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Nutrients
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Nutritional Management and Metabolic Complications of Bariatric Surgery
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Nutritional Management and Metabolic Complications of Bariatric Surgery

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

Deadline for manuscript submissions: closed (25 October 2023) | Viewed by 3329

Special Issue Editor

Dr. Albert Lecube

E-Mail Website
Guest Editor
Full Professor, Head of Endocrinology and Nutrition Department, Arnau de Vilanova University Hospital, Head of Obesity, Diabetes and Metabolism Research Group (ODIM), Institut de Recerca Biomèdica de Lleida (IRBLleida), University of Lleida, Av. Rovira Roure 80, 25198 Lleida, Spain
Interests: obesity; stigma; diet; bariatric surgery; obesity treatment; sleep apnea; type 2 diabetes

Special Issue Information

Dear Colleagues,

Obesity has a very complex multifactorial aetiology in which both genetic and environmental factors are involved; this poses a great challenge. It is not only considered as a chronic and relapsing disease but also a risk factor for a multitude of other chronic noncommunicable diseases, with high rates of disability and all-cause mortality. Bariatric surgery is an increasingly popular treatment choice associated with rapid weight loss and a reduction in obesity-related comorbidities.

However, 25–30% of patients undergoing this type of surgery have a weight response considered insufficient, fail to achieve remission of their complications, experience weight regain, or develop food intolerances and micronutrient deficiencies. With nutritional screening and appropriate intake of diet and supplements, malnutrition following bariatric surgery can be prevented and treated before patients experience debilitating and irreversible consequences. This Special Issue is focused on the nutritional management and assessment of patients before and after bariatric surgery and the health issues following bariatric surgery. We welcome either original research or systematic reviews and meta-analyses.

Dr. Albert Lecube
Guest Editor

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
  • nutrition
  • complications
  • weight regain
  • weight loss
  • MAFLD
  • metabolic hepatic disease
  • type 2 diabetes

Published Papers (3 papers)

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Research

15 pages, 1191 KiB  
Article
A Program of Life-Style Modification Improved the Body Weight and Micronutrient Status in Obese Patients after Bariatric Surgery
by Marta Crespo-Yanguas, Jairo Lumpuy-Castillo, Cristina Espadas, Carmen Aragón-Valera, Clotilde Vázquez and Óscar Lorenzo
Nutrients 2023, 15(17), 3807; https://doi.org/10.3390/nu15173807 - 30 Aug 2023
Viewed by 999
Abstract
Introduction: Bariatric surgery is an efficient approach to rapidly reduce morbid obesity and associated comorbidities. However, approximately one-fourth of patients experience weight and comorbidity recurrence, and both obesity and bariatric surgery can lead to micronutrient deficiencies. Implementing a structured program of lifestyle modification [...] Read more.
Introduction: Bariatric surgery is an efficient approach to rapidly reduce morbid obesity and associated comorbidities. However, approximately one-fourth of patients experience weight and comorbidity recurrence, and both obesity and bariatric surgery can lead to micronutrient deficiencies. Implementing a structured program of lifestyle modification (PLM) might enhance weight loss and improve micronutrient status. Methodology: A total of 121 severely obese patients underwent Roux-en-Y gastric bypass (RYGB). Among them, 71 adhered to a PLM involving dietary changes (low- and very-low-calorie Mediterranean diets) and physical exercises (aerobic and resistance training) both before and after surgery, while 50 patients followed a conventional protocol. Anthropometric measurements and serological parameter quantifications were conducted throughout the procedures. Results: The obese study population, primarily female (76.9%), with an average age of 47.11 ± 9.68, and a body mass index (BMI) of 44.68 ± 5.08 kg/m2, underwent either RYGB with a PLM or a conventional procedure. Before surgery, the PLM group exhibited significant reductions in body weight (6.3%) and phosphoremia compared to the conventional protocol (0.78%). Post-RYGB, the PLM group demonstrated shortened in-hospital stays and further BMI reductions (−16.12 kg/m2) that persisted for up to 2 years. Furthermore, the PLM group experienced increased plasma vitamin D levels (14.79 ng/mL vs. 1.2 ng/mL) for up to 2 years, as well as elevated folic acid (1.52 vs. −0.29 ng/mL) and phosphorus (0.48 vs. 0.06 mg/dL) levels at 1 month and 1 year after intervention, respectively. Notably, these effects were independent of weight loss. Conclusions: Initiating a structured PLM from the early stages of patients’ preparation for RYGB could enhance and extend the benefits of weight loss and positively impact micronutrient (vitamin D, phosphorus, and folic acid) status in obese patients. Full article
(This article belongs to the Special Issue Nutritional Management and Metabolic Complications of Bariatric Surgery)
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15 pages, 1469 KiB  
Article
Longer-Term Weight Loss Outcomes Are Not Primarily Driven by Diet Following Roux-en-Y Gastric Bypass and Sleeve Gastrectomy
by Alicia A. Sorgen, Anthony A. Fodor, Kristine J. Steffen, Ian M. Carroll, Dale S. Bond, Ross Crosby and Leslie J. Heinberg
Nutrients 2023, 15(15), 3323; https://doi.org/10.3390/nu15153323 - 26 Jul 2023
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Abstract
Metabolic and bariatric surgery (MBS) is the most effective long-term treatment for Class III obesity. Reduced dietary intake is considered a behavioral driver of post-surgical weight loss, but limited data have examined this association. Therefore, this study examined prospective, longitudinal relationships between dietary [...] Read more.
Metabolic and bariatric surgery (MBS) is the most effective long-term treatment for Class III obesity. Reduced dietary intake is considered a behavioral driver of post-surgical weight loss, but limited data have examined this association. Therefore, this study examined prospective, longitudinal relationships between dietary intake and weight loss over 24 months following Roux-en-Y Gastric Bypass and Sleeve Gastrectomy. Relationships between weight loss and dietary intake were examined using a validated 24-h dietary recall method. Associations between total energy/macronutrient intake and weight loss outcomes were assessed at 12-, 18-, and 24-months following MBS, defining patients as “responders” and “suboptimal responders”. Consistent with previous literature, 12-month responders and suboptimal responders showed significant associations between weight loss and energy (p = 0.018), protein (p = 0.002), and total fat intake (p = 0.005). However, this study also revealed that many of these associations are no longer significant 24 months post-MBS (p > 0.05), despite consistent weight loss trends. This study suggests a short-term signal between these dietary factors and weight loss outcomes 12 months post-MBS; however, this signal does not persist beyond 12 months. These results are essential for interpreting and designing clinical studies measuring long-term post-surgical weight loss outcomes. Full article
(This article belongs to the Special Issue Nutritional Management and Metabolic Complications of Bariatric Surgery)
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11 pages, 2159 KiB  
Article
The Interplay of Adipokines, Body Composition and Glucose Homeostasis in Pregnant Women with a History of RYGB Operation
by Luise Bellach, Liliana-Imi Gard, Simon David Lindner, Sabina Baumgartner-Parzer, Peter Klimek, Alexandra Kautzky-Willer and Michael Leutner
Nutrients 2023, 15(11), 2498; https://doi.org/10.3390/nu15112498 - 27 May 2023
Cited by 1 | Viewed by 970
Abstract
Roux-en-Y gastric bypass operations (RYGB-OP) and pregnancy alter glucose homeostasis and the adipokine profile. This study investigates the relationship between adipokines and glucose metabolism during pregnancy post-RYGB-OP. (1) Methods: This is a post hoc analysis of a prospective cohort study during pregnancy in [...] Read more.
Roux-en-Y gastric bypass operations (RYGB-OP) and pregnancy alter glucose homeostasis and the adipokine profile. This study investigates the relationship between adipokines and glucose metabolism during pregnancy post-RYGB-OP. (1) Methods: This is a post hoc analysis of a prospective cohort study during pregnancy in 25 women with an RYGB-OP (RY), 19 women with obesity (OB), and 19 normal-weight (NW) controls. Bioimpedance analysis (BIA) was used for metabolic characterization. Plasma levels of adiponectin, leptin, fibroblast-growth-factor 21 (FGF21), adipocyte fatty acid binding protein (AFABP), afamin, and secretagogin were obtained. (2) Results: The phase angle (φ) was lower in RY compared to OB and NW. Compared to OB, RY, and NW had lower leptin and AFABP levels, and higher adiponectin levels. φ correlated positively with leptin in RY (R = 0.63, p < 0.05) and negatively with adiponectin in OB and NW (R = −0.69, R = −0.69, p < 0.05). In RY, the Matsuda index correlated positively with FGF21 (R = 0.55, p < 0.05) and negatively with leptin (R = −0.5, p < 0.05). In OB, FGF21 correlated negatively with the disposition index (R = −0.66, p < 0.05). (3) Conclusions: The leptin, adiponectin, and AFABP levels differ between RY, OB, and NW and correlate with glucose metabolism and body composition. Thus, adipokines might influence energy homeostasis and maintenance of cellular health during pregnancy. Full article
(This article belongs to the Special Issue Nutritional Management and Metabolic Complications of Bariatric Surgery)
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