Skip to main content
Erschienen in: Obesity Surgery 12/2012

01.12.2012 | Clinical Research

Preoperative Nutritional Interventions in Morbid Obesity: Impact on Body Weight, Energy Intake, and Eating Quality

verfasst von: Mariana Silva Melendez-Araújo, Sérgio Lincoln de Matos Arruda, Emily de Oliveira Kelly, Kênia Mara Baiocchi de Carvalho

Erschienen in: Obesity Surgery | Ausgabe 12/2012

Einloggen, um Zugang zu erhalten

Abstract

Background

Although the benefits of preoperative weight loss and adequacy of dietary patterns in bariatric surgery is well-recognized, the nutritional strategies in the preoperative period have been scarcely investigated. We aimed to evaluate the impact of intensive and standard nutritional interventions on body weight, energy intake, and eating quality.

Methods

This is a retrospective study in which 32 patients undergoing intensive nutritional intervention, with low-calorie diet (10 kcal/kg) and biweekly visits, were pair-matched by age, sex, and body mass index with 32 patients under a standard nutritional intervention, based on a general dietary counseling. Twenty-four-hour food recall was used to assess energy intake and to derive healthy eating index (HEI). The follow-up preoperative period varied from 8 to 16 weeks.

Results

Weight loss was observed in 72 % of the patients from the intensive intervention group and 75 % of the patients from the standard intervention group. According to the mixed model analysis, time effect on weight loss in both groups was significant (P = 0.0002); however, no difference was found between the intervention groups (P = 0.71). The time effect was significant in both groups for energy intake reduction as well (P < 0.0001), but no difference was found between the intervention groups (P = 0.25). Improvement of eating quality was expressed by the nutrient score of the HEI that increased significantly overtime (P = 0.02), also without distinction between the groups (P = 0.61).

Conclusion

Both intensive and standard nutritional interventions promoted weight loss, energy intake reduction, and improvement of eating quality in morbidly obese patients during preoperative period.
Literatur
1.
Zurück zum Zitat National Heart, Lung and Blood Institute, National Institutes of Health. The Practical Guide: Identification, Evaluation and Treatment of Overweight and Obesity in Adults., U.S. Department of Health and Human Services. October 2000, NIH Pub. No 00-4084. National Heart, Lung and Blood Institute, National Institutes of Health. The Practical Guide: Identification, Evaluation and Treatment of Overweight and Obesity in Adults., U.S. Department of Health and Human Services. October 2000, NIH Pub. No 00-4084.
2.
Zurück zum Zitat Santos LMP, Oliveira IV, Peters LRP, et al. Trends in morbid obesity and in bariatric surgeries covered by the Brazilian Public Health System. Obes Surg. 2010;20:943–8.PubMedCrossRef Santos LMP, Oliveira IV, Peters LRP, et al. Trends in morbid obesity and in bariatric surgeries covered by the Brazilian Public Health System. Obes Surg. 2010;20:943–8.PubMedCrossRef
3.
Zurück zum Zitat Faintuch J, Matsuda M, Cruz ME, et al. Severe protein–calorie malnutrition after bariatric procedures. Obes Surg. 2004;14(2):175–81.PubMedCrossRef Faintuch J, Matsuda M, Cruz ME, et al. Severe protein–calorie malnutrition after bariatric procedures. Obes Surg. 2004;14(2):175–81.PubMedCrossRef
4.
Zurück zum Zitat Consensus BH, Panel C. Consensus conference statement bariatric surgery for morbid obesity: health implications for patients, health professionals, and third-party payers. Surg Obes Relat Dis. 2005;1(3):371–81.CrossRef Consensus BH, Panel C. Consensus conference statement bariatric surgery for morbid obesity: health implications for patients, health professionals, and third-party payers. Surg Obes Relat Dis. 2005;1(3):371–81.CrossRef
5.
Zurück zum Zitat Phillips ML, Lewis MC, Chew V, et al. The early effects of weight loss surgery on regional adiposity. Obes Surg. 2005;15:1449–55.PubMedCrossRef Phillips ML, Lewis MC, Chew V, et al. The early effects of weight loss surgery on regional adiposity. Obes Surg. 2005;15:1449–55.PubMedCrossRef
6.
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;84:304–11.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;84:304–11.PubMed
7.
Zurück zum Zitat Korner J, Punyanitya M, Taveras C, et al. Sex differences in visceral adipose tissue post-bariatric surgery compared to matched non-surgical controls. Int J Body Compos Res. 2008;6(3):93–9.PubMed Korner J, Punyanitya M, Taveras C, et al. Sex differences in visceral adipose tissue post-bariatric surgery compared to matched non-surgical controls. Int J Body Compos Res. 2008;6(3):93–9.PubMed
8.
9.
Zurück zum Zitat Lewis MC, Phillips ML, Slavotinek JP, et al. Change in liver size and fat content after treatment with Optifast very low calorie diet. Obes Surg. 2006;16:697–701.PubMedCrossRef Lewis MC, Phillips ML, Slavotinek JP, et al. Change in liver size and fat content after treatment with Optifast very low calorie diet. Obes Surg. 2006;16:697–701.PubMedCrossRef
10.
Zurück zum Zitat The Look AHEAD Research Group. Long-term effects of a lifestyle intervention on weight and cardiovascular risk factors in individuals with type 2 diabetes mellitus: four-year results of the Look AHEAD trial. Arch Intern Med. 2010;170:1566–75.CrossRef The Look AHEAD Research Group. Long-term effects of a lifestyle intervention on weight and cardiovascular risk factors in individuals with type 2 diabetes mellitus: four-year results of the Look AHEAD trial. Arch Intern Med. 2010;170:1566–75.CrossRef
11.
Zurück zum Zitat Anandam A, Ainnusi M, Kufel T et al. Effects of dietary weight loss on obstructive sleep apnea: a meta-analysis. Sleep Breath 2012 Feb 29. [Epub ahead of print]). doi:10.1007/s11325-012-0677-3. Anandam A, Ainnusi M, Kufel T et al. Effects of dietary weight loss on obstructive sleep apnea: a meta-analysis. Sleep Breath 2012 Feb 29. [Epub ahead of print]). doi:10.​1007/​s11325-012-0677-3.
12.
Zurück zum Zitat Schwartz ML, Drew RL, Chazin-Caldie M. Laparoscopic Roux-en-Y: preoperative determinants of prolonged operative times, conversion to open gastric bypasses, and postoperative complications. Obes Surg. 2003;12:734–8.CrossRef Schwartz ML, Drew RL, Chazin-Caldie M. Laparoscopic Roux-en-Y: preoperative determinants of prolonged operative times, conversion to open gastric bypasses, and postoperative complications. Obes Surg. 2003;12:734–8.CrossRef
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;7:760–8.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;7:760–8.PubMedCrossRef
14.
Zurück zum Zitat Alvarado R, Alami RS, Hsu G, et al. The impact of preoperative weight loss in patients undergoing laparoscopic Roux-en-Y gastric bypass. Obes Surg. 2005;15(9):1282–6.PubMedCrossRef Alvarado R, Alami RS, Hsu G, et al. The impact of preoperative weight loss in patients undergoing laparoscopic Roux-en-Y gastric bypass. Obes Surg. 2005;15(9):1282–6.PubMedCrossRef
15.
Zurück zum Zitat Still CD, Benotti P, Wood GC, et al. Outcomes of preoperative weight loss in high-risk patients undergoing gastric bypass surgery. Arch Surg. 2007;142(10):994–8. discussion 999.PubMedCrossRef Still CD, Benotti P, Wood GC, et al. Outcomes of preoperative weight loss in high-risk patients undergoing gastric bypass surgery. Arch Surg. 2007;142(10):994–8. discussion 999.PubMedCrossRef
16.
Zurück zum Zitat Alger-Mayer S, Polimeni JM, Malone M. Preoperative weight loss as a predictor of long-term success following Roux-en-Y gastric bypass. Obes Surg. 2008;18:772–5.PubMedCrossRef Alger-Mayer S, Polimeni JM, Malone M. Preoperative weight loss as a predictor of long-term success following Roux-en-Y gastric bypass. Obes Surg. 2008;18:772–5.PubMedCrossRef
17.
Zurück zum Zitat Mrad BA, Stoklossa CJ, Birch DW. Does preoperative weight loss predict success following surgery for morbid obesity? Am J Surg. 2008;195:570–4.PubMedCrossRef Mrad BA, Stoklossa CJ, Birch DW. Does preoperative weight loss predict success following surgery for morbid obesity? Am J Surg. 2008;195:570–4.PubMedCrossRef
18.
Zurück zum Zitat NIH Conference. Gastrointestinal Surgery for Severe Obesity. Proceedings of an NIH Consensus Development Conference, 1991. NIH Conference. Gastrointestinal Surgery for Severe Obesity. Proceedings of an NIH Consensus Development Conference, 1991.
19.
Zurück zum Zitat Mota JF, Rinaldi AEM, Pereira AF, et al. Adaptação do índice de alimentação saudável ao guia alimentar da população brasileira”. Rev Nutr Campinas. 2008;21(5):545–52. Mota JF, Rinaldi AEM, Pereira AF, et al. Adaptação do índice de alimentação saudável ao guia alimentar da população brasileira”. Rev Nutr Campinas. 2008;21(5):545–52.
20.
Zurück zum Zitat Livhits M, Mercado C, Yermilov I, et al. Preoperative predictors of weight loss following bariatric surgery: systematic review. Obes Surg. 2012;22(1):70–89.PubMedCrossRef Livhits M, Mercado C, Yermilov I, et al. Preoperative predictors of weight loss following bariatric surgery: systematic review. Obes Surg. 2012;22(1):70–89.PubMedCrossRef
21.
Zurück zum Zitat Doucet E, St-Pierre S, Almeras N, et al. Reduction of visceral adipose tissue during weight loss. Eur J Clin Nutr. 2002;56:297–304.PubMedCrossRef Doucet E, St-Pierre S, Almeras N, et al. Reduction of visceral adipose tissue during weight loss. Eur J Clin Nutr. 2002;56:297–304.PubMedCrossRef
22.
Zurück zum Zitat Phillips ML, Lewis MC, Chew V, et al. The early effects of weight loss surgery on regional adiposity. Obes Surg. 2005;15:1449–55.PubMedCrossRef Phillips ML, Lewis MC, Chew V, et al. The early effects of weight loss surgery on regional adiposity. Obes Surg. 2005;15:1449–55.PubMedCrossRef
23.
Zurück zum Zitat Korner J, Punyanitya M, Taveras C, et al. Sex differences in visceral adipose tissue post-bariatric surgery compared to matched non-surgical controls. Int J Body Compos Res. 2008;6(3):93–9.PubMed Korner J, Punyanitya M, Taveras C, et al. Sex differences in visceral adipose tissue post-bariatric surgery compared to matched non-surgical controls. Int J Body Compos Res. 2008;6(3):93–9.PubMed
24.
25.
Zurück zum Zitat Martinez DR, Salvador-Sanchis JL, Escrig-Sos J. Pérdida de peso preoperatoria en pacientes candidatos a cirugía bariátrica. Cirurgía Española: Recomendaciones basadas en la evidencia; 2011 [Epub ahead of print]. Martinez DR, Salvador-Sanchis JL, Escrig-Sos J. Pérdida de peso preoperatoria en pacientes candidatos a cirugía bariátrica. Cirurgía Española: Recomendaciones basadas en la evidencia; 2011 [Epub ahead of print].
26.
Zurück zum Zitat Alami RS, Morton JM, Schuster R, et al. Is there any benefit to preoperative weight loss in gastric bypass patients? A retrospective randomized trial. Surg Obes Relat Dis. 2007;3(2):141–5. discussion 145-6.PubMedCrossRef Alami RS, Morton JM, Schuster R, et al. Is there any benefit to preoperative weight loss in gastric bypass patients? A retrospective randomized trial. Surg Obes Relat Dis. 2007;3(2):141–5. discussion 145-6.PubMedCrossRef
27.
Zurück zum Zitat Busetto L, Segato G, De Luca M, et al. Weight loss and postoperative complications in morbidly obese patients with binge eating disorder treated by laparoscopic adjustable gastric banding. Obes Surg. 2005;15(2):195–201.PubMedCrossRef Busetto L, Segato G, De Luca M, et al. Weight loss and postoperative complications in morbidly obese patients with binge eating disorder treated by laparoscopic adjustable gastric banding. Obes Surg. 2005;15(2):195–201.PubMedCrossRef
28.
Zurück zum Zitat Powers PS, Perez A, Boyd F, et al. Eating pathology before and after bariatric surgery: a prospective study. Int J Eat Disord. 1999;25:293–300.PubMedCrossRef Powers PS, Perez A, Boyd F, et al. Eating pathology before and after bariatric surgery: a prospective study. Int J Eat Disord. 1999;25:293–300.PubMedCrossRef
29.
Zurück zum Zitat Kennedy ET, Ohls J, Carlson S, et al. The Healthy Eating Index: design and applications. J Am Diet Assoc. 1995;95(10):1103–9.PubMedCrossRef Kennedy ET, Ohls J, Carlson S, et al. The Healthy Eating Index: design and applications. J Am Diet Assoc. 1995;95(10):1103–9.PubMedCrossRef
30.
Zurück zum Zitat Guo X, Warden BA, Paeratakul S, et al. Healthy Eating Index and obesity. Eur J Clin Nutr. 2004;58(12):1580–6.PubMedCrossRef Guo X, Warden BA, Paeratakul S, et al. Healthy Eating Index and obesity. Eur J Clin Nutr. 2004;58(12):1580–6.PubMedCrossRef
31.
Zurück zum Zitat Brolin RE, Robertson LB, Kenler HA, et al. Weight loss and dietary intake after vertical banded gastroplasty and Roux-en-Y gastric bypass. Ann Surg. 1994;220:782–90.PubMedCrossRef Brolin RE, Robertson LB, Kenler HA, et al. Weight loss and dietary intake after vertical banded gastroplasty and Roux-en-Y gastric bypass. Ann Surg. 1994;220:782–90.PubMedCrossRef
32.
Zurück zum Zitat Sarwer DB, Dilks RJ, West-Smith L. Dietary intake and eating behavior after bariatric surgery: threats to weight loss maintenance and strategies for success. Surg Obes Relat Dis. 2011;7:644–51.PubMedCrossRef Sarwer DB, Dilks RJ, West-Smith L. Dietary intake and eating behavior after bariatric surgery: threats to weight loss maintenance and strategies for success. Surg Obes Relat Dis. 2011;7:644–51.PubMedCrossRef
33.
Zurück zum Zitat Litchtman SW, Pisarska K, Berman ER, et al. Discrepancy between self-reported and actual caloric intake and exercise in obese subjects. N Engl J Med. 1992;327:1893–8.CrossRef Litchtman SW, Pisarska K, Berman ER, et al. Discrepancy between self-reported and actual caloric intake and exercise in obese subjects. N Engl J Med. 1992;327:1893–8.CrossRef
Metadaten
Titel
Preoperative Nutritional Interventions in Morbid Obesity: Impact on Body Weight, Energy Intake, and Eating Quality
verfasst von
Mariana Silva Melendez-Araújo
Sérgio Lincoln de Matos Arruda
Emily de Oliveira Kelly
Kênia Mara Baiocchi de Carvalho
Publikationsdatum
01.12.2012
Verlag
Springer-Verlag
Erschienen in
Obesity Surgery / Ausgabe 12/2012
Print ISSN: 0960-8923
Elektronische ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-012-0737-6

Weitere Artikel der Ausgabe 12/2012

Obesity Surgery 12/2012 Zur Ausgabe

Echinokokkose medikamentös behandeln oder operieren?

06.05.2024 DCK 2024 Kongressbericht

Die Therapie von Echinokokkosen sollte immer in spezialisierten Zentren erfolgen. Eine symptomlose Echinokokkose kann – egal ob von Hunde- oder Fuchsbandwurm ausgelöst – konservativ erfolgen. Wenn eine Op. nötig ist, kann es sinnvoll sein, vorher Zysten zu leeren und zu desinfizieren. 

Wie sieht der OP der Zukunft aus?

04.05.2024 DCK 2024 Kongressbericht

Der OP in der Zukunft wird mit weniger Personal auskommen – nicht, weil die Technik das medizinische Fachpersonal verdrängt, sondern weil der Personalmangel es nötig macht.

Umsetzung der POMGAT-Leitlinie läuft

03.05.2024 DCK 2024 Kongressbericht

Seit November 2023 gibt es evidenzbasierte Empfehlungen zum perioperativen Management bei gastrointestinalen Tumoren (POMGAT) auf S3-Niveau. Vieles wird schon entsprechend der Empfehlungen durchgeführt. Wo es im Alltag noch hapert, zeigt eine Umfrage in einem Klinikverbund.

Recycling im OP – möglich, aber teuer

02.05.2024 DCK 2024 Kongressbericht

Auch wenn sich Krankenhäuser nachhaltig und grün geben – sie tragen aktuell erheblich zu den CO2-Emissionen bei und produzieren jede Menge Müll. Ein Pilotprojekt aus Bonn zeigt, dass viele Op.-Abfälle wiederverwertet werden können.

Update Chirurgie

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

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

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“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar 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“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

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.