Protein intake and lean tissue mass retention following bariatric surgery

• Published in: Clinical nutrition (Edinburgh, Scotland) Vol. 32; no. 4; pp. 550 - 555
• Main Authors: Moizé, Violeta, Andreu, Alba, Rodríguez, Lucía, Flores, Lilliam, Ibarzabal, Ainitze, Lacy, Antonio, Jiménez, Amanda, Vidal, Josep
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier Ltd 01.08.2013; Elsevier
• Subjects: Absorptiometry, Photon; Adult; bariatric surgery; Biological and medical sciences; Body Composition; Body Mass Index; Body Weight; Cohort Studies; Dietary Proteins - administration & dosage; dual-energy X-ray absorptiometry; Feeding. Feeding behavior; Female; Fundamental and applied biological sciences. Psychology; Gastric bypass; Gastric Bypass - methods; Gastroenterology and Hepatology; Gastroplasty; Humans; ideal body weight; Lean tissue mass; Linear Models; Male; Medical sciences; Middle Aged; Morbid obesity; Muscle, Skeletal - physiology; Obesity, Morbid - surgery; observational studies; patients; Protein intake; Recommended Dietary Allowances; Sleeve gastrectomy; Stomach, duodenum, intestine, rectum, anus; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Weight Loss; BC; adjustable gastric banding; LTM; Gastric bypass; FM; fat mass; ideal body weight; dual energy X-ray absorptiometry; BS; body composition; lean tissue mass loss as a percent of weight loss; GBP; SG; BIA; AGB; Protein intake; Sleeve gastrectomy; IBW; LTM loss; Lean tissue mass; bariatric surgery; bioimpedance; DXA; PI; Morbid obesity; Consumption; Tissue; Metabolic diseases; Retention; Protein; Bariatric surgery
• ISSN: 0261-5614; 1532-1983
• DOI: 10.1016/j.clnu.2012.11.007

Summary Background & aim Since current protein intake (PI) recommendations for the bariatric surgery (BS) patient are not supported by conclusive evidence, we aimed to evaluate the relationship between PI and lean tissue mass (LTM) loss following BS. Methods Observational study including patients undergoing gastric bypass (GBP; n  = 25) or sleeve gastrectomy (SG; n  = 25). Dietary advice and daily PI were assessed prior to, and at 2- and 6-weeks, 4-, 8-, and 12-months after surgery. Body composition was assessed by dual energy X-ray absorptiometry (DXA). LTM loss as percent of weight loss (%LTM loss) at 4- and 12-months after surgery were the main outcome variables. Results A PI ≥ 60 g/d was associated with lower %LTM loss at 4- ( p  = 0.030) and 12-months ( p  = 0.013). Similar results were obtained when a PI ≥ 1.1 g/kg of ideal body weight (IBW)/d was considered. Multilinear regression showed the only independent predictor of %LTM loss at 4-months was PI (expressed as g/kg IBW/d) (OR: −0.376, p  = 0.017), whereas PI (OR: −0.468, p  = 0.001) and surgical technique (OR: 0.399, p  = 0.006) predicted 12-months %LTM loss. Conclusions Our data provide supportive evidence for the PI goals of >60 g/d or 1.1 g/kg IBW/d as a being associated with better LTM preservation in the BS patient.