A Comparative Study Examining the Impact of a Protein-Enriched Vs Normal Protein Postoperative Diet on Body Composition and Resting Metabolic Rate in Obese Patients after Sleeve Gastrectomy.
We recently showed that an 8-week preoperative protein-enriched diet (PED) is associated with significant reductions in body weight and fat mass (FM) without significant loss of fat-free mass (FFM) in morbidly obese patients scheduled for laparoscopic sleeve gastrectomy (LSG).



The objective of this study is to evaluate the impact of PED vs a normal protein diet (NPD) on total weight loss (TWL), FM, FFM, and resting metabolic rate (RMR) in patients after LSG.



Before LSG and at 3, 6, and 12 months after, we prospectively measured and compared total body weight (TBW), FM, FFM, and RMR in 60 male patients who received either a NPD (n = 30) with protein intake 1.0 g/kg of ideal body weight, or a PED (n = 30) with protein intake 2.0 g/kg of ideal body weight. Compliance in following the prescribed diet was determined with food frequency questionnaires in all patients. The impact of NPD and PED on renal function was also evaluated.



Despite non-significant variation in total body weight (TBW), FM decreased more significantly (p < 0.01) with the PED compared to the NPD. In addition, the PED group showed a significantly (p < 0.01) lower decrease in FFM and RMR when compared with the NPD group. Both groups showed high compliance in following the prescribed diets, without negative impact on renal function.



PED is more effective than NPD in determining FM loss and is associated with a lower decrease in FFM and RMR, without interfering with renal function in male patients after LSG.
Department of Anesthesiology, Surgery and Emergency Science, Second University of Naples, Naples, Italy. luigi.schiavo@unina2.it.
Luigi
0000-0003-3639-6847
L
Schiavo
Department of Anesthesiology, Surgery and Emergency Science, Second University of Naples, Naples, Italy.
Giuseppe
G
Scalera
Department of Medicine and Surgery, University of Salerno, Salerno, Italy.
Vincenzo
V
Pilone
Department of Anesthesiology, Surgery and Emergency Science, Second University of Naples, Naples, Italy.
Gabriele
G
De Sena
Department of Anesthesiology, Surgery and Emergency Science, Second University of Naples, Naples, Italy.
Vincenzo
V
Quagliariello
Digestive Unit, Archet 2 Hospital, University Hospital of Nice, 06202, Nice, France.|Inserm, U1065, Team 8 "Hepatic complications of obesity", 06204, Nice, France.|University of Nice Sophia-Antipolis, 06107, Nice, France.
Antonio
A
Iannelli
Department of Anesthesiology, Surgery and Emergency Science, Second University of Naples, Naples, Italy.
Alfonso
A
Barbarisi
D000293:Adolescent; D000328:Adult; D000368:Aged; D001481:Basal Metabolism / Q000187:drug effects*; D001823:Body Composition / Q000187:drug effects*; D003131:Combined Modality Therapy; D004044:Dietary Proteins / Q000008:administration & dosage* / Q000494:pharmacology; D005260:Female; D005527:Food, Fortified; D005743:Gastrectomy / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000178:diet therapy* / Q000601:surgery*; D011184:Postoperative Period; D012146:Rest / Q000502:physiology; D015431:Weight Loss / Q000187:drug effects; D055815:Young Adult
D004044:Dietary Proteins
Body composition; Fat-free mass; Obesity; Protein intake; Sleeve gastrectomy
Am Surg. 2015 Aug;81(8):812-5
26215245
Am J Physiol Endocrinol Metab. 2003 Jun;284(6):E1080-8
12604503
Med Sci Sports Exerc. 2010 Feb;42(2):326-37
19927027
Obes Surg. 2014 Jan;24(1):42-55
24081459
J Am Diet Assoc. 2006 Jun;106(6):881-903
16720129
Obesity (Silver Spring). 2013 Mar;21 Suppl 1:S1-27
23529939
Nutrition. 2016 Feb;32(2):186-92
26691769
Nutr Hosp. 2012 Sep-Oct;27(5):1626-30
23478715
JAMA. 2012 Jun 27;307(24):2627-34
22735432
Obes Surg. 2013 Apr;23(4):427-36
23338049
Am J Clin Nutr. 1996 Sep;64(3 Suppl):449S-452S
8780361
Int J Vitam Nutr Res. 2016 May 10;:1-8
27164177
Clin Nutr. 2016 Feb;35(1):12-7
25779332
Int J Obes (Lond). 2007 May;31(5):743-50
17075583
Surg Obes Relat Dis. 2015 Sep-Oct;11(5):1164-70
26052081
Br J Surg. 2014 May;101(6):661-8
24723019
Am J Clin Nutr. 2003 Dec;78(6):1141-5
14668276
Obes Surg. 2014 Sep;24(9):1476-80
24464546
Surg Obes Relat Dis. 2008 Sep-Oct;4(5 Suppl):S73-108
18490202
Obes Surg. 2015 Dec;25(12):2344-51
25948283
N Engl J Med. 1988 Feb 25;318(8):467-72
3340128
Obes Surg. 2015 Oct;25(10):1822-32
25835983
FASEB J. 2013 Sep;27(9):3837-47
23739654
Am J Physiol Endocrinol Metab. 2004 Jan;286(1):E123-8
14532167
Nutr Clin Pract. 2007 Aug;22(4):377-88
17644692
J Clin Endocrinol Metab. 2012 Jul;97(7):2489-96
22535969
Clin Nutr. 2001 Oct;20(5):429-37
11534938
J Nutr. 1999 Jan;129(1S Suppl):256S-259S
9915910
Am J Hum Biol. 2011 May-Jun;23(3):420-2
21448907
Expert Rev Gastroenterol Hepatol. 2010 Feb;4(1):101-19
20136593
Gastroenterol Res Pract. 2012;2012:801325
22701478
Am J Clin Nutr. 2006 Sep;84(3):475-82
16960159
Res Sports Med. 2006 Apr-Jun;14(2):89-96
16869134