scholarly journals Nutrological Management in Bariatric Surgery: A Narrative Review

2021 ◽  
pp. 6-12
Author(s):  
Michelle Silva Rocha ◽  
Durval Ribas Filho
Keyword(s):  
Bariatric Surgery ◽  
Disease Risk ◽  
Gastric Bypass Surgery ◽  
Caloric Intake ◽  
Behavioral Changes ◽  
Nutritional Deficiencies ◽  
Iron Protein ◽  
Balanced Diet ◽  
Surgical Measures ◽  
Genetic And Environmental Factors

Nutrology based on the analysis of benefits and harms generated by the ingestion of nutrients and assessing individual organic needs promotes the maintenance of health and the reduction of disease risk, as well as the treatment of manifestations of deficiency or excess. Obesity is defined by a body mass index greater than 30 kg/m². Its manifestation is the sum of genetic and environmental factors, this through sedentary lifestyle and caloric intake greater than energy consumption. There are many ways to deal with obesity, from behavioral changes such as a balanced diet and physical exercises, pharmacological and even surgical measures of different modalities, with Roux-en-Y gastric bypass surgery being the most used technique in Brazil. The most common postoperative nutritional deficiencies are iron, protein, calcium, folate, thiamine, zinc, copper, and vitamins D, B12, A, C, and K. In this case, we present the importance of nutrology in monitoring patients after bariatric surgery. This research made use of a bibliographic survey, giving priority to articles dated from the last 5 years, using the databases Lilacs, Medline, bireme, where articles, dissertations, and theses were consulted, in search of the following keywords, obesity, bariatric surgery, and nutritional deficiency, post-bariatric feeding.

Specialized Diet Therapies: Exploration for Improving Behavior in Autism Spectrum Disorder (ASD)

2020 ◽  
Vol 27 (40) ◽  
pp. 6771-6786
Author(s):  
Geir Bjørklund ◽  
Nagwa Abdel Meguid ◽  
Maryam Dadar ◽  
Lyudmila Pivina ◽  
Joanna Kałużna-Czaplińska ◽  
...  
Keyword(s):  
Autism Spectrum Disorder ◽  
Neurodevelopmental Disorder ◽  
Caloric Intake ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Nutritional Deficiencies ◽  
Childhood And Adolescence ◽  
Restricted Interests ◽  
Balanced Diet ◽  
The Individual

As a major neurodevelopmental disorder, Autism Spectrum Disorder (ASD) encompasses deficits in communication and repetitive and restricted interests or behaviors in childhood and adolescence. Its etiology may come from either a genetic, epigenetic, neurological, hormonal, or an environmental cause, generating pathways that often altogether play a synergistic role in the development of ASD pathogenesis. Furthermore, the metabolic origin of ASD should be important as well. A balanced diet consisting of the essential and special nutrients, alongside the recommended caloric intake, is highly recommended to promote growth and development that withstand the physiologic and behavioral challenges experienced by ASD children. In this review paper, we evaluated many studies that show a relationship between ASD and diet to develop a better understanding of the specific effects of the overall diet and the individual nutrients required for this population. This review will add a comprehensive update of knowledge in the field and shed light on the possible nutritional deficiencies, metabolic impairments (particularly in the gut microbiome), and malnutrition in individuals with ASD, which should be recognized in order to maintain the improved socio-behavioral habit and physical health.

scholarly journals Long-Term Iron and Vitamin B12 Deficiency Are Present after Bariatric Surgery, Despite the Widespread Use of Supplements

2021 ◽  
Vol 18 (9) ◽  
pp. 4541
Author(s):  
Mauro Lombardo ◽  
Arianna Franchi ◽  
Roberto Biolcati Rinaldi ◽  
Gianluca Rizzo ◽  
Monica D’Adamo ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Vitamin B12 ◽  
Vitamin B12 Deficiency ◽  
Ideal Body Weight ◽  
Excess Weight ◽  
Nutritional Deficiencies ◽  
Average Percentage ◽  
Nutritional Studies

There are few long-term nutritional studies in subjects undergoing bariatric surgery that have assessed weight regain and nutritional deficiencies. In this study, we report data 8 years after surgery on weight loss, use of dietary supplements and deficit of micronutrients in a cohort of patients from five centres in central and northern Italy. The study group consisted of 52 subjects (age: 38.1 ± 10.6 y, 42 females): 16 patients had Roux-en-Y gastric bypass (RYGB), 25 patients had sleeve gastrectomy (SG) and 11 subjects had adjustable gastric banding (AGB). All three bariatric procedures led to sustained weight loss: the average percentage excess weight loss, defined as weight loss divided by excess weight based on ideal body weight, was 60.6% ± 32.3. Despite good adherence to prescribed supplements, 80.7% of subjects (72.7%, AGB; 76.7%, SG; 93.8 %, RYGB) reported at least one nutritional deficiency: iron (F 64.3% vs. M 30%), vitamin B12 (F 16.6% vs. M 10%), calcium (F 33.3% vs. M 0%) and vitamin D (F 38.1% vs. M 60%). Long-term nutritional deficiencies were greater than the general population among men for iron and among women for vitamin B12.

scholarly journals Improvements in cholesterol efflux capacity of HDL and adiponectin contribute to mitigation in cardiovascular disease risk after bariatric surgery in a cohort with morbid obesity

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Himani Thakkar ◽  
Vinnyfred Vincent ◽  
Sakshi Sukhla ◽  
Manraj Sra ◽  
Uma Kanga ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Bariatric Surgery ◽  
Insulin Sensitivity ◽  
Cholesterol Efflux ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Cvd Risk ◽  
Cholesterol Efflux Capacity ◽  
Post Surgery ◽  
Inflammatory Status

Abstract Background Bariatric surgery can alleviate cardiovascular risk via effects on cardiovascular disease (CVD) risk factors such as diabetes mellitus, hypertension, and dyslipidemia. Our study aimed to assess the cholesterol efflux capacity (CEC) of HDL as a negative risk factor for CVD in individuals with obesity and identify the factors associated with improvement in CEC 3 months following bariatric surgery. Methods We recruited 40 control individuals (mean BMI of 22.2 kg/m2) and 56 obese individuals (mean BMI of 45.9 kg/m2). The biochemical parameters, inflammatory status and CEC of HDL was measured for the obese individuals before bariatric surgery and at 3 months after surgery. The CEC was measured using a cell-based cholesterol efflux system of BODIPY-cholesterol-labelled THP-1 macrophages. Results A significant reduction in BMI (− 17%, p < 0.001), resolution of insulin sensitivity (HOMA2-IR = − 23.4%, p = 0.002; Adipo IR = − 16%, p = 0.009) and inflammation [log resistin = − 6%, p = 0.07] were observed 3 months post-surgery. CEC significantly improved 3 months after surgery [Pre: 0.91 ± 0.13; Post: 1.02 ± 0.16; p = 0.001] despite a decrease in HDL-C levels. The change in CEC correlated with the change in apo A-I (r = 0.39, p = 0.02) and adiponectin levels (r = 0.35, p = 0.03). Conclusion The results suggest that improvements in CEC, through improvement in adipose tissue health in terms of adipokine secretion and insulin sensitivity could be an important pathway in modulating obesity-related CVD risk.

Addiction Transfer and Other Behavioral Changes Following Bariatric Surgery

2021 ◽  
Vol 101 (2) ◽  
pp. 323-333
Author(s):  
Afton M. Koball ◽  
Gretchen Ames ◽  
Rachel E. Goetze
Keyword(s):  
Bariatric Surgery ◽  
Behavioral Changes

scholarly journals Human myelomeningocele risk and ultra-rare deleterious variants in genes associated with cilium, WNT-signaling, ECM, cytoskeleton and cell migration

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
K. S. Au ◽  
L. Hebert ◽  
P. Hillman ◽  
C. Baker ◽  
M. R. Brown ◽  
...  
Keyword(s):  
Cell Migration ◽  
Wnt Signaling ◽  
Candidate Genes ◽  
Biological Function ◽  
Disease Risk ◽  
Neural Tube Closure ◽  
Study Cohort ◽  
Gene Transcription Regulation ◽  
Genetic And Environmental Factors ◽  
Tube Closure

AbstractMyelomeningocele (MMC) affects one in 1000 newborns annually worldwide and each surviving child faces tremendous lifetime medical and caregiving burdens. Both genetic and environmental factors contribute to disease risk but the mechanism is unclear. This study examined 506 MMC subjects for ultra-rare deleterious variants (URDVs, absent in gnomAD v2.1.1 controls that have Combined Annotation Dependent Depletion score ≥ 20) in candidate genes either known to cause abnormal neural tube closure in animals or previously associated with human MMC in the current study cohort. Approximately 70% of the study subjects carried one to nine URDVs among 302 candidate genes. Half of the study subjects carried heterozygous URDVs in multiple genes involved in the structure and/or function of cilium, cytoskeleton, extracellular matrix, WNT signaling, and/or cell migration. Another 20% of the study subjects carried heterozygous URDVs in candidate genes associated with gene transcription regulation, folate metabolism, or glucose metabolism. Presence of URDVs in the candidate genes involving these biological function groups may elevate the risk of developing myelomeningocele in the study cohort.

scholarly journals Nutritional profile of patients in a multidisciplinary treatment program for severe obesity and preoperative bariatric surgery

2014 ◽  
Vol 27 (suppl 1) ◽  
pp. 31-34 ◽  
Author(s):  
Fernanda Cristina Carvalho Mattos MAGNO ◽  
Monique Silveira da SILVA ◽  
Larissa COHEN ◽  
Luciana d´Abreu SARMENTO ◽  
Eliane Lopes ROSADO ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Severe Obesity ◽  
Personal Information ◽  
Dietary Assessment ◽  
Multidisciplinary Treatment ◽  
Statistical Treatment ◽  
Caloric Intake ◽  
The Body ◽  
Food Record ◽  
Anthropometric Data

BACKGROUND: Along with the augmentation in obesity rates in recent years, the demand for bariatric surgery has startlingly increased. Nutritional counseling in the preoperative period is very important because it contributes to higher success rate in the post-operative period. AIM: To assess the nutritional status of patients in a multidisciplinary program for the treatment of severe obesity and pre-operatively for bariatric surgery, characterizing the consumption of healthy nutrients. METHODS: A retrospective analysis of 30 patients was conducted. Personal information, anthropometric data and dietary assessment by 24-hour food record were collected. The analysis of energy intake was performed in Dietpro 5.1 Professional(r) program. The statistical treatment of the caloric intake was performed by an ANOVA test with Bonferroni´s post hoc and for anthropometric data the paired t test was used. RESULTS: From the total, 73% of the patients were women and 27% male, mean age was 48.4+12.9 and 49.8+8.1, respectively. A lower weight in the 5th appointment was observed when compared with the 1st one. There was a reduction in caloric intake in the 2nd, 3rd, 4th and 5th appointments when compared with the 1st. It was observed that in the 5th appointment more than 50% of the patients underwent six meals a day. There was an increase in the consumption of fruit along the appointments and 72.2% of patients consumed 1-2 servings of fruit a day. Vegetables intake was high in all appointments in the pre-operative period and, although low, the whole grain products consumption has increased during the pre-operative period achieving 30% of the study population. CONCLUSION: There was a decrease in body weight, a trend in the decrease of the body mass index and waist circumference and quantitative and qualitative improvement of food consumption.

scholarly journals Age at menarche in urban school-going girls: association between socio-economic status, BMI and physical activity

2021 ◽  
Vol 8 (2) ◽  
pp. 666
Author(s):  
Amrita Behel ◽  
Leena Raje
Keyword(s):  
Physical Activity ◽  
Socioeconomic Status ◽  
Disease Risk ◽  
Age Of Onset ◽  
Economic Status ◽  
Pubertal Development ◽  
Age At Menarche ◽  
Older Children ◽  
Activity Data ◽  
Genetic And Environmental Factors

Background: Menarche, one of the most reliable markers of pubertal maturity, is a result of a complex interplay between genetic and environmental factors. Since accelerated pubertal development is an important determinant of prognostic disease risk, especially in developing countries, attention must be focused on this important public health aspect.  Methods: Total 200 school-going girls aged between 10-15 years studying in municipal, public-funded and private schools in Mumbai were included in the study based on the inclusion criteria of having attained menarche only in the last three months. Sociodemographic and anthropometric details were collected using a structured schedule and physical activity data was collected using the physical activity questionnaire for older children and adolescents.Results: Socioeconomic status and family size were found to significantly influence the age of onset of menarche (p<0.001). Anthropometric indices of height, weight and BMI were found to have significant negative correlations indicating that taller, heavier girls reached menarche earlier than their shorter and lighter peers (p<0.000). Level of physical activity was also found to be an important contributing factor to age at menarche such that a higher level of physical activity was observed in girls with higher mean menarcheal age (p<0.000).  Conclusions: Age at menarche was found to be influenced by factors such as socioeconomic status, BMI and physical activity.   

scholarly journals A Very Rare Cause of Dilated Cardiomyopathy after Bariatric Surgery: Selenium Deficiency

2021 ◽  
pp. 1-3
Author(s):  
Gulay Kocak ◽  
Munevver Gul Avsar ◽  
Cansu Yazar ◽  
Aylia Yesilova ◽  
Gulcagri Yildiz ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Trace Elements ◽  
Sleeve Gastrectomy ◽  
Dilated Cardiomyopathy ◽  
Selenium Deficiency ◽  
Water Soluble ◽  
Nutritional Deficiencies ◽  
Reduced Ejection Fraction ◽  
Long Term Follow Up

Background: Sleeve gastrectomy for weight loss has increased significantly nowadays. Various complications may develop after this surgery that requires long-term follow-up of these patients. Nutrition is the most important aspect of the follow-up. The deficiency of trace elements, fat-soluble and water-soluble vitamins following bariatric surgeries have been well-described complications. Although nutritional supplementations are often initiated after bariatric surgery, the clinical outcomes related to the deficiency of trace elements have not been well known yet. Case Presentation: A 27-year-old woman who underwent a laparoscopic sleeve gastrectomy for surgical treatment of obesity 9 months ago presented to the emergency department with a signs of heart failure. Transthoracic echocardiography revealed dilated, poorly functioning left ventricle with reduced ejection fraction (28.9%) consistent with dilated cardiomyopathy. We assumed nutritional deficiencies secondary to sleeve gastrectomy as a cause of dilated cardiomyopathy, as the patient had inappropriate nutritional supplements after surgery. Laboratory tests revealed selenium and zinc deficiency that supported our hypothesis. Our patient completely recovered with adequate supplementation of selenium, zinc and thiamine. Conclusion: We highlighted that the early diagnosis of dilated cardiomyopathy due to selenium deficiency following bariatric surgery is of great importance since selenium deficiency is a cause of reversible cardiomyopathy.

scholarly journals Anthropometric Measurements and Correlations to Glucometabolic and Cardiovascular Risk in Obese Patients Undergoing Gastric Bypass Surgery

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Erica Aldenbäck ◽  
Hans-Erik Johansson
Keyword(s):  
Bariatric Surgery ◽  
Vitamin D ◽  
Gastric Bypass ◽  
Fasting Glucose ◽  
Gastric Bypass Surgery ◽  
Cost Effective ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Inclusion Criteria ◽  
Sagittal Abdominal Diameter

Abdominal obesity is associated with hypertension, increased fasting glucose, HbA1c, and cholesterol. Body mass index (BMI) is frequently used to measure and define obesity and as inclusion criteria for bariatric surgery. Sagittal abdominal diameter (SAD) has been suggested to predict the amount of visceral fat, metabolic traits, and cardiometabolic risk superior to BMI. The aim was to test whether SAD has stronger correlations to glucometabolic traits compared to BMI. One hundred and fifty-five (108 women, 47 men) morbidly obese patients undergoing bariatric surgery were evaluated before (baseline), 6 and 12 months after Roux-en-Y gastric bypass (RYGBP). BMI was reduced from 43.7 kg/m2 (baseline) to 31.3 kg/m2 (12 months) and SAD from 32.6 to 23.2 cm (both p <0 .001 ). SAD correlated with CRP ( p = 0.04 ), fasting glucose ( p = 0.008 ), HbA1c ( p = 0.016 ), triglycerides ( p = 0.017 ), systolic blood pressure ( p = 0.032 ), and vitamin D ( p = 0.027 ). BMI correlated with CRP ( p = 0.006 ), triglycerides ( p = 0.016 ), vitamin D ( p = 0.002 ), and magnesium ( p = 0.037 ). Despite RYGBP surgery, vitamin D was significantly increased. Liver enzymes were significantly lowered after RYGBP and the change over time in SAD correlated with gamma-glutamyltransferase. SAD was superior to BMI to predict glucose disturbance and dyslipidemia implying increased use of SAD as it is cost effective and simple to perform in the clinic and could be of value when considering patients for bariatric surgery.

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