EVALUATION OF EATING QUALITY AFTER LAPAROSCOPIC SLEEVE GASTRECTOMY

Year 2023, Volume: 4 Issue: 3, 220 - 226, 30.12.2023

Gülşah Kaner , Çağla Ayer , Tuba Yalçın

https://doi.org/10.52831/kjhs.1342510

Abstract

Objective: This study aims to evaluate the tolerance to different types of foods after laparoscopic sleeve gastrectomy (LSG).
Method: This cross-sectional study was carried out with a total of 77 patients aged 18-65 years. Patients were divided into three groups according to the time after LSG operation (Group 1=<6th month, Group 2=from 6th to <12th month, and Group 3=from 12th to 24th month). The quality of alimentation questionnaire was used to assess food tolerance.
Results: The mean total food tolerance score (FTS) of patients was 20.83±3.66. Total FTS showed no statistical differences between the groups (p=0.23). After LSG, a statistically significant relationship was determined between the consumption of legumes, green leafy vegetables, and other vegetables and the FTS. The FTS increased as time passed after LSG (p<0.001). Patients reported poor tolerance to red meat (53.2%) and carbohydrates such as rice (36.4%), and bread (35.1%) after LSG. Good tolerance to fish (84.4%), white meat (70.1%), and salad (62.3%) were determined. The tolerance of bread, pasta, and rice increased gradually from group 1 to group 3 (p<0.05). A low level of negative correlation was determined between abdominal pain (r=-0.263), abdominal bloating (r=-0.234), legume consumption (r=-0.297), and FTS.
Conclusion: Food tolerance for different types of food was lower in the first 6 months and increased as time passed after LSG. This situation suggests that individuals attach importance to adequate and balanced nutrition and prefer healthy food choices.

Keywords

Alimentation Questionnaire, Food Tolerance, Laparoscopic Sleeve Gastrectomy, Obesity

Supporting Institution

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Project Number

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Thanks

We would like to thank Dietitian Doğa ÖZKAN for her contribution to the access to patients.

LAPAROSKOPİK SLEEVE GASTREKTOMİ SONRASI BESLENME KALİTESİNİN DEĞERLENDİRİLMESİ

Abstract

Amaç: Bu çalışma, laparoskopik sleeve gastrektomi (LSG) sonrası farklı besin türlerine toleransı değerlendirmeyi amaçlamaktadır.
Yöntem: Bu kesitsel çalışma, 18-65 yaş arası toplam 77 hastanın katılımı ile gerçekleştirilmiştir. Hastalar LSG operasyonu sonrası sürelerine göre üç gruba (Grup 1=<6. ay, Grup 2=6. aydan <12. aya kadar ve Grup 3=12. aydan 24. aya kadar) ayrılmıştır. Besin toleransını değerlendirmek için beslenme kalitesi anketi kullanılmıştır.
Bulgular: Hastaların ortalama toplam besin tolerans skoru (BTS) 20.83±3.66’dır. Toplam BTS, gruplar arasında istatistiksel olarak farklılık göstermemiştir (p=0.23). LSG sonrası baklagiller, yeşil yapraklı sebzeler ve diğer sebzelerin tüketimi ile BTS arasında istatistiksel olarak anlamlı bir ilişki saptanmıştır. LSG süresi arttıkça BTS puanı da artmıştır (p<0.001). Hastalar LSG sonrası kırmızı et (%53.2), pirinç (%36.4) ve ekmek (%35.1) gibi karbonhidratlara karşı zayıf tolerans bildirmiştir. Balık (%84.4), beyaz et (%70.1) ve salata (%62.3) toleransının iyi olduğu belirlenmiştir. Ekmek, makarna ve pirince olan tolerans 1. gruptan 3. gruba doğru kademeli olarak artmıştır (p<0.05). Karın ağrısı (r=-0.263), karın şişkinliği (r=-0.234), bakliyat tüketimi (r=-0.297) ve BTS arasında düşük düzeyde negatif korelasyon saptanmıştır.
Sonuç: Farklı besin türlerine karşı toleransın, LSG sonrası ilk 6 ayda daha düşük olduğu ve sonrasında arttığı belirlenmiştir. Bu durum bireylerin yeterli ve dengeli beslenmeye önem verdiklerini ve sağlıklı besin seçimlerini tercih ettiklerini düşündürmektedir.

Keywords

Beslenme Anketi, Besin Toleransı, Laparoskopik Sleeve Gastrektomi, Obezite

Project Number

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References

• Ray I, Bhattacharya A, De RK. OCDD: an obesity and co-morbid disease database. BioData mining. 2017;10(1):1-11.
• WHO. Obesity and overweight 2021. Available from: https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight.
• Türkiye Beslenme ve Sağlık Araştırması (TBSA), T.C. Sağlık Bakanlığı Halk Sağlığı Genel Müdürlüğü, 1132, Ankara, 2019.
• Panteliou E, Miras A. What is the role of bariatric surgery in the management of obesity? Climacteric. 2017;20(2):97-102.
• Di Lorenzo N, Antoniou SA, Batterham RL, et al. Clinical practice guidelines of the European Association for Endoscopic Surgery (EAES) on bariatric surgery: update 2020 endorsed by IFSO-EC, EASO and ESPCOP. Surgical Endoscopy. 2020;34(6):2332-2358.
• Peterli R, Wölnerhanssen BK, Peters T, et al. Effect of laparoscopic sleeve gastrectomy vs laparoscopic Roux-en-Y gastric bypass on weight loss in patients with morbid obesity: the SM-BOSS randomized clinical trial. JAMA. 2018;319(3):255-265.
• Angrisani L, Santonicola A, Iovino P, et al. Bariatric surgery and endoluminal procedures: IFSO worldwide survey 2014. Obesity Surgery. 2017;27(9):2279-2289.
• Stefater MA, Wilson-Pérez HE, Chambers AP, Sandoval DA, Seeley RJ. All bariatric surgeries are not created equal: insights from mechanistic comparisons. Endocrine Reviews. 2012;33(4):595-622.
• Sundbom M. Laparoscopic revolution in bariatric surgery. World Journal of Gastroenterolgy. 2014;20(41):15135.
• Schweiger C, Weiss R, Keidar A. Effect of different bariatric operations on food tolerance and quality of eating. Obesity Surgery. 2010;20(10):1393-1399.
• Montero PN, Stefanidis D, Norton HJ, Gersin K, Kuwada T. Reported excess weight loss after bariatric surgery could vary significantly depending on calculation method: a plea for standardization. Surgery for Obesity and Related Diseases. 2011;7(4):531-534.
• Karmali S, Stoklossa CJ, Sharma A, et al. Bariatric surgery: a primer. Canadian Family Physician. 2010;56(9):873-879.
• Soykan AU, Burgut R. Beslenme sıklığı anketlerinin geçerliliği ve güvenilirliği. [Yüksek lisans tezi] [Adana]: Çukurova Üniversitesi; 2007.p.101.
• Suter M, Calmes J-M, Paroz A, Giusti V. A new questionnaire for quick assessment of food tolerance after bariatric surgery. Obesity Surgery. 2007;17(1):2-8.
• Pekcan G. Determination of nutritional status. In: Baysal A, editor. Diet handbook. Ankara: Hatiboglu Press; 2008. p. 67-141.
• Khalifa IG, Tobar WL, Hegazy TO, et al. Food tolerance after laparoscopic sleeve gastrectomy with total antral resection. Obesity Surgery. 2019;29(7):2263-2269.
• IBMCorp Ibm S. statistics for windows, version 25.0. Armonk, NY: IBM Corp. 2017.
• Zarshenas N, Tapsell LC, Neale EP, Batterham M, Talbot ML. The relationship between bariatric surgery and diet quality: a systematic review. Obesity Surgery. 2020;30(5):1768-1792.
• Schlottmann F, Herbella FA, Patti MG. Bariatric surgery and gastroesophageal reflux. Journal of Laparoendoscopic & Advanced Surgical Techniques. 2018;28(8):953-955.
• Varner KL, March AL. Prevention of nausea and vomiting after laparoscopic sleeve gastrectomy: are we doing enough? AANA Journal. 2020;88(2):142-147.
• Ruiz-Tovar J, Oller I, Llavero C, et al. Hair loss in females after sleeve gastrectomy: predictive value of serum zinc and iron levels. The American Surgeon. 2014;80(5):466-471.
• Bobowicz M, Lehmann A, Orlowski M, Lech P, Michalik M. Preliminary outcomes 1 year after laparoscopic sleeve gastrectomy based on Bariatric Analysis and Reporting Outcome System (BAROS). Obesity Surgery. 2011;21(12):1843-1848.
• Isom KA, Andromalos L, Ariagno M, et al. Nutrition and metabolic support recommendations for the bariatric patient. Nutrition in Clinical Practice. 2014;29(6):718-739.
• Ağbaba N, Özcan BA. Bariatrik cerrahi sonrası gıda intoleransı. Sağlık ve Yaşam Bilimleri Dergisi. 2020;2(1):16-21.
• Ruiz-Tovar J, Bozhychko M, Del-Campo JM, Zubiaga L, Llavero C. Food tolerance and quality of alimentation following laparoscopic sleeve gastrectomy calibrated with a 50-Fr bougie: long-term results. Journal of Laparoendoscopic & Advanced Surgical Techniques. 2018;28(6):721-725.
• Cano-Valderrama O, Sánchez-Pernaute A, Rubio-Herrera MA, Domínguez-Serrano I, Torres-García AJ. Long-term food tolerance after bariatric surgery: comparison of three different surgical techniques. Obesity Surgery. 2017;27(11):2868-2872.
• Freeman RA, Overs SE, Zarshenas N, Walton KL, Jorgensen JO. Food tolerance and diet quality following adjustable gastric banding, sleeve gastrectomy and Roux-en-Y gastric bypass. Obesity Research & Clinical Practice. 2014;8(2):e183-e91.
• Ramón JM, González CG, Dorcaratto D, et al. Quality of food intake after bariatric surgery: vertical gastrectomy versus gastric bypass. Cirugia Espanola. 2011;90(2):95-101.
• Diaz-Lara C, Curtis C, Romero M, et al. Tolerance to specific foods after laparoscopic sleeve gastrectomy. Obesity Surgery. 2020;30(10):3891-3897.
• Ruiz-Tovar J, Bozhychko M, Del-Campo JM, et al. Changes in frequency intake of foods in patients undergoing sleeve gastrectomy and following a strict dietary control. Obesity Surgery. 2018;28(6):1659-1664.
• Soares FL, Bissoni de Sousa L, Corradi-Perini C, Ramos da Cruz MR, Nunes MGJ, Branco-Filho AJ. Food quality in the late postoperative period of bariatric surgery: an evaluation using the bariatric food pyramid. Obesity Surgery. 2014;24(9):1481-1486.
• Bezerra IN, Curioni C, Sichieri R. Association between eating out of home and body weight. Nutrition Reviews. 2012;70(2):65-79.
• Moizé VL, Pi-Sunyer X, Mochari H, Vidal J. Nutritional pyramid for post-gastric bypass patients. Obesity Surgery. 2010;20(8):1133-1141.
• Miras AD, Jackson RN, Jackson SN, et al. Gastric bypass surgery for obesity decreases the reward value of a sweet-fat stimulus as assessed in a progressive ratio task. The American Journal of Clinical Nutrition. 2012;96(3):467-473.
• Coluzzi I, Raparelli L, Guarnacci L, et al. Food intake and changes in eating behavior after laparoscopic sleeve gastrectomy. Obesity Surgery. 2016;26(9):2059-2067.
• Silva LB, Oliveira BM, Correia F. Evolution of body composition of obese patients undergoing Bariatric Surgery. Clinical Nutrition ESPEN. 2019;31:95-99.
• Bult MJ, van Dalen T, Muller AF. Surgical treatment of obesity. European Journal of Endocrinology. 2008;158(2):135-146.
• Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. Journal of American Medical Association. 2004;292(14):1724-1737.
• Kafri N, Valfer R, Nativ O, Shiloni E, Hazzan D. Health behavior, food tolerance, and satisfaction after laparoscopic sleeve gastrectomy. Surgery for Obesity and Related Diseases. 2011;7(1):82-88.
• Sağlık Bakanlığı Sağlık Hizmetleri Genel Müdürlüğü. Obezite ve Metabolik Cerrahi Klinik Protokolü 2021.
• Amundsen T, Strømmen M, Martins C. Suboptimal weight loss and weight regain after gastric bypass surgery-postoperative status of energy intake, eating behavior, physical activity, and psychometrics. Obesity Surgery. 2017;27(5):1316-1323.
• Warburton DE, Nicol CW, Bredin SS. Health benefits of physical activity: the evidence. Canadian Medical Association Journal. 2006;174(6):801-809.
• Smith LL, Larkey L, Celaya MC, Blackstone RP. Feasibility of implementing a meditative movement intervention with bariatric patients. Applied Nursing Research. 2014;27(4):231-236.
• Neunhaeuserer D, Gasperetti A, Savalla F, et al. Functional evaluation in obese patients before and after sleeve gastrectomy. Obesity Surgery. 2017;27(12):3230-3239.