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Vinjamuri RG, Wu V, Eng A, Tan J, Lim E, Lee PC, Kovalik JP, Tan HC. The Impact of Bariatric Surgery on Nitrogen Balance at Six months Post-surgery. Obes Surg 2024; 34:2363-2368. [PMID: 38748346 DOI: 10.1007/s11695-024-07269-3] [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: 01/21/2024] [Revised: 04/27/2024] [Accepted: 05/08/2024] [Indexed: 07/03/2024]
Abstract
PURPOSE Obesity, defined as abnormal or excessive fat accumulation that presents a risk to health, rose from 8.6 to 10.5% in Singapore's residents. Bariatric surgery, the primary treatment for severe obesity, induces fat and muscle loss. Adequate protein intake is vital for preventing muscle loss. This study examines nitrogen balance in individuals with obesity pre- and post-surgery. MATERIALS AND METHODS Sixteen participants with severe obesity (BMI ≥ 32.5 kg/m2) undergoing bariatric surgery (14 sleeve gastrectomy, 2 Roux-en-Y gastric bypass) and 20 normal-weight controls (BMI < 25 kg/m2) were recruited. Nitrogen balance, calculated from dietary protein intake and urine nitrogen excretion, was assessed. Participants with obesity were re-evaluated 6 months post-surgery. Data were analyzed using parametric methods. RESULTS At baseline, controls had a BMI of 20.8 ± 2.1 kg/m2; those with obesity had 40.9 ± 7.3. Daily calorie and protein intake for participants with obesity were not statistically significantly different from controls (calorie intake at 1467 ± 430 vs. 1462 ± 391 kcal, p = 0.9701, protein intake 74.2 ± 28.7 vs. 64.6 ± 18.3 g, p = 0.2289). Post-surgery, BMI, fat-free mass, fat mass, total energy intake, carbohydrate, and protein intake decreased significantly (p < 0.01). Protein oxidation and urine nitrogen excretion did not change after bariatric surgery. However, nitrogen balance significantly reduced from 2.62 ± 5.07 to - 1.69 ± 5.07 g/day (p = 0.025). CONCLUSION Dietary protein intake is inadequate in individuals with obesity at 6 months post-bariatric surgery and contributes to a state of negative nitrogen balance.
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Affiliation(s)
| | - Vieon Wu
- Department of Endocrinology, Singapore General Hospital, Singapore, 169608, Singapore
| | - Alvin Eng
- Department of Upper Gastrointestinal and Bariatric Surgery, Singapore General Hospital, Singapore, 169608, Singapore
| | - Jeremy Tan
- Department of Upper Gastrointestinal and Bariatric Surgery, Singapore General Hospital, Singapore, 169608, Singapore
| | - Eugene Lim
- Department of Upper Gastrointestinal and Bariatric Surgery, Singapore General Hospital, Singapore, 169608, Singapore
| | - Phong Ching Lee
- Department of Endocrinology, Singapore General Hospital, Singapore, 169608, Singapore
| | | | - Hong Chang Tan
- Department of Endocrinology, Singapore General Hospital, Singapore, 169608, Singapore.
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Boirie Y, Pinel A, Guillet C. Protein and amino acids in obesity: friends or foes? Curr Opin Clin Nutr Metab Care 2023; 26:508-513. [PMID: 37807957 DOI: 10.1097/mco.0000000000000978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/10/2023]
Abstract
PURPOSE OF REVIEW Nutritional interventions using protein and amino acids in obesity are popular therapeutical strategies to limit obesity development. However, the effects of dietary protein intake and amino acid metabolic alterations involved in obesity pathophysiology have not been completely unravelled. Significant recent studies have brought to light new findings in these areas, which are the primary focus of this review. RECENT FINDINGS We describe the effects of protein intake on weight regain prevention, the influence on gut microbiota, the response to low-protein highly processed foods, and the contrasting impacts of a high-protein diet on adults and children. We also explore newly discovered correlations between amino acids, liver fat accumulation, and the dysregulation of the liver-pancreas axis due to alterations in amino acid levels in the context of obesity. Lastly, we consider branched-chain amino acids, along with glycine and tryptophan, as significant biomarkers during periods of positive or negative energy balance. SUMMARY Interventions using dietary protein in obesity may be useful, especially during energy restriction but also in sarcopenic obesity. Furthermore, metabolic profiles that encompass alterations in certain amino acids can provide valuable insights into the metabolic condition of patients with obesity, particularly in relation to insulin resistance and the risk of developing type 2 diabetes.
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Affiliation(s)
- Yves Boirie
- Human Nutrition Unit, University of Clermont Auvergne, INRAE, CRNH Auvergne
- Clinical Nutrition Department, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Alexandre Pinel
- Human Nutrition Unit, University of Clermont Auvergne, INRAE, CRNH Auvergne
| | - Christelle Guillet
- Human Nutrition Unit, University of Clermont Auvergne, INRAE, CRNH Auvergne
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3
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Aguas-Ayesa M, Yárnoz-Esquíroz P, Olazarán L, Gómez-Ambrosi J, Frühbeck G. Precision nutrition in the context of bariatric surgery. Rev Endocr Metab Disord 2023; 24:979-991. [PMID: 36928810 PMCID: PMC10020075 DOI: 10.1007/s11154-023-09794-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/28/2023] [Indexed: 03/17/2023]
Abstract
Bariatric surgery (BS) is the most effective long-term treatment for severe obesity. This review summarizes the main nutritional deficiencies before and after BS, as well as current dietary and supplementation recommendations to avoid them. Likewise, we have reviewed all those aspects that in recent years have been shown to be related to postoperative weight loss (WL) and its subsequent maintenance, such as hormonal changes, dietary patterns, changes in food preference, adherence to recommendations and follow-up, genetic factors and microbiota, among others. Despite all the knowledge, nutritional deficiencies and weight regain after BS are frequent. It is essential to continue studying in this field in order to establish more precise recommendations according to the individual characteristics of patients. It is also a major objective to understand more deeply the role of the factors involved in WL and its maintenance. This will allow the development of precision treatments and nutrition for patients with obesity, optimizing their benefit after BS.
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Affiliation(s)
- Maite Aguas-Ayesa
- Department of Endocrinology and Nutrition, Clínica Universidad de Navarra, 31008, Pamplona, Spain.
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), 31008, Pamplona, Spain.
| | - Patricia Yárnoz-Esquíroz
- Department of Endocrinology and Nutrition, Clínica Universidad de Navarra, 31008, Pamplona, Spain
- Navarra Institute for Health Research, 31008, IdiSNA, Pamplona, Spain
| | - Laura Olazarán
- Department of Endocrinology and Nutrition, Clínica Universidad de Navarra, 31008, Pamplona, Spain
- Navarra Institute for Health Research, 31008, IdiSNA, Pamplona, Spain
| | - Javier Gómez-Ambrosi
- Navarra Institute for Health Research, 31008, IdiSNA, Pamplona, Spain
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), 31008, Pamplona, Spain
- Metabolic Research Laboratory, Clínica Universidad de Navarra, 31008, Pamplona, Spain
| | - Gema Frühbeck
- Department of Endocrinology and Nutrition, Clínica Universidad de Navarra, 31008, Pamplona, Spain.
- Navarra Institute for Health Research, 31008, IdiSNA, Pamplona, Spain.
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), 31008, Pamplona, Spain.
- Metabolic Research Laboratory, Clínica Universidad de Navarra, 31008, Pamplona, Spain.
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Eglseer D, Traxler M, Schoufour JD, Weijs PJM, Voortman T, Boirie Y, Cruz-Jentoft AJ, Reiter L, Bauer S. Nutritional and exercise interventions in individuals with sarcopenic obesity around retirement age: a systematic review and meta-analysis. Nutr Rev 2023; 81:1077-1090. [PMID: 36882046 PMCID: PMC10413430 DOI: 10.1093/nutrit/nuad007] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
Abstract
CONTEXT Retirement is an opportune time for people to establish new healthy routines. Exercise and nutritional interventions are promising in the prevention and treatment of sarcopenic obesity. OBJECTIVE This systematic review aimed. to assess the effectiveness of nutritional and exercise interventions for the treatment of sarcopenic obesity in persons of retirement age. DATA SOURCES PubMed, Embase, CINAHL, and CENTRAL databases were searched in September 2021 for randomized controlled trials; a manual search was also conducted. The search yielded 261 studies, of which 11 were eligible for inclusion. DATA EXTRACTION Studies of community-dwelling individuals with sarcopenic obesity receiving any nutritional or exercise intervention ≥ 8 weeks with the mean age ± standard deviation between 50 and 70 years were included. Primary endpoint was body composition, and secondary endpoints were body mass index, muscle strength, and physical function. The literature review, study selection, data extraction, and risk-of-bias assessment were performed by two reviewers independently. Data were pooled for meta-analysis when possible. RESULTS Meta-analysis was only possible for the exposure "resistance training" and the exposure "training (resistance or aerobic)" in combination with the exposure "added protein" as compared with "no intervention" or "training alone." Resistance training led to a significant body fat reduction of -1.53% (95%CI, -2.91 to -0.15), an increase in muscle mass of 2.72% (95%CI, 1.23-4.22), an increase in muscle strength of 4.42 kg (95%CI, 2.44-6.04), and a slight improvement in gait speed of 0.17 m/s (95%CI, 0.01-0.34). Protein combined with an exercise intervention significantly reduces fat mass (-0.80 kg; 95%CI, -1.32 to -0.28). Some individual studies of dietary or food supplement interventions for which data could not be pooled showed positive effects on body composition. CONCLUSION Resistance training is an effective treatment for persons of retirement age with sarcopenic obesity. Increased protein intake combined with exercise may increase reductions in fat mass. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. CRD42021276461.
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Affiliation(s)
- Doris Eglseer
- Institute of Nursing Science, Medical University of Graz,
Graz, Austria
| | - Mariella Traxler
- Institute of Nursing Science, Medical University of Graz,
Graz, Austria
| | - Josje D Schoufour
- are with the Faculty of Sports and Nutrition, Centre of Expertise Urban
Vitality, Amsterdam University of Applied Sciences, Amsterdam, The
Netherlands
| | - Peter J M Weijs
- are with the Faculty of Sports and Nutrition, Centre of Expertise Urban
Vitality, Amsterdam University of Applied Sciences, Amsterdam, The
Netherlands
- is with the Department of Nutrition and Dietetics, Amsterdam University
Medical Centers, Amsterdam Public Health Institute, Vrije Universiteit,
Amsterdam, The Netherlands
| | - Trudy Voortman
- Division of Human Nutrition and Health, Wageningen University &
Research, Wageningen, The Netherlands
- Department of Epidemiology, Erasmus MC University Medical Center
Rotterdam, Rotterdam, The Netherlands
| | - Yves Boirie
- Clinical Nutrition Department, Human Nutrition Unit, INRA, Centre for
Research in Human Nutrition Auvergne, CHU Clermont-Ferrand, University Clermont
Auvergne, Clermont-Ferrand, France
| | | | - Lea Reiter
- Institute of Nursing Science, Medical University of Graz,
Graz, Austria
| | - Silvia Bauer
- Institute of Nursing Science, Medical University of Graz,
Graz, Austria
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Assessment of the Clinical Condition and Way of Patients' Nutrition before and after Laparoscopic Sleeve Gastrectomy. Nutrients 2023; 15:nu15030514. [PMID: 36771221 PMCID: PMC9919987 DOI: 10.3390/nu15030514] [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: 12/15/2022] [Revised: 01/14/2023] [Accepted: 01/16/2023] [Indexed: 01/21/2023] Open
Abstract
One of the most commonly performed bariatric procedures is the laparoscopic sleeve gastrectomy (LSG). It is highly effective in reducing body weight, but it carries the risk of developing nutritional deficiencies and their consequences. The aim of the study was to determine the clinical condition of obese patients after LSG in terms of nutritional status, metabolic disorders, and way of nutrition. Thirty participants (15 women and 15 men) took part in the study. A statistically significant reduction in the total body fat mass (women by 37.5% p < 0.05, men by 37.06% p < 0.05) and total fat free mass (women by 10% p < 0,05, men by 12.5% p < 0.05) was demonstrated 6 months after LSG. Moreover, insufficient protein intake has been shown in over 73% of women and 40% of men. Before and 6 months after LSG, insufficient intake of calcium, magnesium, potassium, folate, vitamin D, and iron was observed. Six months after the LSG, significant decreases of fasting glucose (p < 0.05), insulin (p < 0.05), TG (p < 0.05), and AST (p < 0.05) concentrations, were observed in both groups. Optimization of nutrition in order to prevent nutritional deficiencies and their complications is a key element of the therapy of obese patients treated surgically.
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Paccou J, Genser L, Lespessailles É, Bertin É, Javier RM, Duclos M, Joly AS, Boirie Y, Pattou F, Delarue J, Cortet B. French recommendations on the prevention and treatment of osteoporosis secondary to bariatric surgery. Joint Bone Spine 2022; 89:105443. [PMID: 35908644 DOI: 10.1016/j.jbspin.2022.105443] [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: 04/02/2022] [Revised: 06/27/2022] [Accepted: 07/12/2022] [Indexed: 10/31/2022]
Abstract
INTRODUCTION This article presents the initial recommendations of the Groupe de Recherche et d'Information sur les Ostéoporoses (Osteoporosis Research and Information Group [GRIO]) and the Société Française de Rhumatologie (French Rheumatology Society [SFR]) on the prevention and treatment of osteoporosis secondary to bariatric surgery. METHODS The recommendations were produced by a working group comprising 4 expert rheumatologists, 3 medically qualified nutritionists, 2 obesity surgeons, 1 physical activity specialist, and 1 patient-association representative. RESULTS The following generally recommended measures apply to all patients with an indication for bariatric surgery or who have already undergone bariatric surgery: normalize calcium and protein intake, attain a 25(OH) vitamin D concentration of between 30 and 60ng/mL; prevent the risk of falls, and introduce a suitable regimen of physical activity. An initial assessment of fracture risk should be routinely performed - ideally before the first bariatric surgery procedure - (i) in the case of RYGB and biliopancreatic diversion, regardless of age, (ii) in patients at high risk of fracture, regardless of age, and (iii) in all menopausal women and all men ≥ 50 years old, regardless of the type of bariatric surgical procedure. The fracture risk assessment is based on a determination of osteoporosis risk factors and bone mineral density measurements. Anti-osteoporosis treatment - zoledronic acid as the first line of treatment - is indicated for menopausal women and men ≥ 50 years old with (i) a history of severe fracture, regardless of T-score, (ii) a history of non-severe fracture and a T-score ≤ -1, and (iii) no history of fracture and a T-score ≤ -2. CONCLUSIONS There is an increased risk of fracture after bariatric surgery. Clinicians should focus their attention on patients at high fracture risk such as postmenopausal women and men older than 50 years. More research is necessary to direct and support guidelines.
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Affiliation(s)
- Julien Paccou
- University Lille, CHU Lille, MABlab ULR 4490, Department of Rheumatology, 59000 Lille, France.
| | - Laurent Genser
- Sorbonne Université, Department of Digestive and Hepato-Pancreato-Biliary Surgery, Liver Transplantation, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière University Hospital, Institut Hospitalo-Universitaire ICAN, Paris, France
| | - Éric Lespessailles
- Department of Rheumatology, Translational Medicine Research Platform, PRIMMO, Regional Hospital of Orleans, 45067 Orléans, France
| | - Éric Bertin
- Clinical Nutrition Transversal Unit (UTNC) of Reims University Hospital and Performance, Health, Metrology, Society Laboratory (PSMS, EA 7507) of Reims Champagne-Ardenne University, Reims, France
| | - Rose-Marie Javier
- Department of Rheumatology, Strasbourg University Hospital, Strasbourg, France
| | - Martine Duclos
- Department of Sport Medicine and Functional Explorations, University Hospital of Clermont-Ferrand, University Clermont Auvergne, INRAE, Human Nutrition Unit, CRNH Auvergne, Clermont-Ferrand, France
| | - Anne-Sophie Joly
- Collectif National des Associations d'Obeses (CNAO), 92800 Puteaux, France
| | - Yves Boirie
- Clinical Nutrition Department, University Hospital of Clermont-Ferrand, University Clermont Auvergne, INRAE, Human Nutrition Unit, CRNH Auvergne, Clermont-Ferrand, France
| | - François Pattou
- Department of Metabolic and Endocrine Surgery, CHRU Lille, Lille, France
| | - Jacques Delarue
- Department of Nutritional Sciences and Laboratory of Human Nutrition, University Hospital, Faculty of Medicine, University of Brest, Brest, France
| | - Bernard Cortet
- University Lille, CHU Lille, MABlab ULR 4490, Department of Rheumatology, 59000 Lille, France
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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: 35] [Impact Index Per Article: 11.7] [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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8
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Toninello P, Montanari A, Bassetto F, Vindigni V, Paoli A. Nutritional Support for Bariatric Surgery Patients: The Skin beyond the Fat. Nutrients 2021; 13:1565. [PMID: 34066564 PMCID: PMC8148584 DOI: 10.3390/nu13051565] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 04/28/2021] [Accepted: 05/03/2021] [Indexed: 12/20/2022] Open
Abstract
Body contouring surgery after the massive weight loss due to bariatric surgery deals with different kinds of complications. The aim of this review is to analyze the role that some nutrients may play in tissue healing after surgery, thus helping plastic surgeons to improve the aesthetic and health outcomes in massive weight loss patients under a multidisciplinary approach. As a matter of fact, preoperative nutritional deficiencies have been shown for vitamins and minerals in a large percentage of post-bariatric patients. Preoperative deficiencies mainly concern iron, zinc, selenium, and vitamins (both fat-soluble and water-soluble), but also total protein. During the postoperative period, these problems may increase because of the patients' very low intake of vitamins and minerals after bariatric surgery (below 50% of the recommended dietary allowance) and the patients' low compliance with the suggested multivitamin supplementation (approximately 60%). In the postoperative period, more attention should be given to nutritional aspects in regard to the length of absorptive area and the percentage of weight loss.
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Affiliation(s)
- Paolo Toninello
- Plastic and Reconstructive Surgery Unit, Department of Neurosciences, University of Padua, 35122 Padua, Italy; (P.T.); (A.M.); (F.B.); (V.V.)
| | - Alvise Montanari
- Plastic and Reconstructive Surgery Unit, Department of Neurosciences, University of Padua, 35122 Padua, Italy; (P.T.); (A.M.); (F.B.); (V.V.)
| | - Franco Bassetto
- Plastic and Reconstructive Surgery Unit, Department of Neurosciences, University of Padua, 35122 Padua, Italy; (P.T.); (A.M.); (F.B.); (V.V.)
| | - Vincenzo Vindigni
- Plastic and Reconstructive Surgery Unit, Department of Neurosciences, University of Padua, 35122 Padua, Italy; (P.T.); (A.M.); (F.B.); (V.V.)
| | - Antonio Paoli
- Department of Biomedical Sciences, University of Padova, 35122 Padua, Italy
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9
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Abstract
Dietary proteins have been used for years to treat obesity. Body weight loss is beneficial when it concerns fat mass, but loss of fat free mass - especially muscle might be detrimental. This occurs because protein breakdown predominates over synthesis, thus administering anabolic dietary compounds like proteins might counter fat free mass loss while allowing for fat mass loss.Indeed, varying the quantity of proteins will decrease muscle anabolic response and increase hyperphagia in rodents fed a low protein diet; but it will favor lean mass maintenance and promote satiety, in certain age groups of humans fed a high protein diet. Beyond protein quantity, protein source is an important metabolic regulator: whey protein and plant based diets exercize favorable effects on the risk of developing obesity, body composition, metabolic parameters or fat free mass preservation of obese patients. Specific amino-acids like branched chain amino acids (BCAA), methionine, tryptophan and its metabolites, and glutamate can also positively influence parameters and complications of obesity especially in rodent models, with less studies translating this in humans.Tuning the quality and quantity of proteins or even specific amino-acids can thus be seen as a potential therapeutic intervention on the body composition, metabolic syndrome parameters and appetite regulation of obese patients. Since these effects vary across age groups and much of the data comes from murine models, long-term prospective studies modulating proteins and amino acids in the human diet are needed.
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Affiliation(s)
- Mathilde Simonson
- UNH, Unité de Nutrition Humaine, CHU Clermont-Ferrand, Service de Nutrition Clinique, CRNH Auvergne, INRA, Université Clermont Auvergne, 63000, Clermont-Ferrand, France
| | - Yves Boirie
- UNH, Unité de Nutrition Humaine, CHU Clermont-Ferrand, Service de Nutrition Clinique, CRNH Auvergne, INRA, Université Clermont Auvergne, 63000, Clermont-Ferrand, France.
| | - Christelle Guillet
- UNH, Unité de Nutrition Humaine, CHU Clermont-Ferrand, Service de Nutrition Clinique, CRNH Auvergne, INRA, Université Clermont Auvergne, 63000, Clermont-Ferrand, France
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