ABSTRACT

1. Initial Weight/Labs 2 weeks prior to surgery: 2 weeks prior to surgery: Healthy Diet (Group A) Liquid Diet (Group B) Surgery 1 month after surgery: Weights / Labs Questionnaire 3 months after surgery: Weight/Labs RESEARCH QUESTIONS A Comparison of Post-Operative Nutrition Status in a Two Week Liquid Pre-Surgical Diet and a Two Week Healthy Diet in Bariatric Surgery Patients ABSTRACT BACKGROUND METHODOLOGY RESULTS CONCLUSION Large noncompliance rate with following up with doctors and lab tests. Strengthened the realization for the need of dietetic professionals within the bariatric surgery group. • Helps instill proper eating in patients • Monitors lab values for significance, need for intervention. • Helps alter eating habits. Even after patients go through nutrition classes, they still need reinforcement to eating ideas. Limitations of study: • Decreased study size • Inconsistencies in surveys Recommended for future research: • Conduct the study using a larger population to determine greater impact of diets. • Extend study to include 6 months and one year to determine long term effects. REFERENCES ARAMARK Dietetic Distance Internship Program - Philadelphia, PA CONTACT For additional information, please contact Melissa Wolynec, Dietetic Intern ARAMARK Distance Learning Dietetic Internship Program mwolynec@yahoo.com Does a two week liquid diet prior to surgery improve post-operative nutritional status compared to a healthy diet, measured by prealbumin levels and fat free mass? Does a two week liquid diet prior to surgery have a greater impact than a two week healthy diet on diet compliance, toleration and understanding of the post-op liquid diet? Are weight loss and fat free mass at one and three months affected by a two week liquid diet prior to surgery as compared to a two week healthy diet? M. Wolynec, M. Majumdar RD LDN CPT, Lisa DeHaven MS RD LDN This study explored the effect of a two week liquid pre-surgical diet on weight loss, BMI, fat free mass and prealbumin levels as compared to a two week healthy diet prior to surgery. Eight bariatric surgery patients completed the study, adhering to pre-surgical doctors’ appointments and laboratory testing, in addition to doctors’ appointments and laboratory testing at one and three months follow surgery. Patients completed a questionnaire at one month following surgery to assess dietary compliance prior to and after the surgical procedure. Descriptive statistics were used to evaluate change in weight, BMI, prealbumin and fat free mass as well as overall dietary compliance. Overall, the two week liquid diet prior to surgery had a least drastic effect on the reduction of prealbumin levels and fat free mass following surgery. Participants following the healthy diet prior to surgery saw an increase in overall weight loss and BMI reduction. Dietary compliance immediately following surgery was strongest in participants following the two week liquid diet prior to surgery. Dietetic professionals play an imperative role in helping to educate and encourage bariatric surgery patients with success through their lifestyle changes. The prevalence of bariatric surgery in the United States is growing. . It was estimated that around 220,000 procedures were performed in 2010.1 The nutritional goals following bariatric surgery are to produce a substantial caloric deficit while maintaining an adequate intake of essential macro- and micronutrients.1 Unsuccessful dietary outcomes at previous weight loss attempts can be attributed to the patients’ inability to follow the postoperative dietary recommendations. 4 Studies have shown that preoperative dietary restrictions improve post-surgical weight loss.6 Bariatric Surgery at Sinai • A center deemed a Center of Excellence by the American College of Surgeons Bariatric Surgery Center Network Accreditation Program, offers physician expertise, nutritional counseling and emotional support to obese patients wishing to lose weight.11 Each diet had different advantages and disadvantages. Participants on the healthy diet pre-surgery had a greater average weight loss as compared to the liquid diet group. Participants in the healthy diet group were less compliant with post-surgical diet the 15 days following surgery. The long term effects of understanding a healthy diet aided in a higher decrease in average BMI. The two week liquid diet helped develop understanding and compliance with the two week liquid diet following surgery. Patients with the two week liquid diet were able to better maintain their prealbumin level due to increased knowledge of adequate protein intake with protein shakes. Hydration status, measured through fat free mass, needs to be better controlled in patients following their bariatric surgery. KulickD, Hark L, Deen D. The Bariatric Surgery Patient: A Growing Role for Registered Dietitians. Journal of the American Dietetic Association. 2010;110:593-599. 4. Gibbons LM, Sarwer DB, Crerang CE, et al. Previous Weight Loss Experiences of Bariatric Surgery Candidates: How Much Have Patients Dieted Prior to Surgery? Obesity. 2006;14(Suppl 2):70S-76S. 6. Sarwer DB, Wadden TA, Moore RH, et al. Preoperative Eating Behavior, Postoperative Dietary Adherence and Weight Loss Following Gastric Bypass Surgery. Surgical and Obesity Related Disorders. 2008;4(5):640-646. 11. Weight Loss Surgery. Lifebridge Health website. http://lifebridgehealthweightloss.org/Welcome.htm. Accessed January 7, 2012. DISCUSSION • Observational, evaluation design frame • Inclusion criteria: Patients having surgery between November 1, 2011 and December 31, 2011. • Exclusion criteria: Patients who did not sign consent form, non compliant with follow up appointments or lab tests. • All participants underwent basic nutrition education through mandatory classes and tests prior to study. • Information provided on healthy diet and liquid diets for before/following surgery.