title: Do Bariatric Patients Follow Dietary and Lifestyle Recommendations during the First Postoperative Year?
abstract: Data on adherence to postoperative lifestyle recommendations by bariatric patients are scarce. Thus, the aim of this study was to evaluate adherence to selected recommendations during the first year following laparoscopic sleeve gastrectomy (LSG) surgery.
  
  
  
  A prospective cohort study with 12 months of follow-up on 100 LSG patients was conducted. Data were collected at baseline and at 3 (M3), 6 (M6), and 12 (M12) months post-surgery and included anthropometrics, biochemical tests, food intake, food tolerance, common surgery-related side effects, physical activity (PA), supplementation, and number of follow-up meetings with a dietitian.
  
  
  
  Data were available for 77 patients (57.1% women, mean age 43.1 ± 9.3 years and preoperative BMI 42.1 ± 4.8 kg/m2). Only a minority of the patients adhered to the recommended protein intake ≥60 g/day at all time points (≤40.3%) and ≥6 meetings with a dietitian at M12 (41.6%). Half of the patients performed ≥150 min/week of PA at all time points (≤50.6%) as recommended. PA of ≥150 min/week was associated with better lipid and glucose changes at M6 and M12 (P ≤ 0.044). Most of the patients adhered to the recommended supplementation at all time points (≥57.1%). Adherence to supplementation at M12 was significantly associated with higher serum levels of folic acid, iron, hemoglobin, and vitamins D and B12 (P ≤ 0.056 for all). Adherence to all recommendations was not significantly associated with excess weight loss ≥60% at M12 (P ≥ 0.195 for all).
  
  
  
  Bariatric patients have medium to high adherence to the major lifestyle recommendations during the first year following LSG; however, adherence to those recommendations was not related to better weight loss at short-term follow-up. Adherence to recommended supplementation was associated with better micronutrient status 1 year postoperatively.
authors.affiliation: Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel. shirisherf@gmail.com.|Assuta Medical Center, Tel-Aviv, Israel. shirisherf@gmail.com.|Department Gastroenterology, Tel-Aviv Medical Center, 6 Weizman St., 6423906, Tel-Aviv, Israel. shirisherf@gmail.com.
authors.forename: Shiri
authors.initials: S
authors.lastname: Sherf Dagan
authors.affiliation: Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.|Assuta Medical Center, Tel-Aviv, Israel.|Department of Surgery, Rabin Medical Center, Campus Beilinson, Petach Tiqva, Israel.
authors.forename: Andrei
authors.initials: A
authors.lastname: Keidar
authors.affiliation: Assuta Medical Center, Tel-Aviv, Israel.
authors.forename: Asnat
authors.initials: A
authors.lastname: Raziel
authors.affiliation: Assuta Medical Center, Tel-Aviv, Israel.|Department of Surgery A, Emek Medical Center, Afula, affiliated with Rappaport Faculty of Medicine, Technion Israel Institute of Technology, Haifa, Israel.
authors.forename: Nasser
authors.initials: N
authors.lastname: Sakran
authors.affiliation: Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.|Assuta Medical Center, Tel-Aviv, Israel.|Department of Surgery C, Sheba Medical Center, Tel Hashomer, Israel.
authors.forename: David
authors.initials: D
authors.lastname: Goitein
authors.affiliation: Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.|Department Gastroenterology, Tel-Aviv Medical Center, 6 Weizman St., 6423906, Tel-Aviv, Israel.
authors.forename: Oren
authors.initials: O
authors.lastname: Shibolet
authors.affiliation: Department Gastroenterology, Tel-Aviv Medical Center, 6 Weizman St., 6423906, Tel-Aviv, Israel.|School of Public Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel.
authors.forename: Shira
authors.initials: S
authors.lastname: Zelber-Sagi
mesh_terms: D000328:Adult; D004032:Diet; D037001:Directive Counseling; D015444:Exercise / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000009:adverse effects / Q000534:rehabilitation* / Q000706:statistics & numerical data; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000453:epidemiology / Q000534:rehabilitation* / Q000601:surgery*; D010349:Patient Compliance / Q000706:statistics & numerical data*; D011184:Postoperative Period; D011446:Prospective Studies; D015431:Weight Loss
keywords: Bariatric surgery; Dietary supplements; Food intake; Micronutrient deficiencies; Physical activity