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Five-year changes in dietary intake and body composition in adolescents with severe obesity undergoing laparoscopic Roux-en-Y gastric bypass surgery

Nyhet: 2019-07-04

Henfridsson P, Laurenius A, Wallengren O, Gronowitz E, Dahlgren J, Flodmark CE, Marcus C, Olbers T, Ellegard L. Five-year changes in dietary intake and body composition in adolescents with severe obesity undergoing laparoscopic Roux-en-Y gastric bypass surgery. Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery. 2019;15(1):51-8. Epub 2018/12/01.

Abstract
BACKGROUND:
Information is scarce on long-term changes in energy intake (EI), dietary energy density (DED), and body composition in adolescents undergoing laparoscopic Roux-en-Y gastric bypass (RYGB).
OBJECTIVES:
To investigate long-term changes in EI, DED, and body composition in adolescents after LRYGB.
SETTING:
University hospitals, multicenter study, Sweden.
METHODS:
Eighty-five adolescents (67% girls; mean ± standard deviation, age 16.0 ± 1.2 yr, body mass index 45.5 ± 6.1 kg/m2) were assessed preoperatively (baseline) and 1, 2, and 5 years after LRYGB with diet history interviews and dual-energy x-ray absorptiometry. Matched obese adolescent controls receiving nonsurgical treatment were assessed only at 5 years.
RESULTS:
Weight decreased 31%, 33%, and 28% at 1, 2, and 5 years after LRYGB (P < .001) while controls gained 13% over 5 years (P < .001). Dietary assessments were completed in 98%, 93%, 87%, and 75% at baseline and 1, 2, and 5 years, respectively, and in 65% of controls. Baseline EI (2558 kcal/d), decreased by 34%, 22%, and 10% after 1, 2, and 5 years (P < .05). DED decreased at 1 year (P = .03). Macronutrient distribution was not different from controls at 5 years, but EI and DED were 31% and 14% lower (P < .015). Fat, fat-free, and muscle mass decreased through 5 years after LRYGB (P < .001). Boys preserved muscle mass more than girls (P < .01). Adequate protein intake was associated with preservation of muscle mass (P = .003).
CONCLUSIONS:
In adolescents undergoing LRYGB EI remained 10% lower 5 years after surgery. Decreased EI and DED, rather than macronutrient distribution, are important factors in weight loss after surgery. Higher protein intake may facilitate preservation of muscle mass.
 

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