Estimation of the Impact of Abdominal Adipose Tissue (Subcutaneous and Visceral) on the Occurrence of Carbohydrate and Lipid Metabolism Disorders in Patients with Obesity-A Pilot Study.

Obesity represents a significant global public health concern. The excessive accumulation of abdominal adipose tissue is often implicated in the development of metabolic complications associated with obesity. Our study aimed to investigate the impact of particular deposits of abdominal adipose tissue on the occurrence of carbohydrate and lipid metabolism complications. We established cut-off points for visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), and the VAT/SAT ratio at which selected metabolic complications of obesity-related diseases (disorders of carbohydrate and/or lipid metabolism) occur. We conducted an observational study involving 91 subjects with first- and second-degree obesity, accounting for gender differences. Anthropometric measurements were taken, body composition analysis (BIA) was conducted, and biochemical determinations were made. Our findings suggest that commonly used parameters for assessing early metabolic risk, such as BMI or waist circumference, may overlook the significant factor of body fat distribution, as well as gender differences. Both visceral and subcutaneous adipose tissue were found to be important in estimating metabolic risk. We identified the cut-off points in women in terms of their elevated fasting glucose levels and the presence of insulin resistance (HOMA-IR: homeostasis model assessment of insulin resistance) based on SAT, VAT, and the VAT/SAT ratio. In men, cut-off points were determined for the presence of insulin resistance (HOMA-IR) based on VAT and the VAT/SAT ratio. However, the results regarding lipid disorders were inconclusive, necessitating further investigation of a larger population.

Assessment of the Clinical Condition and Way of Patients' Nutrition before and after Laparoscopic Sleeve Gastrectomy.

One of the most commonly performed bariatric procedures is the laparoscopic sleeve gastrectomy (LSG). It is highly effective in reducing body weight, but it carries the risk of developing nutritional deficiencies and their consequences. The aim of the study was to determine the clinical condition of obese patients after LSG in terms of nutritional status, metabolic disorders, and way of nutrition. Thirty participants (15 women and 15 men) took part in the study. A statistically significant reduction in the total body fat mass (women by 37.5% p < 0.05, men by 37.06% p < 0.05) and total fat free mass (women by 10% p < 0,05, men by 12.5% p < 0.05) was demonstrated 6 months after LSG. Moreover, insufficient protein intake has been shown in over 73% of women and 40% of men. Before and 6 months after LSG, insufficient intake of calcium, magnesium, potassium, folate, vitamin D, and iron was observed. Six months after the LSG, significant decreases of fasting glucose (p < 0.05), insulin (p < 0.05), TG (p < 0.05), and AST (p < 0.05) concentrations, were observed in both groups. Optimization of nutrition in order to prevent nutritional deficiencies and their complications is a key element of the therapy of obese patients treated surgically.

The use of contraception for patients after bariatric surgery.

Obesity in women of reproductive age is a serious concern regarding reproductive health. In many cases of infertility in obese women, reduction of body weight may lead to spontaneous pregnancy, without the need for more specific methods of treatment. Bariatric surgery is safe and is the most effective method for body weight reduction in obese and very obese patients. In practice there are two bariatric techniques; gastric banding, which leads to weight loss through intake restriction, and gastric bypass, leads to weight loss through food malabsorption. Gastric bypass surgery (the more frequently performed procedure), in most cases, leads to changes in eating habits and may result in vomiting, diarrhea and rapid body mass reduction. There are reliable data describing the continuous increase in the number of women who are trying to conceive, or are already pregnant, following bariatric surgery. Most medical specialists advise women to avoid pregnancy within 12-18 months after bariatric surgery. This allows for time to recover sufficiency from the decreased absorption of nutrients caused by the bariatric surgery. During this period there is a need for the use of reliable contraception. As there is a risk for malabsorption of hormones taken orally, the combined and progestogen-only pills are contraindicated, and displaced by non-oral hormonal contraception or non-hormonal methods, including intrauterine devices and condoms.

The impact of bariatric surgery on nutritional status of patients.

INTRODUCTION: Currently, surgical treatment is considered to be the most efficient method of dealing with morbid obesity. AIM: To evaluate changes in nutritional status after surgical treatment of obesity in the early postoperative period. MATERIAL AND METHODS: The study included 50 patients (30 women and 20 men) treated surgically due to morbid obesity. During the preliminary visit and during control visits measurements of body mass, height, and waist and hip circumference were conducted. Also, analysis of body content was performed and blood was taken for biochemical analysis. Statistical analysis was conducted using the program Statistica 10. RESULTS: Six months after the surgery, in the group of women, significant reduction of average body mass, average waist circumference, average hip circumference and average body mass index (BMI) was observed. Also, significant reduction of the percentage of body fat and an increase in the percentage of fat-free body mass were observed. A significant decrease in muscle mass was also noted. Both in women and in men, 6 months after the surgery, a significant decrease in fasting glucose concentration, fasting insulin and triglycerides in blood serum was observed. CONCLUSIONS: Bariatric procedures lead to significant body mass, BMI, waist and hip circumference reduction. Loss of body mass is caused mainly by the reduction of fat tissue. Application of surgical procedures in morbid obesity treatment also allowed us to achieve improvement in insulin, glucose and lipid metabolism.

Dietetic recommendations after bariatric procedures in the light of the new guidelines regarding metabolic and bariatric surgery.

The frequency of obesity occurrence is constantly increasing all over the world and becoming global epidemic. Facing the lack of the efficiency of conservative treatment, patients with II and III degree of obesity are qualified for surgical treatment; however, the efficiency of surgical treatment is connected with permanent change of nutritional habits and previous lifestyle of the patient. Modification of the way of nutrition, regardless of the type of bariatric procedure, should especially include the lowering of food energetic value and change of type, consistency and size of consumed food. Nutritional treatment after bariatric procedures is multistage. It includes clear liquid diet, full liquid diet, pureed diet, mechanically altered soft diet and regular diet. Gradual expanding of the diet protects gastrointestinal tract from chemical, mechanical and thermal irritation by the food. It also should prevent nutritional deficiencies. Significant influence on the result of surgical treatment of obesity has also regular intake of food, consuming products with high nutritional value, avoiding confectionery and fat products, consuming proper amounts of protein (60-80 g/day) and vitamin-mineral supplementation.

Dietary habits of obese patients qualified for bariatric procedures.

BACKGROUND: Patients with obesity, including morbid obesity, commit numerous dietary mistakes. They prefer high-energy diets, but of poor nutritional value. Patients qualified for bariatric procedures show deficiencies in vitamins and minerals due to insufficient intake of vegetables, fruit and whole grain products. OBJECTIVE: Analysis of dietary habits in morbidly obese patients prepared for bariatric surgery, including assessment of eating style and frequency of consumption of certain products. MATERIAL AND METHODS: The study group contained 39 people aged 18 - 65 years, who were surveyed with a questionnaire elaborated in the Department of Clinical Dietetics and Nutrition, Medical University of Bialystok. The following factors were assessed: number of meals, snacking between meals and eating at night, types of snacks eaten, and frequency of consumption of certain foods. Results were analyzed using Statistica 9.0. RESULTS: The majority of surveyed men (41.7%) ate three meals a day, whereas most women (40.7%) had at least 4 meals a day. Nearly 85% of the respondents admitted snacking between meals, mainly eating fruit, sweets and sandwiches. Whole grain cereal, milk and dairy products, fish, fruit, vegetables and pulses appeared in diet of patients qualified for treatment of obesity very rarely. CONCLUSIONS: Dietary habits of obese patients qualified for bariatric procedures are not consistent with recommendations. Therefore, these patients should receive nutritional education in order to foster proper eating habits that will help in the postoperative nutrition.

Assessment of dietary habits, nutritional status and blood biochemical parameters in patients prepared for bariatric surgery: a preliminary study.

INTRODUCTION: Morbid obesity needs to be treated by bariatric procedures. Proper dietary preparation of patients before surgery conditions their postoperative status. AIM: Assessment of dietary habits, nutritional status and biochemical parameters of the blood in patients being prepared for different bariatric procedures. MATERIAL AND METHODS: The study involved a group of 27 obese adults: 19 women (mean age: 40.4 ±13.9 years) and 8 men (mean age: 39.6 ±12.7 years) qualified for bariatric procedures. Body composition, dietary habits and selected biochemical parameters of blood were assessed. Statistical analysis of the results was conducted using Statistica 9.0. RESULTS: Daily food rations consumed by women provided 1910.6 ±915.9 kcal/day, and by men 2631 ±1463.2 kcal/day on average. In both groups, the consumption of major nutrients was found to be inadequate. In both groups, deficiency was observed in the dietary intake of folic acid and potassium. Additionally, there was a decrease in the intake of vitamin D(3), calcium and iron in women and magnesium in men. In the two groups, disturbances were noted in lipid and carbohydrate metabolism. CONCLUSIONS: Our study indicates the necessity for dietary instructions in bariatric patients with regard to proper dietary habits and to reduce the risk of malnutrition before and after surgery.