Effects of nutritional support long time after total gastrectomy.
OBJECTIVE
Long-term effects of total gastrectomy on nutritional status are not well known, neither is the role of nutritional support. Dietary counselling is usually individualized, but generally not well defined. We aimed to evaluate effects of individualized oral nutritional support long time after total gastrectomy.


METHODS
Dietary advice was given, aiming for an energy and protein rich diet, using ordinary food and liquid supplements tailored to individual needs and preferences. Counselling was repeated monthly. Body weight and a 4-day food record were obtained at baseline, and thereafter-at month 1, 3, 6 and 12. Body composition, resting and total energy expenditure were measured at baseline and at 12 months.


RESULTS
Thirteen of 15 included patients completed the study. Though a trend of weight gain was seen after 1 month, there was no significant weight change at 12 months as weight development was quite heterogeneous. Six patients who remained healthy during the study (all with BMI<25) gained weight (p<0.05), while five patients with intercurrent co-morbidity and two with initial BMI>25 lost weight or remained stable.


CONCLUSIONS
Nutritional intervention long time after total gastrectomy did not change body weight, body composition or energy metabolism. Intercurrent co-morbidity appeared to have a major impact on outcome, as the nutritional support was more effective in patients who remained healthy and had a BMI<25.
Department of Clinical Nutrition, Sahlgrenska University Hospital, S-413 45 Gothenburg, Sweden. lotta.copland@vgr.se
Lotta
L
Copland
Bengt
B
Liedman
Elisabet
E
Rothenberg
Ingvar
I
Bosaeus
D000368:Aged; D000369:Aged, 80 and over; D001481:Basal Metabolism / Q000502:physiology; D001823:Body Composition / Q000502:physiology; D015992:Body Mass Index; D015897:Comorbidity; D003376:Counseling / Q000379:methods*; D004032:Diet / Q000592:standards*; D015930:Diet Records; D004044:Dietary Proteins / Q000008:administration & dosage*; D002149:Energy Intake / Q000502:physiology*; D004734:Energy Metabolism / Q000502:physiology; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D009751:Nutritional Requirements; D009752:Nutritional Status; D009753:Nutritive Value; D015430:Weight Gain
D004044:Dietary Proteins