SpringerLink
Log in

Animal Protein Intake Is Associated with Obesity Remission After Roux-en-Y Gastric Bypass: an Isocaloric Replacement Analysis

  • Original Contributions
  • Published:
Obesity Surgery Aims and scope Submit manuscript

Abstract

Purpose

Some patients do not have the expected weight loss, and the post-surgical diet may partially explain these differences.

Objectives

To estimate the impact of macronutrient substitution on obesity remission after RYGB, considering the protein source.

Materials and Methods

This study included 58 patients undergoing RYGB. Data collection was performed preoperatively, 3 and 12 months after surgery. Eight participants dropped out of the study at 3 months, and the others remained for 12 months. The foods consumed were registered using a 24-h, 3-day food recall. For the isocaloric substitution analysis, foods were classified according to the protein source. The groups were compared using hypothesis tests, and Cox proportional hazard ratio regression was used to analyze isocaloric substitution.

Results

At three months after surgery, every 5% energy from plant protein replaced by animal protein increased by 3.50 [CI 1.204 — 10.205; p = 0.021] the probability of obesity remission. Stratified analysis by protein groups indicated that replacing vegetable protein with white meat was positively associated with remission of obesity. Every 5% vegetable protein replaced with white meat increased by 3.20 [CI 1.026 — 9.981; p = 0.045] the probability of obesity remission. Both results were independent of age, body mass index (BMI), and the presence of comorbidities.

Conclusion

The results suggest that the consumption of animal proteins after RYGB, mainly white meat, favors weight loss.

Graphical Abstract

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price includes VAT (Germany)

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Cooper TC, Simmons EB, Webb K, et al. Trends in weight regain following Roux-en-Y gastric bypass (RYGB ) bariatric surgery. Obes Surg. 2015;25(8):5–12.

    Article  Google Scholar 

  2. Nicoletti CF, de Oliveira BAP, de Pinhel MAS, et al. Influence of excess weight loss and weight regain on biochemical indicators during a 4-year follow-up after Roux-en-Y gastric bypass. Obes Surg. 2015;25(2):279–84.

    Article  PubMed  Google Scholar 

  3. Sarwer DB, Wadden TA, Moore RH, et al. Preoperative eating behavior, postoperative dietary adherence and weight loss following gastric bypass surgery. Surg Obes Relat Dis. 2008;4(5):640–6.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Robinson AH, Adler S, Stevens HB, et al. What variables are associated with successful weight loss outcomes for bariatric surgery after 1 year? Surg Obes Relat Dis. 2014;10(4):697–704.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Tabesh MR, Maleklou F, Ejtehadi F, et al. Nutrition, physical activity, and prescription of supplements in pre- and post-bariatric surgery patients: a practical guideline. Obes Surg. 2019;29:3385–400.

    Article  PubMed  Google Scholar 

  6. Pinto SL, Juvanhol LL, Bressan J. Increase in protein intake after 3 months of RYGB is an independent predictor for the remission of obesity in the first rear of surgery. Obes Surg. 2019;29(12):3780–5.

    Article  PubMed  Google Scholar 

  7. van den Broek M, de Heide LJM, Veeger NJGM, et al. Influence of dietary protein and its amino acid composition on postoperative outcomes after gastric bypass surgery: a systematic review. Nutr Rev. 2016;74(12):749–73.

    Article  PubMed  Google Scholar 

  8. World Medical Association (WMA). World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013;27;310(20):2191–4.

  9.  Pereira DAA, Vieira SA, Fogal AS, et al. Aspectos metodológicos na construção de projetos de pesquisa em Nutrição Clínica. Rev Nutr Campinas. 2014;27(5):597–604.

    Article  Google Scholar 

  10. Barufaldi LA, Abreu GDA, da Veiga GV, et al. Software to record 24-hour food recall: application in the study of cardiovascular risks in adolescents. Rev Bras Epidemiol. 2016;19(2):464–8.

    Article  PubMed  Google Scholar 

  11. Jelliffe DB. The assessment of the nutritional status of the community (with special reference to field surveys in develo** regions of the world). World Heal Organ. monograph series. 1968.  p. 271.

  12. Consultation WHO. Obesity: preventing and managing the global epidemic. WHO techni. Geneva: World Health Organization; 2000.

  13. Callaway CW, Chumlea WC, Bouchard C et al. Circumference. Anthro standardization reference manual, champaign (IL). In: Lohman TG, Roche AF MR, Martorell R (eds.). Human Kinetics Books. 1988. pp. 39–54.

  14. Ben-noun LL, Laor A. Relationship of neck circumference to cardiovascular risk factors. Obes Res. 2003;11(2):226–31.

    Article  PubMed  Google Scholar 

  15. Geloneze B, Carolina A, Vasques J, et al. HOMA1-IR and HOMA2-IR indexes in identifying insulin resistance and metabolic syndrome – Brazilian metabolic syndrome study (BRAMS). Arq Bras Endocrinol Metab. 2009;53(2):281–7.

    Article  Google Scholar 

  16. Alberti KGMM, Zimmet P, Shaw J. Metabolic syndrome — a new world-wide definition. A Consensus Statement from the International Diabetes Federation. Diabet Med. 2006;23(5):469–80.

    Article  CAS  PubMed  Google Scholar 

  17. Gilbert J, Bendsen NT, Tremblay A, et al. Effect of proteins from different sources on body composition. Nutr Metab Cardiovasc Dis. 2011;21(2):B16-31.

    Article  CAS  PubMed  Google Scholar 

  18. Larsen TM, Dalskov S-M, van Baak M, et al. Diets with high or low protein content and glycemic index for weight-loss maintenance. N Engl J Med. 2010;363(22):2102–13.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Kanerva N, Larsson I, Peltonen M, et al. Changes in total energy intake and macronutrient composition after bariatric surgery predict long-term weight outcome: Findings from the Swedish Obese Subjects (SOS) study. Am J Clin Nutr. 2017;106(1):136–45.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Halton TL, Hu FB. The effects of high protein diets on thermogenesis, satiety and weight loss: a critical review. J Am Coll Nutr. 2004;23(5):373–85.

    Article  PubMed  Google Scholar 

  21. Moizé V, Andreu A, Rodríguez L, et al. Protein intake and lean tissue mass retention following bariatric surgery. Clin Nutr. 2013;32:550–5.

    Article  PubMed  Google Scholar 

  22. Evans EM, Mojtahedi MC, Thorpe MP, et al. Effects of protein intake and gender on body composition changes: a randomized clinical weight loss trial. Nutr Metab (Lond). 2012;9(55):1–9.

    Google Scholar 

  23. Alfenas RCG, Bressan J, de Paiva AC. Effects of protein quality on appetite and energy metabolism in normal weight subjects. Arq Bras Endocrinol Metabol. 2010;54(1):45–51.

    Article  PubMed  Google Scholar 

  24. Berrazaga I, Micard V, Gueugneau M, et al. The role of the anabolic properties of plant- versus animal-based protein sources in supporting muscle mass maintenance: a critical review. Nutrients. 2019;11(1825):1–21.

    Google Scholar 

  25. Wilson J, Wilson GJ. Contemporary issues in protein requirements and consumption for resistance trained athletes. J Int Soc Sports Nutr. 2006;3(1):7–27.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Zarshenas N, Tapsell LC, Neale EP, et al. The relationship between bariatric surgery and diet quality: a systematic review. Obes Surg. 2020;30(5):1768–92.

    Article  PubMed  Google Scholar 

  27. Steenackers N, Vanuytsel T, Augustijns P, et al. Adaptations in gastrointestinal physiology after sleeve gastrectomy and Roux-en-Y gastric bypass. Lancet Gastroenterol Hepatol. 2021;6(3):225–37.

    Article  PubMed  Google Scholar 

  28. Mikkelsen PB, Toubro S, Astrup A. Effect of fat-reduced diets on 24-h energy expenditure: comparisons between animal protein, vegetable protein, and carbohydrate. Am J Clin Nutr. 2000;72:1135–41.

    Article  CAS  PubMed  Google Scholar 

  29. Westerterp-Plantenga MS, Nieuwenhuizen A, Tomé D, et al. Dietary protein, weight loss, and weight maintenance. Annu Rev Nutr. 2009;29:21–41.

    Article  CAS  PubMed  Google Scholar 

  30. Yang Y, Churchward-venne TA, Burd NA, et al. Myofibrillar protein synthesis following ingestion of soy protein isolate at rest and after resistance exercise in elderly men. Nutr Metab (Lond). 2012;9(57):1–9.

    Google Scholar 

  31. Giuberti G, Morlacchini M, Crippa L, et al. Effect of omnivorous and vegan diets with different protein and carbohydrate content on growth and metabolism of growing rats. Int J Food Sci Nutr. 2018;69(5):574–83.

    Article  CAS  PubMed  Google Scholar 

  32. Van BMA, Larsen TM, Jebb SA, et al. Dietary intake of protein from different sources and weight regain, changes in body composition and cardiometabolic risk factors after weight loss: The DIOGenes Study. Nutrients. 2017;9(1326):1–13.

    Google Scholar 

  33. Hoffman JR, Falvo MJ. Protein – which is best ? J Sport Sci Med. 2003;3:118–30.

    Google Scholar 

  34. Bernstein AM, Pan A, Rexrode KM, et al. Dietary protein sources and the risk of stroke in men and women. Stroke. 2012;43:637–44.

    Article  CAS  PubMed  Google Scholar 

  35. Bernstein AM, Sun Q, Hu FB, et al. Major dietary protein sources and risk of coronary heart disease in women. Circulation. 2010;122:876–83.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Funding

The coordination for the improvement of higher education personnel—CAPES Foundation (Ministry of Education, Brazil) for Scholarships awarded to D.L.S.V. and A.S. (Funding Code 001) and the National Council for Scientific and Technological Development—CNPq (Ministry of Science, Technology and Innovation, Brazil) of which J.B. is a productivity scholar.

Author information

Authors and Affiliations

  1. Laboratory of Energy Metabolism and Body Composition (LAMECC), Department of Nutrition and Health, Universidade Federal de Viçosa, Av. PH Rolfs S/N, Viçosa, Minas Gerais, 36570‑900, Brazil

    Darlene L S Vilela, Alessandra Silva, Sônia L. Pinto & Josefina Bressan

  2. Nutrition Course, Universidade Federal de Tocantins, Palmas, Tocantins, 77001-090, Brazil

    Sônia L. Pinto

Authors
  1. Darlene L S Vilela
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Alessandra Silva
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sônia L. Pinto
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Josefina Bressan
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Darlene Larissa de Souza Vilela: contributed to the study design, formal analysis and interpretation of the data, drafting of the manuscript, and approval of the final version.

Alessandra da Silva: contributed to the study design, formal analysis and interpretation of the data, critical review of the manuscript, and approval of the final version.

Sônia Lopes Pinto: contributed to study design, data collection and interpretation, supervision, critical review of the manuscript, and approval of the final version.

Josefina Bressan: contributed to study design, supervision, acquisition of funding for English revision, interpretation of data, critical review of the manuscript, and approval of the final version.

Corresponding author

Correspondence to Darlene L S Vilela.

Ethics declarations

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Conflict of Interest

Darlene L.S Vilela has no conflict of interest; Alessandra Silva has no conflict of interest; Sônia L. Pinto has no conflict of interest; Josefina Bressan has no conflict of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Key Points

• Replace plant protein for animal protein increase probability of obesity remission.

•  Replace plant protein for white meat increase probability of obesity remission.

• The group that achieved remission of obesity had lower BMI at baseline.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Vilela, D.L., Silva, A., Pinto, S.L. et al. Animal Protein Intake Is Associated with Obesity Remission After Roux-en-Y Gastric Bypass: an Isocaloric Replacement Analysis. OBES SURG 33, 1382–1389 (2023). https://doi.org/10.1007/s11695-023-06539-w

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11695-023-06539-w

Keywords

Search

Navigation