Dietary Intake and Weight Changes 5 Years After Laparoscopic Sleeve Gastrectomy
Laparoscopic sleeve gastrectomy (LSG) is becoming a leading primary bariatric surgery but long-term outcome remains unclear. The amount of food eaten is drastically reduced after LSG and may lead to nutritional deficiencies potentially. The aim of this study is to investigate long-term dietary intake and weight status after LSG.
Forty patients underwent LSG had more than 5-year follow-up with complete clinical data and food frequency questionnaires were analyzed.
The mean age of subjects is 33.5 years old with mean body mass index (BMI) 37.9 kg/m2. Mean BMI loss at 5 years after LSG is 10.6 kg/m2. Weight regain appeared in 20% of patients. Dietary composition analysis at 5 years showed mean calorie intake of 1230 kcal/day, protein 70 g/day (22.5% of calorie), fat 50 g/day (36.1%), carbohydrate 126 g (41.4%), iron 7.5 mg/day, calcium 536.2 mg/day, and fiber 11.7 g/day. Calorie intake at 5 years after LSG is correlated with weight loss but weight regain is not related to a higher calorie intake. All comorbidities were significantly improved after LSG but hemoglobin and parathyroid hormone significantly changed. Incidence of iron deficiency anemia increased from 7.5% at pre-operation to 41.2% after LSG. Incidence of secondary hyperparathyroidism increased from 17.5 to 60.7%.
LSG is an effective and durable bariatric procedure but with significant changes in nutritional status. Dietary instruction for LSG should include foods rich in protein, iron, calcium, and fiber.
KeywordsMorbid obesity Severe obesity Bariatric surgery Laparoscopic sleeve gastrectomy Weight regain Energy Calorie Anemia Hyperparathyroidism Protein Fat Carbohydrate
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