Health profile of patients subjected to gastric bypass at Clinics Hospital of Acre, Brazil.
Perfil de salud de los pacientes sometidos a bypass gástrico en el Hospital de Clínicas de Acre, Brasil.
Abstract
The study aimed to analyze the health profile of women undergoing Roux-en-Y gastric bypass according to the time elapsed since surgery. Ninety-three women who underwent this procedure at the Clinics Hospital in Acre, Brazil, from 2008-2017, were divided into three groups according to the post-surgery period: G1 (n = 37) up to two years; G2 (n = 20) from two to four years; G3 over four years (n = 36) after surgery. Pre-surgery and post- surgery clinical, anthropometric, and dietary variables were analyzed through a 24-hour recall. The postoperative time was 16.9±7.9 months (G1); 33.9±9.2 months (G2) and 75.3±19.1 months (G3). In the postoperative period, there was a decrease in the number of patients who practiced physical activity (35.5-33.3%). The mean percentage of excess weight loss was 66.1±15.4%. Satisfactory results were achieved by 88.17% (% PEP ≥50%). 67% of the patients presented weight reacquisition, proportional to the postoperative time (p˂0.001). The dietary survey indicated a daily energy consumption of 1262.75±424.11 kcal. The macronutrient distribution showed 59.25±8.33% for carbohydrates, 24.26±6, 90% for lipids and 17.12±6.68% for proteins. The mean protein intake was lower in group G1 (16.09±6.23), and lipid intake slightly increased over time. Bariatric surgery had a significant impact on the reduction of comorbidities, medication use, and the loss of excess weight. However, the nutrient adequacy and the increasing incidence of weight regain in the post- surgery period demonstrated that bariatric surgery does not end the obesity treatment, but it is only a step that requires periodic monitoring.
Downloads
References
Thibault R, Huber O, Azagury D, Pichard C. Twelve key nutritional issues in bariatric surgery. Clin Nutr 2016; 35(1):12-17.
Novais PFS, Júnior IR, Leite CVS, Oliveira MRM. Evolução e classificação do peso corporal em relação aos resultados da cirurgia bariátrica-derivação gástrica em Y de Roux. Arq Bras Endocronol Metabol 2010; 54(3):303-310.
Boscatto EC, Duarte MFS, Gomes MA, Gomes GMB. Aspectos físicos, psicossociais e comportamentais de obesos mórbidos submetidos à cirurgia bariátrica. J Health Sci 2010; 28(2):195-198.
Marcus DA. Obesity and the impact of chronic pain. Clin J Pain 2004; 3(20):186- 191.
Fruhbeck G. Bariatric and metabolic surgery: a shift in eligibility and success criteria. Nat Rev Endocrinol 2015; 11(8):465-477.
Moizé V. Andreu A, Flores L, Torres F, Ibarzabal A. Long-term intake and nutritional deficiencies following sleeve gastrectomy os Roux-em-Y gastric bypass in a Mediterranean population. J Acad Nutr Diet 2013; 113(3):400-10.
Gletsu-Miller N, Wright BN. Mineral malnutrition following bariatric surgery. Adv Nutri 2013; 4(5):506-517
Ministério da saúde. Antropometria: Como pesar e medir. Coordenação geral de política de alimentação e nutrição e centro colaborador em alimentação e nutrição-região sudeste - ENSP - Fiocruz, Departamento de atenção básica. Secretaria de atenção à saúde, 2004. http://www.redesans.com.br/redesans/wpcontent/uploads/2012/10/antopometria_como_pesar_medir_album_biblioteca.pdf.
Ministério da Saúde. Obesidade. Secretaria de Atenção à Saúde. Departamento de Atenção Básica. Cadernos de Atenção Básica 2016; 12(A):1-110.
Maltron BS. Manual de operação Bio Scan 916-917. Cardiomed medicine, sports & fitness. Curitiba, 2009.
Deitel M. Overwheight and obesity world- wide now estimated to involve 1.7 billion people. Obes surg 2003; 13(3):329-330.
Tabela Brasileira de composição de alimentos/NEPA. Unicamp, 4ª ed.rev. e amp. Campinas, 2011. Clarisse M, Di vetta V, Siegrist C, Giust V. How to facilite protein concumption after gastric bypass? Rev Med Suisse 2013; 9(379):670-3.
Silva R, Kelly E. Prevalência e fatores interferentes no reganho de peso em mulheres que se submeteram ao bypass gástrico em y de roux após 2 anos de cirurgia barátrica. Rev Bras Obes, Nutr Emagrecimento 2014; 8(47):134-141.
Nishiyama MF, Carvalho MDB, Pelloso SM, Nakamura RKC, Peralta RM, Marujo FMPS. Avaliação do nível de conhecimento e aderência da consulta nutricional em pacientes submetidos e candidatos à cirurgia bariátrica. Arch Health Sci 2007; 11(2):88-98.
Mota D C L, Costa T M B, Almeida S S. Imagem corporal, ansiedade e depressão em mulheres submetidas à cirurgia bariátrica. Psicologia: teoria e prática 2014; 16.
Pimentel C. Agência Brasil. Artigo: mulheres são a maioria entre os pacientes de cirurgia bariátrica. Published in: 19/03/2013. Acessed in: 28 de fevereiro de 2018.
Harbottle L. Audit of nutritional and dietary outcomes of bariatric surgery patients. Obes Rev 2011; 12(3):198-204.
Siqueira A, Zanotti S. Programa de cirurgia bariátrica e reganho de peso. Ver. Psicologia, saúde e doenças 2017; 18:157-169.
Bruce M, Elizaveta K, Robert E. Treatment of Obesity weight loss and bariatric surgery. Circ Res 2016; 118(11):1844-855.
Pajeck D, Dalcanalle L, Oliveira C P M S, Zilberstein B, Halpern A, Garrido J A, Cecconello I. Follow-up of Roux-en-y gastric bypass patientes at 5 or more years postoperatively. Obes Surg 2007; 17(5):601-607.
Perry, C D; Hutter M M, Smith D B, New house J P, Mcneil B J. Survival and changes in comobidities after bariatric surgery. Ann Surg 2008; 247(1):21-27.
Ceneviva R, Silva G A, Viegas M M, Sankarankutty A K, Chuere F B. Cirurgia bariatrica e apnéia do sono. Medicina (Ribeirão Preto) 2006; 39(2): 235-245.
Buchwald H, Avidor Y, Branwald E, Jensen M D, Pories W, Fahrbach K, Schoelles K A. Bariatric surgery: systematic review and metanalysis. JAMA 2004; 292(14):1724-1737.
White S, Brooks E, Jurikova L, Stubbs R S. Long-term outcomes after gastric by- pass. Obes Surg 2005; 15(2):155-163.
Silva A A, Araújo R P, Gurgel L A, Aguiar J B. Influência do exercício físico sobre a composição corporal após gastroplastia. Braz J Health Sci 2013; 11(38):25-31.
Magro D O, Geloneze B, Delfini R, Pareja BC, Callejas F, Parejas J C. Longterm weight regain after gastric bypass: a 5-year prospective study. Obes Surg 2008; 18(6):565-579.
Welch G, Wesolowski C, Piepul B, Kuhn J, Romanelli J, Garb J. Physical Activity predicts weight loss following gastric surgery: findings from a support group survey. Obes Surg 2008; 18(5):517-524.
Souza J M B, Castro M M, Maria E M C, Ribeiro N A, Almondes K M, Silva N G. Obesidade e tratamento: desafio comportamental e social. Rev bras ter cogn 2005; 1(1):57-59.
Brolin R E, Leung M. Survey os vitamin and mineral supplementation ater gastric bypass and biliopancreatic diversion for morbid obesity. Obes Surg 1999; 9(2):150-154.
Rubio M A, Moreno C. Implicaciones nutricionales de la cirugía bariátrica sobre el tracto gastrointstinal. Nutr hosp 2007; 22(2):124-134.
Dias M C G, Ribeiro A G, Scabim V M, Faintuch J, Zilbertein B, Gama-Rodrigues J. Dietary intake of female bariatric patients after anti-obesity gastroplasty. Clinics 2006; 61(2):93-98.
Wardé-kamar J, Rogers M, Flancbaum L, Laferrere B. Calorie intake and meal patterns up to 4 years after roux-em-y gastric bypass surgery. Obes Surg 2004; 17(8):1070-1079.
Segura D C A, Wozniak S D, Andrade L A, Marreto T M, Ponte E D. Deficiências nutricionais e suplementação em indivíduos submetidos a gastroplastia redutora do tipo Y de Roux. Rev Bras Obes, Nutr Emagrecimento 2017; 11:338-347
Valezi A C, Brito S J, Mali J R, Brito E M. Estudo do padrão alimentar tardio em obesos submetidos à derivação gástrica com bandagem em y de roux: comparação entre homens e mulheres. Rev Col Bras Cir 2008; 35(6):387-391.
Tabesh MR, Eghtesadi M, Abolhasani M, Maleklou F, Ejtehadi F, Alizadeh Z. Nutrition, physical activity, and prescription of supplements in pre- and post-bariatric surgery patients: an updated comprehensive practical guideline. Obes Surg. 2023 Aug;33(8):2557-2572.
Adsit J, Hewlings SJ. Impact of bariatric surgery on breastfeeding: a systematic review. Surg Obes Relat Dis. 2022 Jan;18(1):117-122.
Link TM, Schafer AL. Bariatric surgery negatively impacts bone health in adolescents. Radiology. 2023 Jun;307(5):e231260.
Montana L, Colas PA, Valverde A, Carandina S. Alterations of digestive motility after bariatric surgery. J Visc Surg. 2022 Mar;159(1S):S28-S34.
Steenackers N, Van der Schueren B, Augustijns P, Vanuytsel T, Matthys C. Development and complications of nutritional deficiencies after bariatric surgery. Nutr Res Rev. 2023 Dec;36(2):512-525.
