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Impact of super energy-dense oral nutritional supplementation (SED ONS) on glycemic variability and food intake postoperatively in gastric cancer patients

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Abstract

Purpose

Adherence to oral nutritional supplements (ONS) to prevent weight loss after gastrectomy is problematic. The present study evaluated the impact of super energy-dense ONS (SED ONS; 4 kcal/mL) on glycemic change and energy intake after gastrectomy.

Methods

Gastrectomy patients were placed on continuous glucose monitoring for a 3-day observation period after food intake had been stabilized postoperatively. In addition, they were given 0, 200, and 400 kcal/day of SED ONS on Days 1, 2, and 3, respectively. The primary outcome was the area under the curve < glucose 70 mg/dL (AUC < 70). The secondary outcomes were other indices of glucose fluctuation and the amount of food and SED ONS intake.

Results

Seventeen patients were enrolled. The AUC < 70 did not differ significantly with or without SED ONS over the observation period. SED ONS did not cause postprandial hypoglycemia and prevented nocturnal hypoglycemia. The mean dietary intake did not change significantly during the observation period, and the total energy intake increased significantly according to the amount of SED ONS provided.

Conclusion

SED ONS after gastrectomy increased the total energy intake without dietary reduction and it did not result in hypoglycemia.

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Acknowledgements

We thank Mr. James R. Valera for his assistance with editing this manuscript and Mr. Atsushi Nishida, Mr. Syudo Yamasaki, and Mr. Satoshi Usami for their assistance with the statistical analysis. We are especially grateful to Ms. Tokiko Matsukura, Ms. Keiko Yokota, and the other dietitians at our center for providing nutrition education and evaluating the patients’ caloric intake.

Funding

The present study was supported by a grant from the Clinical Research Fund of the Tokyo Metropolitan Government (Grant no. R02050302).

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Authors and Affiliations

  1. Department of Surgery, Tokyo Metropolitan Tama Medical Center, 2-8-29, Musashidai, Fuchu, Tokyo, 183-8524, Japan

    Ryoto Yamazaki, Fumihiko Hatao, Yuji Ishibashi, Ryuichiro Furuta & Yasuhiro Morita

  2. Center for Medical Research Cooperation, Tokyo Metropolitan Institute of Medical Science, Setagaya City, Tokyo, Japan

    Ryoto Yamazaki & Masanari Itokawa

  3. Course for Molecular and Cellular Medicine, Niigata University Graduate School of Medical and Dental Science, Niigata, Japan

    Ryoto Yamazaki & Masanari Itokawa

  4. Clinical Research Support Center, Tokyo Metropolitan Children’s Medical Center, Fuchu, Japan

    Yoshihiko Morikawa & Masataka Honda

  5. Department of Surgery, Tokyo Metropolitan Bokutoh Hospital, Sumida, Japan

    Kazuhiro Imamura

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  1. Ryoto Yamazaki
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  2. Fumihiko Hatao
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Corresponding author

Correspondence to Fumihiko Hatao.

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All authors have no conflict of interest to declare.

Ethical approval

All data collection and analysis were performed in accordance with the ethical standards of the Declaration of Helsinki. This study was approved by the ethics committee of Tokyo Metropolitan Tama Medical Center (No.3–6) and registered with the University Hospital Medical Information Network Clinical Trials Registry (UMIN-CTR 000041219).

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Yamazaki, R., Hatao, F., Itokawa, M. et al. Impact of super energy-dense oral nutritional supplementation (SED ONS) on glycemic variability and food intake postoperatively in gastric cancer patients. Surg Today 53, 605–613 (2023). https://doi.org/10.1007/s00595-022-02600-w

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  • DOI: https://doi.org/10.1007/s00595-022-02600-w

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