Nutrient and fluid requirements in post-bariatric patients performing physical activity: A systematic review.

OBJECTIVES: The evidence for the benefits of physical activity in post-bariatric patients is growing. Nevertheless, it remains unclear whether nutritional regimens should be adapted to physical activity levels. The aim of this systematic review was to summarize current evidence regarding nutrient and fluid requirements in physically active post-bariatric patients. METHODS: We conducted this systematic review according to the PRISMA guidelines. We searched MEDLINE, Embase, and the Cochrane Library for studies assessing nutritional aspects in physically active post-bariatric patients. Data were extracted based on a predefined, standardized form, and assessed for risk of bias. RESULTS: Of 582 records, 8 studies were included, mostly implementing general fitness programs (30-60 min/d, 3-4 × /wk). There is no evidence for increased energy requirements in physically active post-bariatric patients. None of the studies determined energy, fat, or carbohydrate requirements. Most studies focused on protein, recommending a minimum intake of 60 g/d to preserve or increase muscle mass (upper limit 1.5 g protein/kg ideal body weight/d). Higher protein intake (108 g/d, thereof 48 g whey protein) combined with physical activity increased muscle strength. The effects of physical activity on micronutrient requirements remain unstudied, whereas fluid requirements appear to be increased. CONCLUSION: The present findings strengthen the importance of adequate protein intake in physically active post-bariatric patients. Nutrient reference values for physically active post-bariatric patients are not definable based on the current evidence. Consequently, clinicians should pay special attention to the monitoring of macro- and micronutrients and fluid balance, especially when post-bariatric patients engage in high levels of physical activity.

[Ketogenic Diet and its Evidence-Based Therapeutic Implementation in Endocrine Diseases]. / Ketogene Diät: evidenzbasierte therapeutische Anwendung bei endokrinologischen Erkrankungen.

Ketogenic Diet and its Evidence-Based Therapeutic Implementation in Endocrine Diseases Abstract. Abstract: The ketogenic diet (KD) is a high-fat and very low-carb diet, which has been used primarily for treatment of therapy-resistant epilepsy in children. Implementation of the KD in other target populations is increasingly being discussed. This literature review provides first indications for a clinical benefit of the KD in diabetes mellitus type 2 (T2DM) and polycystic ovarian syndrome (PCOS). In many analysed studies, KD led to significant weight loss and had beneficial effects on lipoprotein profile and insulin resistance. In half of the comparative studies with T2DM, the KD lead to signifiantly greater reductions in HbA1c-levels (HbA1c difference: -0.5 to -1.5 %) compared to reference diets (HbA1c difference: +0.2 to -0.5 %). Nevertheless, study results are too heterogenic for a general recommendation of the KD in this patient population.

[Fasting - Effects on the Human Body and Psyche]. / Fasten ­ Auswirkungen auf Körper und Psyche.

Fasting - Effects on the Human Body and Psyche Abstract. Fasting has become a trend: to lose weight, to increase well-being, or to heal acute and chronic diseases. The positive and negative effects of fasting are controversially discussed. The aim of this pilot study was to investigate the possible effects of fasting on body and well-being/psychic features. A group of twelve healthy volunteers (ten women and two men) was fasting for one week. Several clinical (body weight, blood pressure) and mental (feeling hungry, feeling cold, mood, power, and sleep quality) parameters were measured during this period. Side effects were recorded as well. This pilot study showed a wide range of effects and remarkable interindividual variation.