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Preoperative Carbohydrate Quality Index Is Related to Markers of Glucose Metabolism 12 Months After Roux-en-Y Gastric Bypass

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Abstract

Objective

The role of carbohydrates in weight loss in patients undergoing bariatric surgery (BS) remains poorly understood. Therefore, this study aimed to verify the relationship of the carbohydrate quality index (CQI) with weight loss and cardiometabolic risk markers up to 1 year after BS.

Material and Methods

This study included 50 patients with obesity undergoing Roux-en-Y gastric bypass. Data collection was performed preoperatively and 3 and 12 months after surgery. The foods consumed were documented using a 24-h food recall in 3 days. The CQI was calculated considering the following parameters: dietary fiber intake, sugar level; whole grains: proportion of total grains; solid carbohydrate: total carbohydrate ratio.

Results

From the total study sample, 58 participants were followed up for 3 months, and eight participants dropped out of the study. The remaining 50 patients were followed up for 12 months. Subjects were classified into tertiles according to the index score. A 1-unit increase in CQI was associated with a −1.02 decrease in insulin concentrations at 12 months and a −1.04 decrease in HOMA-IR. Concerning the total sample, the median of the CQI was 8 points and did not change at 3 and 12 months after surgery, but there was an improvement in some components of the index.

Conclusion

The data suggest that the quality of carbohydrates can interfere with markers of insulin resistance after BS and the quality of carbohydrates is a point to be guided in patients undergoing BS.

Graphical abstract

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Abbreviations

BS :

Bariatric surgery

CQI :

Carbohydrate quality index

HOMA-IR :

Homeostatic Model Assessment of Insulin Resistance

RYGB :

Roux-en-Y gastric bypass

BMI :

Body mass index

EBW :

Excess body weight

WC :

Waist circumference

NC :

Neck circumference

BF :

Body fat

GI :

Glycemic index

R24 :

24-h recall

SD :

Standard deviations

IQR :

Interquartile ranges

T2DM :

Type 2 diabetes mellitus

IR :

Insulin resistance

WHO :

World Health Organization

FICT :

Free and informed consent term

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Acknowledgements

The Coordination for the Improvement of Higher Education Personnel - CAPES Foundation (Ministry of Education, Brazil) for Scholarships awarded to D.L.S.V. and A.S. (Funding Code 001); and the National Council for Scientific and Technological Development - CNPq (Ministry of Science, Technology and Innovation, Brazil) of which J.B. is a productivity scholarship.

Author information

Authors and Affiliations

  1. Laboratory of Energy Metabolism and Body Composition (LAMECC), Department of Nutrition and Health, Universidade Federal de Viçosa, Viçosa, Minas Gerais, 36570-900, Brazil

    Darlene L. S. Vilela, Alessandra da Silva, Sônia L. Pinto & Josefina Bressan

  2. Department of Nutrition, Universidade Federal de Tocantins, Palmas, Tocantins, 77001-090, Brazil

    Sônia L. Pinto

Authors
  1. Darlene L. S. Vilela
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  2. Alessandra da Silva
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  3. Sônia L. Pinto
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  4. Josefina Bressan
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Contributions

Darlene Larissa de Souza Vilela contributed to the study design, formal analysis and interpretation of the data, drafting of the manuscript, and approval of the final version. Alessandra da Silva contributed to the study design, formal analysis and interpretation of the data, critical review of the manuscript, and approval of the final version. Sônia Lopes Pinto contributed to data collection and interpretation, supervision, critical review of the manuscript, and approval of the final version. Josefina Bressan contributed to study design, supervision, acquisition of funding for English revision, interpretation of data, critical review of the manuscript, and approval of the final version.

Corresponding author

Correspondence to Darlene L. S. Vilela.

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Ethical Approval

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.

Informed Consent

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

Conflict of Interest

The authors declare no competing interests.

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Key Points

• Insulin was different between the thirds of the CQI.

• Increase in CQI at baseline is associated with decrease in insulin and HOMA-IR at 12 months.

• CQI was 8 points and did not change at 3 and 12 months after surgery.

Supplementary Information

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Vilela, D.L.S., da Silva, A., Pinto, S.L. et al. Preoperative Carbohydrate Quality Index Is Related to Markers of Glucose Metabolism 12 Months After Roux-en-Y Gastric Bypass. OBES SURG 33, 3155–3162 (2023). https://doi.org/10.1007/s11695-023-06771-4

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  • DOI: https://doi.org/10.1007/s11695-023-06771-4

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