scholarly journals Bariatric Surgery in Adults with Obesity: the Impact on Performance, Metabolism, and Health Indices

2021 ◽  
Author(s):  
Georges Jabbour ◽  
Ahmad Salman

AbstractThis systematic review summarizes current evidence on the impact of bariatric surgery (BS) on physical performance, metabolic, and health indices in adults with obesity. This systematic review suggests that BS induced significant reductions in body weight, fat mass, and fat-free mass in individuals with obesity. Additionally, BS may improve many physical fitness and health indicators. Observed improvements manifest during a distinct period of time. To date, studies on BS and performance have been small in number, nonrandomized in design, and not controlled regarding gender distribution and/or post-surgery follow-up. Future studies should further investigate concerns associated with understanding of BS outcomes to improve these outcomes with potential benefits for quality of life, disability, mortality, morbidity, and overall BS success.

Author(s):  
Susanna M. Wallerstedt ◽  
Karin Nylén ◽  
Magnus A. B. Axelsson

Abstract Purpose As a substantial proportion of bariatric surgery patients use psychotropic/antiepileptic drugs, we investigated the impact of this procedure on serum concentrations. Methods In a naturalistic, longitudinal, prospective case series, we compared dose-adjusted trough concentrations of antidepressants, antipsychotics, or antiepileptics in consecutive patients before and after bariatric surgery. Adherence to treatment over 2 weeks preceding each sampling was considered. Results In all, 85 participants were included (86% female, median age 45 years, median body mass index 42 kg/m2). They were being treated with 18 different psychotropic/antiepileptic drugs (7 substances: 6–17 individuals, 11 substances: 1–4 individuals) and contributed 237 samples over a median of 379 days after surgery. For four out of seven substances with pre-/post-surgery samples available from six or more individuals, the dose-adjusted concentration was reduced (sertraline: 51%, mirtazapine: 41%, duloxetine: 35%, citalopram: 19%). For sertraline and mirtazapine, the low-calorie-diet before surgery entirely explained this reduction. A consistent finding, irrespective of drug, was the association between the mean ratio of the post-/pre-diet dose-adjusted concentration and the lipophilicity of the drug (logD; correlation coefficient: −0.69, P = 0.0005), the low-calorie diet often affecting serum concentration more than the surgery itself. Conclusions Serum concentrations of psychotropic/antiepileptic drugs vary after bariatric surgery and can be hard to predict in individual patients, suggesting that therapeutic drug monitoring is of value. Conversely, effects of the pre-surgery, low-calorie diet appear generalizable, with decreased concentrations of highly lipophilic drugs and increased concentrations of highly hydrophilic drugs. Interaction effects (surgery/dose/concentration) were not evident but cannot be excluded.


2020 ◽  
Vol 30 (8) ◽  
pp. 3119-3126
Author(s):  
Malou A. H. Nuijten ◽  
Valerie M. Monpellier ◽  
Thijs M. H. Eijsvogels ◽  
Ignace M. C. Janssen ◽  
Eric J. Hazebroek ◽  
...  

Abstract Purpose Fat-free mass (FFM) loss is a concerning aspect of bariatric surgery, but little is known about its time-course and factors related with excessive FFM loss. This study examined (i) the progress of FFM loss up to 3 years post-bariatric surgery and (ii) the prevalence and determinants of excessive FFM loss. Materials and Methods A total of 3596 patients (20% males, 43.5 ± 11.1 years old, BMI = 44.2 ± 5.5 kg/m2) underwent sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB) surgery. Bioelectrical impedance analysis was performed preoperatively and 3, 6, 9, 12, 18, 24 and 36 months post-surgery. Changes in body composition were assessed by mixed model analysis. Prevalence of excessive FFM loss (based on three different cutoff values: ≥ 25%, ≥ 30% and ≥ 35% FFM loss/weight loss (= %FFML/WL)) was estimated and its determinants were assessed by linear regression analysis. Results Highest rates of FFM loss were found at 3 and 6 months post-surgery, reflecting 57% and 73% of peak FFM loss, respectively. Prevalence of excessive FFM loss ranged from 14 to 46% at 36 months post-surgery, with an older age (β = 0.14, 95%CI = 0.10–0.18, P < .001), being male (β = 3.99, 95%CI = 2.86–5.12, P < .001), higher BMI (β = 0.13, 95%CI = 0.05–0.20, P = .002) and SG (β = 2.56, 95%CI = 1.36–3.76, P < .001) as determinants for a greater %FFML/WL. Conclusion Patients lost most FFM within 3 to 6 months post-surgery. Prevalence of excessive FFM loss was high, emphasizing the need for more vigorous approaches to counteract FFM loss. Furthermore, future studies should assess habitual physical activity and dietary intake shortly after surgery in relation to FFM loss.


Nutrients ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 1168
Author(s):  
Cristian Neira ◽  
Rejane Godinho ◽  
Fabio Rincón ◽  
Rodrigo Mardones ◽  
Janari Pedroso

Confinement at home, quarantine, and social distancing are some measures adopted worldwide to prevent the spread of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-Cov-2), which has been generating an important alteration in the routines and qualities of life of people. The impact on health is still being evaluated, and consequences in the nutritional field are not entirely clear. The study objective was to evaluate the current evidence about the impact that preventive measures of physical contact restriction causes in healthy nutrition. A systematic review was carried out according to the “Preferred Reporting Items for Systematic Reviews and Meta-Analyses” PRISMA Group and Cochrane method for rapid systematic reviews. Searching was performed in six electronic databases and evaluated articles published between 2010 and 2020, including among their participants adult subjects who had been exposed to the preventive measures of physical contact restriction. Seven studies met the selection criteria and reported an overall increase in food consumption, weight, Body Mass Index (BMI), and a change in eating style. Findings suggest that healthy nutrition is affected by preventive measures to restrict physical contact as a result of the COVID-19 syndemic.


2018 ◽  
Vol 13 (2) ◽  
pp. 54-63 ◽  
Author(s):  
Flora Vayr ◽  
Lydie Charras ◽  
Frederic Savall ◽  
Jean Marc Soulat ◽  
Patrick Ritz ◽  
...  

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
B Morrison ◽  
N Chester ◽  
R Mcgregor-Cheers ◽  
G Kleinnibbelink ◽  
C Johnson ◽  
...  

Abstract Funding Acknowledgements Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Canadian Institute of Health Research Michael Smith Foreign Study Supplement Background Image and performance enhancing drugs (IPED) cause cardiac enlargement and dysfunction. Previous work has not assessed impact of user status (current [CU] vs. past [PU]) or allometric scaling cardiac dimensions for individual differences in fat-free mass (FFM). Purpose To investigate CU and PU of IPED and allometric scaling on LV and RV remodeling in strength-trained athletes. Methods Thirty-four (29 ± 6 years; 82% male) strength-trained athletes were recruited. Fourteen were CU, 9 PU and 11 non-users (NU) of IPEDs.  Participants underwent bioelectric impedance body composition analysis, IPED and training questionnaire and 2D echocardiography with strain imaging. All structural data was allometrically scaled to FFM according to the laws of geometric similarity. Results CU and PU had significantly higher FFM compared to NU (82.4 ± 10.1 kg vs. 72.0 ± 6.3 kg vs. 58.2 ± 14.0 kg). Absolute values of all RV and LV size were larger between CU and NU. LV mean wall thickness (MWT) was larger in CU compared to PU but there were no differences between PU and NU. Allometric scaling eliminated all differences with exception of LV mass and LVMWT. LVEF was significantly lower in CU and PU compared to NU (55 ± 3 vs. 57 ± 4 vs. 61 ± 4) whilst LV GLS was lower in CU compared to PU and NU and LV GCS was lower in CU compared to NU but not PU. There was no significant difference between groups for RV functional indices. Conclusion  Strength-trained athletes currently using IPEDs have bi-ventricular enlargement as well as reduced LV function. Allometric scaling highlights that increased size is partially associated with a larger FFM, with exception of LVMWT which is independently increased through IPED use. PUs demonstrate reverse structural remodeling whilst functional differences partially remain. CU PU NU RVD1 (mm) 45 ± 5* 43 ± 6 37 ± 6 Scaled RVD1 (mm/kg^0.33) 10.5 ± 0.9 10.4 ± 1.5 9.7 ± 1.0 LVd (mm) 58 ± 7* 55 ± 4 50 ± 4 Scaled LVd (mm/kg^0.33) 13.4 ± 1.2 13.3 ± 0.7 13.1 ± 0.6 MWT (mm) 10 ± 1*” 8 ± 1 8 ± 1 Scaled MWT (mm/kg^0.33) 2.3 ± 0.2*” 2.0 ± 0.1 2.0 ± 0.2 LVEDV (ml) 169 ± 42* 135 ± 28 116 ± 28 Scaled LVEDV (ml/kg) 2.0 ± 0.4 1.9 ± 0.3 2.0 ± 0.2 LV Mass (g) 255 ± 85*” 179 ± 30 137 ± 40 LV mass index (g/kg) 3.1 ± 0.8* 2.5 ± 0.3 2.4 ± 0.4 * CU and NU “ CU and PU ^ PU and NU Abstract Figure. Myocardial strain imaging


2017 ◽  
Vol 76 (11) ◽  
pp. 1870-1882 ◽  
Author(s):  
Sabrina M Nielsen ◽  
Else M Bartels ◽  
Marius Henriksen ◽  
Eva E Wæhrens ◽  
Henrik Gudbergsen ◽  
...  

ObjectivesWeight loss is commonly recommended for gout, but the magnitude of the effect has not been evaluated in a systematic review. The aim of this systematic review was to determine benefits and harms associated with weight loss in overweight and obese patients with gout.MethodsWe searched six databases for longitudinal studies, reporting the effect of weight loss in overweight/obese gout patients. Risk of bias was assessed using the tool Risk of Bias in Non-Randomised Studies of Interventions. The quality of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation.ResultsFrom 3991 potentially eligible studies, 10 were included (including one randomised trial). Interventions included diet with/without physical activity, bariatric surgery, diuretics, metformin or no intervention. Mean weight losses ranged from 3 kg to 34 kg. Clinical heterogeneity in study characteristics precluded meta-analysis. The effect on serum uric acid (sUA) ranged from −168 to 30 μmol/L, and 0%–60% patients achieving sUA target (<360 μmol/L). Six out of eight studies (75%) showed beneficial effects on gout attacks. Two studies indicated dose–response relationship for sUA, achieving sUA target and gout attacks. At short term, temporary increased sUA and gout attacks tended to occur after bariatric surgery.ConclusionsThe available evidence is in favour of weight loss for overweight/obese gout patients, with low, moderate and low quality of evidence for effects on sUA, achieving sUA target and gout attacks, respectively. At short term, unfavourable effects may occur. Since the current evidence consists of a few studies (mostly observational) of low methodological quality, there is an urgent need to initiate rigorous prospective studies (preferably randomised controlled trials).Systematic review registrationPROSPERO, CRD42016037937.


2022 ◽  
Vol 10 (1) ◽  
Author(s):  
Fatima Safi ◽  
Anna M. Aniserowicz ◽  
Heather Colquhoun ◽  
Jill Stier ◽  
Behdin Nowrouzi-Kia

Abstract Background Eating disorders (ED) can reduce quality of life by limiting participation and performance in social and occupational roles, including paid or unpaid work. The association between ED pathologies and work participation and performance must be well understood to strengthen vocational rehabilitation programmes and prevent occupational disruptions in the ED population. The aims of this study are: (1) to examine the degree of association between ED pathologies and work participation and performance in 15-year-olds and older; (2) to highlight the specific ED symptoms that are most correlated with changes in work performance and participation; (3) to compile the most common metrics and assessments used to measure work participation and performance with ED. Methods Medline, Embase, CINAHL, Web of Science, PsycINFO, and Cochrane Library will be searched for observational and experimental studies that meet the following criteria: (1) a clinical sample of typical or atypical ED; (2) paid or unpaid employment or training; (3) an association between ED pathologies and work participation or performance. Unpublished data will also be examined. Title and abstract, and full-text screening will be conducted in duplicate. Risk of bias and quality of evidence assessments will be completed. A random-effect meta-analysis will be performed. Discussion This synthesis can clarify knowledge and gaps around the impact of ED on work functioning, thereby allowing better evaluation, improvements and development of current workplace assessments, interventions, and policies. Trial registration The registration number for this systematic review on PROSPERO is CRD42021255055.


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