Effects of Two Preoperatory Weight Loss Diets on Hepatic Volume, Metabolic Parameters, and Surgical Complications in Morbid Obese Bariatric Surgery Candidates: a Randomized Clinical Trial

Contreras, Anna Gils; Sanjaume, A Bonada; Jaime, M Montero; Soler, Aranzazu; Sabench, Fàtima; López, Alicia Molina; Becerra‐Tomás, Nerea; Déjardin, Daniel del Castillo; Salas‐Salvadó, Jordi

doi:10.1007/s11695-018-3413-7

Cited by 37 publications

(75 citation statements)

References 16 publications

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“…Andrianzen Vargas et al showed that LCD is insufficient in 60% of cases to achieve the intended 10% weight loss, while VLCD is able to achieve it in practically all patients [31]. However, a more recent study comparing the effect of VLCD and LCD before surgery showed that, although VLCD was more effective in reducing total body weight (5.8 vs. 4.2%), there were no differences in terms of liver volume reduction, with both diets having similar effects on biochemical parameters, rate of surgical complications, and hospital length stay [35]. More recently, very low-calorie ketogenic diet (VLCKD) has been proposed as a new effective and safe method for achieving effective preoperative weight loss.…”

Section: Vlcd and Vlckd Before Bs May Reduce Surgical Riskmentioning

confidence: 99%

Diet approach before and after bariatric surgery

Bettini

Belligoli

Fabris

2020

Rev Endocr Metab Disord

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Bariatric surgery (BS) is today the most effective therapy for inducing long-term weight loss and for reducing comorbidity burden and mortality in patients with severe obesity. On the other hand, BS may be associated to new clinical problems, complications and side effects, in particular in the nutritional domain. Therefore, the nutritional management of the bariatric patients requires specific nutritional skills. In this paper, a brief overview of the nutritional management of the bariatric patients will be provided from pre-operative to post-operative phase. Patients with severe obesity often display micronutrient deficiencies when compared to normal weight controls. Therefore, nutritional status should be checked in every patient and correction of deficiencies attempted before surgery. At present, evidences from randomized and retrospective studies do not support the hypothesis that pre-operative weight loss could improve weight loss after BS surgery, and the insurance-mandated policy of a preoperative weight loss as a pre-requisite for admission to surgery is not supported by medical evidence. On the contrary, some studies suggest that a modest weight loss of 5–10% in the immediate preoperative period could facilitate surgery and reduce the risk of complications. Very low calories diet (VLCD) and very low calories ketogenic diets (VLCKD) are the most frequently used methods for the induction of a pre-operative weight loss today. After surgery, nutritional counselling is recommended in order to facilitate the adaptation of the eating habits to the new gastro-intestinal physiology. Nutritional deficits may arise according to the type of bariatric procedure and they should be prevented, diagnosed and eventually treated. Finally, specific nutritional problems, like dumping syndrome and reactive hypoglycaemia, can occur and should be managed largely by nutritional manipulation. In conclusion, the nutritional management of the bariatric patients requires specific nutritional skills and the intervention of experienced nutritionists and dieticians.

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Section: Vlcd and Vlckd Before Bs May Reduce Surgical Riskmentioning

confidence: 99%

Diet approach before and after bariatric surgery

Bettini

Belligoli

Fabris

2020

Rev Endocr Metab Disord

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“…The above discussion regarding 5-10% weight loss in tier 3 should not be confused with the pre-operative weight loss achieved by the "liver shrinking" diet (which varies between LED, VLED and ketogenic diet) that has been shown to reduce liver volume before bariatric surgery and might have a favourable impact on wound healing, hospital stay and postsurgery complications [61][62][63][64].…”

Section: Selecting the Right Patient: Achieving 5-10% Weight Loss Befmentioning

confidence: 99%

Developing Integrated Clinical Pathways for the Management of Clinically Severe Adult Obesity: a Critique of NHS England Policy

et al. 2020

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Purpose of the Review Pathways for obesity prevention and treatment are well documented, yet the prevalence of obesity is rising, and access to treatment (including bariatric surgery) is limited. This review seeks to assess the current integrated clinical pathway for obesity management in England and determine the major challenges. Recent Findings Evidence for tier 2 (community-based lifestyle intervention) and tier 3 (specialist weight management services) is limited, and how it facilitates care and improve outcomes in tier 4 remains uncertain. Treatment access, rigidity in pathways, uncertain treatment outcomes and weight stigma seems to be major barriers to improved care. Summary More emphasis must be placed on access to effective treatments, treatment flexibility, addressing stigma and ensuring treatment efficacy including long-term health outcomes. Prevention and treatment should both receive significant focus though should be considered to be largely separate pathways. A simplified system for weight management is needed to allow flexibility and the delivery of personalized care including post-bariatric surgery care for those who need it.

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“…Similar results can be found in a clinical trial by Gils Contreras et al where the liver volume was reduced by 15.6% after three weeks of VLCD. The reduction was directly related to the baseline BMI [26]. Generally, the highest decrease in liver volume seems to be achieved in the first two weeks of the diet [28,29].…”

Section: Diet and Microbiomementioning

confidence: 88%

“…Humans get approximately 10% of their daily energy supply from short-chain fatty acids (SCFAs) produced by the gut bacteria. SCFAs act not only as energy substrates for the host but also as signalling molecules thereby influencing energy intake and metabolism [25,26]. However, these SCFA profiles, along with butyrate-producing bacteria, are altered in obese individuals [27].…”

Section: The Intestinal Microbiome In Obesitymentioning

confidence: 99%

“…In addition to its influence on microbial composition, preoperative weight loss with a VLCD can help simplify gastric surgeries [29]. In particular, an enlarged liver compromises the visibility of the gastroesophageal area making it more friable and, therefore, more prone to bleeding [26]. In a study by Lewis et al, after six weeks of an Optifast ® diet, the mean liver volume was reduced by 14.7% and the mean liver fat by 43%.…”

Section: Diet and Microbiomementioning

confidence: 99%

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Microbial Adaptation Due to Gastric Bypass Surgery: The Nutritional Impact

2020

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Bariatric surgery leads to sustained weight loss and the resolution of obesity-related comorbidities. Recent studies have suggested that changes in gut microbiota are associated with the weight loss induced by bariatric surgery. Several studies have observed major changes in the microbial composition following gastric bypass surgery. However, there are inconsistencies between the reported alterations in microbial compositions in different studies. Furthermore, it is well established that diet is an important factor shaping the composition and function of intestinal microbiota. However, most studies on gastric bypass have not assessed the impact of dietary intake on the microbiome composition in general, let alone the impact of restrictive diets prior to bariatric surgery, which are recommended for reducing liver fat content and size. Thus, the relative impact of bariatric surgery on weight loss and gut microbiota remains unclear. Therefore, this review aims to provide a deeper understanding of the current knowledge of the changes in intestinal microbiota induced by bariatric surgery considering pre-surgical nutritional changes.

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Effects of Two Preoperatory Weight Loss Diets on Hepatic Volume, Metabolic Parameters, and Surgical Complications in Morbid Obese Bariatric Surgery Candidates: a Randomized Clinical Trial

Cited by 37 publications

References 16 publications

Diet approach before and after bariatric surgery

Diet approach before and after bariatric surgery

Developing Integrated Clinical Pathways for the Management of Clinically Severe Adult Obesity: a Critique of NHS England Policy

Microbial Adaptation Due to Gastric Bypass Surgery: The Nutritional Impact

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