Protein intake and lean tissue mass retention following bariatric surgery

Background & aim: Since current protein intake (PI) recommendations for the bariatric surgery (BS) patient are not supported by conclusive evidence, we aimed to evaluate the relationship between PI and lean tissue mass (LTM) loss following BS. Methods: Observational study including patients undergoing gastric bypass (GBP; n = 25) or sleeve gastrectomy (SG; n = 25). Dietary advice and daily PI were assessed prior to, and at 2- and 6-weeks, 4-, 8-, and 12-months after surgery. Body composition was assessed by dual energy X-ray absorptiometry (DXA). LTM loss as percent of weight loss (%LTM loss) at 4- and 12-months after surgery were the main outcome variables. Results: A PI >= 60 g/d was associated with lower %LTM loss at 4- (p = 0.030) and 12-months (p = 0.013). Similar results were obtained when a PI >= 1.1 g/kg of ideal body weight (IBW)/d was considered. Multilinear regression showed the only independent predictor of %LTM loss at 4-months was PI (expressed as g/kg IBW/d) (OR: -0.376, p = 0.017), whereas PI (OR: -0.468, p = 0.001) and surgical technique (OR: 0.399, p = 0.006) predicted 12-months %LTM loss. Conclusions: Our data provide supportive evidence for the PI goals of >60 g/d or 1.1 g/kg IBW/d as a being associated with better LTM preservation in the BS patient. (C) 2012 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.