2 results
Comparing the impact of two types of bariatric surgery on food preferences: The BARIATASTE pilot study
- Erika Guyot, Sylvain Iceta, Julie-Anne Nazare, Emmanuel Disse, Anestis Dougkas
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- Journal:
- Proceedings of the Nutrition Society / Volume 79 / Issue OCE2 / 2020
- Published online by Cambridge University Press:
- 10 June 2020, E361
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- Article
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Introduction:
Up to day, the most effective treatment for obesity is bariatric surgery. Nevertheless, weight regain may occur in almost 20% of the patients. Furthermore, nutritional complications such as protein malnutrition and vitamin deficiencies remain common. Clinical experience and scientific literature suggest changes in food preferences after bariatric surgery, which may contribute to weight loss and/or weight regain independently of the surgically-induced reduction of energy intake. Yet, there is inconsistency among the studies as they do not always use objective measures to assess food preferences and only few considered and compared the different types of surgical technics. Our objective was to study the impact of the type of bariatric surgery on the liking and wanting of consuming certain foods varying in composition and appearance.
Materials and methods:We conducted a cross-sectional clinical trial among 90 patients followed at the Integrated Center for Obesity/Hospital of Lyon. The patients were divided into three groups according to whether they had an unoperated severe obesity (OB), a sleeve gastrectomy (LSG) or a gastric bypass (RYGB). We assessed food preferences using the Leeds Food Preference Questionnaire (LFPQ), a behavioral computer task. Binge eating, impulsivity and food addiction were assessed with self-report questionnaires. Statistical analysis of food preferences included ANOVAs, post-hoc comparisons of groups two-by-two and linear regressions to adjust results for potential confounders. Principal Components Analysis (PCA) and Hierarchical Cluster Analysis (HCA) were performed to determine food preference patterns and groups of individuals with similar food preferences.
Results:Our results showed a significant difference in liking scores, with the OB group having higher scores for high-fat savory (HFSA), high-fat sweet (HFSW) and low-fat sweet foods (LFSW) (p < 0.0001) relative to LSG and RYGB groups. Additionally, LSG had greater score of liking for HFSA than RYGB (p = 0.001). There was a high correlation between the binge eating score and the liking scores for HFSA, HFSW and LFSW (p < 0.001).
Discussion:Our study expands the knowledge regarding changes in food preferences after bariatric surgery and may help to better understand potential underlying mechanisms by comparing two different surgical technics. This pilot study will be followed by a prospective study of food preferences after bariatric surgery using the LFPQ, a buffet type food in an experimental restaurant and sensory measurements. Eventually, our project may contribute to modulate post-operative nutritional interventions in order to facilitate the adoption of a healthy diet.
Glycemic profile is improved by High Slowly Digestible Starch diet in type 2 diabetic patients
- Aurelie Goux, Anne-Esther Breyton, Alexandra Meynier, Stephanie Lambert-Porcheron, Monique Sothier, Laurie Van Den Berghe, Sylvie Normand, Emmanuel Disse, Martine Laville, Julie-Anne Nazare, Sophie Vinoy
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- Journal:
- Proceedings of the Nutrition Society / Volume 79 / Issue OCE2 / 2020
- Published online by Cambridge University Press:
- 10 June 2020, E165
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- Article
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- You have access Access
- Export citation
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Introduction
Considering the dramatically increasing incidence of type 2 diabetes (T2D), decreasing glycemic variability in T2D patients is a key challenge to limit the occurrence of diabetic complications. Diet appears as one potential lever that can be set up above medications. Particularly, the ingestion of foods with a high content in slowly digestible starch (SDS) demonstrated both lower postprandial glycemic and insulin responses in healthy and insulin resistant subjects. This study aimed at designing a full high-SDS diet by selecting high-SDS starchy food products and at studying its impact on glycemic response and variability in T2D.
Materials and methodsThis pilot randomized controlled cross-over study included eight T2D patients (HbA1c = 7.0 ± 0.2%, BMI = 31.7 ± 2.1 kg/m2, treated by Metformin & Sitagliptin) who consumed twice, for one week a controlled diet containing starchy food products screened and selected to be either High (High-SDS) or Low (Low-SDS) in SDS, as determined by the SDS in-vitro method developed by Englyst et al. During each diet period, the glycemic profile was monitored for 6 days using a Continuous Glucose Monitoring System (CGMS). Multiple metrics related to variability and glycemic responses were calculated.
Results222 SDS analyses were realized on commercial food products as consumed. 23 High-SDS and 20 Low-SDS food items with associated specific cooking instructions were selected to design two diets consistent with local T2D recommendations. The High-SDS diet demonstrated a significantly higher SDS content compared to the Low-SDS diet (61.6 vs 11.6 g/day; p < 0.0001), mainly driven by selected pasta, rice and high-SDS biscuits (75.6% of the consumed SDS content). The % of total daily energy intake (TDEI) for all macronutrients remained similar between diets (p > 0.05) and the carbohydrate content specifically represented 49 ± 1 % and 47 ± 2 % of the TDEI for High-SDS and Low-SDS diets, respectively. With the high-SDS diet, the Mean Amplitude of Glycemic Excursion, a key parameter of glycemic variability, was significantly decreased (79.6 for Low-SDS vs 61.6 mg/dL for High-SDS; p = 0.0067). The significant correlation between the meals SDS contents and various glycemic parameters such as postprandial iAUC, tAUC (up to 180 min) or peak value strengthen this finding (p < 0.05 for all).
DiscussionIt was the first demonstration that a diet including selected starchy food items and cooking recommendations designed to favor products’ high SDS content beneficially impacts glycemic profile in T2D subjects. Carefully selecting starchy food may be a simple and valuable tool to improve glycemic control in T2D.