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. 2025 Jan-Feb;39(1):426-432.
doi: 10.21873/invivo.13845.

Effect of Oral Nutritional Supplements Composed of High Protein on Body Weight Loss After Gastrectomy

Satoru Kikuchi  1 , Nobuo Takata  2 , Yoshihiko Kakiuchi  3 , Shinji Kuroda  3 , Hajime Kashima  3 , Shunsuke Tanabe  3 , Kazuhiro Noma  3 , Ayako Takahashi  4 , Shunsuke Kagawa  3 , Toshiyoshi Fujiwara  3
Affiliations

Effect of Oral Nutritional Supplements Composed of High Protein on Body Weight Loss After Gastrectomy

Satoru Kikuchi et al. In Vivo. 2025 Jan-Feb.

Abstract

Background/aim: Body weight loss (BWL) after gastrectomy for gastric cancer (GC) decreases postoperative quality of life and survival in patients with GC. This study aimed to evaluate the effect of oral nutritional supplements composed of high protein on BWL in the early period following gastrectomy.

Patients and methods: Pre- and postoperative body weight and skeletal muscle mass were measured using bioelectrical impedance analysis in patients undergoing radical gastrectomy for GC and analyzed retrospectively. Patients received either a regular diet (control group, n=43) or 250 ml (320 kcal) per day of a high-protein oral nutritional supplement (ONS) (22 g protein) in addition to their regular diet (ONS group, n=40) for four weeks after gastrectomy. The actual daily intake of ONS was recorded by patients themselves. The BWL and skeletal muscle loss (SML) at one month after surgery were compared between the two groups.

Results: BWL and SML at one month after surgery were similar between the two groups. In the ONS group, patients were divided into two subgroups (ONS-H and ONS-L) according to whether their ONS intake amount was above or below the average value of 216 kcal. The ONS-H group (ONS intake ≥216 kcal) showed significantly lower BWL compared to the control group (-4.6±2.6% vs. -6.2±2.5%; p=0.03). Moreover, the ONS group showed significantly lower BWL at one month after surgery than the control group in cases of total or proximal gastrectomy (-5.9±3.0% vs. -7.8±1.9%; p=0.04), although no significant difference was observed between the two groups in distal gastrectomy. The hematological nutritional parameters were similar between the two groups.

Conclusion: The administration of ONS composed of high protein for four weeks after gastrectomy did not improve BWL at one month after gastrectomy. However, adequate amount of ONS intake and ONS intake after total or proximal gastrectomy might improve BWL.

Keywords: Amino acid; body weight loss; gastrectomy; nutritional intervention; oral nutritional supplements.

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Conflict of interest statement

The Authors declare that they have no conflicts of interest in relation to this study.

Figures

Figure 1
Figure 1
Flow diagram of the study. GC: Gastric cancer; BIA: bioelectrical impedance analysis; ONS: oral nutritional supplement.
Figure 2
Figure 2
Comparison of body weight loss and skeletal muscle loss (A) Comparison of body weight loss and skeletal muscle loss between the control group and oral nutritional supplement (ONS) group (B) Comparison of body weight loss and skeletal muscle loss according to the amount of ONS intake. Statistical significance was defined as p<0.05 (*). %BWL: Percentage of body weight loss; %SML: Percentage of skeletal muscle loss; ONS-H: oral nutritional supplement-high; ONS-L: oral nutritional supplement-low.
Figure 3
Figure 3
Percentage of body weight loss between the control group and oral nutritional supplement (ONS) group according to the surgical procedures. Statistical significance was defined as p<0.05 (*). DG: Distal gastrectomy; TG: total gastrectomy; PG: proximal gastrectomy.
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References

    1. Karanicolas PJ, Graham D, Gönen M, Strong VE, Brennan MF, Coit DG. Quality of life after gastrectomy for adenocarcinoma: a prospective cohort study. Ann Surg. 2013;257(6):1039–1046. doi: 10.1097/SLA.0b013e31828c4a19. - DOI - PMC - PubMed
    1. Kim AR, Cho J, Hsu YJ, Choi MG, Noh JH, Sohn TS, Bae JM, Yun YH, Kim S. Changes of quality of life in gastric cancer patients after curative resection. Ann Surg. 2012;256(6):1008–1013. doi: 10.1097/SLA.0b013e31827661c9. - DOI - PubMed
    1. Aoyama T, Kawabe T, Fujikawa H, Hayashi T, Yamada T, Tsuchida K, Yukawa N, Oshima T, Rino Y, Masuda M, Ogata T, Cho H, Yoshikawa T. Loss of Lean Body Mass as an Independent Risk Factor for Continuation of S-1 Adjuvant Chemotherapy for Gastric Cancer. Ann Surg Oncol. 2015;22(8):2560–2566. doi: 10.1245/s10434-014-4296-z. - DOI - PubMed
    1. Lee HH, Park JM, Song KY, Choi MG, Park CH. Survival impact of postoperative body mass index in gastric cancer patients undergoing gastrectomy. Eur J Cancer. 2016;52:129–137. doi: 10.1016/j.ejca.2015.10.061. - DOI - PubMed
    1. Kurokawa Y, Sasako M, Sano T, Shibata T, Ito S, Nashimoto A, Kurita A, Kinoshita T, Japan Clinical Oncology Group Functional outcomes after extended surgery for gastric cancer. Br J Surg. 2011;98(2):239–45. doi: 10.1002/bjs.7297. - DOI - PubMed

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