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The Relationship Between Bariatric Surgery and Diet Quality: a Systematic Review

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Abstract

Background

Bariatric surgery is currently the most effective treatment for morbid obesity. These procedures change the gastrointestinal system with the aim of reducing dietary intake. Improving diet quality is essential in maintaining nutritional health and achieving long-term benefits from the surgery. The aim of this systematic review was to examine the relationship between bariatric surgery and diet quality at least 1 year after surgery.

Methods

A systematic search of five databases was conducted. Studies were included that reported diet quality, eating pattern, or quality of eating in adult patients who had undergone laparoscopic-adjusted gastric banding (LAGB), Roux-en-Y gastric bypass (RYGB), and sleeve gastrectomy (SG) procedures. Data was extracted to determine the relationship between having had bariatric surgery and subsequent diet quality.

Results

A total of 34 study articles (described in 36 articles) met the inclusion criteria. The majority of studies were observational in nature and showed a reduction in energy intake following surgery, as well as inadequate intakes of micronutrients and protein, and an excessive intake of fats. There was evidence of nutrient imbalances, suboptimal compliance with multivitamin and mineral supplementation, and limited follow-up of patients.

Conclusion

The current evidence base suggests that despite being effective in reducing energy intake, bariatric surgery can result in unbalanced diets, inadequate micronutrient and protein intakes, and excessive intakes of fats. In combination with suboptimal adherence to multivitamin and mineral supplementation, this may contribute to nutritional deficiencies and weight regain. There is a need for high-quality nutrition studies, to identify optimal dietary compositions following bariatric surgery.

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Authors and Affiliations

  1. School of Medicine, Faculty of Science Medicine and Health, University of Wollongong, Wollongong, NSW, Australia

    Nazy Zarshenas, Linda Clare Tapsell & Elizabeth Phillipa Neale

  2. Shore Surgical, 156-158 Pacific Highway, Greenwich, NSW, 2065, Australia

    Nazy Zarshenas

  3. School of Mathematics and Applied Statistics, Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, NSW, Australia

    Marijka Batterham

  4. Upper Gastrointestinal Surgery, St George Private Hospital, Kogarah, Sydney, NSW, Australia

    Michael Leonard Talbot

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Correspondence to Nazy Zarshenas.

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Appendix

Appendix

The search terms used in Scopus were as follows:

((TITLE-ABS-KEY (“bariatric surgery”) OR TITLE-ABS-KEY (“sleeve gastrectomy”) OR TITLE-ABS-KEY (“gastric banding”) OR TITLE-ABS-KEY (“gastric bypass”) OR TITLE-ABS-KEY (“roux-en-y gastric bypass”))) AND ((TITLE-ABS-KEY (“meal pattern”) OR TITLE-ABS-KEY (“diet quality”) OR TITLE-ABS-KEY (diet*) OR TITLE-ABS-KEY (“food groups”) OR TITLE-ABS-KEY (nutri* ) ) ) AND (LIMIT TO (DOCTYPE, “ar”) OR LIMIT-TO (DOCTYPE, “re” ) ) AND (LIMIT-TO (SUBJAREA, “MEDI”) OR LIMIT-TO (SUBJAREA, “NURS”) OR LIMIT-TO (SUBJAREA, “NEUR”) OR LIMIT-TO (SUBJAREA, “PSYC”) OR LIMIT-TO (SUBJAREA, “HEAL”) OR LIMIT-TO (SUBJAREA, “SOCI” ) ) AND (LIMIT-TO (LANGUAGE, “English” ) ) AND (EXCLUDE (EXACTKEYWORD, “Animals”) OR EXCLUDE (EXACTKEYWORD, “Animal Experiment”) OR EXCLUDE (EXACTKEYWORD, “Animal”) OR EXCLUDE (EXACTKEYWORD, “Child”) OR EXCLUDE (EXACTKEYWORD, “Rat”) OR EXCLUDE (EXACTKEYWORD, “Animal Model” ) ) AND (EXCLUDE (EXACTKEYWORD, “Adolescent”) OR EXCLUDE (EXACTKEYWORD, “Nonhuman”) OR EXCLUDE (EXACTKEYWORD, “Sibutramine”) OR EXCLUDE (EXACTKEYWORD, “Unclassified Drug”) OR EXCLUDE (EXACTKEYWORD, “Pregnancy”) OR EXCLUDE (EXACTKEYWORD, “Adipose Tissue”) OR EXCLUDE (EXACTKEYWORD, “Antiobesity Agent” ) )

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Zarshenas, N., Tapsell, L.C., Neale, E.P. et al. The Relationship Between Bariatric Surgery and Diet Quality: a Systematic Review. OBES SURG 30, 1768–1792 (2020). https://doi.org/10.1007/s11695-020-04392-9

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