Circadian Misalignment Is Negatively Associated with the Anthropometric, Metabolic and Food Intake Outcomes of Bariatric Patients 6 Months After Surgery.

PURPOSE: Circadian misalignment has been associated with an increased risk of overweight and obesity, as well as changes in metabolic parameters. This study evaluated the association between social jet lag (SJL), a measure of circadian misalignment, and anthropometric, metabolic and food intake outcomes 6 months after bariatric surgery. MATERIALS AND METHODS: A total of 122 bariatric patients were included (77% female, aged 33 years (range 28-41); 79.5% underwent Roux-en-Y gastric bypass). Anthropometric, food consumption and SJL were evaluated in the preoperative evaluation and in the third and sixth months after surgery. SJL was calculated based on the absolute difference between the mid-sleep time on weekends and weekdays. Generalised estimating equations and linear regression were performed to evaluate the associations between mean SJL exposure and the outcomes. RESULTS: The interaction between SJL and follow-up time negatively influenced the evolution of weight (p = 0.01), BMI (p = 0.04) and insulin levels (p = 0.01). SJL had an effect on intake of calories (p = 0.001), carbohydrate (p = 0.005) and total (p = 0.007), monounsaturated (p = 0.03) and polyunsaturated fat (p < 0.001). Linear regression showed a negative association between mean SJL exposure over the 6 months and the percentage of weight loss (coefficient = - 0.30, p = 0.006), body weight loss (kg) (coefficient = - 0.17, p = 0.03) and the reduction of BMI (coefficient = - 0.24, p = 0.007). CONCLUSIONS: SJL was negatively associated with anthropometric, metabolic and food consumption outcomes 6 months after bariatric surgery. Future studies with longer follow-up are needed to confirm these findings. TRIAL REGISTRATION: Clinical Trials.gov : NCT03485352.

Perfil de saúde e nutricional de pacientes portadores de obesidade mórbida candidatos à cirurgia bariátrica / Health and nutritional profile of patients with morbid obesity bariatric surgery candidates / La salud y el perfil nutricional de los pacientes con obesidad mórbida candidatos a cirugía bariátrica

OMS define obesidade como uma doença em que o excesso de gordura corporal acumulada pode atingir graus capazes de afetar a saúde do homem. Seu tratamento envolve mudanças no estilo de vida, na alimentação, drogas e, nos casos mais severos, há a possibilidade do tratamento cirúrgico. O objetivo foi avaliar o perfil de pacientes que se encontram na espera para o tratamento cirúrgico de obesidade, além de suas noções sobre a importância da alimentação. Participaram do estudo observacional randomizado 30 pacientes portadores de obesidade grau III, com indicações de tratamento cirúrgico. Eles foram entrevistados e passaram por um recordatório 24 horas para avaliação do consumo alimentar. Dos entrevistados, houve predomínio do sexo feminino de 23 pacientes (76,6%) e 7 (23,4%) do masculino. As doenças mais comuns foram: hipertensão 60%, seguida de diabetes tipo II 10%, apnéia obstrutiva do sono 6,6% e insuficiência cardíaca 3,3%. No consumo alimentar, foram encontrados valores com significãncia estatística, que sugerem a omissão ou subestimação das porções, pois o valor calórico ingerido foi menor que o recomendado. Outro fator importante é que existe significativa diferença entre homens e mulheres, no que se refere ao peso atual e ideal. Os pacientes candidatos à cirurgia bariátrica são, em maior número, portadores de comorbidades e a maioria já passou por orientação nutricional e, tanto homens como mulheres não relatam adequadamente as porções ingeridas no recordatário 24 horas.

WHO defines obesity as a disease in which excess body fat build-up may reach levels that could affect human health. His treatment involves changes in lifestyle, diet, drugs and, in severe cases, there is the possibility of surgical treatment. The objective was to evaluate the profile of patients who are waiting for surgical treatment of obesity, and their notions about the importance of food. Participated in the observational study randomized 30 patients with morbid obesity, with indications for surgical treatment. They were interviewed and underwent a 24-hour recall to assess dietary intake. Of the respondents were predominantly female, 23 patients (76.6%) and 7 (23.4%) males. The most common diseases were hypertension 60%, followed by 10% type II diabetes, sleep apnea and heart failure 6.6% 3.3%. In food intake values were statistically significant, suggesting the omission or understatement of the portions, because the calorie intake was lower than recommended. Another important factor is that there is significant difference between men and women in relation to current weight and ideal. Patients are candidates for bariatric surgery are greater in number, those with comorbidities and most have already gone through nutritional guidance, and both men and women do not report adequately on the portions eaten recordatário 24 hours.

La OMS define la obesidad como una enfermedad en la que el exceso de grasa acumulada puede llegar a niveles que podrían afectar la salud humana. Su tratamiento implica cambios en el estilo de vida, dieta, medicamentos y, en casos graves, existe la posibilidad de tratamiento quirúrgico. El objetivo fue evaluar el perfil de los pacientes que están esperando para el tratamiento quirúrgico de la obesidad, y sus nociones acerca de la importancia de los alimentos. Participaron en el estudio observacional aleatorizado de 30 pacientes con obesidad mórbida, con las indicaciones de tratamiento quirúrgico. Ellos fueron entrevistados y se les realizó un recordatorio de 24 horas para evaluar la ingesta alimentaria. De los encuestados eran en su mayoría mujeres, 23 pacientes (76,6%) y 7 hombres (23,4%). Las enfermedades más frecuentes fueron la hipertensión 60%, seguido del tipo 10% de la diabetes II, apnea del sueño e insuficiencia cardiaca 6,6% al 3,3%. En los valores de ingesta de alimentos fueron estadísticamente significativas, lo que sugiere la omisión o subestimación de las partes, ya que el consumo de calorías fue inferior a la recomendada. Otro factor importante es que no hay diferencia significativa entre hombres y mujeres en relación con el peso actual e ideal. Los pacientes son candidatos a cirugía bariátrica son mayores en número, los que tienen comorbilidades y la mayoría ya han pasado por la orientación nutricional, y tanto hombres como mujeres no informan adecuadamente sobre las porciones comido recordatário 24 horas.