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Observational Study
. 2023 Dec 28;16(1):106.
doi: 10.3390/nu16010106.

Effect on Body Composition of a Meal-Replacement Progression Diet in Patients 1 Month after Bariatric Surgery

Juan J López-Gómez  1   2 , Beatriz Ramos-Bachiller  1   2 , David Primo-Martín  1   2 , Alicia Calleja-Fernández  2 , Olatz Izaola-Jauregui  1   2 , Rebeca Jiménez-Sahagún  1   2 , Jaime González-Gutiérrez  1   2 , Eva López Andrés  1   2 , Pilar Pinto-Fuentes  3 , David Pacheco-Sánchez  3 , Daniel A De Luis-Román  1   2
Affiliations
Observational Study

Effect on Body Composition of a Meal-Replacement Progression Diet in Patients 1 Month after Bariatric Surgery

Juan J López-Gómez et al. Nutrients. .

Abstract

Background: Progression diets after bariatric surgery (BS) are restricted in calories and protein, and they may induce a worsening of body composition. The aim of this study was to evaluate the effect of a modified diet with an oral nutritional supplement that is hyperproteic and normocaloric over the body composition.

Methods: A two-arm ambispective observational cohort study was designed. Forty-four patients who underwent sleeve gastrectomy were included in the study. Thirty patients received a progression diet with a normocaloric, hyperproteic oral nutritional supplement during the first two weeks after surgery (820 kcal, 65.5 g protein). They were compared with a historical cohort of 14 patients treated with a standard progression diet (220 kcal, 11.5 g protein). Anthropometric and body composition (using electrical bioimpedanciometry) data were analyzed before BS and 1 month after the surgery.

Results: The mean age was 47.35(10.22) years; 75% were women, and the average presurgical body mass index (BMI) was 45.98(6.13) kg/m2, with no differences between both arms of intervention. One month after surgery, no differences in the percentage of excess weight loss (%PEWL) were observed between patients in the high-protein-diet group (HP) and low-protein-diet group (LP) (HP: 21.86 (12.60)%; LP: 18.10 (13.49)%; p = 0.38). A lower loss of appendicular skeletal muscle mass index was observed in the HP (HP: -5.70 (8.79)%; LP: -10.54 (6.29)%; p < 0.05) and fat-free mass index (HP: 3.86 (8.50)%; LP:-9.44 (5.75)%; p = 0.03), while a higher loss of fat mass was observed in the HP (HP: -14.22 (10.09)%; LP: -5.26 (11.08)%; p < 0.01).

Conclusions: In patients undergoing gastric sleeve surgery, the addition of a normocaloric, hyperproteic formula managed to slow down the loss of muscle mass and increase the loss of fat mass with no differences on total weight loss.

Keywords: bariatric surgery; hyperproteic diet; oral nutritional supplement; sleeve gastrectomy.

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Conflict of interest statement

Alicia Calleja-Fernández was employed by the company Adventia Pharma. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow chart.
Figure 2
Figure 2
Comparison between groups (high-protein diet and low-protein diet) of changes in electrical bioimpedanciometry variables (resistance, reactance, and phase angle) before, and one month after, bariatric surgery.
Figure 3
Figure 3
Comparison between groups (high-protein diet and low-protein diet) of changes in body composition compartments determined by bioimpedanciometry (total body water, fat-free mass index, fat index, and appendicular skeletal muscle index) before and 1 month after bariatric surgery.
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