Five-year changes in dietary intake and body composition in adolescents with severe obesity undergoing laparoscopic Roux-en-Y gastric bypass surgery
Section snippets
Overview of study design
Adolescent Morbid Obesity Surgery is a Swedish nationwide 10-year prospective intervention multicenter study examining the feasibility and safety of adolescent patients with severe obesity (body mass index [BMI] ≥40 kg/m2) undergoing LRYGB at Sahlgrenska University Hospital (Gothenburg), recruited between February 2006 and June 2009 from 3 academic childhood obesity centers in Sweden: Stockholm, Gothenburg, and Malmö [5], [6]. Inclusion criteria were BMI ≥40 or ≥35 with obesity-related
Anthropometry
Adolescents undergoing LRYGB were older and with higher weight and BMI than the controls at baseline (Table 1).
Anthropometric measurements were complete at all time points in the LRYGB adolescents and in the controls at 5 years (Table 2).
Adolescents undergoing LRYGB had a substantial mean weight loss from baseline through 5 years, as reported [5], [6], [15] (Table 2), with no differences in percentage total weight loss, BMI, percentage BMI loss, or excess BMI lost between sexes (P > .05).
Dietary intake
Discussion
Weight loss and reduced energy intake remained lower after 5 years, similar to observations in adults [22], [27]. In the present study, there were no changes in macronutrient distribution of protein, carbohydrates, and fat at 1 and 2 years after surgery, consistent with earlier findings in adolescents after LRYGB [12]. However, the present study demonstrated a long-term decrease in protein and carbohydrate intake. This could be a result of the inclusion of fiber and alcohol in the calculations
Conclusion
Five years after LRYGB in adolescents with severe obesity there was a 28% weight loss, while controls gained 13%. Decreased energy intake and DED rather than modifications of macronutrient intake are important factors in weight loss after surgery. Ensuring adequate protein intake seems to improve preservation of muscle mass in adolescents after LRYGB.
Disclosures
The authors have no commercial associations that might be a conflict of interest in relation to this article.
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Body Composition Changes in Adolescents Who Underwent Bariatric Surgery: A Systematic Review and Meta-analysis
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The manuscript is part of the Swedish nationwide 10-year prospective multicenter study Adolescent Morbid Obesity Surgery (AMOS) study, conducted at 3 childhood obesity centers: Stockholm, Gothenburg, and Malmö. AMOS is funded by the Swedish Research Council (521-2012-319), Vinnova: Sweden Intervention Bureau Grant (2013-01339), Swedish Heart and Lung Foundation, Research Council of Västra Götalands Regionen (VGFOUREG-307531), and the Swedish Freemason Child foundation, Gothenburg.