目的:除了减肥手术后身体成分的推荐值外,还缺乏荟萃分析来全面评估较高蛋白质摄入量的有效性。我们旨在对随机对照试验进行荟萃分析,以确定蛋白质摄入量高于推荐值对减肥手术后身体成分变化的影响。
方法:电子数据库,包括Scopus,PubMed/Medline,和WebofSciences,一直搜索到2023年7月。评估蛋白质摄入量高于推荐值对术后身体成分的影响的研究,即,体重,体重指数(BMI),脂肪量(FM),无脂质量(FFM),脂肪质量百分比(PFM),和总重量损失百分比(%TWL),有资格。对于每个结果,使用平均值和标准偏差(相对于基线的变化)来合成数据.
结果:本研究包括8项试验。荟萃分析结果表明,与对照组相比,减肥手术后蛋白质摄入量高于推荐值导致体重减轻4.95kg(95%CI:-9.41至-0.49),FM减少7.64kg(95%CI:-14.01至-1.28)。然而,它对术后BMI的变化没有显著影响,FFM,PFM,或%TWL。从饮食和补充剂中获得的蛋白质来源之间的身体组成没有显着差异。当数据根据添加的蛋白质量进行分层时,我们发现,除推荐值外,摄入蛋白质≥40g/d的患者的体重显著下降(MD:-7.80kg;95%CI:-14.50~-1.10).此外,在接受腹腔镜袖状胃切除术(LSG)(MD:6.52kg;95%CI:0.99~12.02)的患者中,蛋白质摄入量高于推荐值降低了FFM损失.
结论:当前的荟萃分析结果表明,与正常蛋白质饮食相比,蛋白质摄入量高于推荐值可能会导致减肥手术后体重和FM损失更大。然而,我们的发现不支持额外的蛋白质在FFM的保存中的作用,LSG患者除外。
There is a lack of a meta-analysis to comprehensively assess the effectiveness of higher protein intake in addition to the recommended value on body composition post-bariatric surgery. We aimed to perform a meta-analysis of randomized controlled trials to determine the effects of protein intake higher than the recommended value on body composition changes after bariatric surgery.
Electronic databases, including Scopus, PubMed/Medline, and Web of Sciences, were searched until July 2023. Studies that assessed the effect of protein intake higher than the recommended value on postoperative body composition, i.e., weight, body mass index (BMI), fat mass (FM), fat-free mass (FFM), percent fat mass (PFM), and percent total weight loss (%TWL), were eligible. For each outcome, the mean and standard deviation (for changes from baseline) were used to synthesize the data.
Eight trials were included in the current study. The results of the meta-analysis indicated protein intake higher than the recommended value after bariatric surgery led to more weight loss by 4.95 kg (95 % CI: -9.41 to -0.49) and FM loss by 7.64 kg (95 % CI: -14.01 to -1.28) compared with the control group. However, it had no significant effects on postoperative changes in BMI, FFM, PFM, or %TWL. There were no significant differences in body composition between protein sources obtained from diet and supplementation. When data was stratified based on the amount of added protein, we found a significant reduction in weight (MD: -7.80 kg; 95 % CI: -14.50 to -1.10) in patients who consumed protein ≥ 40 g/d in addition to the recommended value. Besides, protein intake higher than the recommended value declined FFM loss in patients who underwent laparoscopic sleeve gastrectomy (LSG) (MD: 6.52 kg; 95 % CI: 0.99 to 12.02).
The results of the current meta-analysis indicated that protein intake higher than the recommended value might cause greater weight and FM loss after bariatric surgery than a normal protein diet. However, our findings did not support the role of additional protein in the preservation of FFM, except in patients with LSG.