PDF(Pubmed)
Abstract：
BACKGROUND: Food intakes 1-2 years following bariatric surgery depend more on patients than the surgery\'s gastrointestinal tract changes. This study aimed to determine the major dietary patterns of patients after the first two years of sleeve gastrectomy and to investigate their associations with total weight loss (TWL) and the proportion of TWL as fat mass (FM) and fat-free mass (FFM) loss.
METHODS: This cross-sectional study included 146 patients undergoing sleeve gastrectomy 2-4 years after surgery. Dietary patterns were determined using principal component analysis based on the 19 food groups. The percentage of FM loss relative to TWL (%FML) and FFM loss relative to TWL (%FFML) were calculated. A suboptimal clinical response was defined as a TWL of less than 25%. High FM loss and excessive FFM loss were defined based on the highest tertiles. Linear and logistic regression models were used to derive unstandardized (B) coefficients and odds ratios (OR), with dietary pattern scores serving as both a continuous and a binary variable (higher vs. lower adherence groups based on median).
RESULTS: Two predominant dietary patterns were retained. Each 1-unit increase in the first dietary pattern score characterized by high intakes of fast foods, soft drinks, processed meats, sugar confectionary, salty snacks, grains, and organ meats was associated with higher %FFML (B = 1.99; 95% confidence interval (CI) 0.34, 3.66), lower %FML (B = - 1.84; 95% CI - 3.49, - 0.20), and higher odds of excessive FFM loss (OR = 1.84; 95% CI 1.09, 3.11). Participants with higher adherence to the first dietary pattern had lower %TWL, and greater odds of suboptimal clinical response and excessive FFM loss than those with lower adherence. Each 1-unit increase in score for the second dietary pattern characterized by a high intake of fruits, dairy, vegetables, legumes, eggs, nuts, red meats, poultry, and fish was associated with lower odds of suboptimal clinical response (OR = 0.51; 95% CI 0.31, 0.86).
CONCLUSIONS: Patients should be encouraged to modify their diet by reducing the consumption of ultra-processed foods and increasing their intake of high-quality protein sources, fruits, and vegetables to achieve the best postoperative outcome.
METHODS: This cross-sectional study included 146 patients undergoing sleeve gastrectomy 2-4 years after surgery. Dietary patterns were determined using principal component analysis based on the 19 food groups. The percentage of FM loss relative to TWL (%FML) and FFM loss relative to TWL (%FFML) were calculated. A suboptimal clinical response was defined as a TWL of less than 25%. High FM loss and excessive FFM loss were defined based on the highest tertiles. Linear and logistic regression models were used to derive unstandardized (B) coefficients and odds ratios (OR), with dietary pattern scores serving as both a continuous and a binary variable (higher vs. lower adherence groups based on median).
RESULTS: Two predominant dietary patterns were retained. Each 1-unit increase in the first dietary pattern score characterized by high intakes of fast foods, soft drinks, processed meats, sugar confectionary, salty snacks, grains, and organ meats was associated with higher %FFML (B = 1.99; 95% confidence interval (CI) 0.34, 3.66), lower %FML (B = - 1.84; 95% CI - 3.49, - 0.20), and higher odds of excessive FFM loss (OR = 1.84; 95% CI 1.09, 3.11). Participants with higher adherence to the first dietary pattern had lower %TWL, and greater odds of suboptimal clinical response and excessive FFM loss than those with lower adherence. Each 1-unit increase in score for the second dietary pattern characterized by a high intake of fruits, dairy, vegetables, legumes, eggs, nuts, red meats, poultry, and fish was associated with lower odds of suboptimal clinical response (OR = 0.51; 95% CI 0.31, 0.86).
CONCLUSIONS: Patients should be encouraged to modify their diet by reducing the consumption of ultra-processed foods and increasing their intake of high-quality protein sources, fruits, and vegetables to achieve the best postoperative outcome.
摘要：
背景：减肥手术后1-2年的食物摄入量更多地取决于患者，而不是手术的胃肠道变化。本研究旨在确定袖状胃切除术前两年患者的主要饮食模式，并研究其与总体重减轻（TWL）以及TWL占脂肪量（FM）和无脂肪量（FFM）损失的比例的关系。
方法：本横断面研究纳入了146例患者在手术后2-4年接受袖状胃切除术。基于19种食物组，使用主成分分析确定饮食模式。计算FM损失相对于TWL的百分比(%FML)和FFM损失相对于TWL的百分比(%FFML)。次优临床反应被定义为TWL小于25%。高FM损失和过度FFM损失是基于最高三元率定义的。线性和逻辑回归模型用于得出非标准化（B）系数和优势比（OR），膳食模式得分既是连续变量又是二元变量(较高与基于中位数的依从性较低的组)。
结果：保留了两种主要的饮食模式。第一膳食模式得分每增加1个单位，其特征是快餐摄入量高，软饮料,加工肉类,糖糖果，咸小吃,谷物,和器官肉类与较高的%FFML相关(B=1.99;95%置信区间(CI)0.34,3.66),较低的%FML(B=-1.84；95%CI-3.49，-0.20)，过度FFM丢失的可能性更高(OR=1.84；95%CI1.09，3.11)。坚持第一种饮食模式的参与者有较低的%TWL，与依从性较低的患者相比，出现不良临床反应和过度FFM损失的可能性更大。第二种膳食模式的分数每增加1个单位，其特征是水果摄入量高，乳制品，蔬菜,豆类,鸡蛋,坚果,红肉,家禽,鱼与较低的不良临床反应几率相关(OR=0.51;95%CI0.31,0.86)。
结论：应鼓励患者通过减少超加工食品的消费和增加高质量蛋白质来源的摄入量来改变他们的饮食。水果,和蔬菜，以达到最佳的术后效果。
方法：本横断面研究纳入了146例患者在手术后2-4年接受袖状胃切除术。基于19种食物组，使用主成分分析确定饮食模式。计算FM损失相对于TWL的百分比(%FML)和FFM损失相对于TWL的百分比(%FFML)。次优临床反应被定义为TWL小于25%。高FM损失和过度FFM损失是基于最高三元率定义的。线性和逻辑回归模型用于得出非标准化（B）系数和优势比（OR），膳食模式得分既是连续变量又是二元变量(较高与基于中位数的依从性较低的组)。
结果：保留了两种主要的饮食模式。第一膳食模式得分每增加1个单位，其特征是快餐摄入量高，软饮料,加工肉类,糖糖果，咸小吃,谷物,和器官肉类与较高的%FFML相关(B=1.99;95%置信区间(CI)0.34,3.66),较低的%FML(B=-1.84；95%CI-3.49，-0.20)，过度FFM丢失的可能性更高(OR=1.84；95%CI1.09，3.11)。坚持第一种饮食模式的参与者有较低的%TWL，与依从性较低的患者相比，出现不良临床反应和过度FFM损失的可能性更大。第二种膳食模式的分数每增加1个单位，其特征是水果摄入量高，乳制品，蔬菜,豆类,鸡蛋,坚果,红肉,家禽,鱼与较低的不良临床反应几率相关(OR=0.51;95%CI0.31,0.86)。
结论：应鼓励患者通过减少超加工食品的消费和增加高质量蛋白质来源的摄入量来改变他们的饮食。水果,和蔬菜，以达到最佳的术后效果。
