The effect of protein supplements on weight loss, body composition, protein status, and micronutrients post laparoscopic sleeve gastrectomy (LSG): A Randomised Controlled Trial (RCT)

Abstract

Background Low protein intake post-bariatric surgery can result in protein malnutrition, and muscle mass loss. Authors aim to assess the effect of protein supplements on weight loss, body composition, and micronutrient status following LSG. Methods This is a double-blinded RCT conducted between February/2017 to January/2018. Eligible post LSG patients were randomized into the intervention group who received daily protein supplements containing 20 g of protein and placebo group received zero protein supplements. Both groups received a standardized diet. Weight loss, body composition, and micronutrient status were analyzed at 1, 3, and 6 months. Results 48 participants were included in the final analysis (intervention: 21 and placebo:27). Excess weight loss percentage (EWL%) at 6 months was comparable between both groups (69.44 ± 21.99% and 71.40 ± 19.27% respectively). No significant difference observed in the anthropometric parameters. There was an increase in muscle mass and a decrease in muscle mass loss in the intervention group throughout the study period. However, these changes were not statistically significant. There was a significant increase in total protein ( P=0.027) and magnesium ( P=0.008 ) in the intervention group at 3 months. Albumin and iron levels were significantly higher at 6 months in the intervention group ( P=0.036 & P=0.028 respectively). Other micronutrients did not differ at any time point between both groups. Conclusion Protein supplements resulted in significant improvement in total protein, albumin, magnesium, and iron levels post LSG. Although not significant, protein supplements helped in maintaining the muscle mass and preventing muscle mass loss. Original article This RCT is an original article and provides a level 2 evidence.

Effect on Body Composition of a Meal-Replacement Progression Diet in Patients 1 Month after Bariatric Surgery

“…A study from Alshamari et al compared the effectiveness of a protein supplement with 250 kcal and 20 g protein in 200 mL with a placebo supplement with carbohydrates. There were neither differences in body composition nor weight loss at 1, 3, or 6 months, but there was an increase in total plasma protein in the study group [ 32 ]. In our study, we use a similar oral nutritional supplement (200 kcal, 18 g protein in 200 mL), but the intake regimen was different (three bottles per day in an incomplete oral natural diet).…”

Precision nutrition in the context of bariatric surgery

“…Despite the established recommendations, the prevalence of post-surgical micronutrient deficiencies is very high, being more prevalent for some vitamins or minerals detailed below [22]. 3.2.2.1 Iron, vitamin B12 and folic acid Iron deficiency is one of the most common deficiencies after SG and RYGB affecting around 33% of patients [40] being especially prevalent in menstruating women [33]. This deficiency occurs because of several reasons.…”

Sensory Analysis of Formulations Containing Whey Protein to Individuals Undergoing Bariatric Surgery

“…1,2 In these individuals, insu cient and irregular protein intake is common, aside from the low adherence to regular supplement use, which may result in complications, such as sarcopenia and muscle mass loss. 4,5 In addition to that, the inadequate protein intake, and the return to the pre-surgery dietary pattern with carbohydrates and fat-rich diets, can reduce weight loss or even trigger weight regain. 6 Nutritional post-bariatric guidelines and recommendations suggest the adoption of a relatively high protein intake specially in the rst months after surgery.…”