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Clinical and Nutritional Management of Bariatric Surgery Patients

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A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Clinical Nutrition".

Deadline for manuscript submissions: closed (31 December 2023) | Viewed by 10226

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Special Issue Editors

Prof. Dr. Luigi Schiavo

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Guest Editor

Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Baronissi, Italy
Interests: obesity; obesity management; metabolism; metabolic and bariatric surgery; body composition; micronutrient deficiencies; nutritional supplementation
Special Issues, Collections and Topics in MDPI journals

Prof. Dr. Vincenzo Pilone

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Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana", University of Salerno, Baronissi, Italy
Interests: obesity; obesity management; metabolism; bariatric surgery; weight loss; body composition

Prof. Dr. Antonio Iannelli

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Guest Editor

1. Centre Hospitalier Universitaire de Nice - Digestive Surgery and Liver Transplantation Unit, Archet 2 Hospital, Nice, France
2. Faculty of Medicine, Université Côte d'Azur, Nice, France
3. Inserm, U1065, Team 8 "Hepatic Complications of Obesity and Alcohol", Nice, France
Interests: bariatric surgery; obesity surgery; liver steatosis; liver surgery

Special Issue Information

Dear Colleagues,

The World Obesity Atlas 2022, published by the World Obesity Federation, predicts that one billion people globally, including one in five women and one in seven men, will be living with obesity by 2030. With an increasing rate of global metabolic and bariatric surgery (MBS) experience, long-term studies have proven it an effective and durable treatment for severe obesity and its co-morbidities. After surgery, significant improvements in metabolic disease, as well as decreases in the overall mortality rate, have been reported in multiple studies, further supporting the importance of this treatment modality. Concurrently, the safety of MBS surgery has been studied and reported extensively. Nevertheless, some issues persist in the correct clinical and nutritional management of these patients both in the pre- and postoperative phases.

In this Special Issue entitled “Clinical and Nutritional Management of Bariatric Surgery Patients”, we would like to advance our knowledge regarding the clinical and nutritional management of patients with obesity along the whole course of their journey. Ideal contributors are authors of international and national standing, leaders in the field, and trendsetters, such as nutritionists, dietitians, surgeons, health care professionals, research scientists, molecular and cellular biochemists, physicians, general practitioners, public health workers, and anyone involved in MBS multidisciplinary teams. We encourage the submission of original research and review articles that cover the gaps of knowledge regarding the importance of clinical and nutritional management in bariatric patients before and after surgery.

We expect this Special Issue to attract significant interest in view of the worrying worldwide burden of obesity, its complications, and complications within its management.

We look forward to receiving your contributions and will be pleased to answer queries you might have regarding article submission.

Prof. Dr. Luigi Schiavo
Prof. Dr. Vincenzo Pilone
Prof. Dr. Antonio Iannelli
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Nutrients is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

obesity
bariatric surgery
bariatric nutrition
bariatric surgery complications
nutrition

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Published Papers (5 papers)

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Research

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16 pages, 341 KiB

Open AccessArticle

Association between Self-Perception of Chewing, Chewing Behavior, and the Presence of Gastrointestinal Symptoms in Candidates for Bariatric Surgery

by Flávia Luciana Pinheiro de Souza Pinto Martins, Millena Borges Inete, Yasmym Dannielle do Espírito Santo Souza, Rafaela Lorena Viana Costa, Rafaelle Dias Gabbay, Tainá Martins Moraes, Vanessa Vieira Lourenço Costa, Carla Cristina Paiva Paracampo, Luiz Carlos de Albuquerque and Daniela Lopes Gomes

Nutrients 2024, 16(8), 1096; https://doi.org/10.3390/nu16081096 - 9 Apr 2024

Viewed by 1077

Abstract

Given the changes in the digestive tract post-bariatric surgery, adapting to a new pattern of eating behavior becomes crucial, with special attention to the specifics of chewing mechanics. This study aimed to investigate the association between self-perception of chewing, chewing behavior, and the presence of gastrointestinal symptoms in preoperative patients undergoing bariatric surgery. Sixty adult candidates for bariatric surgery at a public hospital in Belém (Brazil) were analyzed. Participants predominantly exhibited unilateral chewing patterns (91.6%), a fast chewing rhythm (73.3%), a large food bolus (80%), liquid intake during meals (36.7%), and 41.7% reported that chewing could cause some issue. Significant associations were found between the perception of causing problems and chewing scarcity (p = 0.006), diarrhea (p = 0.004), absence of slow chewing (p = 0.048), and frequent cutting of food with front teeth (p = 0.034). These findings reveal a relationship between the perception of chewing problems and chewing scarcity, presence of diarrhea, and fast chewing. Full article

(This article belongs to the Special Issue Clinical and Nutritional Management of Bariatric Surgery Patients)

12 pages, 439 KiB

Open AccessArticle

Psychometric Analysis of the Rapid Eating Assessment for Participants-Short Form to Evaluate Dietary Quality in a Pre-Surgical Bariatric Population

by Daisuke Hayashi, Travis D. Masterson, Ann M. Rogers, Andrea Rigby and Melissa Butt

Nutrients 2023, 15(15), 3372; https://doi.org/10.3390/nu15153372 - 29 Jul 2023

Cited by 1 | Viewed by 2406

Abstract

Dietary quality and eating behaviors are essential to evaluating bariatric surgery candidates. The Rapid Eating Assessment for Participants–Short Form (REAP-S) is a previously validated measure of dietary quality suited for use in primary care. This study aimed to evaluate the psychometric properties of the REAP-S in a pre-surgical bariatric population. This study included data from one academic medical center from August 2020 to August 2022. Variables included socio-demographics, the REAP-S, mental health, and assessments of appetitive traits. Statistical methods included Cronbach’s alpha, confirmatory factor analysis (CFA), and multivariable analyses. A total of 587 adult patients were included in this analysis. The mean score for the REAP-S was 28.32 (SD: 4.02), indicative of relatively moderate dietary quality. The internal consistency of the REAP-S was moderate, with a Cronbach’s alpha of 0.65. The three-factor CFA model resulted in a comparative fit index of 0.91. Race (p = 0.01), body mass index (p = 0.01), food fussiness (p < 0.0001), food responsiveness (p = 0.005), and socially desirable responses (p = 0.003) were significantly associated with the total REAP-S score. Although the REAP-S’s original purpose was to assess dietary quality within a primary care population, it shows promise for application within a bariatric surgery-seeking population. Full article

(This article belongs to the Special Issue Clinical and Nutritional Management of Bariatric Surgery Patients)

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10 pages, 745 KiB

Open AccessArticle

Effects of Preoperative Sarcopenia-Related Parameters on Cardiac Autonomic Function in Women with Obesity Following Bariatric Surgery: A One-Year Prospective Study

by Nara Nóbrega Crispim Carvalho, Vinícius José Baccin Martins, Vinícius Almeida da Nóbrega, Adélia da Costa Pereira de Arruda Neta, Luís Antônio Cavalcante da Fonseca, Francisco Bandeira and José Luiz de Brito Alves

Nutrients 2023, 15(12), 2656; https://doi.org/10.3390/nu15122656 - 7 Jun 2023

Cited by 5 | Viewed by 1694

Abstract

Objectives: Investigate changes in blood pressure (BP) and heart rate variability (HRV) in women with and without sarcopenia-related parameters who underwent bariatric surgery (BS) during a one-year follow-up. Subjects and Methods: Women were separated into obesity (OB, n = 20) and women with obesity displaying sarcopenia-related parameters (SOP, n = 14) and evaluated before BS and 3, 6, and 12 months after BS. SOP was defined as low handgrip strength (HS) and/or low appendicular skeletal mass adjusted for weight (ASM/wt × 100, %) in the lowest quartile of the sample. ASM/wt × 100, % and HS were significantly lower in SOP than OB over a one-year follow-up of BS (p < 0.05). Results: There was a reduction in diastolic BP, heart rate (HR), SDHR, LF, and the LF/HF ratio (p < 0.05) and an increase in the HF band in both groups during the follow-up period (p < 0.05). SOP women had reduced root mean square differences of successive RR intervals (RMSSD) and HF band and an increased LF band and SD2/SD1 ratio compared to the OB group during the one-year follow-up (p < 0.05). ASM/wt × 100, % was negatively associated with the LF band (r = −0.24, p = 0.00) and positively associated with the HF band (r = 0.22, p = 0.01). Conversely, HS had no association with LF (r = −0.14, p = 0.09) and HF (r = 0.11, p = 0.19). ASM/wt × 100, % and HS were negatively associated with the LF/HF ratio (p < 0.05). Conclusions: Women who underwent BS had an improved HRV over a one-year follow-up. However, the improvement in HRV variables was less pronounced in women with low muscle mass and/or HS during the follow-up period. Full article

(This article belongs to the Special Issue Clinical and Nutritional Management of Bariatric Surgery Patients)

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13 pages, 916 KiB

Open AccessArticle

Clinical Impact of Enteral Protein Nutritional Therapy on Patients with Obesity Scheduled for Bariatric Surgery: A Focus on Safety, Efficacy, and Pathophysiological Changes

by Giuseppe Castaldo, Luigi Schiavo, Imma Pagano, Paola Molettieri, Aurelio Conte, Gerardo Sarno, Vincenzo Pilone and Luca Rastrelli

Nutrients 2023, 15(6), 1492; https://doi.org/10.3390/nu15061492 - 20 Mar 2023

Cited by 4 | Viewed by 2121

Abstract

Background: Ketogenic diet-induced weight loss before bariatric surgery (BS) has beneficial effects on the reduction in the liver volume, metabolic profile, and intra- and post-operative complications. However, these beneficial effects can be limited by poor dietary adherence. A potential solution in patients showing a poor adherence in following the prescribed diet could be represented by enteral nutrition strategies. To date, no studies describe the protocol to use for the efficacy and the safety of pre-operative enteral ketogenic nutrition-based dietary protocols in terms of weight reduction, metabolic efficacy, and safety in patients with obesity scheduled for BS. Aims and scope: To assess the clinical impact, efficacy, and safety of ketogenic nutrition enteral protein (NEP) vs. nutritional enteral hypocaloric (NEI) protocols on patients with obesity candidate to BS. Patients and methods: 31 NEP were compared to 29 NEI patients through a 1:1 randomization. The body weight (BW), body mass index (BMI), waist circumference (WC), hip circumference (HC), and neck circumference (NC) were assessed at the baseline and at the 4-week follow-up. Furthermore, clinical parameters were assessed by blood tests, and patients were asked daily to report any side effects, using a self-administered questionnaire. Results: Compared to the baseline, the BW, BMI, WC, HC, and NC were significantly reduced in both groups studied (p < 0.001). However, we did not find any significative difference between the NEP and NEI groups in terms of weight loss (p = 0.559), BMI (p= 0.383), WC (p = 0.779), and HC (p = 0.559), while a statistically significant difference was found in terms of the NC (NEP, −7.1% vs. NEI, −4%, p = 0.011). Furthermore, we found a significant amelioration of the general clinical status in both groups. However, a statistically significant difference was found in terms of glycemia (NEP, −16% vs. NEI, −8.5%, p < 0.001), insulin (NEP, −49.6% vs. NEI, −17.8%, p < 0.0028), HOMA index (NEP, −57.7% vs. NEI, −24.9%, p < 0.001), total cholesterol (NEP, −24.3% vs. NEI, −2.8%, p < 0.001), low-density lipoprotein (NEP, −30.9% vs. NEI, 1.96%, p < 0.001), apolipoprotein A1 (NEP, −24.2% vs. NEI, −7%, p < 0.001), and apolipoprotein B (NEP, −23.1% vs. NEI, −2.3%, p < 0.001), whereas we did not find any significative difference between the NEP and NEI groups in terms of aortomesenteric fat thickness (p = 0.332), triglyceride levels (p = 0.534), degree of steatosis (p = 0.616), and left hepatic lobe volume (p = 0.264). Furthermore, the NEP and NEI treatments were well tolerated, and no major side effects were registered. Conclusions: Enteral feeding is an effective and safe treatment before BS, with NEP leading to better clinical results than NEI on the glycemic and lipid profiles. Further and larger randomized clinical trials are needed to confirm these preliminary data. Full article

(This article belongs to the Special Issue Clinical and Nutritional Management of Bariatric Surgery Patients)

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Review

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15 pages, 1479 KiB

Open AccessReview

The Impact and Effectiveness of Weight Loss on Kidney Transplant Outcomes: A Narrative Review

by Gerardo Sarno, Evelyn Frias-Toral, Florencia Ceriani, Martha Montalván, Beatriz Quintero, Rosario Suárez, Eloísa García Velasquèz, Giovanna Muscogiuri, Antonio Iannelli, Vincenzo Pilone and Luigi Schiavo

Nutrients 2023, 15(11), 2508; https://doi.org/10.3390/nu15112508 - 28 May 2023

Cited by 2 | Viewed by 2321

Abstract

Obesity is a worldwide epidemic that leads to several non-communicable illnesses, including chronic kidney disease (CKD). Diet and lifestyle modifications have shown a limited impact in the treatment of obesity. Because the group of end-stage renal disease (ESRD) patients examined in this study had limited access to kidney transplantation (KT), patients with obesity were thought to be at an increased risk of intraoperative and postoperative KT complications. Although bariatric surgery (BS) is now recognized as the gold standard treatment for morbid obesity, its role in ESRD or kidney transplant patients remains unknown. It is critical to know the correlation between weight loss and complications before and after KT, the impact of the overall graft, and patients’ survival. Hence, this narrative review aims to present updated reports addressing when to perform surgery (before or after a KT), which surgical procedure to perform, and again, if strategies to avoid weight regain must be specific for these patients. It also analyzes the metabolic alterations produced by BS and studies its cost-effectiveness pre- and post-transplantation. Due to the better outcomes found in KT recipients, the authors consider it more convenient to perform BS before KT. However, more multicenter trials are required to provide a solid foundation for these recommendations in ERSD patients with obesity. Full article

(This article belongs to the Special Issue Clinical and Nutritional Management of Bariatric Surgery Patients)

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