Diet after bariatric surgery in practice

Summary: Bariatric-metabolic surgery is associated with many health benefi ts and improved quality of life. However, the resulting eff ect largely depends on the patient’s compliance and willingness and ability to adopt a new diet, which is associated with bariatric procedures. A whole team of experts plays an important role in preparing the patient for this change. Appropriately composed diet and adherence to the frequency and size of portions is essential in the prevention of nutritional defi ciencies. The bariatric food pyramid is a suitable helper for the implementation of nutritional recommendations. Key words: main nutrients – energy intake – bariatric food pyramid – bariatric plate

Nutrition, Physical Activity, and Dietary Supplementation to Prevent Bone Mineral Density Loss: A Food Pyramid

Bone is a nutritionally modulated tissue. Given this background, aim of this review is to evaluate the latest data regarding ideal dietary approach in order to reduce bone mineral density loss and to construct a food pyramid that allows osteopenia/osteoporosis patients to easily figure out what to eat. The pyramid shows that carbohydrates should be consumed every day (3 portions of whole grains), together with fruits and vegetables (5 portions; orange-colored fruits and vegetables and green leafy vegetables are to be preferred), light yogurt (125 mL), skim milk (200 mL,) extra virgin olive oil (almost 20 mg/day), and calcium water (almost 1 l/day); weekly portions should include fish (4 portions), white meat (3 portions), legumes (2 portions), eggs (2 portions), cheeses (2 portions), and red or processed meats (once/week). At the top of the pyramid, there are two pennants: one green means that osteopenia/osteoporosis subjects need some personalized supplementation (if daily requirements cannot be satisfied through diet, calcium, vitamin D, boron, omega 3, and isoflavones supplementation could be an effective strategy with a great benefit/cost ratio), and one red means that there are some foods that are banned (salt, sugar, inorganic phosphate additives). Finally, three to four times per week of 30–40 min of aerobic and resistance exercises must be performed.

High Adherence to the Food Pyramid’s Recommendations Avoids the Risk of Insufficient Nutrient Intake among Farmers in Peri-Urban Kenya

This study aimed to investigate whether the Kenyan Food Pyramid (FP) can evaluate excess or insufficient nutrient intake. Participants were farmers (56 men and 64 women, aged 18–60 years) in Wangige Village, Kiambu County—a peri-urban area of Kenya. Cross-sectional data were collected for demographic characteristics, physical measurements, and 2-day and 24-hour dietary recalls. The average adherence level to the FP (hereafter, “FP score”) was 25.0 out of 50.0, with a minimum and maximum of 14.1 and 41.5, respectively. Energy and protein % energy ratio were significantly higher (p for trend < 0.05) in the higher FP score group. A higher FP score was also associated with a higher energy-adjusted micronutrient intake, and it was more likely to meet nutrient requirements. However, the higher FP score group had a higher risk of excess sodium intake (p for trend < 0.001). The Kenyan FP could be a useful tool for avoiding the risk of insufficient nutrient intake, but not for avoiding high energy and sodium intake. It is necessary to include appropriate evaluations to limit energy, sugar, and salt. Food groups and recommendations of the FP should be optimised according to the dietary environment of the target population so as to promote their health.

Healthy Habits and Emotional Balance in Women during the Postpartum Period: Differences between Term and Preterm Delivery

Breastfeeding could be considered as a vulnerable period, rising the risk to shift from optimism to pessimism. Preterm delivery is an event that increases postpartum maternal stress and depression, which can have a negative impact on breastfeeding and maternal–filial wellbeing. The adherence to healthy habits may have a positive influence on this vulnerable population. We aimed to analyze the impact of prematurity on maternal psychological aspects during postpartum and to study if adherence to the Healthy Food Pyramid influences psychological variables. Fifty-five breastfeeding women being attended in the Hospital Clínico San Carlos (Madrid, Spain) were recruited during the first day postpartum. The medical data were collected from the obstetrical records. The women answered an auto-administered questionnaire with several sections: sociodemographic characteristics, Perceived Stress Scale (PSS), and Life Orientation Test (LOT), at 14 days and 6 months postpartum, Adherence to the Healthy Food Pyramid Questionnaire (AP-Q) at 28 days postpartum and the Edinburgh Postpartum Depression Scale (EPDS) at 6 months postpartum. The PSS and LOT scores were not statistically different in mothers with preterm compared to term delivery either at 14 days or at 6 months postpartum. Longitudinally, the PSS did not show significant differences, but the LOT score was lower at 6 months compared to 14 days postpartum (p-Value = 0.046). A higher EPDS score was significantly found in mothers with preterm delivery (9.0 ± 4.7) than those with a term delivery (5.4 ± 4.2; p-value = 0.040). A significant and positive correlation was observed between the AP-Q score and LOT both at 14 days and 6 months postpartum. Conclusively, maternal optimism decreases during the postpartum period, women with preterm delivery being at risk of postpartum depression. Furthermore, there is a relationship between optimism and adherence to healthy habits. Healthcare professional counseling is essential during the entire breastfeeding period, particularly in vulnerable mothers with preterm delivery.

Risks for obesity development, features of food behavior and bio-impedansemetric parameters in adolescents

Background. The problem of obesity in adolescents has gained its medical and social relevance since the incidence of the disease is steadily increasing. The purpose of the study is to improve the effectiveness of early diagnosis and prevention of obesity in adolescents. Materials and methods. To study the risk factors for obesity, a comparative assessment of lifestyle among adolescents aged 15–17 years with obesity, overweight and physiological body weight was conducted. In adolescents of the same age with comorbid obesity (basic group), overweight and physiological body weight (two comparison groups), the types of food behavior were determined using the Dutch eating behavior questionnaire (DEBQ). Bioelectrical indicators of bio-impedancemetric analysis were studied on a Tanita apparatus (Japan). The probability of differences in mean values was determined using Student’s t-test. Results. It was found that the frequency of imbalance of the food pyramid, movement disorders, sleep and rest, nervous tension, burdened heredity increased significantly among obese adolescents. Obesity was found to dominate by external type of eating behavior (57.2 %); at the excess weight — restrictive type (60 %); at physiological body weight — emotional type (40 %). Bio-impedancemetry showed that the reliable bioelectrical parameters of obesity were total fat (35.5 ± 4.5 % and 29 ± 2 % vs. 17.5 ± 2.5 %); visceral fat (17 ± 2 % and 12 ± 3 % vs. 8.5 ± 1.5 %); and metabolic age (33 ± 8 and 21.5 ± 1.5 years versus 16 ± 1 years). Conclusions. Risk factors for obesity include the imbalance of the food pyramid, movement disorders, sleep and rest, nervous tension, bad habits, burdened here­dity. The predominance of external type of eating behavior in obesity, restrictive — in overweight and emotional type in adolescents with physiological body weight should be taken into account when prescribing personalized lifestyle adjustments. The most informative bioelectrical parameters of bio-impedancemetry were total fat, visceral fat, and metabolic age. Bio-impedancemetry as a non-invasive predictive method of diagnosing obesity can be re­commended for widespread implementation in pediatric practice.

Assessment of Adherence to the Healthy Food Pyramid in Pregnant and Lactating Women

There are numerous dietary recommendations during pregnancy. However, there are limited recommendations during the lactation period, a nutritionally vulnerable period for women. The Mediterranean Diet and adherence to the Healthy Food Pyramid (HFP) is considered as the standard for healthy eating. In this study, we investigated the differences in adherence to the HFP in pregnant, lactating, and non-pregnant/non-lactating (NPNL) women concerning sociodemographic factors. A sociodemographic and nutritional and lifestyle questionnaire (AP-Q) were used to assess adherence to the HFP, including lifestyle. The AP-Q score ranges from 0 to 10 meaning the higher the score, the greater the adherence to the HFP. Lactating women had the lowest AP-Q score (6.13 [5.31; 6.82]) compared to the pregnant (6.39 [5.56; 7.05]) and NPNL women (6.27 [5.43; 6.88]), while pregnant women had the highest scores. Maternal age was positively correlated with AP-Q score in pregnant (rho = 0.22; p-Value < 0.001) and lactating women (rho = 0.18; p-Value < 0.001), but not in NPNL women. Educational level and monthly income had a positive influence on the degree of adherence to the HFP. In conclusion, breastfeeding mothers of young age and low socioeconomic and educational level would be the target population to carry out nutritional interventions that improve their adherence to the HFP. The knowledge gained from this study can help to design recommendation guidelines and nutritional educational interventions for a given population.

Multidimensional Approach to Assess Nutrition and Lifestyle in Breastfeeding Women during the First Month of Lactation

The first month of lactation is a vulnerable nutritional period for the mother. Our aims were (1) to evaluate the nutritional status of breastfeeding women in the first month of lactation, and (2) to explore different aspects of nutrition and lifestyle through a multidimensional approach. A total of 30 healthy breastfeeding women were enrolled in this study. Dietary pattern was assessed through a 72-hour dietary recall questionnaire (days 7 and 28 postpartum) and data were compared with Dietary Recommendation Values (DRV), and through the Adherence to Healthy Food Pyramid (HFP) questionnaire (day 28). Anthropometric parameters were evaluated by bioimpedance. Using factor analysis, nutritional dimensions were extracted, and linear regression models were used to analyze the association between anthropometric parameters and dimensions. Compared to the DRV, women showed insufficient energy, water, vitamin D, and potassium intake and excessive proteins, vitamins B1, B2, B3, B6, B12, and iron intake. We observed a moderate adherence to the HFP, with women being high in the fruits, vegetables, and oil categories, and low adherence to the physical activity, dairy products, and hydration categories. The nutritional dimension, including the HFP categories of physical activity, hydration, and animal protein intake together, was negatively associated with body weight (β = −3.7 ± 1.7; p-value = 0.047). In conclusion, during the first month postpartum, breastfeeding women exhibited several nutritional imbalances and poor physical activity negatively influencing anthropometric parameters. We propose a multidimensional approach to assess the nutritional status of breastfeeding women as a tool to detect specific deficiencies, allowing for personalized counseling.

A Food Pyramid for Sub-Saharan Africa. Health Protection with Mushroom Nutraceuticals

In Sub-Saharan Africa, despite poverty, chronic hunger and food insecurity, traditional eating has been related to positive health outcomes and sustainability. There is little health research on diet quality based on what African people consume. The defining characteristics of the traditional African cuisine are the richness in herbs and spices, fermented foods and beverages, and healthy and whole ingredients used. However, as countries in this region become more economically developed, there is a shift to “modern” occidental foods rich in saturated fats, sugar and sweeteners. As a result, there are increased incidences of previously unreported ailments due to unbalanced diet. The regular practice of infinite international aid to the region to curb food insecurity has been unsustainable, ineffective and with no end in sight. Local increase in production and productivity is imperative. Protein rich foods in dietary guidelines enhance only those of animal or plant sources while rich protein sources such of mushroom, has been absent in these charts. This article considers the valorisation of traditional African foods and the importance of establishing an African Food-Based Dietary Guidelines (AFBDGs), an unprecedented Food Pyramid, along with the added emphasis on the potential of African mushrooms, which may play a role in shielding Sub-Saharan Africans against the side-effects of a western stylish diet and promote health. It enhances the preventive role of mushrooms in viral diseases and other disorders.

Mediterranean diet and food consumption in an urban adult population of Northwest Algeria

Background: Knowing the eating habits of populations is important to better define appropriate public health interventions. Aims: The aim of the current study was to describe the food consumption among adults in an urban population in North-western Algeria and to compare it to the Mediterranean diet. Subjects and methods: During 2007-2009, 787 individuals aged 30-64 years, randomly selected from the list of insured persons residing in Oran city. A questionnaire on socio-economic and nutritional habits was completed during a face-to-face interview. Results: Mostly, Bread was the most consumed food, three times a day for the majority of the participants (92.2%), followed by vegetal oil (67.9%) and milk (51.2%) twice a day. Dessert was more consumed (64.7%) than vegetables (58.7%), once a day. Olive oil was the least consumed. According to sex, women’s diet appears to be different from men regarding several foods. We observed that young subjects (30 to 39 years) displayed a high consumption of desserts (68.7%, p<0.0001) and potatoes (62.7%, p=0.024), as well as peanuts (44.9%, p=0.032). The most educated subjects, likewise, subjects with a sufficient monthly income consumed significantly more animal proteins, red meat and fish, as well as fruits. The food pyramid in the ISOR (Insulino-résistance à Oran) population was different from the MD (Mediterranean Diet), except for cereals and grain products. Conclusion: The diet of the urban population of northern Algeria is far to be compared to the Mediterranean diet with a high consumption of desserts and animal proteins, in particular among men with a good income. Keywords: Northwest Algeria, urban population, Mediterranean diet, monthly income, educational level.