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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

Henfridsson, Pia; Laurenius, Anna; Wallengren, Ola; Gronowitz, Eva; Dahlgren, Jovanna; Flodmark, Carl Erik LU ; Marcus, Claude; Olbers, Torsten and Ellegård, Lars (2018) In Surgery for Obesity and Related Diseases
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.... (More)

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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author
publishing date
type
Contribution to journal
publication status
epub
subject
keywords
Adolescent, Body composition, Dietary assessment, Laparoscopic Roux-en-Y Gastric Bypass
in
Surgery for Obesity and Related Diseases
publisher
Elsevier
external identifiers
  • scopus:85057094037
ISSN
1550-7289
DOI
10.1016/j.soard.2018.10.011
language
English
LU publication?
no
id
c41f3ce3-6bad-4964-9a03-13455730d21a
date added to LUP
2018-12-04 14:34:54
date last changed
2019-08-04 05:23:47
@article{c41f3ce3-6bad-4964-9a03-13455730d21a,
  abstract     = {<p>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/m<sup>2</sup>) 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 &lt;.001) while controls gained 13% over 5 years (P &lt;.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 &lt;.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 &lt;.015). Fat, fat-free, and muscle mass decreased through 5 years after LRYGB (P &lt;.001). Boys preserved muscle mass more than girls (P &lt;.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.</p>},
  author       = {Henfridsson, Pia and Laurenius, Anna and Wallengren, Ola and Gronowitz, Eva and Dahlgren, Jovanna and Flodmark, Carl Erik and Marcus, Claude and Olbers, Torsten and Ellegård, Lars},
  issn         = {1550-7289},
  keyword      = {Adolescent,Body composition,Dietary assessment,Laparoscopic Roux-en-Y Gastric Bypass},
  language     = {eng},
  month        = {10},
  publisher    = {Elsevier},
  series       = {Surgery for Obesity and Related Diseases},
  title        = {Five-year changes in dietary intake and body composition in adolescents with severe obesity undergoing laparoscopic Roux-en-Y gastric bypass surgery},
  url          = {http://dx.doi.org/10.1016/j.soard.2018.10.011},
  year         = {2018},
}