title: Protein intake compliance of morbidly obese patients undergoing bariatric surgery and its effect on weight loss and biochemical parameters.
abstract: BACKGROUND
  Grade D evidence supports a daily protein intake (DPI) of >60 g/d after Roux-en-Y gastric bypass. However, the physiologic effects of this recommendation have yet to be elucidated. The primary aim of the present study was to assess the effects of DPI after laparoscopic Roux-en-Y gastric bypass on weight loss, leptin levels, and albumin levels. The setting was a 617-acute inpatient bed university-affiliated teaching hospital.
  
  
  METHODS
  The data from 427 consecutive bariatric surgery patients were prospectively collected from December 2007 to April 2011. The data were analyzed using Pearson's correlation, the chi-square test, the paired t test, analysis of covariance, and hierarchical linear regression analysis.
  
  
  RESULTS
  Of the 427 patients, 167 (39.1%) had complete data at 3, 6, and 12 months of follow-up and were used for the present analysis. Of the 427 patients, 140 (83.8%) were women with a mean age and preoperative body mass index (BMI) of 42.7 ± 11 years and 47.3 ± 8.1 kg/m(2), respectively. Of the 427 patients, 71.3% were compliant with a DPI of ≥1 g/kg/d at 12 months postoperatively. The patients had a mean percentage of excess weight loss of 74.9% ± 16.7% and a mean BMI of 29.4 ± 5.4 kg/m2 at 12 months. When controlling for the preoperative BMI, carbohydrate violations, and exercise increase, DPI was associated with a greater percentage of excess weight loss (P = .001), BMI change (P < .0001), and percentage of lean mass (P = .003), and a lower percentage of body fat (P < .0001) at 12 months.
  
  
  CONCLUSIONS
  Excellent compliance with a DPI of ≥1 g/kg/d at 12 months after laparoscopic Roux-en-Y gastric bypass is feasible and might result in the benefits of increased weight loss, a decreased percentage of body fat, and improved percentage of lean mass.
authors.affiliation: Bariatric Center at Saint Francis Hospital and Medical Center, Hartford, Connecticut 06105, USA. iraftopo@stfranciscare.org
authors.forename: Ioannis
authors.initials: I
authors.lastname: Raftopoulos
authors.forename: Bruce
authors.initials: B
authors.lastname: Bernstein
authors.forename: Kristine
authors.initials: K
authors.lastname: O'Hara
authors.forename: Jeannine A
authors.initials: JA
authors.lastname: Ruby
authors.forename: Ravi
authors.initials: R
authors.lastname: Chhatrala
authors.forename: Judy
authors.initials: J
authors.lastname: Carty
mesh_terms: D000328:Adult; D001823:Body Composition; D015992:Body Mass Index; D004044:Dietary Proteins / Q000008:administration & dosage*; D005260:Female; D015390:Gastric Bypass; D006801:Humans; D020738:Leptin / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000097:blood / Q000178:diet therapy / Q000601:surgery*; D010349:Patient Compliance; D011182:Postoperative Care / Q000379:methods; D011446:Prospective Studies; D011788:Quality of Life; D012709:Serum Albumin / Q000378:metabolism; D015431:Weight Loss
chemical_list: D004044:Dietary Proteins; D020738:Leptin; D012709:Serum Albumin