Lifestyle Patterns in the Late Postoperative Period of Bariatric Surgery: a Descriptive Analysis of the CINTO Study.

BACKGROUND: The behavior of patients undergoing metabolic bariatric surgery (MBS) has been widely investigated to better understand their attitudes and to formulate effective advisory strategies. Although these elements have been studied separately, the magnitude of these behaviors still needs to be determined from a combined factors approach. This study aimed to identify the lifestyle patterns of patients who underwent MBS 5 or more years ago. METHODS: In this observational study, 123 patients who underwent MBS at least 5 years ago were included. Anthropometric data, sociodemographic profile, dietary intake, physical activity level, sleeping, smoking, and alcohol consumption were collected for all participants. Lifestyle pattern was evaluated using principal component analysis (PCA) and the Kaiser-Meyer-Olkin (KMO) index was applied to evaluate data factorability. RESULTS: PCA identified two patterns of behavior adopted by the participants in the late postoperative (PO) period (more than 5 years PO) of MBS. In the first pattern, a positive correlation was found between consumption of ultra-processed foods (r = 0.459), risky consumption of alcoholic beverages (r = 0.630), and tobacco use (r = 0.584). In the second, a positive correlation was observed between the consumption of unprocessed or minimally processed foods (r = 0.692) and more sleep time per day (r = 0.654). CONCLUSION: After 5 years of PO, combined behavior analysis revealed healthy and unhealthy lifestyle patterns, which points to the relevance of permanent clinical follow-up of these patients to ensure the best health status.

Dietary protein and appetite sensations in individuals with overweight and obesity: a systematic review.

PURPOSE: This systematic review aimed to synthesize the available evidence on the effects of a high-protein diet on appetite sensations in individuals with overweight and obesity. METHODS: Two authors independently conducted literature searches, study selection, design of the method, and quality appraisal. The main inclusion criteria were studies involving protocols that present a protein intake greater than 1.2 g/kg/day or 25% of the total daily energy content compared to a normal protein diet, i.e., 0.8-1.2 g/kg/day or 15%-20% of the total energy content. Studies that evaluated test meals or diet within a period of less than 7 days and participants with diabetes, cancer, or other specific conditions were excluded from this review. The literature search was updated until November 2019 using the main databases available. RESULTS: Of a total of 4191 records, ten articles met the inclusion criteria and included a total of 1079 subjects. In six studies, participants experienced enhanced fullness or satiety in response to a high-dietary protein intake, of which four studies had an intervention period of 10-12 weeks. CONCLUSION: Our results suggest that among individuals with overweight or obesity, higher dietary protein intake may influence appetite sensations by enhancing fullness or satiety. The low level of evidence, due to the heterogeneity of the protocols and the high risk of bias, highlights the need for further studies to confirm these results.

Effect of Grazing Behavior on Weight Regain Post-Bariatric Surgery: A Systematic Review.

Grazing, a type of maladaptive eating behavior, has been associated with poor weight outcomes in bariatric patients. The purpose of this study was to conduct a systematic review of the association between grazing behavior and weight regain post-bariatric surgery. Literature searches, study selection, design of the method, and quality appraisal were carried out by two independent authors. The search strategy was performed until October 2017 in Medline, Embase, Cochrane, Lilacs, Scopus, Web of Science, Google Scholar, ProQuest Dissertation & Theses, and Open Grey. Of a total of 3764 articles, five papers met the inclusion criteria (four original articles and one thesis), comprising 994 subjects, mostly women. The prevalence of grazing behavior ranged from 16.6 to 46.6%, and the highest prevalence of significant weight regain was 47%. The association between grazing and weight regain was observed in four of the five evaluated studies. Our findings support an association between grazing behavior and weight regain after bariatric surgery, regardless of surgery type and contextual concept of grazing. Further studies are needed to confirm the clarity of the real prevalence and interfering factors related to grazing behavior and weight outcomes.

Workplace nutrition knowledge questionnaire: psychometric validation and application.

Workplace dietary intervention studies in low- and middle-income countries using psychometrically sound measures are scarce. This study aimed to validate a nutrition knowledge questionnaire (NQ) and its utility in evaluating the changes in knowledge among participants of a Nutrition Education Program (NEP) conducted at the workplace. A NQ was tested for construct validity, internal consistency and discriminant validity. It was applied in a NEP conducted at six workplaces, in order to evaluate the effect of an interactive or a lecture-based education programme on nutrition knowledge. Four knowledge domains comprising twenty-three items were extracted in the final version of the NQ. Internal consistency of each domain was significant, with Kuder-Richardson formula values>0·60. These four domains presented a good fit in the confirmatory factor analysis. In the discriminant validity test, both the Expert and Lay groups scored>0·52, but the Expert group scores were significantly higher than those of the Lay group in all domains. When the NQ was applied in the NEP, the overall questionnaire scores increased significantly because of the NEP intervention, in both groups (P<0·001). However, the increase in NQ scores was significantly higher in the interactive group than in the lecture group, in the overall score (P=0·008) and in the healthy eating domain (P=0·009). The validated NQ is a short and useful tool to assess gain in nutrition knowledge among participants of NEP at the workplace. According to the NQ, an interactive nutrition education had a higher impact on nutrition knowledge than a lecture programme.