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Effects of Two Preoperatory Weight Loss Diets on Hepatic Volume, Metabolic Parameters, and Surgical Complications in Morbid Obese Bariatric Surgery Candidates: a Randomized Clinical Trial

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Abstract

Objective

To assess which type of preoperative dietary strategy is most effective in reducing liver volume and assessing its influence on different biochemical parameters and on surgical complications in individuals undergoing bariatric surgery.

Methods

Parallel randomized trial comparing the effect of a very low calorie diet (VLCD) and a low calorie diet (LCD) for a period of 21 days before surgery on hepatic volume, anthropometric and biochemical parameters. Compliance and tolerance to the diets, surgical complications, and hospital stay were also determined.

Results

Eighty-six morbid obese participants undergoing bariatric surgery were randomized. The hepatic volume was significantly reduced in both intervention groups, but no differences in changes between groups were detected. The reduction in the hepatic volume was higher in those patients with a baseline hepatic volume > 3 L compared to those with < 3 L (adjusted P value < 0.001). The percentages of total weight lost were 5.8 and 4.2% (adjusted P value = 0.004) for participants on the VLCD and LCD, respectively. There were no differences between groups for any of the biochemical parameters analyzed, nor in the number of surgical complications nor the length of hospital stay. Adherence to the diet was good; nevertheless, participants in the VLCD intervention showed worse tolerance.

Conclusions

In subjects with morbid obesity undergoing bariatric surgery, compared to a LCD, a preoperative 21-day intervention with VLCD is more effective in terms of reducing total body weight but not in terms of reducing the liver volume. Both types of preoperative diets have similar effects on clinical biochemical parameters, rate of surgical complications, and hospital length stay.

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Authors and Affiliations

  1. Nutrition Unit, Department of Internal Medicine, University Hospital of Sant Joan, Reus, Spain

    A. Gils Contreras, A. Bonada Sanjaume, A. Rabassa Soler & J. Salas-Salvadó

  2. Human Nutrition Unit, Faculty of Medicine and Health Sciences, Universitat Rovira i Virgili, C/Sant Llorenç 21, 43201, Reus, Spain

    A. Gils Contreras, A. Bonada Sanjaume, A. Rabassa Soler, N. Becerra Tomás & J. Salas-Salvadó

  3. Diagnostic Service for the Image, Department of Radiology, University Hospital of Sant Joan, Reus, Spain

    M. Montero Jaime

  4. Bariatric and Metabolic Surgery Unit, General and Digestive Surgery Department, University Hospital of Sant Joan, Reus, Spain

    F. Sabench Pereferrer, A. Molina López & D. Del Castillo Déjardin

  5. Surgery Service, Sant Joan University Hospital, Faculty of Medicine and Health Sciences, IISPV, Rovira i Virgili University, Reus, Spain

    F. Sabench Pereferrer & D. Del Castillo Déjardin

  6. Consorcio CIBER, M.P., Physiopathology of Obesity and Nutrition (CIBERobn), Instituto de Salud Carlos III (ISCIII), 28029, Madrid, Spain

    N. Becerra Tomás & J. Salas-Salvadó

Authors
  1. A. Gils Contreras
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  2. A. Bonada Sanjaume
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  3. M. Montero Jaime
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  4. A. Rabassa Soler
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  5. F. Sabench Pereferrer
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  6. A. Molina López
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  7. N. Becerra Tomás
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  8. D. Del Castillo Déjardin
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  9. J. Salas-Salvadó
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Corresponding authors

Correspondence to D. Del Castillo Déjardin or J. Salas-Salvadó.

Ethics declarations

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

Author 9 reports receiving a grant from Nestle thorough his Institution. The rest of authors declare that they have no conflict of interest.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

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Gils Contreras, A., Bonada Sanjaume, A., Montero Jaime, M. et al. Effects of Two Preoperatory Weight Loss Diets on Hepatic Volume, Metabolic Parameters, and Surgical Complications in Morbid Obese Bariatric Surgery Candidates: a Randomized Clinical Trial. OBES SURG 28, 3756–3768 (2018). https://doi.org/10.1007/s11695-018-3413-7

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  • DOI: https://doi.org/10.1007/s11695-018-3413-7

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