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Published in: Obesity Surgery 2/2020

01-02-2020 | Obesity | Original Contributions

Adherence to Mediterranean Diet or Physical Activity After Bariatric Surgery and Its Effects on Weight Loss, Quality of Life, and Food Tolerance

Authors: Anna Gils Contreras, Anna Bonada Sanjaume, Nerea Becerra-Tomás, Jordi Salas-Salvadó

Published in: Obesity Surgery | Issue 2/2020

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Abstract

Objective

To assess whether a healthy dietary pattern or physical activity after bariatric surgery mediates the effects of surgery on weight loss, the quality of life, or food tolerance.

Methods

A prospective observational study conducted in the context of a randomized controlled trial. We assessed the extent to which increasing or decreasing adherence to the Mediterranean diet (MedDiet)—assessed by MEDAS (Mediterranean Diet Adherence Screener)—and of increasing or decreasing physical activity (PA)—assessed with the Short Questionnaire of International PA (IPAQ-Short Q)—after bariatric surgery affected changes in weight, body mass index (BMI), quality of life (Moorehead-Arlet Questionnaire), and food tolerance (Suter test). Assessments were recorded at baseline and quarterly up to 12 months of surgery.

Results

Seventy-eight morbidly obese participants undergoing bariatric surgery were assessed up to 1 year after surgery. Those individuals who increased adherence to MedDiet showed a significantly higher mean of total weight loss percentage than those who decreased or maintained their adherence during follow-up: 37.6% (35.5–39.8) versus 34.1% (31.8–36.5) (p = 0.036). No significant differences were observed in changes in weight or BMI comparing individuals who increased their PA versus those who maintained or decreased PA, nor in quality of life or food tolerance between those individuals who increased versus those who decreased adherence to MedDiet or PA during the follow-up.

Conclusions

After bariatric surgery, morbidly obese subjects present greater weight loss if they adhere to the MedDiet. PA after surgery is not associated with the magnitude of weight loss nor the quality of life and tolerance to diet.
Literature
1.
go back to reference Aranceta-Bartrina J, Pérez-Rodrigo C, Alberdi-Aresti G, et al. Prevalencia de obesidad general y obesidad abdominal en la población adulta española (25–64 años) 2014–2015: estudio ENPE. 2017;69(6):579–87. Aranceta-Bartrina J, Pérez-Rodrigo C, Alberdi-Aresti G, et al. Prevalencia de obesidad general y obesidad abdominal en la población adulta española (25–64 años) 2014–2015: estudio ENPE. 2017;69(6):579–87.
2.
go back to reference Prospective Studies Collaboration, Whitlock G, Lewington S, et al. Body-mass index and cause-specific mortality in 900 000 adults: collaborative analyses of 57 prospective studies. Lancet. 2009;373(9669):1083–96.PubMedCentralCrossRef Prospective Studies Collaboration, Whitlock G, Lewington S, et al. Body-mass index and cause-specific mortality in 900 000 adults: collaborative analyses of 57 prospective studies. Lancet. 2009;373(9669):1083–96.PubMedCentralCrossRef
3.
go back to reference Oria HE, Moorehead MK, et al. Bariatric Analysis and Reporting Outcome System (BAROS). Obes Surg. 1998;8(5):487–99.PubMedCrossRef Oria HE, Moorehead MK, et al. Bariatric Analysis and Reporting Outcome System (BAROS). Obes Surg. 1998;8(5):487–99.PubMedCrossRef
4.
go back to reference Moorehead MK, Ardelt-Gattinger E, Lechner H, et al. The validation of the Moorehead-Ardelt Quality of Life Questionnaire II. Obes Surg. 2003;13(5):684–92.PubMedCrossRef Moorehead MK, Ardelt-Gattinger E, Lechner H, et al. The validation of the Moorehead-Ardelt Quality of Life Questionnaire II. Obes Surg. 2003;13(5):684–92.PubMedCrossRef
5.
go back to reference Suter M, Calmes JM, Paroz A, et al. A new questionnaire for quick assessment of food tolerance after bariatric surgery. Obes Surg. 2007;17(1):2–8.PubMedCrossRef Suter M, Calmes JM, Paroz A, et al. A new questionnaire for quick assessment of food tolerance after bariatric surgery. Obes Surg. 2007;17(1):2–8.PubMedCrossRef
6.
go back to reference Ramón JM, Gustavo C. Dorcaratto D, et al. Calidad de la ingesta alimentaria tras la cirugía bariátrica: gastrectomía vertical vs bypass gástrico. Cir Esp 2012;90 (2):95-101.PubMedCrossRef Ramón JM, Gustavo C. Dorcaratto D, et al. Calidad de la ingesta alimentaria tras la cirugía bariátrica: gastrectomía vertical vs bypass gástrico. Cir Esp 2012;90 (2):95-101.PubMedCrossRef
7.
go back to reference Giugliano D, Esposito K. Mediterranean diet and metabolic diseases. Curr Opin Lipidol. 2008;19:63–8.PubMed Giugliano D, Esposito K. Mediterranean diet and metabolic diseases. Curr Opin Lipidol. 2008;19:63–8.PubMed
8.
go back to reference Salas-Salvadó J, Díaz-López A, Ruiz-Canela M, et al. Effect of a lifestyle intervention program with energy-restricted mediterranean diet and exercise on weight loss and cardiovascular risk factors: one-year results of the PREDIMED-Plus Trial. Diabetes Care. 2018:1–12. Salas-Salvadó J, Díaz-López A, Ruiz-Canela M, et al. Effect of a lifestyle intervention program with energy-restricted mediterranean diet and exercise on weight loss and cardiovascular risk factors: one-year results of the PREDIMED-Plus Trial. Diabetes Care. 2018:1–12.
9.
go back to reference Ruiz-Tovar J, Boix E, Bozhychko M, et al. Adherencia pre y postoperatoria a la dieta mediterránea y su efecto sobre la pérdida de peso y el perfil lipídico en pacientes obesos mórbidos sometidos a gastrectomía vertical como procedimiento bariátrico. Nutr Hosp. 2014;30(4):756–62.PubMed Ruiz-Tovar J, Boix E, Bozhychko M, et al. Adherencia pre y postoperatoria a la dieta mediterránea y su efecto sobre la pérdida de peso y el perfil lipídico en pacientes obesos mórbidos sometidos a gastrectomía vertical como procedimiento bariátrico. Nutr Hosp. 2014;30(4):756–62.PubMed
10.
go back to reference Fontana AD, Lopes AD, Lunardi AC. Bariatric surgery associated with practice of moderate to intense physical activity related to weight loss, activity level in daily life, dyspnea, and quality of life of sedentary individuals with morbid obesity: a prospective longitudinal study. Obes Surg. 2019;29:2442–8. https://doi.org/10.1007/s11695-019-03859-8.PubMedCrossRef Fontana AD, Lopes AD, Lunardi AC. Bariatric surgery associated with practice of moderate to intense physical activity related to weight loss, activity level in daily life, dyspnea, and quality of life of sedentary individuals with morbid obesity: a prospective longitudinal study. Obes Surg. 2019;29:2442–8. https://​doi.​org/​10.​1007/​s11695-019-03859-8.PubMedCrossRef
11.
go back to reference Esposito K, Kastorini C-M, Panagiotakos DB, et al. Mediterranean diet and weight loss: meta-analysis of randomized controlled trials. Metab Syndr Relat Disord. 2011;9(1):1–12.PubMedCrossRef Esposito K, Kastorini C-M, Panagiotakos DB, et al. Mediterranean diet and weight loss: meta-analysis of randomized controlled trials. Metab Syndr Relat Disord. 2011;9(1):1–12.PubMedCrossRef
12.
go back to reference Schröder H, Fitó M, Estruch R, et al. A short screener is valid for assessing Mediterranean diet adherence among older Spanish men and women. J Nutr. 2011 Jun;141(6):1140–5.PubMedCrossRef Schröder H, Fitó M, Estruch R, et al. A short screener is valid for assessing Mediterranean diet adherence among older Spanish men and women. J Nutr. 2011 Jun;141(6):1140–5.PubMedCrossRef
13.
go back to reference Mantilla SC, Gómez-Conesa A. El Cuestionario Internacional de Actividad Física . Un instrumento adecuado en el seguimiento de la actividad física poblacional. Rev Iberoam Fisioter Kinesol. 2007;10(1):48–52. RevisiónCrossRef Mantilla SC, Gómez-Conesa A. El Cuestionario Internacional de Actividad Física . Un instrumento adecuado en el seguimiento de la actividad física poblacional. Rev Iberoam Fisioter Kinesol. 2007;10(1):48–52. RevisiónCrossRef
14.
go back to reference Román B, Ribas L, Ngo J, et al. Validación en población catalana del cuestionario internacional de actividad física. Gac Sanit. 2013;27(3):254–7.CrossRef Román B, Ribas L, Ngo J, et al. Validación en población catalana del cuestionario internacional de actividad física. Gac Sanit. 2013;27(3):254–7.CrossRef
15.
go back to reference Ramón JM, González CG, Dorcaratto D, et al. Quality of food intake after bariatric surgery: vertical gastrectomy versus gastric bypass. Cir Esp. 2012;90(2):95–101. Ramón JM, González CG, Dorcaratto D, et al. Quality of food intake after bariatric surgery: vertical gastrectomy versus gastric bypass. Cir Esp. 2012;90(2):95–101.
16.
go back to reference Boan J, Kolotkin RL, Westman EC, et al. Binge eating, quality of life and physical activity improve after Roux-en-Y gastric bypass for morbid obesity. Obes Surg. 2004;14(3):341–8.PubMedCrossRef Boan J, Kolotkin RL, Westman EC, et al. Binge eating, quality of life and physical activity improve after Roux-en-Y gastric bypass for morbid obesity. Obes Surg. 2004;14(3):341–8.PubMedCrossRef
17.
go back to reference Hatoum IJ, Stein HK, Merrifield BF, et al. Capacity for physical activity predicts weight loss after roux-en-Y gastric bypass. Obesity. 2009;17(1):92–9.PubMedCrossRef Hatoum IJ, Stein HK, Merrifield BF, et al. Capacity for physical activity predicts weight loss after roux-en-Y gastric bypass. Obesity. 2009;17(1):92–9.PubMedCrossRef
18.
go back to reference Bellicha A, Ciangura C, Poitou C, et al. Effectiveness of exercise training after bariatric surgery-a systematic literature review and meta-analysis. Obes Rev. 2018;10 Bellicha A, Ciangura C, Poitou C, et al. Effectiveness of exercise training after bariatric surgery-a systematic literature review and meta-analysis. Obes Rev. 2018;10
19.
go back to reference Johns DJ, Hartmann-Boyce J, Jebb SA, et al. Behavioural Weight Management Review Group. Diet or exercise interventions vs combined behavioral weight management programs: a systematic review and meta-analysis of direct comparisons. J Acad Nutr Diet. 2014;114(10):1557–68. Johns DJ, Hartmann-Boyce J, Jebb SA, et al. Behavioural Weight Management Review Group. Diet or exercise interventions vs combined behavioral weight management programs: a systematic review and meta-analysis of direct comparisons. J Acad Nutr Diet. 2014;114(10):1557–68.
21.
go back to reference Ramos C, Bandeira AA, Ramos A, et al. Avaliação da qualidade de vida, perda de peso e comorbidades de pacientes submetidos à cirurgia bariátrica. Rev Col Bras Cir. 2018;45(3):1–9. Ramos C, Bandeira AA, Ramos A, et al. Avaliação da qualidade de vida, perda de peso e comorbidades de pacientes submetidos à cirurgia bariátrica. Rev Col Bras Cir. 2018;45(3):1–9.
22.
go back to reference Costa RCNC, Yamaguchi N, Santo MA, et al. Outcomes on quality of life, weight loss, and comorbidities after roux-en-y gastric bypass. Arq Gastroenterol. 2014;3:165–70.CrossRef Costa RCNC, Yamaguchi N, Santo MA, et al. Outcomes on quality of life, weight loss, and comorbidities after roux-en-y gastric bypass. Arq Gastroenterol. 2014;3:165–70.CrossRef
23.
go back to reference Hachem A, Brennan L. Quality of life outcomes of bariatric surgery: a systematic review. Obes Surg. 2016 Feb;26(2):395–409. ReviewCrossRef Hachem A, Brennan L. Quality of life outcomes of bariatric surgery: a systematic review. Obes Surg. 2016 Feb;26(2):395–409. ReviewCrossRef
24.
go back to reference Stumpf MA, Rodrigues MR, Kluthcovsky AC, et al. Analysis of food tolerance in patients submitted to bariatric surgery using the questionnaire quality of alimentation. Arq Bras Cir Dig. 2015;28:79–83.PubMedPubMedCentralCrossRef Stumpf MA, Rodrigues MR, Kluthcovsky AC, et al. Analysis of food tolerance in patients submitted to bariatric surgery using the questionnaire quality of alimentation. Arq Bras Cir Dig. 2015;28:79–83.PubMedPubMedCentralCrossRef
25.
go back to reference Ruiz-Tovar J, Bozhychko M, Del-Campo JM, et al. Food tolerance and quality of alimentation following laparoscopic sleeve gastrectomy calibrated with a 50-Fr bougie: long-term results. J Laparoendosc Adv Surg Tech A. 2018;28(6):721–5.PubMedCrossRef Ruiz-Tovar J, Bozhychko M, Del-Campo JM, et al. Food tolerance and quality of alimentation following laparoscopic sleeve gastrectomy calibrated with a 50-Fr bougie: long-term results. J Laparoendosc Adv Surg Tech A. 2018;28(6):721–5.PubMedCrossRef
26.
go back to reference Freeman RA, Overs SE, Zarshenas N, et al. Food tolerance and diet quality following adjustable gastric banding, sleeve gastrectomy and Roux-en-Y gastric bypass. Obes Res Clin Pract. 2014;8(2):e183–91.CrossRef Freeman RA, Overs SE, Zarshenas N, et al. Food tolerance and diet quality following adjustable gastric banding, sleeve gastrectomy and Roux-en-Y gastric bypass. Obes Res Clin Pract. 2014;8(2):e183–91.CrossRef
Metadata
Title
Adherence to Mediterranean Diet or Physical Activity After Bariatric Surgery and Its Effects on Weight Loss, Quality of Life, and Food Tolerance
Authors
Anna Gils Contreras
Anna Bonada Sanjaume
Nerea Becerra-Tomás
Jordi Salas-Salvadó
Publication date
01-02-2020
Publisher
Springer US
Published in
Obesity Surgery / Issue 2/2020
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-019-04242-3

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