-Luc, 1200, Brussels, Belgium.,Cliniques Universitaires Saint-Luc, Secteur de kinésithérapie, 1200, Brussels, Belgium
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Oliveira GS, Vieira FT, Lamarca F, Lima RM, Carvalho KMB, Dutra ES. Resistance Training Improves Muscle Strength and Function, Regardless of Protein Supplementation, in the Mid- to Long-Term Period after Gastric Bypass. Nutrients 2021; 14:14. [PMID: 35010889 PMCID: PMC8746810 DOI: 10.3390/nu14010014] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Revised: 12/05/2021] [Accepted: 12/08/2021] [Indexed: 11/17/2022] Open
Abstract
Inadequate protein intake and low levels of physical activity are common long-term sequelae after bariatric surgery and can negatively affect muscle strength (MS) and physical function (PF). The study investigated the effects of resistance training with or without protein supplementation on MS and PF. The study, which involved a 12-week controlled trial (n = 61) of individuals 2-7 years post-Roux-en-Y gastric bypass (RYGB), comprised four groups: whey protein supplementation (PRO; n = 18), maltodextrin placebo (control [CON]; n = 17), resistance training combined with placebo (RTP; n = 11), and resistance training combined with whey protein supplementation (RTP+PRO; n = 15). An isokinetic dynamometer was used to measure MS (peak torque at 60°/s and 180°/s). PF was measured with the 30-s sit-to-stand (30-STS), 6-min walk (6-MWT), and timed up-and-go (TUG) tests. There were improvements in the absolute and relative-to-bodyweight peak torque at 60°/s and 180°/s, TUG, 6-MWT and 30-STS in the RTP and RTP+PRO groups, but not in the CON and PRO groups. Changes in MS were significantly correlated with changes in PF between the pre- and post-intervention periods. A supervised resistance training program, regardless of protein supplementation, improved MS and PF in the mid-to-long-term period after RYGB and can lead to clinical benefits and improved quality of life.
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Affiliation(s)
- Gabriela S. Oliveira
- Graduate Program in Human Nutrition, University of Brasília, Brasília 70910-900, Brazil; (G.S.O.); (F.T.V.); (F.L.); (R.M.L.); (K.M.B.C.)
| | - Flávio T. Vieira
- Graduate Program in Human Nutrition, University of Brasília, Brasília 70910-900, Brazil; (G.S.O.); (F.T.V.); (F.L.); (R.M.L.); (K.M.B.C.)
| | - Fernando Lamarca
- Graduate Program in Human Nutrition, University of Brasília, Brasília 70910-900, Brazil; (G.S.O.); (F.T.V.); (F.L.); (R.M.L.); (K.M.B.C.)
- Department of Applied Nutrition, Federal University of the State of Rio de Janeiro, Rio de Janeiro 22290-240, Brazil
| | - Ricardo M. Lima
- Graduate Program in Human Nutrition, University of Brasília, Brasília 70910-900, Brazil; (G.S.O.); (F.T.V.); (F.L.); (R.M.L.); (K.M.B.C.)
- Graduate Program in Physical Education, University of Brasília, Brasília 70910-900, Brazil
| | - Kênia M. B. Carvalho
- Graduate Program in Human Nutrition, University of Brasília, Brasília 70910-900, Brazil; (G.S.O.); (F.T.V.); (F.L.); (R.M.L.); (K.M.B.C.)
| | - Eliane S. Dutra
- Graduate Program in Human Nutrition, University of Brasília, Brasília 70910-900, Brazil; (G.S.O.); (F.T.V.); (F.L.); (R.M.L.); (K.M.B.C.)
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12
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Klasnja P, Rosenberg DE, Zhou J, Anau J, Gupta A, Arterburn DE. A quality-improvement optimization pilot of BariFit, a mobile health intervention to promote physical activity after bariatric surgery. Transl Behav Med 2021; 11:530-539. [PMID: 32421187 DOI: 10.1093/tbm/ibaa040] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Bariatric surgery is the most effective treatment for severe obesity (body mass index >40), helping individuals lose, on average, 25%-29% of their body weight over the first year. However, many patients begin to plateau and regain weight within 12-24 months, and 20% of patients begin to regain weight within 6 months postsurgery. As physical activity (PA) is an important predictor of weight loss and maintenance postsurgery, there is a need for scalable, effective lifestyle interventions to help bariatric patients increase PA in order to maximize their weight loss and maintenance. To assess feasibility of using mobile health (mHealth) tools to support PA postsurgery, we conducted a quality-improvement optimization pilot of BariFit, an mHealth intervention that combines commercial devices and custom text messages. Fifty-one bariatric patients enrolled in a 16-week optimization pilot of BariFit. To assess feasibility, pre-post changes in PA were assessed using activPAL. In addition, the pilot randomized, using a 2 × 2 factorial design, two adaptive approaches to daily step goals (variable and 60th percentile goals) and provision of rest days (yes/no), and microrandomized provision of SMS-delivered activity suggestions five times a day for each participant. Adherence to using study equipment was over 95% at 16 weeks. Participants increased PA by 1,866 steps from baseline to end-of-study (p < .007). Participants who received variable step goals averaged 1,141 more steps per day (p = .096) than those who received 60th percentile goals. Activity suggestions had no effect. mHealth interventions are feasible for supporting PA postbariatric surgery.
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Affiliation(s)
- Predrag Klasnja
- Kaiser Permanente Washington Health Research Institute, Seattle WA, USA.,School of Information, University of Michigan, Ann Arbor, MI, USA
| | - Dori E Rosenberg
- Kaiser Permanente Washington Health Research Institute, Seattle WA, USA
| | - Jing Zhou
- Kaiser Permanente Washington Health Research Institute, Seattle WA, USA
| | - Jane Anau
- Kaiser Permanente Washington Health Research Institute, Seattle WA, USA
| | - Anirban Gupta
- Bariatric Surgery Program, Kaiser Permanente Bellevue, Seattle, WA, USA
| | - David E Arterburn
- Kaiser Permanente Washington Health Research Institute, Seattle WA, USA
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13
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Ren Z, Zhu H, Zhang T, Hua H, Zhao K, Yang N, Liang H, Xu Q. Effects of a 12-Week Transtheoretical Model-Based Exercise Training Program in Chinese Postoperative Bariatric Patients: a Randomized Controlled Trial. Obes Surg 2021; 31:4436-4451. [PMID: 34373988 DOI: 10.1007/s11695-021-05607-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 07/11/2021] [Accepted: 07/16/2021] [Indexed: 02/07/2023]
Abstract
PURPOSE This study aims to investigate the effectiveness of the transtheoretical model (TTM)-based exercise training on TTM variables, exercise adherence, and physical function in patients in the early stages after bariatric surgery (BS). MATERIALS AND METHODS We conducted a single-blinded, prospective, randomized controlled trial (RCT) to evaluate the effects of TTM-based exercise training on BS patients immediately after surgery. Participants (n = 120) were randomized into a TTM-based exercise training group (n = 60) and a control group (n = 60). Main outcomes included TTM variables (measured by exercise stages of change (ESCs), exercise self-efficacy (ESE), and decisional balance), exercise adherence, and physical function (determined by the 6-min walk distance (6MWD)). Secondary outcomes were physical activity, anthropometrics, and body composition. We performed all analyses in accordance with the intention-to-treat principle. RESULTS Retention rates for the interventions were 91.7% for the intervention group and 90.0% for the control group. Compared with the control group, the 12-week TTM-based intervention significantly helped participants advance through ESCs, demonstrate higher ESE, perceive more benefits and fewer barriers to exercise, and show higher exercise adherence and better physical function afterward (all P < 0.05). However, we observed no statistically significant difference between the two groups in anthropometric parameters or body composition after intervention. CONCLUSION The TTM-based exercise intervention had significant positive effects on the TTM variables, which could further help increase patients' exercise adherence and physical function immediately after BS. TRIAL REGISTRATION This study was retrospectively registered at the Chinese Clinical Trial Registry (website: www.chictr.org.cn , registry number: ChiCTR2000039319).
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Affiliation(s)
- Ziqi Ren
- School of Nursing, Nanjing Medical University, 818 Tianyuan East Road, Jiangning District, Nanjing, 210029, Jiangsu, China.,School of Nursing, Fudan University, Shanghai, 200032, China
| | - Hanfei Zhu
- School of Nursing, Nanjing Medical University, 818 Tianyuan East Road, Jiangning District, Nanjing, 210029, Jiangsu, China
| | - Tianzi Zhang
- Department of Nursing, Jiangsu College of Nursing, Huai'an, 223000, Jiangsu, China
| | - Hongxia Hua
- Department of Bariatric and Metabolic Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Kang Zhao
- School of Nursing, Nanjing Medical University, 818 Tianyuan East Road, Jiangning District, Nanjing, 210029, Jiangsu, China
| | - Ningli Yang
- Department of Bariatric and Metabolic Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Hui Liang
- Department of Bariatric and Metabolic Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Qin Xu
- School of Nursing, Nanjing Medical University, 818 Tianyuan East Road, Jiangning District, Nanjing, 210029, Jiangsu, China.
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14
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Bellicha A, van Baak MA, Battista F, Beaulieu K, Blundell JE, Busetto L, Carraça EV, Dicker D, Encantado J, Ermolao A, Farpour-Lambert N, Pramono A, Woodward E, Oppert JM. Effect of exercise training before and after bariatric surgery: A systematic review and meta-analysis. Obes Rev 2021; 22 Suppl 4:e13296. [PMID: 34080281 PMCID: PMC8365633 DOI: 10.1111/obr.13296] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 05/13/2021] [Accepted: 05/15/2021] [Indexed: 12/21/2022]
Abstract
We aimed to assess the effectiveness of exercise training programs in adults with severe obesity undergoing bariatric surgery. A systematic search of controlled trials published up to October 2019 that assigned participants to either a preoperative or postoperative exercise training group or a nonexercise group was performed. Meta-analyses were conducted using random-effects models. Twenty-two training programs were assessed (18 performed after bariatric surgery). The effect of preoperative exercise training on postsurgery outcomes was reported in only one study. Compared with the control condition without exercise, postoperative exercise training led to higher weight loss (N = 14, mean difference [95% CI] = -1.8 [-3.2; -0.4] kg, P = 0.01), fat loss (N = 9, P = 0.01), increase in VO2 max (N = 8, P < 0.0001), and increase in muscle strength (N = 9, P < 0.0001). No significant effect was found on lean body mass (N = 11). Preliminary evidence suggests a beneficial effect of postoperative exercise training on bone mineral density (N = 3, P < 0.001) and weight maintenance after the end of the intervention (N = 2, P < 0.001) but no significant effect on quality of life (N = 2), habitual physical activity (N = 2), or cardiometabolic outcomes (N < 4). In conclusion, exercise training performed after bariatric surgery improves physical fitness and leads to a small additional weight and fat loss and may prevent bone loss and weight regain after bariatric surgery.
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Affiliation(s)
- Alice Bellicha
- INSERM, Nutrition and Obesities: Systemic Approaches, NutriOmics, Sorbonne University, Paris, France.,UFR SESS-STAPS, University Paris-Est Créteil, Créteil, France
| | - Marleen A van Baak
- NUTRIM School of Nutrition and Translational Research in Metabolism, Department of Human Biology, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Francesca Battista
- Sport and Exercise Medicine Division, Department of Medicine, University of Padova, Padua, Italy
| | - Kristine Beaulieu
- Appetite Control and Energy Balance Group (ACEB), School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - John E Blundell
- Appetite Control and Energy Balance Group (ACEB), School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Luca Busetto
- Obesity Management Task Force (OMTF), European Association for the Study of obesity (EASO), London, UK.,Department of Medicine, University of Padova, Padova, Italy
| | - Eliana V Carraça
- CIDEFES, Faculdade de Educação Física e Desport, Universidade Lusófona de Humanidades e Tecnologias, Lisbon, Portugal
| | - Dror Dicker
- Obesity Management Task Force (OMTF), European Association for the Study of obesity (EASO), London, UK.,Department of Internal Medicine, Hasharon Hospital, Rabin Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Jorge Encantado
- APPsyCI - Applied Psychology Research Center Capabilities & Inclusion, ISPA - University Institute, Lisbon, Portugal
| | - Andrea Ermolao
- Sport and Exercise Medicine Division, Department of Medicine, University of Padova, Padua, Italy
| | - Nathalie Farpour-Lambert
- Obesity Management Task Force (OMTF), European Association for the Study of obesity (EASO), London, UK.,Obesity Prevention and Care Program Contrepoids, Service of Endocrinology, Diabetology, Nutrition and Patient Education, Department of Internal Medicine, University Hospitals of Geneva and University of Geneva, Geneva, Switzerland
| | - Adriyan Pramono
- NUTRIM School of Nutrition and Translational Research in Metabolism, Department of Human Biology, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Euan Woodward
- Obesity Management Task Force (OMTF), European Association for the Study of obesity (EASO), London, UK
| | - Jean-Michel Oppert
- Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié-Salpêtrière Hospital, Department of Nutrition, Institute of Cardiometabolism and Nutrition, Sorbonne University, Paris, France
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15
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Cornejo-Pareja I, Molina-Vega M, Gómez-Pérez AM, Damas-Fuentes M, Tinahones FJ. Factors Related to Weight Loss Maintenance in the Medium-Long Term after Bariatric Surgery: A Review. J Clin Med 2021; 10:jcm10081739. [PMID: 33923789 PMCID: PMC8073104 DOI: 10.3390/jcm10081739] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 03/27/2021] [Accepted: 04/09/2021] [Indexed: 12/15/2022] Open
Abstract
Despite bariatric surgery being the most effective treatment for obesity, some individuals do not respond adequately, especially in the long term. Identifying the predictors of correct weight maintenance in the medium (from 1 to 3 years after surgery) and long term (from 3 years and above) is of vital importance to reduce failure after bariatric surgery; therefore, we summarize the evidence about certain factors, among which we highlight surgical technique, psychological factors, physical activity, adherence to diet, gastrointestinal hormones or neurological factors related to appetite control. We conducted a search in PubMed focused on the last five years (2015–2021). Main findings are as follows: despite Roux-en-Y gastric bypass being more effective in the long term, sleeve gastrectomy shows a more beneficial effectiveness–complications balance; pre-surgical psychological and behavioral evaluation along with post-surgical treatment improve long-term surgical outcomes; physical activity programs after bariatric surgery, in addition to continuous and comprehensive care interventions regarding diet habits, improve weight loss maintenance, but it is necessary to improve adherence; the impact of bariatric surgery on the gut–brain axis seems to influence weight maintenance. In conclusion, although interesting findings exist, the evidence is contradictory in some places, and long-term clinical trials are necessary to draw more robust conclusions.
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Affiliation(s)
- Isabel Cornejo-Pareja
- Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, 29010 Málaga, Spain; (I.C.-P.); (M.D.-F.); (F.J.T.)
- Instituto de Investigación Biomédica de Málaga (IBIMA), Virgen de la Victoria University Hospital, 29010 Málaga, Spain
- Centro de Investigación Biomédica en Red de la Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - María Molina-Vega
- Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, 29010 Málaga, Spain; (I.C.-P.); (M.D.-F.); (F.J.T.)
- Instituto de Investigación Biomédica de Málaga (IBIMA), Virgen de la Victoria University Hospital, 29010 Málaga, Spain
- Correspondence: (M.M.-V.); (A.M.G.-P.); Tel.: +34-95-1034-044 (M.M.-V. & A.M.G.-P.)
| | - Ana María Gómez-Pérez
- Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, 29010 Málaga, Spain; (I.C.-P.); (M.D.-F.); (F.J.T.)
- Instituto de Investigación Biomédica de Málaga (IBIMA), Virgen de la Victoria University Hospital, 29010 Málaga, Spain
- Correspondence: (M.M.-V.); (A.M.G.-P.); Tel.: +34-95-1034-044 (M.M.-V. & A.M.G.-P.)
| | - Miguel Damas-Fuentes
- Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, 29010 Málaga, Spain; (I.C.-P.); (M.D.-F.); (F.J.T.)
- Instituto de Investigación Biomédica de Málaga (IBIMA), Virgen de la Victoria University Hospital, 29010 Málaga, Spain
| | - Francisco J. Tinahones
- Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, 29010 Málaga, Spain; (I.C.-P.); (M.D.-F.); (F.J.T.)
- Instituto de Investigación Biomédica de Málaga (IBIMA), Virgen de la Victoria University Hospital, 29010 Málaga, Spain
- Centro de Investigación Biomédica en Red de la Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, 28029 Madrid, Spain
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16
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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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17
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Herrera-Santelices A, Tabach-Apraiz A, Andaur-Cáceres K, Zamunér AR. Effect of physical exercise in bariatric surgery patients: protocol of a randomized controlled clinical trial. Trials 2021; 22:107. [PMID: 33522950 PMCID: PMC7849097 DOI: 10.1186/s13063-021-05056-4] [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: 04/27/2020] [Accepted: 01/20/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Bariatric surgery is an effective approach to weight loss and long-term comorbidity resolution. Although recommended in several guidelines, supervised exercise has not been systematically prescribed after bariatric surgery. The aim of this study is to determine the effects of two types of exercise, moderate-intensity continuous training (MICT) and high-intensity interval training (HIIT), on body composition, cardiopulmonary function, and perceived quality of life in bariatric surgery patients. METHODS This randomized controlled exploratory pilot trial will include 75 adults of both sexes scheduled for bariatric surgery. They will be randomly assigned to one of three groups: (1) MICT, (2) HIIT, or (3) a control group. The intervention will occur 2 days a week for 4 months. Outcomes will be assessed at four points: (1) 1 week before surgery, (2) 21 days after surgery (baseline before the exercise program), (3) 8 weeks after beginning the exercise program, and (4) 1 week after the end of intervention. Primary outcomes will include body composition, heart rate variability, and 6-min walk test and quality of life scores. Secondary outcomes will be maximal respiratory pressure, flowmeter, hand dynamometry, and 30-s sit-to-stand test results. DISCUSSION Both exercise protocols in this study were developed according to evidence-based practice. It is expected that, after 16 weeks of intervention, body composition (measured by electrical bioimpedance), cardiopulmonary function (measured by heart rate variability, maximal inspiratory pressure, maximal expiratory pressure, peak expiratory flow, handgrip strength, and the 6-min walk test), and perceived quality of life (measured by the Moorehead-Ardelt quality of life questionnaire II and bariatric analysis and reporting outcome system scores) will improve, especially in the HIIT group. TRIAL REGISTRATION ClinicalTrials.gov NCT04235842 . Registered on 22 January 2020.
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Affiliation(s)
- Andrea Herrera-Santelices
- Department of Physical Medicine and Rehabilitation, San Juan de Dios Hospital, Curicó, Chile.,Laboratory of Clinical Research in Kinesiology, Department of Kinesiology, Universidad Católica del Maule, Talca, Chile
| | - Andrea Tabach-Apraiz
- Department of Physical Medicine and Rehabilitation, San Juan de Dios Hospital, Curicó, Chile
| | | | - Antonio Roberto Zamunér
- Laboratory of Clinical Research in Kinesiology, Department of Kinesiology, Universidad Católica del Maule, Talca, Chile.
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18
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In G, Taskin HE, Al M, Alptekin HK, Zengin K, Yumuk V, Ikitimur B. Comparison of 12-Week Fitness Protocols Following Bariatric Surgery: Aerobic Exercise Versus Aerobic Exercise and Progressive Resistance. Obes Surg 2021; 31:1475-1484. [PMID: 33409974 DOI: 10.1007/s11695-020-05144-5] [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: 06/04/2020] [Revised: 11/19/2020] [Accepted: 12/02/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Successful bariatric surgery outcomes are better maintained with an exercise program. This pilot study compared the effects on short-term functional capacity and body composition of 2 post-bariatric surgery home-based programs: aerobic exercise alone versus aerobic exercise combined with progressive resistance conditioning. METHODS Laboratory measures and self-assessments of post-bariatric surgery patients (BMI ≥ 30 kg/m2) undergoing either aerobic exercise (AE group) or aerobic + progressive-resistance exercise (AEPR group) were compared at postoperative months 1 and 3. Anthropometric characteristic changes were recorded, as well as changes in functional capacity (e.g., 6-min walking test), muscle strength (e.g., hand grip strength test; five-times-sit-to-stand test), and quality of life (i.e., Beck Depression Inventory). RESULTS Between July 2018 and March 2019, 35 patients completed the AE (n = 17) or AEPR (n = 18) program. The AEPR group lost statistically significantly more weight (mean 2.2 kg) relative to baseline than the AE group (p < 0.05). The AEPR group achieved significantly greater mean total muscle, liquid, and bone mass; upper-extremity muscle strength; uric acid levels; body fat loss; and performed better on the 6-min walking test (all p < 0.05). In month 3, the AEPR group achieved a greater mean walking distance (p = 0.029) and O2 saturation related to dyspnea (p = 0.001) than the AE group. Group quality of life scores were comparable. CONCLUSIONS In a comparative 12-week post-bariatric surgery study, both aerobic exercise alone and aerobic exercise plus progressive-resistance training were positively correlated with general health improvement. However, the progressive-resistance regimen resulted in significantly greater weight loss, functional capacity, muscle mass, and upper-body strength.
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Affiliation(s)
- Gozde In
- School of Health Sciences, Bahçeşehir University, Istanbul, Turkey
| | - Halit Eren Taskin
- Cerrahpasa Medical Faculty, Department of Surgery, Istanbul University Cerrahpasa, Istanbul, Turkey.
| | - Muzaffer Al
- Faculty of Medicine, Department of Surgery, Near East University, Nicosia, Cyprus
| | | | - Kagan Zengin
- Cerrahpasa Medical Faculty, Department of Surgery, Istanbul University Cerrahpasa, Istanbul, Turkey
| | - Volkan Yumuk
- Cerrahpasa Medical Faculty, Department of Endocrinology and Metabolism, Istanbul University Cerrahpasa, Istanbul, Turkey
| | - Baris Ikitimur
- Cerrahpasa Medical Faculty, Department of Cardiology, Istanbul University Cerrahpasa, Istanbul, Turkey
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19
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Robinson A, Husband AK, Slight RD, Slight SP. Digital technology to support lifestyle and health behaviour changes in surgical patients: systematic review. BJS Open 2020; 5:6054048. [PMID: 33688953 PMCID: PMC7944850 DOI: 10.1093/bjsopen/zraa009] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 06/10/2020] [Accepted: 08/23/2020] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Digital technologies (such as smartphone applications, activity trackers, and e-learning platforms) have supported patients with long-term conditions to change their lifestyle health behaviours. The aim of this study was to examine the effectiveness of digital technologies in supporting patients undergoing elective surgery to change their health behaviours. METHODS A systematic review was conducted of articles reporting a digital intervention supporting behaviour change in adult patients who underwent elective bariatric, oncological or orthopaedic surgery. MEDLINE, Embase, CINAHL, PsycINFO, Web of Science, and Scopus were searched from inception to March 2019 for quantitative intervention studies with a specific focus on physical activity, dietary intake, and weight loss in patients before and after surgery (PROSPERO: CRD42019127972). The Joanna Briggs Institute critical appraisal checklist was used to assess study quality. RESULTS Of 3021 citations screened, 17 studies were included comprising 4923 surgical patients; these included experimental (pre-post design, feasibility studies, and RCTs) and observational studies. Three factors were identified as effective for supporting health behaviour change in elective surgical populations: digital technology delivery, implementation, and theoretical underpinning. Six of eight studies that referred to behaviour change theories observed significant improvements in health behaviour relating to reduced weight regain, and improved lifestyle choices for physical activity and diet. Meta-analysis was not possible because of heterogeneous outcome measures. CONCLUSION Digital technologies may effectively support behavioural change in patients undergoing elective surgery.
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Affiliation(s)
- A Robinson
- School of Pharmacy, Newcastle University, Newcastle upon Tyne, UK
| | - A K Husband
- School of Pharmacy, Newcastle University, Newcastle upon Tyne, UK
| | - R D Slight
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - S P Slight
- School of Pharmacy, Newcastle University, Newcastle upon Tyne, UK.,Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
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20
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Robinson A, Husband AK, Slight RD, Slight SP. Digital Support for Patients Undergoing Bariatric Surgery: Narrative Review of the Roles and Challenges of Online Forums. JMIR Perioper Med 2020; 3:e17230. [PMID: 33393926 PMCID: PMC7709839 DOI: 10.2196/17230] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 06/15/2020] [Accepted: 06/15/2020] [Indexed: 12/11/2022] Open
Abstract
Background The internet has become an important medium within health care, giving patients the opportunity to search for information, guidance, and support to manage their health and well-being needs. Online forums and internet-based platforms appear to have changed the way many patients undergoing bariatric surgery view and engage with their health, before and after weight loss surgery. Given that significant health improvements result from sustained weight loss, ensuring patient adherence to recommended preoperative and postoperative guidance is critical for bariatric surgery success. In a patient cohort with high information needs preoperatively, and notoriously high attrition rates postoperatively, online forums may present an underutilized method of support. Objective The aim of this study was to conduct a narrative review focusing on the developing roles that online forums can play for patients with bariatric conditions preoperatively and postoperatively. Methods A literature search was conducted in October-November 2019 across 5 electronic databases: Scopus, EMBASE, PsycINFO, CINAHL, and MEDLINE. Qualitative or mixed methods studies were included if they evaluated patients undergoing bariatric surgery (or bariatric surgery health care professionals) engaging with, using, or analyzing online discussion forums or social media platforms. Using thematic analysis, themes were developed from coding patterns within the data to identify the roles and challenges of online forums for patients undergoing bariatric surgery. Results A total of 8 studies were included in this review, with 5 themes emerging around (1) managing expectations of a new life; (2) decision making and signposting; (3) supporting information seeking; (4) facilitating connectedness: peer-to-peer social and emotional support; and (5) enabling accessibility and connectivity with health care professionals. Conclusions Online forums could offer one solution to improving postoperative success by supporting and motivating patients. Future research should consider how best to design and moderate online forums for maximal effectiveness and the sharing of accurate information. The surgical multidisciplinary team may consider recommendations of online peer-support networks to complement care for patients throughout their surgical journey.
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Affiliation(s)
- Anna Robinson
- School of Pharmacy, Institute of Population Health Sciences, Newcastle University, Newcastle Upon Tyne, United Kingdom
| | - Andrew K Husband
- School of Pharmacy, Institute of Population Health Sciences, Newcastle University, Newcastle Upon Tyne, United Kingdom
| | - Robert D Slight
- Institute of Population Health Sciences, Newcastle University, Newcastle Upon Tyne, United Kingdom
| | - Sarah P Slight
- School of Pharmacy, Institute of Population Health Sciences, Newcastle University, Newcastle Upon Tyne, United Kingdom
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21
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Morledge MD, Pories WJ. Mental Health in Bariatric Surgery: Selection, Access, and Outcomes. Obesity (Silver Spring) 2020; 28:689-695. [PMID: 32202073 DOI: 10.1002/oby.22752] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 01/07/2020] [Indexed: 12/11/2022]
Abstract
Severe obesity has many psychiatric consequences that can be influenced by bariatric surgery. The goal of this article is to review these challenges, including the mental health status of patients with severe obesity, the evaluation of surgical candidates, and the early and late effects of the operations, and to offer some recommendations to manage these challenges. The failure of the insurance-mandated preoperative psychosocial evaluation is also discussed.
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Affiliation(s)
- Michael D Morledge
- Department of Psychiatry and Behavioral Medicine, Brody School of Medicine, East Carolina University, Greenville, North Carolina, USA
| | - Walter J Pories
- Department of Surgery, Brody School of Medicine, East Carolina University, Greenville, North Carolina, USA
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22
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Civi Karaaslan T, Leblebici G, Ucgul MS, Yilmaz M, Kalayci MG, Kuran Aslan G. Exercise Program in Patients After Bariatric Surgery: A Systematic Review. Bariatr Surg Pract Patient Care 2020. [DOI: 10.1089/bari.2019.0048] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Affiliation(s)
- Tugba Civi Karaaslan
- Division of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Gokce Leblebici
- Division of Physiotherapy and Rehabilitation, Istanbul Medeniyet University, Istanbul, Turkey
- Department of Physiotherapy and Rehabilitation, Postgraduate Education Institute, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Merve Suay Ucgul
- Department of Physiotherapy and Rehabilitation, Postgraduate Education Institute, Istanbul University-Cerrahpasa, Istanbul, Turkey
- Health Directorate of Iskenderun, Physical Activity Consulting Department, Hatay, Turkey
| | - Mustafa Yilmaz
- Department of Physiotherapy and Rehabilitation, Postgraduate Education Institute, Istanbul University-Cerrahpasa, Istanbul, Turkey
- Sisli Kolan International Hospital, Orthopedics and Traumatology, Istanbul, Turkey
| | - Melike Gizem Kalayci
- Department of Physiotherapy and Rehabilitation, Postgraduate Education Institute, Istanbul University-Cerrahpasa, Istanbul, Turkey
- Physiotherapy Program, Avrupa Vocational School, Istanbul, Turkey
| | - Goksen Kuran Aslan
- Division of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Istanbul University-Cerrahpasa, Istanbul, Turkey
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23
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Robinson A, Slight R, Husband A, Slight S. The value of teachable moments in surgical patient care and the supportive role of digital technologies. Perioper Med (Lond) 2020; 9:2. [PMID: 32042404 PMCID: PMC6998815 DOI: 10.1186/s13741-019-0133-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Accepted: 12/16/2019] [Indexed: 12/01/2022] Open
Abstract
Evidence strongly supports improved outcomes following surgery when patients are more physically active, have better dietary intake, or are generally fitter prior to surgery. Having an operation is a major life event for patients, and many are not educated around what they can do as individuals to aid a speedier and more successful recovery following their operation. What if there was a time point before surgery where clinicians could inspire patients to adjust their lifestyles for the better, in order to see fewer complications after surgery? This is where the concept of teachable moments comes into play. This commentary explores the concept of teachable moments and their value in surgical patient care and discusses the potentially under-utilized opportunities on hand to the surgical multidisciplinary team to remotely support patients using digital health technologies.
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Affiliation(s)
- Anna Robinson
- 1School of Pharmacy, Newcastle University, King George VI Building, Newcastle upon Tyne, NE1 7RU UK
| | - Robert Slight
- 2Institute of Health and Society, Newcastle University, Baddiley Clark Building, Newcastle upon Tyne, UK.,3The Newcastle upon Tyne Hospitals NHS Foundation Trust, Queen Victoria Road, Newcastle upon Tyne, NE1 4LP UK
| | - Andrew Husband
- 1School of Pharmacy, Newcastle University, King George VI Building, Newcastle upon Tyne, NE1 7RU UK
| | - Sarah Slight
- 1School of Pharmacy, Newcastle University, King George VI Building, Newcastle upon Tyne, NE1 7RU UK.,3The Newcastle upon Tyne Hospitals NHS Foundation Trust, Queen Victoria Road, Newcastle upon Tyne, NE1 4LP UK
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24
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Villa-González E, Barranco-Ruiz Y, Rodríguez-Pérez MA, Carretero-Ruiz A, García-Martínez JM, Hernández-Martínez A, Torrente-Sánchez MJ, Ferrer-Márquez M, Soriano-Maldonado A, Artero EG. Supervised exercise following bariatric surgery in morbid obese adults: CERT-based exercise study protocol of the EFIBAR randomised controlled trial. BMC Surg 2019; 19:127. [PMID: 31488115 PMCID: PMC6729089 DOI: 10.1186/s12893-019-0566-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 07/19/2019] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND There is increasing evidence of weight regain in patients after bariatric surgery (BS), generally occurring from 12 to 24 months postoperatively. Postoperative exercise has been suggested to ad long-term weight maintenance and to improve physical function in BS patients. However, there are a limited number of intervention studies investigating the possible benefits of exercise in this population. The aim of the current report is to provide a comprehensive CERT (Consensus on Exercise Reporting Template)-based description of the rationale and details of the exercise programme implemented in the EFIBAR Study (Ejercicio FÍsico tras cirugía BARiátrica), a randomised controlled trial investigating the effects of a 16-week supervised concurrent (aerobic and strength) exercise intervention program on weight loss (primary outcome), body composition, cardiometabolic risk, physical fitness, physical activity and quality of life (secondary outcomes) in patients with severe/morbid obesity following bariatric surgery. METHODS A total of 80 BS patients [60-80% expected women, aged 18 to 60 years, body mass index (BMI) ≥ 40 kg/m2 or ≥ 35 kg/m2 with comorbid conditions)] will be enrolled in the EFIBAR Randomized Control Trial (RCT). Participants allocated in the exercise group (n = 40) will undertake a 16-week supervised concurrent (strength and aerobic) exercise programme (three sessions/week, 60 min/session), starting 7 to 14 days after surgery. The rationale of the exercise programme will be described following the CERT criteria detailing the 16 key items. The study has been reviewed and approved by the Ethics Committee of the Torrecárdenas University Hospital (Almería, Spain) (ref. N° 76/2016). DISCUSSION The present study details the exercise programme of the EFIBAR RCT, which may serve: 1) exercise professionals who would like to implement an evidence-based exercise programme for BS patients, and 2) as an example of the application of the CERT criteria. TRIAL REGISTRATION The trial was prospectively registered at Clinicaltrials.gov NCT03497546 on April 13, 2018.
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Affiliation(s)
- Emilio Villa-González
- Department of Physical and Sports Education, PROFITH “PROmoting FITness and Health through Physical Activity” Research Group, Sport and Health University Research Institute (iMUDS), Faculty of Education and Sport Sciences, University of Granada, 52005 Melilla, Spain
| | - Yaira Barranco-Ruiz
- Department of Physical and Sports Education, PROFITH “PROmoting FITness and Health through Physical Activity” Research Group, Sport and Health University Research Institute (iMUDS), Faculty of Education and Sport Sciences, University of Granada, 52005 Melilla, Spain
| | - Manuel A. Rodríguez-Pérez
- Department of Education, Faculty of Education Sciences, University of Almería, Almería, Spain
- SPORT Research Group (CTS-1024), CERNEP Research Center, University of Almería, Almería, Spain
| | - Alejandro Carretero-Ruiz
- Department of Education, Faculty of Education Sciences, University of Almería, Almería, Spain
- SPORT Research Group (CTS-1024), CERNEP Research Center, University of Almería, Almería, Spain
| | - José María García-Martínez
- Department of Education, Faculty of Education Sciences, University of Almería, Almería, Spain
- SPORT Research Group (CTS-1024), CERNEP Research Center, University of Almería, Almería, Spain
| | - Alba Hernández-Martínez
- Department of Education, Faculty of Education Sciences, University of Almería, Almería, Spain
- SPORT Research Group (CTS-1024), CERNEP Research Center, University of Almería, Almería, Spain
| | | | - Manuel Ferrer-Márquez
- Hospital Mediterráneo, Almería, Spain
- Torrecárdenas University Hospital, Almería, Spain
| | - Alberto Soriano-Maldonado
- Department of Education, Faculty of Education Sciences, University of Almería, Almería, Spain
- SPORT Research Group (CTS-1024), CERNEP Research Center, University of Almería, Almería, Spain
| | - Enrique G. Artero
- Department of Education, Faculty of Education Sciences, University of Almería, Almería, Spain
- SPORT Research Group (CTS-1024), CERNEP Research Center, University of Almería, Almería, Spain
| | - On behalf of the EFIBAR Study Group
- Department of Physical and Sports Education, PROFITH “PROmoting FITness and Health through Physical Activity” Research Group, Sport and Health University Research Institute (iMUDS), Faculty of Education and Sport Sciences, University of Granada, 52005 Melilla, Spain
- Department of Education, Faculty of Education Sciences, University of Almería, Almería, Spain
- SPORT Research Group (CTS-1024), CERNEP Research Center, University of Almería, Almería, Spain
- Hospital Mediterráneo, Almería, Spain
- Torrecárdenas University Hospital, Almería, Spain
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25
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Noack Segovia JP, Sánchez López A, García-García I, Rodríguez-Blanque R, León Ríos XA, Aguilar Cordero MJ. Physical Exercise and Grip Strength in Patients Intervened through Bariatric Surgery. AQUICHAN 2019. [DOI: 10.5294/aqui.2019.19.3.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective: This work sought to evaluate a physical exercise program of moderate intensity in patients operated of bariatric surgery and its influence on muscle strength. Method: Randomized clinical trial, with an intervention group and a control group. Forty-three patients were operated of bariatric surgery. The intervention group was applied a program of moderate physical activity during six months. Grip strength and bioimpedance were measured at their baseline form, at one month, and six months after surgery. A bivariate study was conducted to observe variable changes. Results: Upon conducting Student´s t for independent samples in all the variables (weight, body mass index, grip strength, lean mass, fat mass, and metabolism), the result is that no significant differences exist between the intervention group and the control group with p > 0.05. Conclusion: A program of moderate physical activity lasting six months in patients intervened of bariatric surgery has no significant result in the development of muscle mass evaluated through manual dynamometry and bioimpedance.
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26
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Carretero-Ruiz A, Olvera-Porcel MDC, Cavero-Redondo I, Álvarez-Bueno C, Martínez-Vizcaíno V, Ferrer-Márquez M, Soriano-Maldonado A, Arter EG. Effects of Exercise Training on Weight Loss in Patients Who Have Undergone Bariatric Surgery: a Systematic Review and Meta-Analysis of Controlled Trials. Obes Surg 2019; 29:3371-3384. [DOI: 10.1007/s11695-019-04096-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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27
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Maggisano M, Maeda A, Okrainec A, Wnuk S, Sockalingam S, Jackson T. Physical activity and its association with psychosocial health following bariatric surgery. Appl Physiol Nutr Metab 2019; 44:1379-1382. [PMID: 31163111 DOI: 10.1139/apnm-2019-0040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Physical activity (PA) helps sustain weight loss and may also provide psychological benefits in patients undergoing bariatric surgery. Using a set of questionnaires, we demonstrated that bariatric patients with increased level of PA at 1-year follow-up had better psychosocial outcomes including depressive symptoms and mental health-related quality of life compared with those who had reduced or unchanged level of PA. Our findings indicate the benefit of incorporating PA in the postoperative care for bariatric patients. Novelty Postoperative behavioural change in terms of physical activity improves psychosocial health in patients undergoing bariatric surgery.
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Affiliation(s)
- Melinda Maggisano
- Department of Surgery, University of Toronto, Toronto, ON M5T 1P5, Canada
| | - Azusa Maeda
- Division of General Surgery, University Health Network, Toronto, ON M5G 2C4, Canada
| | - Allan Okrainec
- Department of Surgery, University of Toronto, Toronto, ON M5T 1P5, Canada.,Division of General Surgery, University Health Network, Toronto, ON M5G 2C4, Canada.,Bariatric Surgery Program, Toronto Western Hospital, Toronto, ON M5T 2S8, Canada
| | - Susan Wnuk
- Bariatric Surgery Program, Toronto Western Hospital, Toronto, ON M5T 2S8, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8, Canada
| | - Sanjeev Sockalingam
- Bariatric Surgery Program, Toronto Western Hospital, Toronto, ON M5T 2S8, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8, Canada.,Centre for Addiction and Mental Health, Toronto, ON M6J 1H1, Canada
| | - Timothy Jackson
- Department of Surgery, University of Toronto, Toronto, ON M5T 1P5, Canada.,Division of General Surgery, University Health Network, Toronto, ON M5G 2C4, Canada.,Bariatric Surgery Program, Toronto Western Hospital, Toronto, ON M5T 2S8, Canada
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28
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Coen PM, Carnero EA, Goodpaster BH. Exercise and Bariatric Surgery: An Effective Therapeutic Strategy. Exerc Sport Sci Rev 2018; 46:262-270. [PMID: 30052546 PMCID: PMC6147093 DOI: 10.1249/jes.0000000000000168] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Exercise is a clinically effective adjunct therapy with the potential to promote long-term weight loss maintenance for bariatric surgery patients. The long-term efficacy of bariatric surgery is not entirely clear, and weight regain and diabetes relapse are problems for some patients. Exercise is a feasible and clinically effective adjunct therapy for bariatric surgery patients. We hypothesize that exercise is also a critical factor for long-term weight loss maintenance and lasting remission of type 2 diabetes.
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Affiliation(s)
- Paul M Coen
- Translational Research Institute for Metabolism and Diabetes, Florida Hospital.,Sanford Burnham Prebys Medical Discovery Institute at Lake Nona, Orlando, FL
| | - Elvis A Carnero
- Translational Research Institute for Metabolism and Diabetes, Florida Hospital
| | - Bret H Goodpaster
- Translational Research Institute for Metabolism and Diabetes, Florida Hospital.,Sanford Burnham Prebys Medical Discovery Institute at Lake Nona, Orlando, FL
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29
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Bellicha A, Ciangura C, Poitou C, Portero P, Oppert JM. Effectiveness of exercise training after bariatric surgery-a systematic literature review and meta-analysis. Obes Rev 2018; 19:1544-1556. [PMID: 30156007 DOI: 10.1111/obr.12740] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 05/18/2018] [Accepted: 06/09/2018] [Indexed: 12/18/2022]
Abstract
We aimed to conduct a systematic review and meta-analysis of controlled trials assessing exercise training programs in patients with obesity undergoing bariatric surgery. We systematically searched exercise training studies performed after bariatric surgery published up to June 2017. Studies reporting changes in body composition, physical fitness, functional capacity, objectively measured physical activity, quality of life or relevant health outcomes were included. The review protocol is available from PROSPERO (CRD42017069380). Meta-analyses were conducted using random-effects models when data were available from at least five articles. Twenty articles were included, describing 16 exercise training programs, of which 15 were included in the meta-analysis. Overall, exercise training was associated with higher weight loss (mean difference: -2.4 kg, 95% CI: -4.2; -0.6, I2 = 49%, n = 12), higher fat mass loss (-2.7 kg, 95% CI: -4.5; -1.0, I2 = 50%, n = 8) and improved VO2 max and functional walking (standardized mean difference: 0.86, 95% CI: 0.29; 1.44, I2 = 57%, n = 6; 1.45, 95% CI: 0.32; 2.58, I2 = 89%, n = 6, respectively). Exercise training was not associated with lean body mass changes. In conclusion, exercise training programs performed after bariatric surgery were found effective to optimize weight loss and fat mass loss and to improve physical fitness, although no additional effect on lean body mass loss was found.
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Affiliation(s)
- A Bellicha
- Laboratory Bioengineering, Tissues and Neuroplasticity (BIOTN EA7377), University Paris-Est, Créteil, France.,Institute of Cardiometabolism and Nutrition (ICAN), Sorbonne University, Paris, France
| | - C Ciangura
- Institute of Cardiometabolism and Nutrition (ICAN), Sorbonne University, Paris, France.,AP-HP, Pitie-Salpetriere University Hospital, Department of Nutrition, Sorbonne University, Centre for Research on Human Nutrition Ile-de-France (CRNH IdF), Paris, France
| | - C Poitou
- Institute of Cardiometabolism and Nutrition (ICAN), Sorbonne University, Paris, France.,AP-HP, Pitie-Salpetriere University Hospital, Department of Nutrition, Sorbonne University, Centre for Research on Human Nutrition Ile-de-France (CRNH IdF), Paris, France.,INSERM, UMRS NutriOmics Team, Paris, France
| | - P Portero
- Laboratory Bioengineering, Tissues and Neuroplasticity (BIOTN EA7377), University Paris-Est, Créteil, France
| | - J-M Oppert
- Institute of Cardiometabolism and Nutrition (ICAN), Sorbonne University, Paris, France.,AP-HP, Pitie-Salpetriere University Hospital, Department of Nutrition, Sorbonne University, Centre for Research on Human Nutrition Ile-de-France (CRNH IdF), Paris, France
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30
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Ren ZQ, Lu GD, Zhang TZ, Xu Q. Effect of physical exercise on weight loss and physical function following bariatric surgery: a meta-analysis of randomised controlled trials. BMJ Open 2018; 8:e023208. [PMID: 30385445 PMCID: PMC6252776 DOI: 10.1136/bmjopen-2018-023208] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVES We performed a meta-analysis of all of the available randomised controlled trials (RCTs) to investigate whether physical exercise contributes to weight loss or physical function improvement in adults receiving bariatric surgery. METHODS We searched PubMed, Embase, the Cochrane Library, OVID and the CINAHL up through May 2018. RCTs that assigned adults with obesity to either an exercise training group or a no-exercise group after bariatric surgery were included. The primary outcomes were weight loss and physical function. Study bias was assessed using the Cochrane risk of bias tool, and the quality of evidence was assessed using GRADEpro. RESULTS A total of eight studies met the inclusion criteria (n=347 participants). Most of the studies carried a low risk of bias due to randomisation and blinding. Compared with those without exercise intervention after surgery, patients engaging in physical exercise were associated with greater weight loss (weighted mean difference (WMD) -1.94 kg; 95% CI -3.18 to -0.69; n=8) and longer 6 min walk distance (6MWD; WMD29.67 m; 95% CI 25.97 to 33.37; n=2) during follow-up. By subgroup analyses, the additional weight loss in exercise group was related to the starting time and type of exercise: patients engaging in exercise 1 year or more after surgery and patients received aerobic-resistance exercise experienced more weight loss. Besides, patients in exercise training group also had lower systolic blood pressure and resting heart rate after surgery. The quality of evidence for these outcomes was moderate to very low. CONCLUSIONS Physical exercise after bariatric surgery provides 1.94 kg additional weight loss and 29.67 m longer 6MWD compared with surgery alone. Moreover, engaging in exercise 1 year or more after surgery, and a combined aerobic and resistance training programme may result in greater weight loss.
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Affiliation(s)
- Zi-Qi Ren
- School of Nursing, Nanjing Medical University, Nanjing, China
| | - Guang-Dong Lu
- Department of Interventional Radiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Tian-Zi Zhang
- School of Nursing, Nanjing Medical University, Nanjing, China
| | - Qin Xu
- School of Nursing, Nanjing Medical University, Nanjing, China
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31
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Bradley LE, Thomas JG, Hood MM, Corsica JA, Kelly MC, Sarwer DB. Remote assessments and behavioral interventions in post-bariatric surgery patients. Surg Obes Relat Dis 2018; 14:1632-1644. [DOI: 10.1016/j.soard.2018.07.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 06/21/2018] [Accepted: 07/09/2018] [Indexed: 12/14/2022]
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32
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Physical training following gastric bypass: effects on physical activity and quality of life—a randomized controlled trial. Qual Life Res 2018; 27:3113-3122. [DOI: 10.1007/s11136-018-1938-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/12/2018] [Indexed: 12/26/2022]
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33
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Mundbjerg LH, Stolberg CR, Cecere S, Bladbjerg EM, Funch-Jensen P, Gram B, Juhl CB. Supervised Physical Training Improves Weight Loss After Roux-en-Y Gastric Bypass Surgery: A Randomized Controlled Trial. Obesity (Silver Spring) 2018; 26:828-837. [PMID: 29566463 DOI: 10.1002/oby.22143] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 01/20/2018] [Accepted: 01/24/2018] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Bariatric surgery results in significant weight loss and reduces cardiovascular morbidity. However, a large variation in postsurgery weight loss is seen. Physical activity promotes weight loss in nonsurgically treated subjects with obesity. The aim of this study was to investigate the effects of 6 months of supervised physical training following Roux-en-Y gastric bypass surgery (RYGB) on body weight and cardiovascular risk markers. METHODS Sixty participants eligible for RYGB were included. Six months post surgery, the participants were randomly assigned to either twice-weekly supervised physical training sessions in a fitness center (INT) or a control group (CON) for 26 weeks. Before surgery and 6, 12, and 24 months after surgery, the participants underwent an examination program that included anthropometric measurements, blood pressure, heart rate, blood samples, and an abdominal computed tomography scan. RESULTS RYGB significantly reduced body weight and improved cardiovascular risk markers (all P < 0.01). The supervised physical training intervention resulted in a 4.2-kg (CI: -0.2 to -8.3 kg) lower body weight in INT compared with CON at the study end (P = 0.042). The high-density lipoprotein concentration was significantly higher in INT than in CON at the termination of the intervention, but this was not maintained at the 24-months examination. CONCLUSIONS Physical training following RYGB improves weight loss and cardiovascular health.
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Affiliation(s)
- Lene Hymøller Mundbjerg
- Department of Medicine/Endocrinology, Hospital of Southwest Jutland, Esbjerg, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
- Odense Patient Data Explorative Network, Odense University Hospital, Odense, Denmark
| | - Charlotte Røn Stolberg
- Department of Medicine/Endocrinology, Hospital of Southwest Jutland, Esbjerg, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
- Odense Patient Data Explorative Network, Odense University Hospital, Odense, Denmark
| | - Stefano Cecere
- Department of Diagnostic Radiology, Copenhagen University Hospital, Herlev, Denmark
| | - Else-Marie Bladbjerg
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
- Unit for Thrombosis Research, Department of Clinical Biochemistry, Hospital of Southwest Jutland, Esbjerg, Denmark
| | - Peter Funch-Jensen
- Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Bibi Gram
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Claus Bogh Juhl
- Department of Medicine/Endocrinology, Hospital of Southwest Jutland, Esbjerg, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
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The Effect of Aerobic or Aerobic-Strength Exercise on Body Composition and Functional Capacity in Patients with BMI ≥35 after Bariatric Surgery: a Randomized Control Trial. Obes Surg 2018; 27:2792-2801. [PMID: 28527156 DOI: 10.1007/s11695-017-2717-3] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND Although previous studies suggested that bariatric surgery is the most effective and sustainable treatment method for morbid obesity in long term, but without changing in lifestyle, maintaining optimal weight loss is almost impossible. METHODS Sixty morbid obese patients (BMI ≥ 35) were evaluated before and after 12 weeks of bariatric surgery in order to compare the impact of two different exercise programs on body composition and functional capacity outcomes. Participants were divided into three groups: aerobic (A), aerobic-strength (AS), and control (C) group. Aerobic capacity was assessed with 12-min walk-run test (12MWRT). One-repetition maximum (1RM) test was performed to evaluation upper limb muscle strength. Lower extremity functional capacity was assessed by sit-to-stand test. RESULTS Weight, percent body fat (PBF), and fat mass (FM) reduced greater in the trial groups in comparison to the C group (P < 0.05). In the AS group, the reduction of fat-free mass (FFM) was significantly lower than that in the other groups. Mean changes in 12MWRT increased significantly in the intervention groups. The mean change in the sit-to-stand scores was not statistically significant between the three groups. Comparing the intervention groups showed that mean changes in 1RM variables increased in AS group (P = 0.03). CONCLUSIONS The data suggests a positive effect of exercise on weight and PBF decrease after surgery, and it leads to significant improvement on aerobic capacity. Moreover, doing resisted exercise caused greater preserving of lean mass.
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Zabatiero J, Smith A, Hill K, Hamdorf JM, Taylor SF, Hagger MS, Gucciardi DF. Do factors related to participation in physical activity change following restrictive bariatric surgery? A qualitative study. Obes Res Clin Pract 2017; 12:307-316. [PMID: 29150223 DOI: 10.1016/j.orcp.2017.11.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Revised: 10/21/2017] [Accepted: 11/03/2017] [Indexed: 12/31/2022]
Abstract
AIMS To explore participants' ability to participate in physical activity (PA), and barriers and facilitators to PA, at 12 months following restrictive bariatric surgery, and how these differed from participants' pre-surgery perceptions. Motivators for PA post-surgery were also explored. METHODS Qualitative one-on-one in-depth interviews were conducted pre- and 12 months post-surgery. Data were analysed using inductive thematic analysis. RESULTS Fourteen adults (12 females), with a mean (range) age of 41.4 years (25.0-56.0), body mass index (BMI) of 31.7kg/m2 (22.3-48.2), and excess weight loss of 66% (2-127) completed both interviews. Lack of participation in PA during the first 3-6 months post-surgery was a common theme. Although participants reported increased ability to participate in PA, attributing this to a reduction in obesity-related physical barriers to PA, many participants reported that some pre-surgery obesity-related barriers to PA remained at 12 months post-surgery. For most participants, pre-surgery non-obesity related barriers to PA also remained at 12 months post-surgery. Facilitators to PA were consistent pre- and post-surgery. Weight loss and improvement in physical appearance were the most common motivators for PA post-surgery. CONCLUSIONS At 12 months following surgery, many participants reported residual obesity and non-obesity related barriers to PA. These barriers may explain the small, if any, pre- to post-surgery change in PA levels reported by earlier research. Facilitators to PA did not change and post-surgery motivators for PA were mostly esteem-related. These data are relevant to shape interventions aimed at optimising PA in this population.
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Affiliation(s)
- Juliana Zabatiero
- School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia.
| | - Anne Smith
- School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Kylie Hill
- School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia; Institute for Respiratory Health, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Jeffrey M Hamdorf
- School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia; School of Medicine, Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Western Australia, Australia; Western Surgical Health, Hollywood Private Hospital, Perth, Western Australia, Australia
| | - Susan F Taylor
- School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia; School of Medicine, Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Western Australia, Australia; Western Surgical Health, Hollywood Private Hospital, Perth, Western Australia, Australia
| | - Martin S Hagger
- Health Psychology and Behavioral Medicine Research Group, School of Psychology and Speech Pathology, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia; Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Daniel F Gucciardi
- School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
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Campanha-Versiani L, Pereira DAG, Ribeiro-Samora GA, Ramos AV, de Sander Diniz MFH, De Marco LA, Soares MMS. The Effect of a Muscle Weight-Bearing and Aerobic Exercise Program on the Body Composition, Muscular Strength, Biochemical Markers, and Bone Mass of Obese Patients Who Have Undergone Gastric Bypass Surgery. Obes Surg 2017; 27:2129-2137. [PMID: 28285470 DOI: 10.1007/s11695-017-2618-5] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND The effect of an exercise program on the body composition, muscular strength (MS), biochemical markers, and bone mineral density (BMD) of individuals undergoing gastric bypass is unclear. We assessed lean mass (LM), MS, bone remodeling markers, and BMD before and after supervised weight-bearing and aerobic exercise training in obese patients who underwent Roux-en-Y gastric bypass (RYGB). METHODS This study included 37 obese patients (81.1% women, mean age 38.2 years, mean body mass index 42.4 ± 0.5 kg/m2). Whole body densitometry was used to evaluate pre- and postoperative BMD, total body fat, and LM. Serum calcium, parathyroid hormone, 25-hydroxyvitamin D, and bone remodeling markers were measured. MS was determined through the concentric 10 repetition maximum test. Postoperatively, participants were divided into two groups: the training group, who followed an exercise program (TG, n = 18), and the control group, who did not (CG, n = 19). RESULTS After 1 year, the TG showed a lower decrease in total BMD and at the lumbar spine and right hip compared with the CG (p < 0.001). The TG had lower mass reduction and an increase in upper limb LM compared with the CG (both p < 0.05). There was no significant difference between groups in bone markers or calcium metabolism. MS was higher in the TG than the CG (p < 0.05). CONCLUSION The supervised exercise program attenuated lumbar spine and right hip BMD loss and improved LM in the arms and overall MS but did not affect bone remodeling.
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Affiliation(s)
- Luciana Campanha-Versiani
- ICBS, University Center's of Belo Horizonte (UNI-BH), Professor Mario Werneck Avenue, 1685 Estoril, Belo Horizonte, MG, 30455-610, Brazil.
| | | | | | | | | | | | - Maria Marta Sarquis Soares
- Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil.,Felício Rocho Hospital, Belo Horizonte, Brazil
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The Underestimated Effect of Perioperative Exercise Interventions in Bariatric Surgery: Increasing Need for Large Impact Studies. Obes Surg 2017; 27:2690-2691. [DOI: 10.1007/s11695-017-2826-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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38
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Afshar S, Seymour K, Kelly SB, Woodcock S, van Hees VT, Mathers JC. Changes in physical activity after bariatric surgery: using objective and self-reported measures. Surg Obes Relat Dis 2016; 13:474-483. [PMID: 27771316 DOI: 10.1016/j.soard.2016.09.012] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Revised: 08/22/2016] [Accepted: 09/08/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Many studies using self-reported physical activity (PA) assessment tools have suggested there is an increase in PA after bariatric surgery. OBJECTIVES Our aim was to assess PA and sedentary behavior before bariatric surgery and at 6 months after, using subjective and objective tools. SETTING Bariatric surgery candidates were recruited from a single center. METHODS Demographic data, medical history, current medications, and anthropometric measurements were recorded. Participants were asked to complete a PA and lifestyle questionnaire and to wear an accelerometer on their nondominant wrist. Data were collected before and at 6 months after surgery. RESULTS Twenty-two participants were included (17 gastric bypass; 4 sleeve gastrectomy; 1 intragastric balloon). Mean age was 46 years and the majority were female (72%). At a median of 6.3 months follow-up, there were significant reductions in measures of body fatness with a mean reduction of 27 kg in weight. The majority of daytime (12.5±1.1 out of 16 h) was spent in sedentary behavior presurgery with little change postsurgery (12.2±1.2; P = .186). Objectively measured mean moderate-vigorous PA did not change significantly from pre- to postsurgery (mean 11.5±13.9 and 11.6±13.1 min/d, respectively; P = .971). Self-reported total nonoccupational PA did not change significantly (P = .390). CONCLUSIONS The majority of bariatric surgery candidates were physically inactive presurgery, and there was no significant change in either subjectively or objectively measured PA at follow-up. This patient group may benefit from objective PA assessment and interventions aimed at increasing PA.
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Affiliation(s)
- Sorena Afshar
- Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Campus for Ageing and Vitality, Newcastle on Tyne, UK; Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, UK.
| | - Keith Seymour
- Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, UK
| | - Seamus B Kelly
- Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, UK
| | - Sean Woodcock
- Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, UK
| | | | - John C Mathers
- Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Campus for Ageing and Vitality, Newcastle on Tyne, UK
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