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Winning by Losing?: Nutritional Consequences of Bariatric Surgery.

紀錄類型:	書目-電子資源 : Monograph/item
正題名/作者:	Winning by Losing?: Nutritional Consequences of Bariatric Surgery./
作者:	Heusschen, Laura.
出版者:	Ann Arbor : ProQuest Dissertations & Theses, : 2023,
面頁冊數:	263 p.
附註:	Source: Dissertations Abstracts International, Volume: 85-04, Section: B.
Contained By:	Dissertations Abstracts International85-04B.
標題:	Physiology. -
電子資源:	https://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=30680829
ISBN:	9798380564090

Winning by Losing?: Nutritional Consequences of Bariatric Surgery.
Heusschen, Laura.

Winning by Losing?: Nutritional Consequences of Bariatric Surgery. - Ann Arbor : ProQuest Dissertations & Theses, 2023 - 263 p.

Source: Dissertations Abstracts International, Volume: 85-04, Section: B.

Thesis (Ph.D.)--Wageningen University and Research, 2023.

This item must not be sold to any third party vendors.

To date, bariatric surgery is the only effective strategy to treat severe obesity, resulting in long-term weight loss, reduction of obesity-related comorbidities, overall mortality and improvement in quality of life. Despite these benefits, all bariatric procedures alter the anatomy and physiology of the gastrointestinal tract, thereby influencing intake, digestion and absorption of nutrients. This may in turn impact nutritional status. The overall aim of this thesis was to gain more insight into factors affecting nutritional status after bariatric surgery, including dietary intake and nutritional supplementation. Furthermore, we have studied pregnancy after bariatric surgery as this period may pose an additional risk on nutritional status.In part A of this thesis, we focused on dietary intake and diet quality after bariatric surgery. In Chapter 2, short-term changes in macro- and micronutrient composition and diet quality in the first six months following bariatric surgery were evaluated. Diet quality was assessed by adherence to the Dutch food-based dietary guidelines by using the cutoff criteria of the Dutch Healthy Diet index. Favorable changes in dietary intake included a decrease in the consumption of unhealthy food choices (e.g. sweets and snacks), red and processed meat and sodium, and an increase in dairy consumption as well as in relative protein intake after bariatric surgery. However, unfavorable changes including reduced consumption of vegetables and wholegrain products along with a decreased fiber and micronutrient intake, and an increase in the intake of mono- and disaccharides were also observed six months post-surgery.Collecting accurate measures of dietary intake is essential for optimal nutritional care after bariatric surgery. However, validated dietary assessment tools in this specific population are lacking. In Chapter 3, we evaluated the relative validity and reproducibility of the Eetscore FFQ as a short screener for diet quality after bariatric surgery. The Eetscore FFQ showed to be acceptably correlated with the Dutch Healthy Diet index derived from 3-day food records (reference method). Yet, the Eetscore FFQ showed higher index scores than the food records and absolute agreement between the two methods was poor. Considering the need for valid dietary assessment tools that reduce the burden for patients, practitioners and researchers, the Eetscore FFQ can be used for ranking individuals according to diet quality and for monitoring relative changes in diet quality over time.In part B of this thesis, we focused on nutritional supplementation after bariatric surgery. In Chapters 4, 5 and 6, a specialized 'weight loss surgery' multivitamin supplement (MVS) for sleeve gastrectomy patients was designed and optimized (WLS Optimum).In Chapter 4, the first version of this supplement was compared to a standard over-thecounter MVS in a randomized controlled trial. Intention-to-treat analysis demonstrated higher serum levels of vitamin B1 and more folic acid deficiencies in the intervention group compared to the control group after 12 months. Based on these results, WLS Optimum was optimized and evaluated in a single-arm open-label trial (Chapter 5). Compared to its previous version, use of WLS Optimum 2.0 resulted in higher serum levels of vitamin B12, vitamin B6 and zinc, but lower serum levels of folic acid during the first year after sleeve gastrectomy. Deficiencies for vitamin B12 and phosphate were also less prevalent in the WLS Optimum 2.0 group. In Chapter 6, the three year follow-up results of both studies were presented.

ISBN: 9798380564090Subjects--Topical Terms:

518431
Physiology.

Winning by Losing?: Nutritional Consequences of Bariatric Surgery.
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500 $a Source: Dissertations Abstracts International, Volume: 85-04, Section: B.
500 $a Advisor: Hazebroek, E. J.;Berendsen, A. A.M.
502 $a Thesis (Ph.D.)--Wageningen University and Research, 2023.
506 $a This item must not be sold to any third party vendors.
520 $a To date, bariatric surgery is the only effective strategy to treat severe obesity, resulting in long-term weight loss, reduction of obesity-related comorbidities, overall mortality and improvement in quality of life. Despite these benefits, all bariatric procedures alter the anatomy and physiology of the gastrointestinal tract, thereby influencing intake, digestion and absorption of nutrients. This may in turn impact nutritional status. The overall aim of this thesis was to gain more insight into factors affecting nutritional status after bariatric surgery, including dietary intake and nutritional supplementation. Furthermore, we have studied pregnancy after bariatric surgery as this period may pose an additional risk on nutritional status.In part A of this thesis, we focused on dietary intake and diet quality after bariatric surgery. In Chapter 2, short-term changes in macro- and micronutrient composition and diet quality in the first six months following bariatric surgery were evaluated. Diet quality was assessed by adherence to the Dutch food-based dietary guidelines by using the cutoff criteria of the Dutch Healthy Diet index. Favorable changes in dietary intake included a decrease in the consumption of unhealthy food choices (e.g. sweets and snacks), red and processed meat and sodium, and an increase in dairy consumption as well as in relative protein intake after bariatric surgery. However, unfavorable changes including reduced consumption of vegetables and wholegrain products along with a decreased fiber and micronutrient intake, and an increase in the intake of mono- and disaccharides were also observed six months post-surgery.Collecting accurate measures of dietary intake is essential for optimal nutritional care after bariatric surgery. However, validated dietary assessment tools in this specific population are lacking. In Chapter 3, we evaluated the relative validity and reproducibility of the Eetscore FFQ as a short screener for diet quality after bariatric surgery. The Eetscore FFQ showed to be acceptably correlated with the Dutch Healthy Diet index derived from 3-day food records (reference method). Yet, the Eetscore FFQ showed higher index scores than the food records and absolute agreement between the two methods was poor. Considering the need for valid dietary assessment tools that reduce the burden for patients, practitioners and researchers, the Eetscore FFQ can be used for ranking individuals according to diet quality and for monitoring relative changes in diet quality over time.In part B of this thesis, we focused on nutritional supplementation after bariatric surgery. In Chapters 4, 5 and 6, a specialized 'weight loss surgery' multivitamin supplement (MVS) for sleeve gastrectomy patients was designed and optimized (WLS Optimum).In Chapter 4, the first version of this supplement was compared to a standard over-thecounter MVS in a randomized controlled trial. Intention-to-treat analysis demonstrated higher serum levels of vitamin B1 and more folic acid deficiencies in the intervention group compared to the control group after 12 months. Based on these results, WLS Optimum was optimized and evaluated in a single-arm open-label trial (Chapter 5). Compared to its previous version, use of WLS Optimum 2.0 resulted in higher serum levels of vitamin B12, vitamin B6 and zinc, but lower serum levels of folic acid during the first year after sleeve gastrectomy. Deficiencies for vitamin B12 and phosphate were also less prevalent in the WLS Optimum 2.0 group. In Chapter 6, the three year follow-up results of both studies were presented.
520 $a Bariatrische chirurgie, ook wel metabole chirurgie genoemd, is momenteel de enige bewezen effectieve behandeling voor langdurig gewichtsverlies bij personen met ernstige obesitas. De meest voorkomende operaties zijn de Roux-en-Y gastric bypass en de gastric sleeve. Bij de gastric bypass wordt de maag verkleind tot het formaat van ongeveer een kiwi en wordt een deel van de dunne darm omgeleid zodat de ingenomen voeding niet volledig wordt opgenomen. Bij de gastric sleeve wordt een groot deel van de maag verwijderd zodat er een kleine, buisvormige maag overblijft. Elke bariatrische ingreep verandert dus in meer of mindere mate iets aan de anatomie en fysiologie van het maagdarmkanaal. Ondanks de voordelen zoals gewichtsverlies en het verminderen of verdwijnen van obesitas-gerelateerde aandoeningen waaronder diabetes en een verhoogde bloeddruk, ontstaat hierdoor ook een hoger risico op voedingstekorten. Dit kan uiteindelijk leiden tot onder andere bloedarmoede, osteoporose (botontkalking) of ondervoeding. Het doel van dit proefschrift was inzicht krijgen in de factoren die van invloed zijn op de voedingsstatus na bariatrische chirurgie, waaronder voedingsinname en het gebruik van supplementen. Voeding en supplementen kunnen worden gezien als twee kanten van dezelfde medaille. Hoewel de inname van supplementen meer bijdraagt aan de totale voedingsstofinname dan de inname via de voeding, zijn beiden even belangrijk voor het bereiken van een optimale voedingsstatus na bariatrische chirurgie. Daarnaast was een deel van dit proefschrift gewijd aan zwangerschap na bariatrische chirurgie, gezien deze periode een extra risico kan vormen voor de voedingstoestand.In deel A van dit proefschrift hebben we ons gericht op de (kwaliteit van) voedingsinname na bariatrische chirurgie. In hoofdstuk 2werden veranderingen in de macro- en micronutrienten samenstelling van het eetpatroon en de kwaliteit van de voedingsinname gedurende de eerste zes maanden na bariatrische chirurgie geevalueerd. De kwaliteit van de voeding werd beoordeeld aan de hand van de Nederlandse voedingsrichtlijnen, waarbij we gebruik hebben gemaakt van de afkapwaarden van de 'Dutch Healthy Diet index'. Gunstige veranderingen in de voedingsinname waren onder meer een afname in de consumptie van ongezonde voedselkeuzes (bijv. snoep en snacks), rood en bewerkt vlees en zout, en een toename in de consumptie van zuivel. Daarnaast zagen we ook een toename in de relatieve eiwitinname na bariatrische chirurgie. Daarentegen werden er zes maanden na de operatie ook ongunstige veranderingen in de voedingsinname waargenomen, waaronder een verminderde consumptie van groenten en volkorenproducten, een verminderde inname van vezels en micronutrienten en een toename van de suikerinname.Het verkrijgen van nauwkeurige gegevens over de voedingsinname is essentieel voor het kunnen bieden van optimale voedingszorg na bariatrische chirurgie. Er ontbreken echter gevalideerde methoden voor het meten en beoordelen van de (kwaliteit van) voedingsinname in deze specifieke populatie. In hoofdstuk 3evalueerden we de relatieve validiteit en reproduceerbaarheid van de Eetscore FFQ als korte screener voor de kwaliteit van voedingsinname na bariatrische chirurgie. We vonden een acceptabele correlatie tussen de 'Dutch Healthy Diet' index scores afkomstig van de Eetscore FFQ en de scores afkomstig van 3-daagse eetdagboeken (referentie methode). Echter resulteerde de Eetscore FFQ over het algemeen in hogere index scores dan de voedingsdagboeken en de absolute overeenkomst tussen de twee methoden was matig.
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