title: Dietary assessment of adolescents undergoing laparoscopic Roux-en-Y gastric bypass surgery: macro- and micronutrient, fiber, and supplement intake.
abstract: BACKGROUND
  Extremely obese adolescents are increasingly undergoing bariatric procedures, which restrict dietary intake. However, as yet, no data are available describing the change in caloric density or composition of the adolescent bariatric patient's diet pre- and postoperatively. Our objective was to assess the 1-year change in the dietary composition of adolescents undergoing bariatric surgery at a tertiary care children's hospital.
  
  
  METHODS
  A total of 27 subjects (67% female, 77% white, age 16.7 ± 1.4 yr, baseline body mass index 60.1 ± 14.1 kg/m(2)) were prospectively enrolled into an observational cohort study 1 month before undergoing laparoscopic Roux-en-Y gastric bypass from August 2005 to March 2008. The 3-day dietary intake was recorded at baseline (n = 24) and 2 weeks (n = 16), 3 months (n = 11), and 1 year (n = 9) postoperatively. The dietary record data were verified by structured interview and compared with the Dietary Reference Intake values for ages 14-18 years.
  
  
  RESULTS
  By 1 year after surgery, the mean caloric intake, adjusted for body mass index was 1015 ± 182 kcal/d, a 35% reduction from baseline. The proportion of fat, protein, and carbohydrate intake did not differ from baseline. However, the protein intake was lower than recommended postoperatively. The calcium and fiber intake was also persistently lower than recommended. Calcium and vitamin B(12) supplementation increased the likelihood of meeting the daily minimal recommendations (P ≤ .02).
  
  
  CONCLUSIONS
  At 1 year after Roux-en-Y gastric bypass, the adolescents' caloric intake remained restricted, with satisfactory macronutrient composition but a lower than desirable intake of calcium, fiber, and protein.
authors.affiliation: Division of Pediatric and Thoracic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229-3039, USA.
authors.forename: Renee M
authors.initials: RM
authors.lastname: Jeffreys
authors.forename: Kathleen
authors.initials: K
authors.lastname: Hrovat
authors.forename: Jessica G
authors.initials: JG
authors.lastname: Woo
authors.forename: Marcia
authors.initials: M
authors.lastname: Schmidt
authors.forename: Thomas H
authors.initials: TH
authors.lastname: Inge
authors.forename: Stavra A
authors.initials: SA
authors.lastname: Xanthakos
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D004032:Diet; D004043:Dietary Fiber; D019587:Dietary Supplements; D002149:Energy Intake; D005260:Female; D015390:Gastric Bypass / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D018977:Micronutrients / Q000008:administration & dosage*; D009767:Obesity, Morbid / Q000601:surgery*; D011446:Prospective Studies; D014131:Trace Elements / Q000008:administration & dosage; D015431:Weight Loss
chemical_list: D004043:Dietary Fiber; D018977:Micronutrients; D014131:Trace Elements