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Impact of varying levels of protein intake on protein status indicators after gastric bypass in patients with multiple complications requiring nutritional support.

Abstract

BACKGROUND

<6% of patients who undergo Roux-en-Y gastric bypass (RYGBP) for morbid obesity require nutritional support after surgery. Protein and caloric needs have been estimated as 14-21 kcal, 1.2 g protein/kg/current body weight/day in uncomplicated morbidly obese patients. This study assesses the effect of varying protein-calorie intake in complicated patients after RYGBP on two markers of protein status: thyroxine-binding prealbumin (TBPA) and serum albumin.

METHODS

This 25-month retrospective study consisted of 22 patients with postoperative complications. Serum albumin, TBPA, medical nutrition care-plans, laboratory data and history were reviewed. These post-RYGBP patients who had BMI>35 and no multi-system organ failure or fistulas, had complications after surgery requiring nutrition support services (NSS). Serum albumin and TBPA were matched to fed levels of protein using random coefficient regression analysis.

RESULTS

Mean incremental increases of 2.34 mg/dl (TBPA, P=0.0113) and 0.11 g/dl (serum albumin, P=0.0272) were found with each 0.5 g protein intake increase/kg ideal body weight/day (kg/IBW/day). Patients required NSS for 23+/-21 (mean+/-SD) days, with 15+/-19 days fed at goal rate. Initial serum albumin was 2.3+/-0.5, with a final measure of 2.7+/-0.5 g/dl. Goal protein and calorie intake were 2.1 g and 17 kcal/kg IBW/day versus actual intake of 1.6 g and 13 kcal/kg IBW/day.

CONCLUSION

Morbidly obese patients requiring NSS following RYGBP risk iatrogenic protein malnutrition. There was a positive linear relationship between protein status and protein intake that warrants further study of higher protein feeding in complicated post-RYGBP patients.

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  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Department of Medical Nutrition Therapy, Poudre Valley Hospital, Fort Collins, CO 80524, and Department of Public Health and Preventive Medicine, Oregon Health and Science University, Portland, OR, USA. ers3@pvhs.org

    , ,

    Source

    Obesity surgery 16:1 2006 Jan pg 24-30

    MeSH

    Adult
    Albumins
    Dietary Proteins
    Eating
    Female
    Gastric Bypass
    Humans
    Male
    Middle Aged
    Nutrition Assessment
    Nutritional Status
    Nutritional Support
    Obesity, Morbid
    Postoperative Complications
    Protein-Energy Malnutrition
    Thyroxine-Binding Proteins

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    16417753

    Citation

    Rinaldi Schinkel, Elizabeth, et al. "Impact of Varying Levels of Protein Intake On Protein Status Indicators After Gastric Bypass in Patients With Multiple Complications Requiring Nutritional Support." Obesity Surgery, vol. 16, no. 1, 2006, pp. 24-30.
    Rinaldi Schinkel E, Pettine SM, Adams E, et al. Impact of varying levels of protein intake on protein status indicators after gastric bypass in patients with multiple complications requiring nutritional support. Obes Surg. 2006;16(1):24-30.
    Rinaldi Schinkel, E., Pettine, S. M., Adams, E., & Harris, M. (2006). Impact of varying levels of protein intake on protein status indicators after gastric bypass in patients with multiple complications requiring nutritional support. Obesity Surgery, 16(1), pp. 24-30.
    Rinaldi Schinkel E, et al. Impact of Varying Levels of Protein Intake On Protein Status Indicators After Gastric Bypass in Patients With Multiple Complications Requiring Nutritional Support. Obes Surg. 2006;16(1):24-30. PubMed PMID: 16417753.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Impact of varying levels of protein intake on protein status indicators after gastric bypass in patients with multiple complications requiring nutritional support. AU - Rinaldi Schinkel,Elizabeth, AU - Pettine,Stefan M, AU - Adams,Elizabeth, AU - Harris,Mary, PY - 2006/1/19/pubmed PY - 2006/4/28/medline PY - 2006/1/19/entrez SP - 24 EP - 30 JF - Obesity surgery JO - Obes Surg VL - 16 IS - 1 N2 - BACKGROUND: <6% of patients who undergo Roux-en-Y gastric bypass (RYGBP) for morbid obesity require nutritional support after surgery. Protein and caloric needs have been estimated as 14-21 kcal, 1.2 g protein/kg/current body weight/day in uncomplicated morbidly obese patients. This study assesses the effect of varying protein-calorie intake in complicated patients after RYGBP on two markers of protein status: thyroxine-binding prealbumin (TBPA) and serum albumin. METHODS: This 25-month retrospective study consisted of 22 patients with postoperative complications. Serum albumin, TBPA, medical nutrition care-plans, laboratory data and history were reviewed. These post-RYGBP patients who had BMI>35 and no multi-system organ failure or fistulas, had complications after surgery requiring nutrition support services (NSS). Serum albumin and TBPA were matched to fed levels of protein using random coefficient regression analysis. RESULTS: Mean incremental increases of 2.34 mg/dl (TBPA, P=0.0113) and 0.11 g/dl (serum albumin, P=0.0272) were found with each 0.5 g protein intake increase/kg ideal body weight/day (kg/IBW/day). Patients required NSS for 23+/-21 (mean+/-SD) days, with 15+/-19 days fed at goal rate. Initial serum albumin was 2.3+/-0.5, with a final measure of 2.7+/-0.5 g/dl. Goal protein and calorie intake were 2.1 g and 17 kcal/kg IBW/day versus actual intake of 1.6 g and 13 kcal/kg IBW/day. CONCLUSION: Morbidly obese patients requiring NSS following RYGBP risk iatrogenic protein malnutrition. There was a positive linear relationship between protein status and protein intake that warrants further study of higher protein feeding in complicated post-RYGBP patients. SN - 0960-8923 UR - https://www.unboundmedicine.com/medline/citation/16417753/Impact_of_varying_levels_of_protein_intake_on_protein_status_indicators_after_gastric_bypass_in_patients_with_multiple_complications_requiring_nutritional_support_ L2 - https://dx.doi.org/10.1381/096089206775222168 DB - PRIME DP - Unbound Medicine ER -