General dietary interventions may matter more than specific habits before bariatric surgery, Concordia study shows
People preparing for metabolic-bariatric surgery may eat quite differently from one another, but those differences do not necessarily translate into different measures of cardiometabolic health, according to anew Concordia study. The researchers say the findings could help health professionals and patients inform lifestyle and eating habits in the lead-up to surgery — and earlier.
Researchers identified two distinct dietary profiles among 64 people preparing for surgery. One group reported a higher intake of calories, fats, sugars and most micronutrients. The other reported substantially lower overall nutrient intake, including less fibre and vitamins.
Despite these differences, the two groups had no significant differences in important health markers, including blood sugar, cholesterol, triglycerides, body fat, waist-to-height ratio or C-reactive protein, a marker of inflammation.
The findings suggest that the bigger nutritional concern may be what the two groups have in common: both diets shared characteristics of a Western dietary pattern, including high energy density, relatively high amounts of carbohydrates, sugars and fats, and low fibre intake.
“The high sugar and high fat group might be eating more fatty food like beef as opposed to chicken, or even putting more sugar in their coffee,” says corresponding author Simon Bacon, a professor in the Department of Health, Kinesiology and Applied Physiology. “The low fiber and vitamin group could be consuming less fruits and vegetables.”
Simon Bacon: "These findings show that we can keep our messaging relatively simple and consider more general interventions rather than worrying about specific dietary habits before surgery."
Differences and similarities in eating patterns
The study, published in Obesity Surgery, involved participants with an average age of 48 and an average body mass index of 45, indicating severe obesity. All participants were scheduled for metabolic-bariatric surgery.
Three months before their procedures, participants were tasked with tracking their food and beverage intake through a smartphone app. The app then used machine learning to identify and calculate each food’s calories and nutrients based on the Canadian Nutrient File, a food composition database. Trained reviewers supervised by a dietitian oversaw the food entries to ensure accuracy.
The data was analyzed with controls for age, sex, ethnicity, marital status, education and income, as well as levels of physical activity and baseline body mass index.
Aside from clustering respondents into two general categories, the study also identified widespread gaps in food-derived nutrient intake. About 83 per cent of participants had fibre intakes below recommended levels, while more than 90 per cent had food-derived vitamin D intake below the estimated average requirement. Sodium intake was also above recommended levels for about 60 per cent of women and 65 per cent of men.
At the same time, both groups showed signs of higher metabolic risk, including higher than recommended blood sugar levels and c-reactive protein, an indicator of general inflammation in the body.
Jessica Burdick
Part of a larger study
The researchers stress that the study was small and cross-sectional and should not be taken as proof that dietary patterns cause changes in cardiometabolic health over time. However, as part of a larger study that will be published in the coming months, they say it does offer preliminary insights into dietary patterns..
“Clinically, these findings show we do not have to get too detailed in thinking about nuanced potential interventions,” Bacon says. “That means we can keep our messaging relatively simple and consider more general interventions that may be much more important that worrying about specific dietary habits before surgery.”
PhD candidate Jessica Burdick is the study’s lead author. Tair Ben-Porat of the University of Haifa, Israel; Tamara Cohen and Patricia Acosta at the University of British Columbia; Maximilien Vakambi and Tarek Allaw at Santé Québec Nord-de-l’ile-de-Montréal-Universitaire, Montreal Behavioural Medicine Centre, conducted additional research as part of the EMBRACE study.
Funding was provided by the Weston Family Foundation.
Read the paper: “Inter-Individual Differences in Dietary Clusters in Candidates for Metabolic-Bariatric Surgery and their Association to Cardiometabolic Health Status”