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Whey Protein Supplementation Enhances Body Fat and Weight Loss in Women Long After Bariatric Surgery: a Randomized Controlled Trial

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Abstract

Background

The ideal nutritional approach for weight regain after bariatric surgery remains unclear.

Objective

The objective of this study is to assess the effect of whey protein supplementation on weight loss and body composition of women who regained weight 24 or more months after bariatric surgery.

Methods

This is a 16-week open-label, parallel-group, randomized controlled trial of women who regained at least 5 % of their lowest postoperative weight after a Roux-en-Y gastric bypass (RYGB). A total of 34 participants were treated with hypocaloric diet and randomized (1:1) to receive or not supplementation with whey protein, 0.5 g/kg of the ideal body weight. The primary outcomes were changes in body weight, fat free mass (FFM), and fat mass (FM), evaluated by tetrapolar bioelectrical impedance analysis (BIA). Secondary outcomes included resting energy expenditure, blood glucose, lipids, adiponectin, interleukin 6 (IL-6), and cholecystokinin levels. Statistical analyses included generalized estimating equations adjusted for age and physical activity.

Results

Fifteen patients in each group were evaluated: mean age was 45 ± 11 years, body mass index (BMI) was 35.7 ± 5.2 kg/m2, and time since surgery was 69 ± 23 months. Protein intake during follow-up increased by approximately 75 % in the intervention group (p = 0.01). The intervention group presented more body weight loss (1.86 kg, p = 0.017), accounted for FM loss (2.78, p = 0.021) and no change in FFM, as compared to controls (gain of 0.42 kg of body weight and 0.6 kg of FM). No differences in secondary outcomes were observed between groups.

Conclusions

Whey protein supplementation promoted body weight and FM loss in women with long-term weight regain following RYGB.

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References

  1. Puzziferri N, Roshek TB, Mayo HG, et al. Long-term follow-up after bariatric surgery: a systematic review. JAMA. 2014;312(9):934–42.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Magro DO, Geloneze B, Delfini R, et al. Long-term weight regain after gastric bypass: a 5-year prospective study. Obes Surg. 2008;18:648–51.

    Article  PubMed  Google Scholar 

  3. Karmali SI, Brar B, Shi X, et al. Weight recidivism post-bariatric surgery: a systematic review. Obes Surg. 2013;23(11):1922–33.

    Article  PubMed  Google Scholar 

  4. Faria SL, Faria OP, Buffington C, et al. Energy expenditure before and after roux-en-Y gastric bypass. Obes Surg. 2012;22(9):1450–5.

    Article  PubMed  Google Scholar 

  5. Carey DG, Pliego GJ, Raymond RL, et al. Body composition and metabolic changes following bariatric surgery: effects on fat mass, lean mass and basal metabolic rate. Obes Surg. 2006;16:469–77.

    Article  PubMed  Google Scholar 

  6. Mechanick JI, Youdim A, Jones DB, et al. Clinical practice guidelines for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient—2013 update: cosponsored by American Association of Clinical Endocrinologists, The Obesity Society, and American Society for Metabolic & Bariatric surgery (AACE/TOS/ASMBS Guidelines). Endocr Pract, 2013;19(2):337–372.

  7. Moizé V, Andreu A, Rodríguez L, et al. Protein intake and lean tissue mass retention following bariatric surgery. Clin Nutr. 2012;32(4):550–5.

    Article  PubMed  Google Scholar 

  8. Näslund E, Hellström PM. Appetite signaling: from gut peptides and enteric nerves to brain. Physiol Behav. 2007;92(1):256–62.

    Article  PubMed  Google Scholar 

  9. Forsythe LK, Wallace JM, Livingstone MB, et al. Obesity and inflammation: the effects of weight loss. Nutr Res Rev. 2008;21:117–33.

    Article  CAS  PubMed  Google Scholar 

  10. Zhou J, Keenan MJ, Losso JN, et al. Dietary whey protein decreases food intake and body fat in rats. Obesity. 2011;19(8):1568–73.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Hector AJ, Marcotte GR, Churchward-Venne TAJ, et al. Whey protein supplementation preserves postprandial myofibrillar protein synthesis during short-term energy restriction in overweight and obese adults. Nutrition. 2015;145(2):246–52.

    Article  Google Scholar 

  12. Verreijen AM, Verlaan S, Engberink MF, et al. A high whey protein, leucine, and vitamin D-enriched supplement preserves muscle mass during intentional weight loss in obese older adults: a double-blind randomized controlled trial. Am J Clin Nutr. 2015;101(2):279–86.

    Article  CAS  PubMed  Google Scholar 

  13. Kyle UG, Bosaeus I, De Lorenzo AD, et al. Bioelectrical impedance analysis—part II: utilization in clinical practice. Clin Nutr. 2004;23:1430–53.

    Article  PubMed  Google Scholar 

  14. WHO. World Health Organization. Global recommendations on physical activity for health. Geneva: WHO; 2010.

    Google Scholar 

  15. Friedewald WT, Levy RI, Fredrickson DS, et al. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem. 1972;18:499–502.

    CAS  PubMed  Google Scholar 

  16. Matthews DR, Hosker JP, Rudenski AS, et al. Homeostasis model assessment: insulin resistance and B-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985;28:412–9.

    Article  CAS  PubMed  Google Scholar 

  17. Gomes DL, de Almeida Oliveira D, Dutra E, et al. Resting energy expenditure and body composition of women with weight regain 24 months after bariatric surgery. Obes Surg. 2015:1–5.

  18. Raftopoulos I, Bernstein B, O’Hara C, et al. Protein intake compliance of morbidly obese patients undergoing bariatric surgery and its effect on weight loss and biochemical parameters. Surg Obes Relat Dis. 2011;7(6):733–42.

    Article  PubMed  Google Scholar 

  19. Zheng Y, Sereika SM, Ewing LI, et al. Association between self-weighing and percent weight change: mediation effects of adherence to energy intake and expenditure goals. J Acad Nutr Diet. 116(4):660–6.

  20. Wibisono C, Probst Y, Neale E, et al. Impact of food supplementation on weight loss in randomised-controlled dietary intervention trials: a sistematic review and meta-analysis. Br J Nutr. 2016;18:1–9.

    Article  Google Scholar 

  21. Aquino LA, Pereira SE, Silva JS, et al. Bariatric surgery: impact on body composition after roux-en-y gastric bypass. Obes Surg. 2012;22(2):195–200.

    Article  PubMed  Google Scholar 

  22. Tamboli RA. Body composition and energy metabolism following roux-en-y gastric bypass surgery. Obesity. 2010;18(9):1718–24.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Freire RH, Borges MC, Alvarez-Leite JI, et al. Food quality, physical activity and nutritional follow-up as determinant of weight regain after roux-en-Y gastric bypass. Nutrition. 2012;28:53–8.

    Article  PubMed  Google Scholar 

  24. Gaesser GA, Angadi SA, Brandon J, et al. Exercise and diet, independent of weight loss, improve cardiometabolic risk profile in overweight and obese individuals. Phys Sports Med. 2011;39(2):87–97.

    Article  Google Scholar 

  25. Burguera B, Jesús Tur J, Escudero AJ, et al. An intensive lifestyle intervention is an effective treatment of morbid obesity: the TRAMOMTANA study—a two year randomized controlled clinical trial. Int J Endocrinol 2015; 2015:194696.

  26. Pal S, Ellis V, Dhaliwal S, et al. Effects of whey protein isolate on body composition, lipids, insulin and glucose in overweight and obese individuals. Brit J Nutr. 2010;104(5):716–23.

    Article  CAS  PubMed  Google Scholar 

  27. Cummings DE, Overduin J. Gastrointestinal regulation of food intake. J Clin Invest. 2007;117(1):13.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Herder C, Peltonen M, Svensson PA, et al. Adiponectin and bariatric surgery: associations with diabetes and cardiovascular disease in the Swedish obese subjects study. Diabetes Care. 2014;37(5):1401–9.

    Article  CAS  PubMed  Google Scholar 

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Acknowledgments

This study was sponsored by CNPQ under process number 476459/2011-7; notice/universal call 14/2011 and by Fundo de Incentivo à Pesquisa e Eventos (FIPE) of the Hospital de Clínicas de Porto Alegre (HCPA).

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Authors and Affiliations

  1. Department of Nutrition, University of Brasilia, Brasilia, Brazil

    Daniela Lopes Gomes, Fernanda Bassan Lopes da Silva, Eliane Said Dutra & Kenia Mara Baiocchi de Carvalho

  2. Endocrine Division, Porto Alegre Clinical Hospital, University of Rio Grande do Sul, Porto Alegre, RS, Brazil

    Milene Moehlecke & Beatriz D’Agord Schaan

Authors
  1. Daniela Lopes Gomes
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  2. Milene Moehlecke
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  3. Fernanda Bassan Lopes da Silva
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  4. Eliane Said Dutra
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  5. Beatriz D’Agord Schaan
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  6. Kenia Mara Baiocchi de Carvalho
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Corresponding author

Correspondence to Daniela Lopes Gomes.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Conflict of Interest Disclosure Statement

The authors have no commercial associations that might be a conflict of interest in relation to this article.

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Lopes Gomes, D., Moehlecke, M., Lopes da Silva, F.B. et al. Whey Protein Supplementation Enhances Body Fat and Weight Loss in Women Long After Bariatric Surgery: a Randomized Controlled Trial. OBES SURG 27, 424–431 (2017). https://doi.org/10.1007/s11695-016-2308-8

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  • DOI: https://doi.org/10.1007/s11695-016-2308-8

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