Dietary outcome in obese patients treated with a gastroplasty program

Article Abstract:

Gastroplasty is a type of stomach surgery used to treat morbid obesity. The stomach is partitioned off to create a smaller pouch; this procedure is also known as 'stapling the stomach'. The goal of the surgery is to improve compliance with weight loss diets, ideally, on a permanent basis. Eighteen patients who had gastroplasty were studied to evaluate both their compliance with the postoperative diet and the nutritional adequacy of their eating habits. Beginning one week after surgery, patients were counselled on how to follow a 500 calorie per day diet; they were also warned to avoid foods that might obstruct the small stomach pouch. The patients' diet was assessed before gastroplasty and postoperatively at 6, 12, 18 and 24 months. The average energy intake before surgery was 1,880 calories per day. Food intake had been successfully reduced by 61 percent, to 740 calories per day, at six months after surgery. Average caloric intake rose to 1100 calories daily two years after gastroplasty, but this still represented a 42 percent decrease from before surgery. However, the patients did not improve the nutritional quality of their diet, which is necessary to avoid malnutrition and nutrient deficiencies while on a very-low-calorie diet. Many patients had inadequate intakes of a wide variety of nutrients. These patients were at nutritional risk from a combination of severe energy restriction and poor-quality food choices. In conclusion, long-term nutrient supplements may be necessary for patients after gastroplasty. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Surgery, Stomach

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Impaired glucose-induced thermogenesis and arterial norepinephrine response persist after weight reduction in obese humans

Article Abstract:

Thermogenesis is the temporary increase in heat production by the body that occurs after a meal; this process of liberating energy contributes to the calories burned every day. Research has demonstrated that compared to normal-weight persons, obese individuals have reduced thermogenesis, or thermic response, to meals rich in carbohydrates, such as glucose. This means that they burn less energy following high carbohydrate meals than a person of normal weight, but it is not known whether the reduced thermogenesis precedes, or results from, the obesity. A study was conducted with eight severely obese subjects; their thermogenesis and sympathetic nervous system (SNS) hormone levels were measured before and after they lost a substantial amount of weight. The SNS hormones were evaluated because the thermic response to carbohydrate is influenced by the SNS catecholamines, epinephrine and norepinephrine. Results showed that the thermic response to glucose was dramatically lower in the obese subjects versus the control subjects, both before and after the obese individuals lost an average of 66 pounds. The increase in blood norepinephrine after consuming glucose was also blunted in the obese subjects before and after they lost weight. Blood levels of epinephrine did not differ by group. These data suggest that impaired function of the SNS may be a causative factor in the development of obesity. Defective SNS function could promote the initial weight gain, and favor regain of weight after successful weight reduction. (Consumer Summary produced by Reliance Medical Information, Inc.)

Laws, regulations and rules, Reducing diets, Nervous system, Sympathetic, Sympathetic nervous system

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Caffeine: a double-blind, placebo-controlled study of its thermogenic, metabolic, and cardiovascular effects in healthy volunteers

Article Abstract:

Caffeine is as popular a drug as alcohol and nicotine, and is used in some weight-loss preparations. However, its effects on weight loss in humans are not known, although it has been found to stimulate thermogenesis, heat production by the body which burns calories. The effects of three doses of caffeine, or of a placebo (inert) control, on six habitual coffee drinkers were evaluated. The dose of caffeine administered was positively correlated with energy expenditure, meaning the more caffeine ingested, the more calories were burned. There were also positive correlations between blood levels of glucose and lactic acid (produced in muscle and fat cells during metabolism) and caffeine dose. Blood levels of glycerol and triglycerides correlated with caffeine dose, and changes in fatty acid levels were also observed, suggesting that breakdown of fats in fat cells and fat resynthesis in the liver may be occurring. Heart rate and blood pressure changed somewhat following caffeine administration. Caffeine intake by subjects prior to the study may have complicated some results (by causing tolerance, for example), but significant thermogenesis even at the lowest doses of caffeine was found. Further study is needed, but the results suggest that caffeine intake, accompanied by physical activity without increased eating, may reduce body fat stores. (Consumer Summary produced by Reliance Medical Information, Inc.)

Heart, Caffeine, Weight reducing preparations, Anti-obesity agents

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