Nutritional repercussions in patients submitted to bariatric surgery

To identify nutritional changes in patients undergoing bariatric surgery and correlate them with weight loss, control of comorbidities and quality of life.

METHOD:

A prospective cohort, analytical and descriptive study involving 59 patients undergoing bariatric surgery was done. Data were collected preoperatively at three and six months postoperatively, evaluating nutritional aspects and outcomes using BAROS questionnaire. The data had a confidence interval of 95%.

RESULTS:

The majority of patients was composed of women, 47 (79.7%), with 55.9% of the series with BMI between 40 to 49.9 kg/m². In the sixth month after surgery scores of quality of life were significantly higher than preoperatively (p<0.05) and 27 (67.5 %) patients had comorbidities resolved, 48 (81.3 %) presented BAROS scores of very good or excellent. After three and six months of surgery 16 and 23 presented some nutritional disorder, respectively. There was no relationship between the loss of excess weight and quality of life among patients with or without nutritional disorders.

CONCLUSION:

Nutritional disorders are uncommon in the early postoperative period and, when present, have little or no influence on quality of life and loss of excess weight.

Bariatric surgery; Nutrition, public health; Obesity

BMI	Men	Women	Total
	n / % / mean of %WE	n / % / mean of %WE	n / % / mean of %WE
35 to 39,9	2 / 16,7% / 164,2	20 / 42,6% / 167,9	22 / 37,3% / 167,6
40 to 49,9	8 / 66,7% / 196	25 / 53,2% / 192,7	33 /55,9% / 193
50 to 59,9	2 / 16,7% / 250,8	2 / 4,3% / 236,4	4 /6,8% / 243
Total	12 / 20,3% / 199,9	47 / 79,7% / 184	59 / 100% / 187,3

	Total	Not resolved		Partly resolved		Fully resolved
		3^rd month	6^th month	3^rd month	6^th month	3^rd month	6^th month
Diabetes mellitus	9/22,5%	-	-	3/33,3%	2/22,2%	6/66,7%	7/77,8%
Hipertension	26/65%	3/11,5%	1/3,8%	6/23,1%	6/23,1%	17/65,4%	19/73,1
Dyslipidemia	10/25%	-	-	-	-	10/25%	10/25%
Sleep apnea	4/10%	-	-	3/75%	1/25%	1/25%	3/75%
Arthrosis	7/17,5%	-	-	3/43%	3/43%	4/57%	4/57%
Lower extremities venous stasis	1/2,5%	-	-	1/100%	1/100%	-	-
Reflux disease	7/17,5%	2/29%	2/29%	2/29%	-	3/43%	5/71,4%

Quality of life	Variation	Pre-op mean (SD*)	3^rd month mean (SD)	6^th month mean (SD)	Difference 6^th M– Pre-op
Self-esteem	-0,5 a 0,5	0,11 (±0,28)	0,41(±0,11)	0,43(±0,10)	0,32
Physical activity	-0,5 a 0,5	-0,05(±0,31)	0,17(±0,26)	0,24(±0,23)	0,29
Social contacts	-0,5 a 0,5	0,22(±0,25)	0,41(±0,12)	0,42(±0,13)	0,20
Work	-0,5 a 0,5	0,19(±0,28)	0,39(±0,14)	0,42(±0,13)	0,23
Sexual activity	-0,5 a 0,5	0,13(±0,32)	0,31(±0,26)	0,33(±0,25)	0,20
Food	-0,5 a 0,5	0,04(±0,23)	0,38(±0,14)	0,42(±0,10)	0,38
Total	-3 a 3	0,66	2,1	2,28	1,62

	3^rd month		6^th month
I. % of wight excess loss	N	%	N	%
Weight gain (-1)*	-		-
0-24 (0)*	1	1,7	-
25-49 (1)*	43	72,9	9	15,3
50-74 (2)*	15	25,4	43	72,9
75-100 (3)*	-		7	11,9
Total	59		59
II. Comorbidities control
Aggravated (-1)*	0	0	0	0
Unchanged (0)*	5	12,5	3	7,5
Improved (1)*	7	17,5	5	12,5
One > resolved (2)*	8	20	5	12,5
All > resolved (3)*	20	50	27	67,5
No comorbidities	19		19
Total	59

Deficiency	3^rd month postoperative	6^th month postoperative
Proteins	6 / 10,2 %	6 / 10,2%
B 12 Vitamin	3 / 5,1%	1 / 1,7%
Ferritin	0	0
D Vitamin	3 / 5,1%	9 / 15,3%
Calcium	2 / 3,4%	3 / 5,1%
Anemia	4 / 6,8%	8 / 13,6%

	3^rd month			6^th Month
	With ND (n=16)	Without ND (n=43)	p	With ND (n=23)	Without ND (n=36)	P
%OLP (mean/SD)	42,9 (±10,9)	43,9 (±8,01)	0,70	60,9 (±10,6)	61,9 (±13,2)	0,77
QoL (mean/SD)	1,8 (±0,92)	2,21 (±0,71)	0,12	2,41 (±0,71)	2,21 (±0,53)	0,21

Colégio Brasileiro de Cirurgia Digestiva Av. Brigadeiro Luiz Antonio, 278 - 6° - Salas 10 e 11, 01318-901 São Paulo/SP Brasil, Tel.: (11) 3288-8174/3289-0741 - São Paulo - SP - Brazil
E-mail: revistaabcd@gmail.com

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[1] Correspondence: Sérgio Silveira Júnior E-mail: raphamz@hotmail.com