Comprehensive nutrition and lifestyle education improves weight loss and physical activity in Hispanic Americans following gastric bypass surgery: a randomized controlled trial.
BACKGROUND
As morbid obesity increasingly affects Hispanic Americans, the incidence of bariatric procedures among this population is rising. Despite this, prospective research on the effects of comprehensive postoperative education-centered interventions on weight loss and physical activity focused on Hispanic Americans is lacking.


OBJECTIVE
To examine whether a comprehensive nutrition education and behavior modification intervention improves weight loss and physical activity in Hispanic Americans with obesity following Roux-en-Y gastric bypass surgery (RYGB).


METHODS
A prospective randomized-controlled trial was conducted between November 2008 and April 2010. At 6 months following RYGB, 144 Hispanic Americans with obesity were randomly assigned to a comprehensive nutrition and lifestyle educational intervention (n=72) or a noncomprehensive approach (comparison group n=72). Those in the comprehensive group received education sessions every other week for 6 weeks in small groups and frequent contact with a registered dietitian. Those in the comparison group received brief, printed healthy lifestyle guidelines. Patients were reassessed at 12 months following surgery. Main outcome measures were excess weight loss and physical activity changes over time. Statistical analyses used t test, ?(2) test, Wilcoxon signed rank, Mann-Whitney U test, and intent-to-treat analysis, significance P<0.05.


RESULTS
Participants (mean age 44.5 ± 13.5 years) were mainly Cuban-born women (83.3%). Mean preoperative excess weight and body mass index (calculated as kg/m(2)) were 72.20 ± 27.81 kg and 49.26 ± 9.06, respectively. At 12 months following surgery, both groups lost weight significantly, but comprehensive group participants experienced greater excess weight loss (80% vs 64% from preoperative excess weight; P<0.001) and greater body mass index reduction (6.48 ± 4.37 vs 3.63 ± 3.41; P<0.001) than comparison group participants. Comprehensive group participants were significantly more involved in physical activity (+14 min/wk vs ?4 min/wk; P<0.001) than comparison group participants. Mean protein intake was significantly lower in the comparison group than that in the comprehensive group (P<0.024).


CONCLUSIONS
Findings support the importance of comprehensive nutrition education for achieving more effective weight reduction in Hispanic Americans following RYGB.
Department of Dietetics and Nutrition, Robert Stempel School of Public Health and Social Work, Florida International University, Miami, FL, USA. monijamkin@yahoo.com
Monica Petasne
MP
Nijamkin
Adriana
A
Campa
Jorge
J
Sosa
Marianna
M
Baum
Susan
S
Himburg
Paulette
P
Johnson
D000328:Adult; D015992:Body Mass Index; D004044:Dietary Proteins / Q000008:administration & dosage; D015444:Exercise; D005260:Female; D015390:Gastric Bypass; D006266:Health Education / Q000379:methods*; D006630:Hispanic or Latino / Q000193:education / Q000523:psychology*; D006801:Humans; D008019:Life Style; D008297:Male; D052756:Nutritional Sciences / Q000193:education*; D009767:Obesity, Morbid / Q000601:surgery / Q000628:therapy*; D011446:Prospective Studies; D016896:Treatment Outcome; D015431:Weight Loss
D004044:Dietary Proteins