Skip to main content
Erschienen in: Obesity Surgery 3/2014

01.03.2014 | Original Contributions

Pre-operative Dietary Restriction for Patients Undergoing Bariatric Surgery in the UK: Observational Study of Current Practice and Dietary Effects

verfasst von: Emma L. Baldry, Paul C. Leeder, Iskandar R. Idris

Erschienen in: Obesity Surgery | Ausgabe 3/2014

Einloggen, um Zugang zu erhalten

Abstract

Background

Bariatric surgery is effective at achieving weight loss in the severely obese, with the majority of procedures performed laparoscopically. A short-term pre-operative energy restrictive diet is widely adopted to enable surgery by reducing liver size and improving liver flexibility. However, the dietary approach is not standardised. This observational study reports on pre-operative restrictive diets in use across bariatric services in the UK.

Methods

Between September and November 2012, information was collected from bariatric services on current or past pre-operative diets, and any research providing evidence for the use or modification of their diets.

Results

Around one third of bariatric services (28) in the UK responded, with a total of 49 diets in current use. Types of diet include low energy, low carbohydrate and liquid, with 59 % offering low energy/low carbohydrate food-based, 21 % milk/yoghurt, 18 % meal replacement (liquid) and 2 % clear liquid. Diet duration varies between 7 and 42 days. Limited anecdotal evidence was provided by services evaluating the pre-operative diet, and its alternative approaches, with dietary choice primarily clinician-led.

Conclusions

This study has highlighted variability and lack of consensus in the form of pre-bariatric surgery diet used across different centres. Further research comparing outcomes for alternative diets would support best practice in the future.
Fußnoten
1
A very-low-calorie diet is defined as an energy intake of <1,000 kcal/day by NICE (2006) Obesity guidance on the prevention, identification, assessment and management of overweight and obesity in adults and children.
 
Literatur
1.
Zurück zum Zitat Colquitt JL, Picot J, Loveman E, Clegg AJ. Surgery for obesity. Cochrane Database Syst Rev. 2009;(2). Colquitt JL, Picot J, Loveman E, Clegg AJ. Surgery for obesity. Cochrane Database Syst Rev. 2009;(2).
3.
Zurück zum Zitat Farrell T, Haggerty S, Overby D, et al. Clinical application of laparoscopic bariatric surgery: an evidence-based review. Surg Endosc. 2009;23(5):930–49.PubMedCrossRef Farrell T, Haggerty S, Overby D, et al. Clinical application of laparoscopic bariatric surgery: an evidence-based review. Surg Endosc. 2009;23(5):930–49.PubMedCrossRef
4.
Zurück zum Zitat NBSR. The United Kingdom National Bariatric Surgery Registry: first registry report to March 2010. In: Committee ND, editor. Dendrite Clinical Systems Limited; 2011. NBSR. The United Kingdom National Bariatric Surgery Registry: first registry report to March 2010. In: Committee ND, editor. Dendrite Clinical Systems Limited; 2011.
5.
Zurück zum Zitat Colles SL, Dixon JB, Marks P, et al. Preoperative weight loss with a very-low-energy diet: quantitation of changes in liver and abdominal fat by serial imaging. Am J Clin Nutr. 2006;84(2):304–11.PubMed Colles SL, Dixon JB, Marks P, et al. Preoperative weight loss with a very-low-energy diet: quantitation of changes in liver and abdominal fat by serial imaging. Am J Clin Nutr. 2006;84(2):304–11.PubMed
6.
Zurück zum Zitat Collins J, McCloskey C, Titchner R, et al. Preoperative weight loss in high-risk superobese bariatric patients: a computed tomography-based analysis. Surg Obes Relat Dis. 2011;7(4):480–5.PubMedCrossRef Collins J, McCloskey C, Titchner R, et al. Preoperative weight loss in high-risk superobese bariatric patients: a computed tomography-based analysis. Surg Obes Relat Dis. 2011;7(4):480–5.PubMedCrossRef
7.
Zurück zum Zitat Edholm D, Kullberg J, Haenni A, et al. Preoperative 4-week low-calorie diet reduces liver volume and intrahepatic fat, and facilitates laparoscopic gastric bypass in morbidly obese. Obes Surg. 2011;21(3):345–50.PubMedCrossRef Edholm D, Kullberg J, Haenni A, et al. Preoperative 4-week low-calorie diet reduces liver volume and intrahepatic fat, and facilitates laparoscopic gastric bypass in morbidly obese. Obes Surg. 2011;21(3):345–50.PubMedCrossRef
8.
9.
Zurück zum Zitat Segaran E, Wheeler A. Dietitian’s guide to liver shrinkage prior to bariatric surgery. DOM UK, BOSS; 2008. Segaran E, Wheeler A. Dietitian’s guide to liver shrinkage prior to bariatric surgery. DOM UK, BOSS; 2008.
10.
Zurück zum Zitat Del Corral P, Chandler-Laney PC, Casazza K, et al. Effect of dietary adherence with or without exercise on weight loss: a mechanistic approach to a global problem. J Clin Endocrinol Metab. 2009;94(5):1602–7.PubMedCrossRef Del Corral P, Chandler-Laney PC, Casazza K, et al. Effect of dietary adherence with or without exercise on weight loss: a mechanistic approach to a global problem. J Clin Endocrinol Metab. 2009;94(5):1602–7.PubMedCrossRef
11.
Zurück zum Zitat Chaston TB, Dixon JB. Factors associated with percent change in visceral versus subcutaneous abdominal fat during weight loss: findings from a systematic review. Int J Obes. 2008;32(4):619–28.CrossRef Chaston TB, Dixon JB. Factors associated with percent change in visceral versus subcutaneous abdominal fat during weight loss: findings from a systematic review. Int J Obes. 2008;32(4):619–28.CrossRef
12.
Zurück zum Zitat Kirk E, Reeds DN, Finck BN, et al. Dietary fat and carbohydrates differentially alter insulin sensitivity during caloric restriction. Gastroenterology. 2009;136(5):1552–60.PubMedCentralPubMedCrossRef Kirk E, Reeds DN, Finck BN, et al. Dietary fat and carbohydrates differentially alter insulin sensitivity during caloric restriction. Gastroenterology. 2009;136(5):1552–60.PubMedCentralPubMedCrossRef
13.
Zurück zum Zitat Cassie S, Menezes C, Birch DW, et al. Effect of preoperative weight loss in bariatric surgical patients: a systematic review. Surg Obes Relat Dis. 2011;7(6):760–7.PubMedCrossRef Cassie S, Menezes C, Birch DW, et al. Effect of preoperative weight loss in bariatric surgical patients: a systematic review. Surg Obes Relat Dis. 2011;7(6):760–7.PubMedCrossRef
14.
Zurück zum Zitat Kadeli DK, Sczepaniak JP, Kumar K, et al. The effect of preoperative weight loss before gastric bypass: a systematic review. J Obes. 2012;2012:7.CrossRef Kadeli DK, Sczepaniak JP, Kumar K, et al. The effect of preoperative weight loss before gastric bypass: a systematic review. J Obes. 2012;2012:7.CrossRef
15.
Zurück zum Zitat NICE. Obesity: guidance on the prevention, identification, assessment and management of overweight and obesity in adults and children. National Institute for Health and Care Excellence; 2006. NICE. Obesity: guidance on the prevention, identification, assessment and management of overweight and obesity in adults and children. National Institute for Health and Care Excellence; 2006.
16.
Zurück zum Zitat Browning JD, Baker JA, Rogers T, et al. Short-term weight loss and hepatic triglyceride reduction: evidence of a metabolic advantage with dietary carbohydrate restriction. Am J Clin Nutr. 2011;93(5):1048–52.PubMedCrossRef Browning JD, Baker JA, Rogers T, et al. Short-term weight loss and hepatic triglyceride reduction: evidence of a metabolic advantage with dietary carbohydrate restriction. Am J Clin Nutr. 2011;93(5):1048–52.PubMedCrossRef
17.
Zurück zum Zitat Barrett P, Finer N, Fisher C, et al. Evaluation of a multimodality treatment programme for weight management at the Luton and Dunstable Hospital NHS Trust. J Hum Nutr Diet. 1999;12:43–52.CrossRef Barrett P, Finer N, Fisher C, et al. Evaluation of a multimodality treatment programme for weight management at the Luton and Dunstable Hospital NHS Trust. J Hum Nutr Diet. 1999;12:43–52.CrossRef
18.
Zurück zum Zitat Summerbell CD, Watts C, Higgins JPT, et al. Randomised controlled trial of novel, simple, and well supervised weight reducing diets in outpatients. BMJ. 1998;317(7171):1487–9.PubMedCrossRef Summerbell CD, Watts C, Higgins JPT, et al. Randomised controlled trial of novel, simple, and well supervised weight reducing diets in outpatients. BMJ. 1998;317(7171):1487–9.PubMedCrossRef
19.
Zurück zum Zitat Van Nieuwenhove Y, Dambrauskas Z, Campillo-Soto A, et al. Preoperative very low-calorie diet and operative outcome after laparoscopic gastric bypass: a randomized multicenter study. Arch Surg. 2011;146(11):1300–5.PubMedCrossRef Van Nieuwenhove Y, Dambrauskas Z, Campillo-Soto A, et al. Preoperative very low-calorie diet and operative outcome after laparoscopic gastric bypass: a randomized multicenter study. Arch Surg. 2011;146(11):1300–5.PubMedCrossRef
20.
Zurück zum Zitat Lewis M, Phillips M, Slavotinek J, et al. Change in liver size and fat content after treatment with Optifast (R) very low calorie diet. Obes Surg. 2006;16(6):697–701.PubMedCrossRef Lewis M, Phillips M, Slavotinek J, et al. Change in liver size and fat content after treatment with Optifast (R) very low calorie diet. Obes Surg. 2006;16(6):697–701.PubMedCrossRef
21.
Zurück zum Zitat Shirai K, Saiki A, Oikawa S, et al. The effects of partial use of formula diet on weight reduction and metabolic variables in obese type 2 diabetic patients—multicenter trial. Obes Res Clin Pract. 2013;7(1):e43–54.PubMedCrossRef Shirai K, Saiki A, Oikawa S, et al. The effects of partial use of formula diet on weight reduction and metabolic variables in obese type 2 diabetic patients—multicenter trial. Obes Res Clin Pract. 2013;7(1):e43–54.PubMedCrossRef
22.
Zurück zum Zitat Ernst B, Thurnheer M, Schmid S, et al. Evidence for the necessity to systematically assess micronutrient status prior to bariatric surgery. Obes Surg. 2009;19(1):66–73.PubMedCrossRef Ernst B, Thurnheer M, Schmid S, et al. Evidence for the necessity to systematically assess micronutrient status prior to bariatric surgery. Obes Surg. 2009;19(1):66–73.PubMedCrossRef
23.
Zurück zum Zitat Schweiger C, Weiss R, Berry E, et al. Nutritional deficiencies in bariatric surgery candidates. Obes Surg. 2010;20(2):193–7.PubMedCrossRef Schweiger C, Weiss R, Berry E, et al. Nutritional deficiencies in bariatric surgery candidates. Obes Surg. 2010;20(2):193–7.PubMedCrossRef
24.
Zurück zum Zitat Damms-Machado A, Friedrich A, Kramer K, et al. Pre- and postoperative nutritional deficiencies in obese patients undergoing laparoscopic sleeve gastrectomy. Obes Surg. 2012;22(6):881–9.PubMedCrossRef Damms-Machado A, Friedrich A, Kramer K, et al. Pre- and postoperative nutritional deficiencies in obese patients undergoing laparoscopic sleeve gastrectomy. Obes Surg. 2012;22(6):881–9.PubMedCrossRef
25.
Zurück zum Zitat Thorell A. Clinical Nutrition University: nutritional support after bariatric surgery. e-SPEN. 2011;6(2):e96–e100.CrossRef Thorell A. Clinical Nutrition University: nutritional support after bariatric surgery. e-SPEN. 2011;6(2):e96–e100.CrossRef
26.
Zurück zum Zitat Heinberg LJ, Ashton K, Coughlin J. Alcohol and bariatric surgery: review and suggested recommendations for assessment and management. Surg Obes Relat Dis. 2012;8(3):357–63.PubMedCrossRef Heinberg LJ, Ashton K, Coughlin J. Alcohol and bariatric surgery: review and suggested recommendations for assessment and management. Surg Obes Relat Dis. 2012;8(3):357–63.PubMedCrossRef
27.
Zurück zum Zitat Olsen NJ, Heitmann BL. Intake of calorically sweetened beverages and obesity. Obes Rev. 2009;10(1):68–75.PubMedCrossRef Olsen NJ, Heitmann BL. Intake of calorically sweetened beverages and obesity. Obes Rev. 2009;10(1):68–75.PubMedCrossRef
28.
Zurück zum Zitat Awad S, Varadhan KK, Ljungqvist O, et al. A meta-analysis of randomised controlled trials on preoperative oral carbohydrate treatment in elective surgery. Clin Nutr. 2013;32(1):34–44.PubMedCrossRef Awad S, Varadhan KK, Ljungqvist O, et al. A meta-analysis of randomised controlled trials on preoperative oral carbohydrate treatment in elective surgery. Clin Nutr. 2013;32(1):34–44.PubMedCrossRef
Metadaten
Titel
Pre-operative Dietary Restriction for Patients Undergoing Bariatric Surgery in the UK: Observational Study of Current Practice and Dietary Effects
verfasst von
Emma L. Baldry
Paul C. Leeder
Iskandar R. Idris
Publikationsdatum
01.03.2014
Verlag
Springer US
Erschienen in
Obesity Surgery / Ausgabe 3/2014
Print ISSN: 0960-8923
Elektronische ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-013-1125-6

Weitere Artikel der Ausgabe 3/2014

Obesity Surgery 3/2014 Zur Ausgabe

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

CME: 2 Punkte

Prof. Dr. med. Gregor Antoniadis Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

CME: 2 Punkte

Dr. med. Benjamin Meyknecht, PD Dr. med. Oliver Pieske Das Webinar S2e-Leitlinie „Distale Radiusfraktur“ beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

CME: 2 Punkte

Dr. med. Mihailo Andric
Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.