- Email: [email protected]
Factors Associated with Success After Gastric Bypass Surgery
SUNDAY, SEPTEMBER 30
POSTER SESSION: PROFESSIONAL SKILLS/NUTRITION ASSESSMENT/MEDICAL NUTRITION THERAPY Title: PASS THE FRUITS AND VEGETABLES Author(s): S. Weerts; University of North Florida, Jacksonville, FL
Author(s): A. Lynch, C. Bisogni; Nutritional Sciences, Cornell University, Ithaca, NY
Learning Outcome: The participant will be able to state the relationship between increasing consumption of fruits and vegetables and weight loss. Text: This was a study designed to reduce obesity and food insecurity among low income African American women. The objectives were to reduce caloric intake, test the feasibility of coupon use to purchase fresh produce, and evaluate the effectiveness of food coupons and 15-minute brief counseling sessions to increase fruit and vegetable consumption as a twopronged intervention to promote behavioral change. Twenty participants were randomly assigned to experimental and control groups of 10 each. The groups received four (baseline, months 1-3), monthly 15-minute brief counseling sessions at which $40.00 per month in free coupons were provided; the experimental group’s coupons could only be used for fresh produce; no instructions for use were provided to the control group. Monthly data collected included weights, measurements and dietary recall data. There was no significant difference in any variable at baseline. The mean change in weight loss from baseline to month 3 was significantly greater in the experimental group (p ⬍ .01). The mean change in BMI reduction from baseline to month 3 was significantly greater in the experimental group (p ⬍ .01). The mean change from baseline to month 3 and mean intake of raw, fresh fruits and vegetables at month 3 was significantly greater in the experimental group (p ⬍ .05). These data show the extent to which intake of raw fruits and vegetables can lead to weight loss. African American women are at disproportionate risk for developing obesity co-morbidities; this study was an example of an effective intervention for weight loss. Funding Disclosure: Funding was a 2006 Summer Research grant from our University’s Office of Academic Affairs ($5,000) and donation of fresh fruits and vegetables and other groceries incentives for subject participation by Publix grocers ($5,000).
2
3
Learning Outcome: To describe the effects of a low-carbohydrate, highprotein compared to a high-carbohydrate, low-fat diet on body weight, body mass index, body fat mass, body fat percentage, and central adipose tissue in healthy, but overweight, premenopausal women. Text: Central adipose tissue (CAT), along with total body fat (BF), is a risk factor for some chronic diseases. Dietary interventions that reduce CAT and BF may improve the health status of adults. This clinical trial compared the effects of a low-carbohydrate, high-protein (LCHP) diet versus a high-carbohydrate, low-fat (HCLF) diet on changes in total BF mass (BFM; kg), BF percentage (BF%), and CAT (kg) in healthy premenopausal women. For 12 weeks, overweight women (32-45 years) followed a LCHP (n ⫽ 13) or HCLF diet (n ⫽ 12). Body height (cm) was measured at baseline; body weight (kg) was measured at baseline and week 12. Body mass index (BMI; kg/m2) was calculated from body weight and height measures. Total BFM, BF%, and CAT were measured by dualenergy X-ray absorptiometry (Hologic QDR4500A, version 8.26a:3*) at baseline and week 12. Significant differences between diet groups for age, height, body weight, BMI, BFM, BF%, and CAT did not exist at baseline. Women in the LCHP diet group experienced significant changes in weight (27.0⫾2.9 kg; p⬍0.0001), BMI (22.5⫾1.7; p⬍0.05), BFM (24.3⫾4.1 kg; p⬍0.01), BF% (22.9⫾1.9 %; p⬍0.05), and CAT (21.7⫾1.2 kg; p⬍0.0001). Women in the LCHP diet group also had significant changes in body weight (26.2⫾2.7 kg; p⬍0.0001), BMI (22.4⫾1.0; p⬍0.05), BFM (24.9⫾2.1 kg; p⬍0.01), BF% (23.5⫾1.2 %; p⬍0.01), and CAT (21.6⫾1.0 kg; p⬍0.001). Significant differences between diet groups over time in these morphometric parameters were not shown. Both LCHP and HCLF diets were found to lower body weight, BMI, BFM, BF%, and CAT.
A-44 / August 2007 Suppl 3—Abstracts Volume 107 Number 8
Text: Gastric bypass surgery requires substantial dietary behavior changes both for weight loss success and to prevent negative health consequences, however, changes beyond one year of surgery have rarely been reported in the literature. The goal of this study was to understand the food and eating behaviors of men and women who have undergone gastric bypass surgery. Two men and eight women were recruited from peer-run support groups to participate in two, semi-structured qualitative interviews about their experiences of dietary changes after gastric bypass surgery. Participants were between 15 months and eight years post-surgery. Interviews were audio recorded and transcribed verbatim. Transcripts were analyzed using the constant comparative method. Participants reported complex and individualized ways of managing food and eating to maintain weight loss and avoid nutritional or physiological consequences. Four themes emerged describing the ways participants managed food and eating: 1) Ways of eating, 2) Food selection 3) Quantity, and 4) Context. Ways of eating includes guidelines for eating behaviors such as chewing and eating rate. Food selection describes the categories and explanations participants had for the foods they did and did not eat. Quantity relates to how much participants ate during each eating episode and why. Context refers to how participants handled environmental and social settings affecting eating habits and food selection. Managing food and eating after gastric bypass surgery is thus a complex process that dietitians need to be aware of in order to better counsel and educate this unique population.
Title: FACTORS ASSOCIATED WITH SUCCESS AFTER GASTRIC BYPASS SURGERY
Author(s): S. M. Nickols-Richardson, J. J. Volpe, M. D. Coleman-Kelly ; 1 Nutritional Sciences, The Pennsylvania State University, University Park, PA, 2Self-Employed, Blacksburg, VA, 3Family and Consumer Sciences, Appalachian State University, Boone, NC
Funding Disclosure: None
Learning Outcome: To explain how gastric bypass patients vary in the ways they manage food and eating after surgery.
Funding Disclosure: Division of Nutritional Sciences Small Grant, Cornell University
Title: LOW-CARBOHYDRATE, HIGH-PROTEIN AND HIGHCARBOHYDRATE, LOW-FAT DIETS SIMILARLY LOWER BODY WEIGHT AND BODY FAT MEASUREMENTS IN OVERWEIGHT PREMENOPAUSAL WOMEN 1
Title: MANAGING FOOD AND EATING AFTER GASTRIC BYPASS SURGERY: PATIENTS’ PERSPECTIVES
Author(s): S. A. Kuzemchak, K. N. Wolf, S. A. Kindrick, J. A. Bell-Wilson; The Ohio State University, Columbus, OH Learning Outcome: At the end of the presentation, the participant will be able to name three behaviors associated with long-term success after gastric bypass surgery. Text: Gastric bypass surgery is considered a “behavioral” surgery because an enormous commitment to lifestyle change must be made for the surgery to be successful over the long term. Weight regain is common beginning at two years postsurgery, with many patients’ weight eventually remaining 50 percent above their ideal body weight. Forty patients (35 females and 5 males) who were 5 to 6 years post gastric bypass surgery were interviewed about dietary patterns, exercise habits, satisfaction, and quality of life. Mean pre-surgery weight was 330.7 pounds and mean post-surgery weight was 236.2 pounds. Although no significant differences occurred amongst the 20 successful and 20 unsuccessful subjects, the 20 successful subjects reported eating more frequent meals, as well as more protein and calcium, and were more likely to take a multivitamin, exercise, and follow-up with a health professional other than their physician after surgery. Barriers to weight loss cited included the ability to eat large portions of food, emotional eating, lack of exercise due to health problems and life stressors such as a death of loved one. Counselors will need to recognize these barriers and assist individuals to overcome any encountered post-surgery. Long-term counseling is needed to assist in many of these problems. Funding Disclosure: None
POSTER SESSION: PROFESSIONAL SKILLS/NUTRITION ASSESSMENT/MEDICAL NUTRITION THERAPY Title: PASS THE FRUITS AND VEGETABLES Author(s): S. Weerts; University of North Florida, Jacksonville, FL
Author(s): A. Lynch, C. Bisogni; Nutritional Sciences, Cornell University, Ithaca, NY
Learning Outcome: The participant will be able to state the relationship between increasing consumption of fruits and vegetables and weight loss. Text: This was a study designed to reduce obesity and food insecurity among low income African American women. The objectives were to reduce caloric intake, test the feasibility of coupon use to purchase fresh produce, and evaluate the effectiveness of food coupons and 15-minute brief counseling sessions to increase fruit and vegetable consumption as a twopronged intervention to promote behavioral change. Twenty participants were randomly assigned to experimental and control groups of 10 each. The groups received four (baseline, months 1-3), monthly 15-minute brief counseling sessions at which $40.00 per month in free coupons were provided; the experimental group’s coupons could only be used for fresh produce; no instructions for use were provided to the control group. Monthly data collected included weights, measurements and dietary recall data. There was no significant difference in any variable at baseline. The mean change in weight loss from baseline to month 3 was significantly greater in the experimental group (p ⬍ .01). The mean change in BMI reduction from baseline to month 3 was significantly greater in the experimental group (p ⬍ .01). The mean change from baseline to month 3 and mean intake of raw, fresh fruits and vegetables at month 3 was significantly greater in the experimental group (p ⬍ .05). These data show the extent to which intake of raw fruits and vegetables can lead to weight loss. African American women are at disproportionate risk for developing obesity co-morbidities; this study was an example of an effective intervention for weight loss. Funding Disclosure: Funding was a 2006 Summer Research grant from our University’s Office of Academic Affairs ($5,000) and donation of fresh fruits and vegetables and other groceries incentives for subject participation by Publix grocers ($5,000).
2
3
Learning Outcome: To describe the effects of a low-carbohydrate, highprotein compared to a high-carbohydrate, low-fat diet on body weight, body mass index, body fat mass, body fat percentage, and central adipose tissue in healthy, but overweight, premenopausal women. Text: Central adipose tissue (CAT), along with total body fat (BF), is a risk factor for some chronic diseases. Dietary interventions that reduce CAT and BF may improve the health status of adults. This clinical trial compared the effects of a low-carbohydrate, high-protein (LCHP) diet versus a high-carbohydrate, low-fat (HCLF) diet on changes in total BF mass (BFM; kg), BF percentage (BF%), and CAT (kg) in healthy premenopausal women. For 12 weeks, overweight women (32-45 years) followed a LCHP (n ⫽ 13) or HCLF diet (n ⫽ 12). Body height (cm) was measured at baseline; body weight (kg) was measured at baseline and week 12. Body mass index (BMI; kg/m2) was calculated from body weight and height measures. Total BFM, BF%, and CAT were measured by dualenergy X-ray absorptiometry (Hologic QDR4500A, version 8.26a:3*) at baseline and week 12. Significant differences between diet groups for age, height, body weight, BMI, BFM, BF%, and CAT did not exist at baseline. Women in the LCHP diet group experienced significant changes in weight (27.0⫾2.9 kg; p⬍0.0001), BMI (22.5⫾1.7; p⬍0.05), BFM (24.3⫾4.1 kg; p⬍0.01), BF% (22.9⫾1.9 %; p⬍0.05), and CAT (21.7⫾1.2 kg; p⬍0.0001). Women in the LCHP diet group also had significant changes in body weight (26.2⫾2.7 kg; p⬍0.0001), BMI (22.4⫾1.0; p⬍0.05), BFM (24.9⫾2.1 kg; p⬍0.01), BF% (23.5⫾1.2 %; p⬍0.01), and CAT (21.6⫾1.0 kg; p⬍0.001). Significant differences between diet groups over time in these morphometric parameters were not shown. Both LCHP and HCLF diets were found to lower body weight, BMI, BFM, BF%, and CAT.
A-44 / August 2007 Suppl 3—Abstracts Volume 107 Number 8
Text: Gastric bypass surgery requires substantial dietary behavior changes both for weight loss success and to prevent negative health consequences, however, changes beyond one year of surgery have rarely been reported in the literature. The goal of this study was to understand the food and eating behaviors of men and women who have undergone gastric bypass surgery. Two men and eight women were recruited from peer-run support groups to participate in two, semi-structured qualitative interviews about their experiences of dietary changes after gastric bypass surgery. Participants were between 15 months and eight years post-surgery. Interviews were audio recorded and transcribed verbatim. Transcripts were analyzed using the constant comparative method. Participants reported complex and individualized ways of managing food and eating to maintain weight loss and avoid nutritional or physiological consequences. Four themes emerged describing the ways participants managed food and eating: 1) Ways of eating, 2) Food selection 3) Quantity, and 4) Context. Ways of eating includes guidelines for eating behaviors such as chewing and eating rate. Food selection describes the categories and explanations participants had for the foods they did and did not eat. Quantity relates to how much participants ate during each eating episode and why. Context refers to how participants handled environmental and social settings affecting eating habits and food selection. Managing food and eating after gastric bypass surgery is thus a complex process that dietitians need to be aware of in order to better counsel and educate this unique population.
Title: FACTORS ASSOCIATED WITH SUCCESS AFTER GASTRIC BYPASS SURGERY
Author(s): S. M. Nickols-Richardson, J. J. Volpe, M. D. Coleman-Kelly ; 1 Nutritional Sciences, The Pennsylvania State University, University Park, PA, 2Self-Employed, Blacksburg, VA, 3Family and Consumer Sciences, Appalachian State University, Boone, NC
Funding Disclosure: None
Learning Outcome: To explain how gastric bypass patients vary in the ways they manage food and eating after surgery.
Funding Disclosure: Division of Nutritional Sciences Small Grant, Cornell University
Title: LOW-CARBOHYDRATE, HIGH-PROTEIN AND HIGHCARBOHYDRATE, LOW-FAT DIETS SIMILARLY LOWER BODY WEIGHT AND BODY FAT MEASUREMENTS IN OVERWEIGHT PREMENOPAUSAL WOMEN 1
Title: MANAGING FOOD AND EATING AFTER GASTRIC BYPASS SURGERY: PATIENTS’ PERSPECTIVES
Author(s): S. A. Kuzemchak, K. N. Wolf, S. A. Kindrick, J. A. Bell-Wilson; The Ohio State University, Columbus, OH Learning Outcome: At the end of the presentation, the participant will be able to name three behaviors associated with long-term success after gastric bypass surgery. Text: Gastric bypass surgery is considered a “behavioral” surgery because an enormous commitment to lifestyle change must be made for the surgery to be successful over the long term. Weight regain is common beginning at two years postsurgery, with many patients’ weight eventually remaining 50 percent above their ideal body weight. Forty patients (35 females and 5 males) who were 5 to 6 years post gastric bypass surgery were interviewed about dietary patterns, exercise habits, satisfaction, and quality of life. Mean pre-surgery weight was 330.7 pounds and mean post-surgery weight was 236.2 pounds. Although no significant differences occurred amongst the 20 successful and 20 unsuccessful subjects, the 20 successful subjects reported eating more frequent meals, as well as more protein and calcium, and were more likely to take a multivitamin, exercise, and follow-up with a health professional other than their physician after surgery. Barriers to weight loss cited included the ability to eat large portions of food, emotional eating, lack of exercise due to health problems and life stressors such as a death of loved one. Counselors will need to recognize these barriers and assist individuals to overcome any encountered post-surgery. Long-term counseling is needed to assist in many of these problems. Funding Disclosure: None