Roux-En-Y Gastric Bypass and Sleeve Gastrectomy Does Not Affect Food Preferences When Assessed by an Ad libitum Buffet Meal
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Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) lead to a reduction in energy intake. It is uncertain whether this reduction is simply due to eating smaller portions or if surgery changes food preferences towards less energy-dense food. Previous results rely on verbal reports, which may be prone to recall bias and underestimation of especially unhealthy foods.
Using an ad libitum buffet meal targeting direct behavior, we investigated if RYGB and SG surgery leads to changes in food preferences. In addition, we assessed food preferences by a picture display test to explore differences between a method relying on verbal report and a method assessing direct behavior.
Forty-one subjects (BMI 45.0 ± 6.8 kg/m2) completed a visit pre- and 6 months post-RYGB (n = 31) and SG (n = 10). Mean BMI decreased with 11.7 ± 0.6 kg/m2 and total energy intake at the buffet meal with 54% (4491 ± 208 kJ vs. 2083 ± 208 kJ, P < 0.001), respectively. However, relative energy intake from the following food categories: high-fat, low-fat, sweet, savory, high-fat-savory, high-fat-sweet, low-fat-savory, and low-fat-sweet, as well as energy density did not change following surgery (all P ≥ 0.18). In contrast, the picture display test showed that food from the low-fat-savory group was chosen more often post-surgery (34 ± 8% vs. 65 ± 9%, P = 0.02).
The reduction in energy intake after RYGB and SG surgery and the subsequent weight loss seems to be primarily related to a reduction in portion sizes and not by changes in food preferences towards less energy-dense foods. These results underline the necessity of investigating eating behavior by targeting direct behavior.
KeywordsEating behavior Food preferences Ad libitum buffet meal Roux-en-y gastric bypass Sleeve gastrectomy
We wish to thank surgeons and surgical staff at the Bariatric Clinic, Køge Hospital, Denmark; the kitchen and laboratory staff and master’s students at the Department of Nutrition, Exercise and Sports, University of Copenhagen, for helping with recruitment and data collection; and Lene Stevner for support with the protocol. A special thanks to all the participants in the GO Bypass study.
Compliance with Ethical Standards
The study was approved by the Scientific Ethic Committees of the Capital Region of Denmark (J.no H-3-2013-138) and registered in the database www.clinicaltrials.gov (ID no NCT02070081).
This study was carried out as a part of the research program “Governing Obesity” funded by the University of Copenhagen Excellence Programme for Interdisciplinary Research (www.go.ku.dk). Furthermore, the study is funded by The Danish Diabetes Academy supported by the Novo Nordisk Foundation, the Lundbeck Foundation, and the Aase and Ejnar Danielsens Foundation.
Conflict of Interest
MSN received a research grant from the Danish Diabetes Academy, and BJC and JBS received a research grant from University of Copenhagen. AS received a research grant from the University of Copenhagen, the Lundbeck Foundation, and the Aase and Ejnar Danielsens Foundation. CWlR is supported by a Science Foundation Ireland grant (ref 12/YI/B2480) and Health Research Board grant (USIRL-2016-2). The other authors declare no competing interests.
All procedures performed in the study involving human participants were in accordance with the ethical standard of the national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
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