The effect of nutrition on sleeve gastrectomy patients' weight loss, biochemical measurements, and comorbids: A clinical study.

BACKGROUND: This study investigates the effect of a nutrition program applied to patients as per bariatric surgery protocol at the sixth month postoperative. The study also compares and contrasts the postoperative findings with preoperative data. METHODS: Twenty severely obese sleeve gastrectomy patients between the ages of 18-65 participated in the study. Energy requirements were calculated as 22 kcal/ideal body weight (kg/day) and protein requirements as 1.5 g/ideal body weight (kg/day). The study evaluates patients' anthropometric and biochemical measurements, body mass index, waist circumference, fat mass (%), weight loss (%), excess weight loss (%), comorbids, and dietary habits at the third and sixth months preoperative and postoperative. Patients' daily macro-micronutrient intake was also calculated. The Friedman Test and Cochran's Q test were performed to determine statistically significant data (p < 0.05). RESULTS: During the first 6 months postoperative, patients lost 34 kg of weight and 16.7% of fat mass, and their percent excess weight loss was measured at 60.2% (<0.0001). Biochemical measurements of the patients revealed that fasting blood glucose, low-density lipoprotein cholesterol, total cholesterol, triglyceride, and calcium levels, which were above the reference range in the preoperative period, were within this range in the postoperative period (<0.0001). Thirteen out of 21 comorbidities, including type 2 diabetes, hypertension, hyperlipidemia, pulmonary problems, and sleep apnea, improved at different rates in the sixth month postoperative. CONCLUSIONS: Thanks to the nutrition program applied as per bariatric surgery protocol, patients lost weight, and their biochemical measurements and comorbids have improved following sleeve gastrectomy.

Effects of Whey Protein, Omega-3 Fatty Acid and Roux-En-Y Gastric Bypass on Body Weight, Biochemical Parameters and Organ Functions in an Obese Rat Model: Experimental Research.

PURPOSE: Extreme obesity (EO) is one of the biggest public health problems in the world and has grown considerably over the years. The aim of the study is to examine the effect of Roux-en-Y gastric bypass (RYGB), whey protein (WP), and omega-3 polyunsaturated fatty acid (PUFA) supplementation applied to EO rats on weight loss, histopathological changes in internal organs and biochemical alterations. MATERIALS AND METHODS: Wistar albino female rats (n = 28) were used in the study and randomly divided into four groups. All rats were made obese by adding high fructose corn syrup (HFCS) to their drinking water. After the EO, WP and omega-3 PUFA supplementation was given and RYGB process was applied. At the end of the study, glucose, total cholesterol, HDL, VLDL, AST, ALT and uric acid changes and liver, kidney and pancreatic tissues were evaluated histopathologically. RESULTS: WP and omega-3 PUFA supplementation decreased body weight (p > 0.05). Omega-3 PUFA and RYGB caused a decrease in total cholesterol (p < 0.05), WP decreased HDL (p < 0.05), WP and omega-3 PUFA caused an increase in ALT (p < 0.05). WP has been shown to have greater curative effects in rat liver and kidney tissues. It has been determined that RYGB causes necrosis in the liver and HFCS causes inflammation in the kidney. CONCLUSION: In the study; the positive effects of WP, omega-3 PUFA and bariatric surgery on obesity and dyslipidemia have been demonstrated. With this result, it was determined that WP, omega-3 PUFA supplementation and bariatric surgery were not superior to each other.

Comparison of a pre-bariatric surgery very low-calorie ketogenic diet and the Mediterranean diet effects on weight loss, metabolic parameters, and liver size reduction.

This study compared the effects on weight as well as on metabolic parameters and liver size of a very low-calorie ketogenic diet versus a Mediterranean diet in patients with morbid obesity preparing to undergo bariatric surgery. This prospective comparison study evaluated patients 18-65 years of age who enrolled for bariatric surgery. Study duration was limited to an immediate preoperative period of 15 days. The very low-calorie ketogenic diet incorporated 10-12 kcal/kg/day of energy and 1-1.2 g/kg of protein using Kalibra (Societa Dietetica Medica) (VLCKD-SDM). The Mediterranean diet (MD) included 15-20% protein, 45-50% carbohydrate, and 25-35% fat. Changes in body mass index (BMI), liver size, and anthropometric and metabolic measurements were assessed. Between January 2016 and March 2017, of 45 patients enrolled, 30 completed the study (VLCKD-SDM, n = 15; MD, n = 15). Respective median BMI loss after VLCKD-SDM was 2.7 kg/m2 versus MD 1.4 kg/m2 (p < 0.05); median fat percentage reduction was 3.2 units versus 1.7 units (p < 0.05). Median liver size decreased 5.5% in the VLCKD-SDM group versus 1.7% in the MD group (p < 0.05). Median total cholesterol, and LDL levels decreased in both groups (p < 0.05), with greater relative decreases in the VLCKD-SDM group. Short-term preoperative diet-based weight loss in patients with morbid obesity preparing for bariatric surgery was significantly greater following a very low-calorie ketogenic diet versus a Mediterranean diet. The very low-calorie diet also significantly improved anthropometric and metabolic parameters and reduced preoperative liver size above that of the MD.

The effect of intermittent fasting diets on body weight and composition.

BACKGROUND & AIMS: This study was carried out to determine and compare the effects on anthropometric measurements of the Mediterranean Diet (MD) with daily energy restriction and four different intermittent fasting diets (IFD), which were created as an alternative to MD and gained popularity. METHODS: 360 people aged 18-65 years, with body mass index (BMI) between 27 and 35 kg/m2 participated to the study. Demographic information, anthropometric measurements, physical activity and food consumption records were obtained by the researcher through weekly face-to-face interviews. The study lasted for 13 weeks, the first of which was a trial. Statistical significance level was accepted as 0.05. Participants were randomly assigned to 5 equal groups: Mediterranean Diet (MD), Week on Week off (WOWO), 6-Hour Time-Restricted Eating (TRE-6), 8-Hour Time-Restricted Eating (TRE-8), Alternative Day Diet (ADD). Of the 360 people who participated in the study, 32 (2 TRE-6, 7 WOWO, 1 MD, 16 ADD, 6 TRE-8) dropped out after the trial week. RESULTS: It was determined that throughout the study, body weights, BMI, arm circumferences and waist circumferences in all groups decreased significantly. However, trends in changes in body weights and BMIs did not differ between groups. While the energy, carbohydrate, protein and fat intakes of the participants did not change significantly during the study, fiber consumption increased considerably in the MD and WOWO groups. CONCLUSIONS: It was observed that IFD were not superior to MD in terms of anthropometric measurements. The health effects and long-term consequences are not clear for IFD, unlike MD. For these reasons, it is thought that the most effective nutritional therapy that can be preferred for healthy weight loss is the energy-restricted MD model.

Probiotic Foods Are Effective on Weight Loss, Biochemical Parameters, and Intestinal Microbiota in Wistar Albino Rats with Obese Microbiota.

The positive effects of various probiotic foods on weight control, intestinal microbiota, and biochemical markers have been proven by various studies. However, there is no study on such effects of tarhana and kefir + tarhana consumption, a type of Turkish food rich in Lactobacillus spp., Pediococcus pentosaceus, Pediococcus acidilactici, and Saccharomyces cerevisiae. This study aimed to determine the changes caused by regular consumption of kefir and/or tarhana for 6 months on weight gain, intestinal microbiota, and biochemical parameters in Wistar albino rats with obese microbiota. Therefore, thirty-five rats were fed with five different methods of oral gavage (n = 7 per group): Normal Diet Control (NDC), High Fat Diet Control (HFDC), 6 mL/kg Kefir + High Fat Diet (Kefir + HFD), 0.2 g/kg Tarhana + High Fat Diet (Tarhana + HFD), and 6 mL/kg Kefir + 0.2 g/kg Tarhana + High Fat Diet (Kefir + Tarhana + HFD). Normality tests were evaluated using the One-Sample Kolmogorov test and Histogram graph. Multiple group comparisons were performed using one-way ANOVA and Tukey's HSD post hoc test, and the statistical significances were indicated by different letters (p < 0.05). Comparisons by gender were performed using the independent samples t-test. Kefir consumption was more effective on decreasing weight gain. Obese microbiota significantly increased blood glucose level and decreased red blood cell (RBC), hematocrit (HCT), hemoglobin, mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), platelets (PLT), and white blood cells. RBC and HCT values in Kefir + HFD, PLT value in Tarhana + HFD, and mean corpuscular volume (MCV), MCH, and MCHC values in Kefir + Tarhana + HFD were higher than those of other groups (p < 0.05). Kefir + tarhana consumption significantly showed an increase in blood glucose. Kefir and/or tarhana induced the abundance of Lactobacillus and blocked the abundances of total coliform bacteria and Escherichia coli (p < 0.05). We demonstrated that kefir was effective in decreasing weight gain, and all dietary interventions induced positive alterations on biochemical findings and intestinal microbiota.

The Relationship between Bariatric Food Pyramid and Long-Term Anthropometric Measurements of Patients Undergoing Bariatric Surgery.

The bariatric food pyramid is a standard for long-term healthy living and nutritional habits of patients who have undergone bariatric surgery, taking their gastric capacity and special nutritional requirements into account. This study aimed to evaluate how the compliance with the pyramid affects the anthropometric change in patients who have undergone bariatric surgery, depending on the period after surgery. 81 patients who have undergone bariatric surgery between August 2016 and September 2018 participated in the study. The patients were evaluated in the postoperative period and were divided into three groups according to the year they had the operation. Food consumption frequency information was obtained from the patients, and the amount of food consumed per day was recorded in grams. Protein, vegetable, fruit, grain, and oil consumption was calculated according to the pyramid and calculated as portions. A statistically significant difference was found for all three groups in terms of weight loss and body mass index (BMI) changes before and after surgery (p < 0.001, p < 0.001, respectively). It was observed that the amount of protein consumed by the patients was sufficient, cereal was high, and fruit was insufficient. Patients who consumed foods that were not recommended slowed in weight loss. In conclusion, it is estimated that increased consumption of grains and nonrecommended foods may cause weight gains. In order to prevent this, it is necessary to ensure that patients are fed in accordance with the pyramid and followed for many years.

The Effect of Different Amounts of Cinnamon Consumption on Blood Glucose in Healthy Adult Individuals.

BACKGROUND: This study was aimed at investigating the effect of consumption of different amounts of cinnamon on preprandial blood glucose (PrBG), postprandial blood glucose (PoBG), glycosylated hemoglobin (HbA1c), and body mass index (BMI). METHODS: This study was carried out on 41 healthy adult individuals. The individuals were divided into 3 groups and monitored for 40 days. The first, second, and third groups were given 1 g/day, 3 g/day, and 6 g/day cinnamon, respectively. Before the beginning of the consumption of cinnamon, HbA1c and PrBG blood tests of the individuals were examined on an empty stomach at family practice centers. Two hours after these tests were carried out and breakfast, PoBG tests were performed. RESULTS: According to the findings of the study, the differences between the average weight measurements, BMI values, and HbA1c values before consumption on days 20 and 40 were not statistically significant in the individuals consuming 1 g, 3 g, and 6 g of cinnamon a day. The difference between the average PrBG measurements was found to be significant in the individuals consuming 6 g of cinnamon per day. The difference between the average PoBG measurements before consumption on days 20 and 40 was significant in the individuals consuming 1 g, 3 g, and 6 g of cinnamon per day. CONCLUSIONS: In particular a 3-6 g of cinnamon consumption was found to affect certain blood parameters of individuals positively. Therefore, it is considered to be beneficial to raise awareness of individuals to be conscious to regularly consume cinnamon.

Conversion Surgery for Failed Adjustable Gastric Banding: Outcomes with Sleeve Gastrectomy vs Roux-en-Y Gastric Bypass.

OBJECTIVES: Laparoscopic adjustable gastric banding (LAGB) was once a preferred method of obesity treatment featuring a straightforward technique, removability, and good early results. In a significant proportion of patients, however, it was not a durable weight-loss procedure and has been associated with a high longer-term complication rate. The purpose of this study was to directly compare the results of conversion to laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic sleeve gastrectomy (LSG) after failed LAGB. METHODS: Post-LAGB complications and weight outcomes of conversion (absolute weight, excess weight loss [%EWL], total weight loss [%TWL]) to LSG vs LRYGB were retrospectively reviewed and statistically compared using Fisher's exact test and the independent samples t test. RESULTS: Over a 6-year period, 74/272 (27.2%) morbidly obese LAGB patients experienced marked complications requiring band removal. Forty-nine of these patients underwent conversion by LRYGB (n = 29) or LSG (n = 20). There was no statistically significant difference in complication rates between converted procedures and no significant difference in respective EWL and TWL (6-month EWL: LRYGB, 53.6% vs LSG, 51.3% and respective TWL, 22.8 vs 21.3%; 12-month EWL, 70.1 vs 56.1%; and TWL, 30.7 vs 23.2%; p > 0.05). All conversion patients were present at each time point. CONCLUSIONS: Outcomes for LSG vs LRYGB following failed LAGB were equally safe and effective.

Comparison of early and late changes in immunoglobulins and acute phase reactants after laparoscopic adjustable gastric banding in patients with morbid obesity.

BACKGROUND: There are differences in the levels of inflammation mediators, lipids, and formed elements of the blood in morbidly obese patients compared with individuals of normal weight. In the current study, the change in these parameters was determined in patients who achieved weight loss by undergoing laparoscopic adjustable gastric banding (LAGB) by comparing preoperative, and early (3 months) and late (12 months) postoperative values. METHODS: The body mass index (BMI), weight, blood pressure, and waist circumference of 72 patients treated by LAGB procedures between September 2006 and February 2009 were measured and recorded. Pre- and postoperative 3- and 12-month C-reactive protein (CRP), immunoglobulin (Ig) G, IgA, IgM, fibrinogen (Fbg), complement components C3 and C4, total cholesterol, triglycerides, low-density lipoprotein-C and high-density lipoprotein-C levels, and leukocyte, neutrophil, lymphocyte, and platelet counts were also measured. Results were presented as mean +/- SD. The preoperative values were compared with the 3- and 12-month values. A p value < 0.05 was considered statistically significant. RESULTS: BMI, weight, blood pressure, and waist circumference measurements were reduced at 3 and 12 months postoperatively compared with preoperative values (p < 0.05). Among the inflammatory mediators, IgG, IgM, and Fbg were reduced to near-normal values, beginning in the early postoperative period (p < 0.05). There was no significant reduction parallel to weight loss with respect to CRP, C3, C4, and IgA values at 3 months postoperatively (p > 0.05). However, the 12-month values of these parameters were significantly reduced (p < 0.05). CONCLUSIONS: Morbid obesity leads to significant changes in the levels of inflammation mediators. While there is a significant reduction in some of these mediators accompanying slight weight loss in the early period following an LAGB procedure, significant changes occur in other mediators in the late period when there is a larger amount of weight loss.