Inadequate protein intake after laparoscopic sleeve gastrectomy surgery is associated with a greater fat free mass loss

Sherf-Dagan, Shiri; Tovim, Tali Ben; Keidar, Andrei; Raziel, Asnat; Shibolet, Oren; Zelber‐Sagi, Shira

doi:10.1016/j.soard.2016.05.026

Cited by 42 publications

(16 citation statements)

References 25 publications

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“…Moreover, the first post-surgical phase could be characterized by an intensified condition of protein catabolism, inevitably induced by the surgical stress. Several studies indeed confirmed a significant loss of lean body mass during the first months after surgery [18][19][20]. Protein intake could have a role in modulating the loss of FFM [2,3], and a moderately hyper-proteic diet is associated with FFM preservation [4,5].…”

Section: Discussionmentioning

confidence: 91%

“…Protein intake could have a role in modulating the loss of FFM [2,3], and a moderately hyper-proteic diet is associated with FFM preservation [4,5]. In particular, adequate protein intake in the first six months after SG was found to be associated with FFM saving [18]. Therefore, current guidelines [11][12][13] recommend the adoption of a relatively high protein intake in the first months after surgery, with a recommended protein intake ranging from 1.0 to 1.5 g/kg of ideal body weight, and with some patients requiring even higher amounts (2.1 g/kg of ideal body weight) [11].…”

Section: Discussionmentioning

confidence: 95%

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Assessment of Protein Intake in the First Three Months after Sleeve Gastrectomy in Patients with Severe Obesity

et al. 2021

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An adequate protein intake prevents the loss of fat-free mass during weight loss. Laparoscopic sleeve gastrectomy (SG) jeopardizes protein intake due to post-operative dietary restriction and intolerance to protein-rich foods. The purpose of this study is to evaluate protein intake in the first three months after SG. We evaluated, 1 month and 3 months after surgery, 47 consecutive patients treated with SG. Protein intake, both from foods and from protein supplementation, was assessed through a weekly dietary record. Patients consumed 30.0 ± 10.2 g of protein/day on average from foods in the first month, with a significant increase to 34.9 ± 4.8 g of protein/day in the third month (p = 0.003). The use of protein supplementation significantly increased total protein intake to 42.3 ± 15.9 g protein/day (p < 0.001) in the first month and to 39.6 ± 14.2 g of protein/day (p = 0.002) in the third one. Compliance with supplement consumption was 63.8% in the first month and only 21.3% in the third month. In conclusion, both one and three months after SG, protein intake from foods was not sufficient. The use of modular supplements seems to have a significant impact on protein intake, but nevertheless it remains lower than recommended.

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Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 95%

Assessment of Protein Intake in the First Three Months after Sleeve Gastrectomy in Patients with Severe Obesity

et al. 2021

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“…References of the studies reviewed in this section: [ 7 , 10 , 11 , 12 , 13 , 14 , 16 , 17 , 18 , 20 , 21 , 22 , 25 , 26 , 28 , 30 , 31 , 32 , 35 , 36 , 37 , 38 , 39 , 42 , 43 , 44 , 45 , 50 , 51 , 52 , 57 , 62 , 65 , 67 , 71 , 72 , 73 , 74 , 75 , 77 , 80 , 81 , 82 , 83 , 84 , 85 , 87 , 89 , 90 , 93 , 95 , 96 , 97 ,…”

Section: Discussionunclassified

Recommendations Based on Evidence by the Andalusian Group for Nutrition Reflection and Investigation (GARIN) for the Pre- and Postoperative Management of Patients Undergoing Obesity Surgery

et al. 2020

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In order to develop evidence-based recommendations and expert consensus for nutrition management of patients undergoing bariatric surgery and postoperative follow-up, we conducted a systematic literature search using PRISMA methodology plus critical appraisal following the SIGN and AGREE-II procedures. The results were discussed among all members of the GARIN group, and all members answered a Likert scale questionnaire to assess the degree of support for every recommendation. Patients undergoing bariatric surgery should be screened preoperatively for some micronutrient deficiencies and treated accordingly. A VLCD (Very Low-Calorie Diet) should be used for 4–8 weeks prior to surgery. Postoperatively, a liquid diet should be maintained for a month, followed by a semi-solid diet also for one month. Protein requirements (1–1.5 g/kg) should be estimated using adjusted weight. Systematic use of specific multivitamin supplements is encouraged. Calcium citrate and vitamin D supplements should be used at higher doses than are currently recommended. The use of proton-pump inhibitors should be individualised, and vitamin B12 and iron should be supplemented in case of deficit. All patients, especially pregnant women, teenagers, and elderly patients require a multidisciplinary approach and specialised follow-up. These recommendations and suggestions regarding nutrition management when undergoing bariatric surgery and postoperative follow-up have direct clinical applicability.

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“…This explains the need to further strengthen the post-bariatric protein intake and allows new recommendations to be made [ 43 ]. Postoperatively, lower protein intake leads to decrease in fat free mass, increasing the risk for sarcopenic obesity [ 44 ]. Higher intakes of dietary protein or protein supplementation following bariatric surgery are associated with a higher, long term weight loss and fat mass loss [ 45 – 47 ].…”

Section: Using Proteins To Treat Obesitymentioning

confidence: 99%

Protein, amino acids and obesity treatment

Simonson

Boirie‌

Guillet

2020

Rev Endocr Metab Disord

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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 massespecially 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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Inadequate protein intake after laparoscopic sleeve gastrectomy surgery is associated with a greater fat free mass loss

Cited by 42 publications

References 25 publications

Assessment of Protein Intake in the First Three Months after Sleeve Gastrectomy in Patients with Severe Obesity

Assessment of Protein Intake in the First Three Months after Sleeve Gastrectomy in Patients with Severe Obesity

Recommendations Based on Evidence by the Andalusian Group for Nutrition Reflection and Investigation (GARIN) for the Pre- and Postoperative Management of Patients Undergoing Obesity Surgery

Protein, amino acids and obesity treatment

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