Nutrition Care in Bariatric Surgery

NCBS: Post-operative Macronutrient Intake (2017)

• Intervention
  What is the relationship between post-operative macronutrient distribution and weight loss in adults who have undergone bariatric surgery?

  • Conclusion
    Seven studies (including gastric bypass, gastric band and sleeve gastrectomy, with the majority of patients having undergone gastric bypass) report that post-operative macronutrient distribution based on percentage of energy ranges from 35% to 50% from carbohydrates, 15% to 23% from protein and 35% to 42% from fat, for a period of up to five years. While a particular post-operative macronutrient distribution may be associated with receiving medical nutrition therapy, post-operative dietary adherence and daily caloric intake, there was no statistically significant relationship between post-operative macronutrient distribution and post-operative weight loss. These ranges may be due to the variation in methods used to measure macronutrient distribution. Ongoing research is needed regarding the effect of available bariatric surgical options on macronutrient distribution.
    
     
  • Grade: II
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: What is the relationship between post-operative macronutrient distribution and weight loss in adults who have undergone bariatric surgery?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Faria SL, Kelly ED, Faria OP, Ito MK. Snack-eating patients experience lesser weight loss after Roux-en-Y gastric bypass surgery. Obesity surgery 2009; 19:1,293-1,296
      • Forbush S, Nof L, Echternach J, Hill C, Rainey J. Influence of activity levels and energy intake on percent excess weight loss after Roux-en-Y gastric bypass. Obesity Surgery 2011; 21:1,731-1,738
      • Moizé V, Andreu A, Flores L, Torres F, Ibarzabal A, Delgado S, Lacy A, Rodriguez L, Vidal J. Long-term dietary intake and nutritional deficiencies following sleeve gastrectomy or Roux-En-Y gastric bypass in a Mediterranean population. Journal of the Academy of Nutrition and Dietetics 2013; 113:400-410
      • Ortega J, Ortega-Evangelio G, Cassinello N, Sebastia V. What are obese patients able to eat after Roux-en-Y gastric bypass?. Obesity facts 2012; 5:339-348
      • Sarwer D, Moore R, Spitzer J, Wadden T, Raper S, Williams N. A pilot study investigating the efficacy of postoperative dietary counseling to improve outcomes after bariatric surgery. Surgery for Obesity and Related Diseases: Official Journal of the American Society for Bariatric Surgery 2012; 8:561-568
      • Sarwer D, Wadden T, Moore R, Baker A, Gibbons L, Raper S, Williams N. Preoperative eating behavior, postoperative dietary adherence, and weight loss after gastric bypass surgery. Surgery for Obesity and Related Diseases: Official Journal of the American Society for Bariatric Surgery 2008; 4:640-646
      • Swenson B, Saalwachter Schulman A, Edwards M, Gross M, Hedrick T, Weltman A, Northrup C, Schirmer B, Sawyer R. The effect of a low-carbohydrate, high-protein diet on post laparoscopic gastric bypass weight loss: a prospective randomized trial. The Journal of Surgical Research 2007; 142:308-313
  • Search Plan and Results: NCBS: Energy and Macronutrient Intake 2015