학술논문
Bariatric surgery affects obesity-related protein requirements.
Document Type
Academic Journal
Author
Guillet C; Clermont Auvergne University, INRA, UNH, Unité de Nutrition Humaine, CRNH Auvergne, F-63000, Clermont-Ferrand, France. Electronic address: Christelle.Guillet@uca.fr.; Masgrau A; Clermont Auvergne University, INRA, UNH, Unité de Nutrition Humaine, CRNH Auvergne, F-63000, Clermont-Ferrand, France.; Mishellany-Dutour A; Clermont Auvergne University, INRA, UNH, Unité de Nutrition Humaine, CRNH Auvergne, F-63000, Clermont-Ferrand, France.; Blot A; Clermont Auvergne University, INRA, UNH, Unité de Nutrition Humaine, CRNH Auvergne, F-63000, Clermont-Ferrand, France.; Caille A; Clermont Auvergne University, INRA, UNH, Unité de Nutrition Humaine, CRNH Auvergne, F-63000, Clermont-Ferrand, France.; Lyon N; Clermont Auvergne University, INRA, UNH, Unité de Nutrition Humaine, CRNH Auvergne, F-63000, Clermont-Ferrand, France.; Pereira B; Clermont Auvergne University, CHU Clermont-Ferrand, DRCI, Biostatistics Unit, Clermont-Ferrand, France.; Slim K; Clermont Auvergne University, CHU Clermont-Ferrand, Service de Chirurgie Digestive, Clermont-Ferrand, France.; Robert M; CH Edouard Herriot, Service de Chirurgie Digestive, Hospices Civils de Lyon, Lyon, France.; Disse E; CH Lyon Sud, Service D'Endocrinologie Diabétologie et Nutrition, Hospices Civils de Lyon, CRNH Rhône-Alpes, Pierre-Bénite, France.; Feugier N; CH Lyon Sud, Service D'Endocrinologie Diabétologie et Nutrition, Hospices Civils de Lyon, CRNH Rhône-Alpes, Pierre-Bénite, France.; Le Ruyet P; Lactalis, Research and Development, Retiers, France.; Louvet C; Clermont Auvergne University, CHU Clermont-Ferrand, Service de Nutrition Clinique, Clermont-Ferrand, France.; Miolanne M; Clermont Auvergne University, CHU Clermont-Ferrand, Service de Nutrition Clinique, Clermont-Ferrand, France.; Farigon N; Clermont Auvergne University, CHU Clermont-Ferrand, Service de Nutrition Clinique, Clermont-Ferrand, France.; Laville M; CH Lyon Sud, Service D'Endocrinologie Diabétologie et Nutrition, Hospices Civils de Lyon, CRNH Rhône-Alpes, Pierre-Bénite, France.; Boirie Y; Clermont Auvergne University, INRA, UNH, Unité de Nutrition Humaine, CRNH Auvergne, F-63000, Clermont-Ferrand, France; Clermont Auvergne University, CHU Clermont-Ferrand, Service de Nutrition Clinique, Clermont-Ferrand, France.
Source
Publisher: Elsevier Ltd Country of Publication: England NLM ID: 101654592 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2405-4577 (Electronic) Linking ISSN: 24054577 NLM ISO Abbreviation: Clin Nutr ESPEN Subsets: MEDLINE
Subject
Language
English
Abstract
Context: Following bariatric surgery, protein deficiency intakes are reported in morbidly obese patients, whereas post-bariatric protein requirements are not specifically defined with validated method in this population.
Objective: To assess average protein requirement (APR) in obese subjects, before, 3 months and 12 months after bariatric surgery using the validated method of nitrogen balance.
Design and Setting: Prospective longitudinal study conducted in 21 morbidly obese patients (BMI 43.9 ± 1.4 kg/m2 ) before (M0), 3 months (M3) and 12 months (M12) after sleeve gastrectomy or Roux-en-Y gastric by-pass. An additional larger cross-sectional study was performed to validate APR before surgery in non-operated matched obese patients (n = 106). APR was evaluated at M0, M3, M12 by measuring 3 days dietary intakes together with losses of nitrogen in urine and stools.
Main Outcome Measure: APR was defined as the mean value of protein intake required to achieve balance nitrogen equilibrium.
Results: Before surgery, APR in morbidly obese patients was 0.76 [95%CI, 0.66-0.92] g/kg Body Weight (BW)/d in the experimental group, and 0.74 [0.70-0.80] g/kg BW/d in the validation group. APR was 0.62 [0.51-0.75] g/kg/d at M3 and 0.87 [0.75-0.98] g/kg/d at M12, with no difference between surgical procedures. Spontaneous protein intakes were respectively 0.80 ± 0.05, 0.43 ± 0.03 and 0.71 ± 0.04 g/kg BW/d respectively at M0, M3 and M12.
Conclusion: This study demonstrates a temporal change in protein requirement after bariatric surgery whatever the type of surgery. Spontaneous protein intakes following bariatric surgery does not cover protein requirements for most patients, suggesting that specific dietary protein recommandations have to be adapted in obese patients with bariatric surgery.
Trial Registration: Clinicaltrials.gov Identifier: NCT01249326.
Competing Interests: Declaration of competing interest CG, AM and YB have received research funding from Lactalis. PLR is employed by Lactalis Group.
(Copyright © 2020 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.)
Objective: To assess average protein requirement (APR) in obese subjects, before, 3 months and 12 months after bariatric surgery using the validated method of nitrogen balance.
Design and Setting: Prospective longitudinal study conducted in 21 morbidly obese patients (BMI 43.9 ± 1.4 kg/m
Main Outcome Measure: APR was defined as the mean value of protein intake required to achieve balance nitrogen equilibrium.
Results: Before surgery, APR in morbidly obese patients was 0.76 [95%CI, 0.66-0.92] g/kg Body Weight (BW)/d in the experimental group, and 0.74 [0.70-0.80] g/kg BW/d in the validation group. APR was 0.62 [0.51-0.75] g/kg/d at M3 and 0.87 [0.75-0.98] g/kg/d at M12, with no difference between surgical procedures. Spontaneous protein intakes were respectively 0.80 ± 0.05, 0.43 ± 0.03 and 0.71 ± 0.04 g/kg BW/d respectively at M0, M3 and M12.
Conclusion: This study demonstrates a temporal change in protein requirement after bariatric surgery whatever the type of surgery. Spontaneous protein intakes following bariatric surgery does not cover protein requirements for most patients, suggesting that specific dietary protein recommandations have to be adapted in obese patients with bariatric surgery.
Trial Registration: Clinicaltrials.gov Identifier: NCT01249326.
Competing Interests: Declaration of competing interest CG, AM and YB have received research funding from Lactalis. PLR is employed by Lactalis Group.
(Copyright © 2020 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.)