title: Inadequate protein intake after laparoscopic sleeve gastrectomy surgery is associated with a greater fat free mass loss.
abstract: BACKGROUND
  Low postoperative protein intake may represent a modifiable risk factor that leads to fat free mass (FFM) loss postlaparoscopic sleeve gastrectomy (LSG), but data concerning this phenomenon is scarce.
  
  
  OBJECTIVE
  To evaluate the association between daily protein intake and relative FFM loss at 6 (M6) and 12 (M12) months after LSG surgery.
  
  
  METHODS
  Private hospital and university hospital.
  
  
  METHODS
  A prospective cohort study with 12 months follow-up of 77 patients who underwent LSG surgery. Anthropometrics including body composition analysis measured by multifrequency bioelectrical impedance analysis, 3-day food diaries, food intolerance, and habitual physical activity were evaluated at baseline and at M3, M6, and M12.
  
  
  RESULTS
  Repeated body composition measurements and food diary were available for 77 patients (45 women) at M6 and for 68 patients at M12. Mean age was 42.7±9.4 years and mean preoperative body mass index was 42.2±4.8 kg/m2. A protein intake of≥60 g/d was achieved in 13.3%, 32.5% and 39.7% of the study participants at M3, M6 and M12, respectively. FFM significantly decreased at M6 and stabilized at M12. Protein intake of≥60 g/d was associated with a significantly lower relative FFM loss at M6 among women (8.9±6.5% versus 12.4±4.1%; P = .039) and this trend was also reported among men (9.5±5.5% versus 13.4±6.0%; P = .068). A logistic regression for the prediction of FFM loss of≥10% at M6, indicated that protein intake≥60 g/d is a strong protective factor (odds ratio = 0.29, 95% confidence interval .09-.96, P = .043).
  
  
  CONCLUSIONS
  Our study supports the currently recommended protein intake goal of≥60 g/d as an efficient strategy for better preservation of FFM post-LSG.
authors: Assuta Medical Center, Tel Aviv, Israel; Department of Gastroenterology, Tel-Aviv Medical Center, Tel-Aviv, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel. Electronic address: shirisherf@gmail.com.
authors: Shiri
authors: S
authors: Sherf Dagan
authors: Department of Gastroenterology, Tel-Aviv Medical Center, Tel-Aviv, Israel; School of Public Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel.
authors: Tali Ben
authors: TB
authors: Tovim
authors: Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel; Department of Surgery, Rabin Medical Center, Campus Beilinson, Petach Tiqva, Israel.
authors: Andrei
authors: A
authors: Keidar
authors: Assuta Medical Center, Tel Aviv, Israel.
authors: Asnat
authors: A
authors: Raziel
authors: Department of Gastroenterology, Tel-Aviv Medical Center, Tel-Aviv, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors: Oren
authors: O
authors: Shibolet
authors: Department of Gastroenterology, Tel-Aviv Medical Center, Tel-Aviv, Israel; School of Public Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel.
authors: Shira
authors: S
authors: Zelber-Sagi
mesh_terms: D000273:Adipose Tissue; D000328:Adult; D000886:Anthropometry; D001823:Body Composition; D015992:Body Mass Index; D015930:Diet Records; D000073600:Diet, High-Protein; D004044:Dietary Proteins / Q000008:administration & dosage*; D015444:Exercise / Q000523:psychology; D005260:Female; D000073923:Food Intolerance / Q000150:complications; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D011182:Postoperative Care; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control; D011446:Prospective Studies
chemical_list: D004044:Dietary Proteins
keywords: Body composition; Fat free mass; Obesity; Protein intake; Sleeve gastrectomy