Abstract
Obesity is a clinical condition characterized by fat mass reserves increased to such an extent as to represent a health risk. The clinical diagnosis of obesity requires a careful nutritional status valuation to get an early diagnosis of malnutrition (undernutrition, overnutrition, or mixed malnutrition); to establish nutrition requirements; to identify those patients who require a nutritional intervention for global or selective nutrient deficiencies; and to check the effectiveness of such an intervention. The main components which characterize nutritional status are energy balance (nutritional habits and physical activity), body composition, body function, and inflammatory status. Nutrition intervention will focus on achieving a weight loss of at least 10 % from baseline body weight with a significant reduction in body fat and preservation of lean mass; reconstructing long-term healthy eating habits (quality, quantity, rate) based on the canons of the Mediterranean Diet; obtaining a patient’s compliance adequate to achieve the established objectives. The nutritional intervention should be included into a process of therapeutic education aimed at the implementation of the knowledge about the disease and its management, and to change behaviors related to it for better management. In addition, therapeutic education allows to understand and to manage the psychological aspects related with the disease itself. An increasing number of new inpatient admissions in Rehabilitation settings consist of either failed or complicated post-surgical cases characterized by malnutrition, functional impairment and psychological uneasiness. Nutritional rehabilitation may be effective in reducing short-term and long-term complications related to bariatric surgery in improving the results of bariatric surgery and the recovery from psychological and functional impairments.
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References
Apovian CM, Cummings S, Anderson W, Borud L, Boyer K, Day K, Hatchigian E, Hodges B, Patti ME, Pettus M, Perna F, Rooks D, Saltzman E, Skoropowski J, Tantillo MB, Thomason P (2009) Best Practice Updates for Multidisciplinary Care in Weight Loss Surgery. Obesity (Silver Spring) 17:871–879
Ashton K, Heinberg L, Windover A, Merrell J (2011) Positive response to binge eating intervention enhances postoperative weight loss. Surg Obes Relat Dis 315–20
Baumgartner RN, Wayne SJ, Waters DL, Janssen I, Gallagher D, Morley JE (2004) Sarcopenic obesity predicts instrumental activities of daily living disability in the elderly. Obes Res 12:1995–2004
Bedogni G, Battistini N, Severi S, Borghi A (1996) The physiological bases of the assessment of nutritional status. Clin Diet 23:141–146
Bedogni G, Borghi A, Battistini NC (2001) Manuale di valutazione antropometrica dello stato nutrizionale. EDRA. pp 72–73
Breland JY, Fox AM, Horowitz CR, Leventhall H (2012) Applying a common-sense approach to fighting obesity. J Obesity, Article ID 710427, 8 pages, doi:10.1155/2012/710427
Busetto L, Enzi G, Inelmen EM, Costa G, Negrin V, Sergi G, Vianello A (2005) Obstructive sleep apnea syndrome in morbid obesity: effects of intragastric balloon. Chest 128:618–623
Butryn ML, Phelan S, Hill JO, Wing RR (2007) Consistent self-monitoring of weight: a key component of successful weight loss maintenance. Obesity 15:3091–3096
Canadian clinical practice guidelines on the management and prevention of obesity in adults and children CMAJ (2007) 176 (8): S1–13
Cheryl CHC (2001) A concept analysis of malnutrition in the elderly. J Adv Nurs 36(1):131–142
Christou NV, Look D, Maclean LD (2006) Weight gain after short- and long-limb gastric bypass in patients followed for longer than 10 years. Ann Surg 244:734–740
Clinical guidelines on the identification (1998) evaluation, and treatment of overweight and obesity in adults: executive summary. Expert Panel on the Identification, Evaluation, and Treatment of Overweight in Adults. Am J Clin Nutr 68(4):899–917
Clinical guidelines on the identification, evaluation, and treatment of Overweight and obesity in Adults - The Evidence Report, National Institutes of Health (1998) Obes Res 6 Suppl 2: 51S-209S
Coin A, Sergi G, Minicucci N, Giannini S, Barbiero E, Manzato E, Pedrazzoni M, Minisola S, Rossini M, Del Puente A, Zamboni M (2008) Fat-free mass and fat-mass reference values by DEXA in a 20–80 year-old Italian population. Clin Nutr 27:87–94
Davison KK, Ford ES, Cogswell ME, Dietz WH (2002) Percentage of body fat and body mass index are associated with mobility limitations in people aged 70 and older from NHANES III. JAGS 50:1802–2002
De Lorenzo A, Deurenberg P, Pietrantuono M, Di Daniele N, Cervelli V, Andreoli A (2003) How fat is obese? Acta Diabetol 40:S254–S257
Delmonico MJ, Harris TB, Lee JS, Visser M, Nevitt M, Kritchevsky SB, Tylavsky FA, Newman AB; Health, Aging and Body Composition Study (2007) Alternative definitions of sarcopenia, lower extremity performance, and functional impairment with aging in older men and women.JAGS 55:769–774
Deurenberg P, van der Kooy K, Hulshof T, Evers P (1989) Body mass index as a measure of body fatness in the elderly. Eur J Clin Nutr 43:231–236
Deurenberg P (1999) Deurenberg Yap M, Wang J, Lin FP, Schmidt G.: The impact of body build on the relationship between body mass index and percent body fat. Int J Obes Relat Metab Disord 23(5):537–542
Deurenberg P, Yap M, van Staveren WA (1998) Body mass index and percent body fat: a meta analysis among different ethnic groups. Int J Obes Relat Metab Disord 22(12):1164–1171
Donini LM, Cuzzolaro M, Spera G, Badiali M, Basso N, Bollea MR, Bosello O, Brunani A, Busetto L, Cairella G, Cannella C, Capodaglio P, Carbonelli MG, Castellaneta E, Castra R, Clini E, Contaldo F, Dalla Ragione L, Dalle Grave R, D’Andrea F, Del Balzo V, De Cristofaro P, Di Flaviano E, Fassino S, Ferro AM, Forestieri P, Franzoni E, Gentile MG, Giustini A, Jacoangeli F, Lubrano C, Lucchin L, Manara F, Marangi G, Marcelli M, Marchesini G, Marri G, Marrocco W, Melchionda N, Mezzani B, Migliaccio P, Muratori F, Nizzoli U, Ostuzzi R, Panzolato G, Pasanisi F, Persichetti P, Petroni ML, Pontieri V, Prosperi E, Renna C, Rovera G, Santini F, Saraceni V, Savina C, Scuderi N, Silecchia G, Strollo F, Todisco P, Tubili C, Ugolini G, Zamboni M (2010) Obesità e disturbi dell’Alimentazione. Indicazioni per i diversi livelli di trattamento. Documento di Consensus. Eat Weight Disord. 15(1–2):1–31
Dwyer JT (1999): Nutritional Status. Encyclopaedia of Human Nutrition. Sadler MJ, Strain JJ, Caballero B (eds) Acedemic Press, San Diegop 1347–1389
Elia M, Stubbs RJ, Henry CJK (1999) Differences in fat, carbohydrate, and protein metabolism between lean and obese subjects undergoing total starvation. Obesity Res. 7:597–604
Fried M, Hainer V, Basdevant A, Buchwald H, Deitel M, Finer N, Greve JW, Horber F, Mathus-Vliegen E, Scopinaro N, Steffen R, Tsigos C, Weiner R, Widhalm K (2008) Interdisciplinary European guidelines on surgery of severe obesity. Obes Facts. 1:52–59
Fujioka K (2005) Follow-up of nutritional and metabolic problems after bariatric surgery. Diabetes Care
Fugioka K (2005) Follow-up of nutritional and metabolic problems after bariatric surgery. Diabetes Care 28:481–484
Gallagher D, DeLegge M (2011) Body Composition (Sarcopenia) in Obese Patients: implications for care in the intensive care unit. JPEN 35(Supplement 1):21S–28S
Gallagher D, Heymsfield SB, Heo M, Jebb SA, Murgatroyd PR, Sakamoto Y (2000) Healthy percentage body fat ranges: an approach for developing guidelines based on body mass index. Am J Clin Nutr 72:694–701
Harris, JA; Benedict, FG (1919) A biometric study of basal metabolism in man. Carnegie Institute of Washington, Washington DC, Publ 279
Heber D, Greenway FL, Kaplan LM, Livingston E, Salvador J and Still C (2010) Endocrine and nutritional management of the post-bariatric surgery patient: an endocrine society clinical practice guideline. J Clin Endocrinol Metab 95:4823–4843
Heitmann BL, Erikson H, Ellsinger BM, Mikkelsen KL, Larsson B.: Mortality associated with body fat, fat-free mass and body mass index among 60-year-old swedish men-a 22-year follow-up. The study of men born in 1913 (2000) Int J. Obesity 24:33–37
Hill GL (1992) Body composition research: implications for the practice of clinical nutrition. JPEN 16:197–218
INRAN Istituto Nazionale di Ricerca per gli Alimenti e la Nutrizione (2003) Linee Guida per una sana alimentazione italiana, http://www.inran.it
Janssen I, Baumgartner RN, Ross R, Rosenberg IH, Roubenoff R (2004) Skeletal muscle cutpoints associated with elevated physical disability risk in older men and women. Am J Epidemiol 159:413–421
Janssen I, Heymsfield SB, Ross R (2002) Low relative skeletal muscle mass in older persons is associated with functional impairment and physical disability. JAGS 50:889–896
Karason K, Peltonen M, Lindroos AK, Sjostrom L, Lonn L, Torgerson JS (2005) Effort-related calf pain in the obese and long-term changes after surgical obesity treatment. Obes Res 13:137–145
Kendrick ML, Dakin GF (2006) Surgical approaches to obesity. Mayo Clin Proc 81(10 Suppl):S18–S24
Kyle UG, Morabia A, Schutz Y, Richard C (2003a) Sedentarism affects body fat mass index and fat-free mass index in adults aged 18–98 years. Nutrition 20:255–260
Kyle UG, Pirlich M, Lochs H, Schuetz T, Pichard C (2005) Increased length of hospital stay in underweight and overweight patients at hospital admission: a controlled population study. Clin Nutr 24:133–142
Kyle UG, Schutz Y, Dupertuis YM, Pichard C (2003b) Body composition interpretation: contributions of the fat-free mass index and the body fat mass index. Nutrition 19:597–604
Lean MEJ, Han TS, Morrison CE (1995) Waist circumference as a measure for indicating need for weight management. BMJ 311:158–161
Lier HØ, Biringer E, Stubhaug B, Tangen T (2012) The impact of preoperative counseling on postoperative treatment adherence in bariatric surgery patients: a randomized controlled trial. Patient Educ Couns 201(87):336–42
Livelli di Assunzione Raccomandati di Energia e Nutrienti per la Popolazione Italiana - LARN - Revisione 2012 - Società Italiana di Nutrizione Umana
Long CL, Schaffel N, Geiger JW, Schiller WR, Blakemore WS (1979) Metabolic response to injury and illness: estimation of energy and protein needs from indirect calorimetry and nitrogen balance. JPEN J Parenter Enteral Nutr, 3(6):452–456
Maniscalco M, Zedda A, Giardiello C et al (2006) Effect of bariatric surgery on the six-minute walk test in severe uncomplicated obesity. Obes Surg 16:836–841
McCullough PA, Gallagher MJ, Dejong AT et al (2006) Cardiorespiratory fitness and short-term complications after bariatric surgery. Chest 130:517–525
Mechanick JI, Kushner RF, Sugerman HJ, Gonzalez-Campoy JM, Collazo-Clavell ML, Spitz AF, Apovian CM, Livingston EH, Brolin R, Sarwer DB, Anderson WA, Dixon J, Guven S (2009) American Association of Clinical Endocrinologists. The Obesity Society, and American Society for Metabolic & Bariatric Surgery medical guidelines for clinical practice for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient. Obesity 17(Suppl 1):S1–70
Metcalf B, Rabkin RA, Rabkin JM, Metcalf LJ, Lehman-Becker LB (2005) Weight loss composition: the effects of exercise following obesity surgery as measured by bioelectrical impedance analysis. Obes Surg 15:183–186
Movsesyan L, Tankó LB, Larsen PJ, Christiansen C, Svendsen OL (2003) Variations in percentage of body fat within different BMI groups in young, middle-aged and old women. Clin Physiol Funct Imaging 23:130–133
Murr MM, Siadati MR, Sarr MG (1995) Results of bariatric surgery for morbid obesity in patients older than 56 years. Obes Surg 5:399–402
Narbro K, Agren G, Jonsson E, Naslund I, Sjostrom L (2002) Swedish Obese Subjects Intervention Study. Pharmaceutical costs in obese individuals: comparison with a randomly selected population sample and long-term changes after conventional and surgical treatment: the SOS intervention study. Arch Intern Med 162:2061–2069
National Heart Lung and Blood Institute (NHLBI) (2000) North American Association for the Study of Obesity (NAASO). Practical Guide to the identification, evaluation and treatment of overweight and obesity in adults. National Institutes of Health, Bethesda
Nguyen NT, Paya M, Stevens CM, Mavandadi S, Zainabadi K, Wilson SE (2004) The relationship between hospital volume and outcome in bariatric surgery at academic medical centers. Ann Surg 240:586–593
Nijamkin MP, Campa A, Sosa J, Baum M, Himburg S, Johnson P (2012) J Comprehensive nutrition and lifestyle education improves weight loss and physical activity in Hispanic Americans following gastric bypass surgery: a randomized controlled trial. Acad Nutr Diet 112:382–390
Norgan NG, Durnin JVGA (1980) The effect of 6 weeks of overfeeding on the body weight, body composition, and energy metabolism of young men. Am J Clin Nutr 33:978–988
Pain H, Wiles R (2006) The experience of being disabled and obese. Disabil Rehabil 28:1211–1220
Passmore R, Meiklejohn AP, Dewar AD, Thow RK (1955) An analysis of the gain in weight of overfed thin young men. Br J Nutr 9(1):27–37
Pelizzo G, Nakib G, Alfei A, Iasci A, Cena H, Locatelli D, Mosconi M, Zappoli F, Calcaterra V (2012) Fetal neural tube defects in pregnant women previously submitted to bariatric surgery: more attention to a new emerging entità. Prenat Diag 32:1–2
Prado CM, Wells JC, Smith SR, Stephan BC, Siervo M (2012) Sarcopenic obesity: a Critical appraisal of the current evidence. Clin Nutr. 31(5):583–601
Physical Status: the use and interpretation of anthropometry (1995) Report of a WHO Expert Committee. WHO Technical report Series–854–Geneva
Resnik L, Lapane KL, Allen SM (2005) Obesity and receipt of personal care assistance for people with mobility impairments. Obes Res 13:1307–1310
Roubenoff R (2004) Sarcopenic obesity: the confluence of two epidemics. Obes Res 12(6):887e8
Schutz Y, Kyle UG, Pichard C (2002) Fat-free mass index and fat mass index percentiles in Caucasians aged 19–98 y. Int J Obes 26:953–960
Schweitzer DH, Posthuma EF (2008) Prevention of vitamin and mineral deficiencies after bariatric surgery: evidence and algorithms. Obes Surg 18:1485–1488
Segal A (2004) Kinoshita Kussunoki D, Larino MA: Post-surgical refusal to eat: anorexia nervosa, bulimia nervosa or a new eating disorder? A case series Obes Surg 14:353–360
Seidell JC, Cigolini M et al (1992) Fat distribution in European men: a comparison of anthropometric measurements in relation to cardiovascular risk factors. Int J Obes 16:17–22
Seidell JC, Cigolini M et al (1990) Fat distribution in European women: a comparison of anthropometric measurements in relation to cardiovascular risk factors. Int J Epidemiol 19:303–308
Shah M, Simha V, Garg A (2006) Long-term impact of bariatric surgery on body weight, comorbidities and nutritional status. J Clin Endocrinol Metab 91:4223–4231
Shikora SA, Kim JJ, Tarnoff ME (2007) Nutrition and gastrointestinal complications of bariatric surgery. Nutr Clin Pract 22:29–40
SINU Società Italiana di Nutrizione Umana (2012) Livelli di Assunzione di Riferimento di Nutrienti ed energia per la popolazione, http://www.sinu.it
SINPE Società Italiana Nutrizione Parenterale ed Enterale (2002) Linee Guida SINPE per la Nutrizione Artificiale Ospedaliera (Guidelines for Hospital Nutrition Support Therapy)
Sockalingam S, Cassin S, Crawford SA, Pitzul K, Khan A, Hawa R, Jackson T, Okrainec A (2012). Psychiatric predictors of surgery non-completion following suitability assessment for bariatric surgery. Obes Surg Sep 9
Soeters PB, Rejiven PLM, van Bokhorst-de van der SChuren MAE, Schols JMGA, Halfens RJG, Meijers JMM, van Gemert WG (2008) A rational approach to nutritional assessment. Clin Nutr 27(5):706-16
“Standard Italiani per la Cura dell’Obesità” a cura SIO-Soc It dell’Obesità e ADI – Ass It Dietetica e Nutrizione Clinica – 2012-2013. P Sbracca, R Vettor eds, cap 3.c
Sugerman HJ, Fairman RP, Sood RK, Engle K, Wolfe L, Kellum JM (1992) Long-term effects of gastric surgery for treating respiratory insufficiency of obesity. Am J Clin Nutr 55(2 Suppl):597S–601S
Suter M, Calmes JM, Paroz A (2006) Giusti V.A 10-year experience with laparoscopic gastric banding for morbid obesity: high long-term complication and failure rates. Obes Surg 16:829–835
Tabelle di Composizione degli Alimenti. Istituto Nazionale della Nutrizione. 2000; 106–108
Tichet J, Vol S, Goxe D, Salle A, Berrut G, Ritz P (2008) Prevalence of sarcopenia in the French senior population. JNHA 12:202–206
Van Dorsten B, Lindley EM (2011) Cognitive and behavioral approaches in the treatment of obesity. Med Clin North Am 95:971–988
Velcu LM, Adolphine R, Mourelo R, Cottam DR, Angus LD (2005) Weight loss, quality of life and employment status after Roux-en-Y gastric bypass: 5-year analysis. Surg Obes Relat Dis 1:413–416
Virji A, Murr MM (2006) Caring for patients after bariatric surgery. Am Fam Physician 73:1403–1408
Weir JB (1949) New methods for calculating metabolic rate with special reference to protein metabolism. J Physiol 109:1–9
Zamboni M, Mazzali G, Fantin F, Rossi A, Di Francesco V (2008) Sarcopenic obesity: a new category of obesity in the elderly. NMCD 18:388–395
Zamboni M, Turcato E, Armellini F, Kahn HS, Zivelonghi A, Santana H, Bergano-Andreis IA, Bosello O (1998) Sagittal abdominal diameter as a practical predictor of visceral fat. Int J Obes Relat Metab Disord 22(7):655–660
Zhu S, Wang Z, Shen W, Heymsfield SB, Heshka S (2003) Percentage body fat ranges associated with metabolic syndrome risk: results based on the third National Health and Nutrition Examination Survey (1988–1994). Am J Clin Nutr 78:228–235
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Donini, L.M., Petroni, M.L. (2013). Principles and Protocols in Nutritional Rehabilitation. In: Capodaglio, P., Faintuch, J., Liuzzi, A. (eds) Disabling Obesity. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-35972-9_11
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