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Baseline Pro-inflammatory Diet Is Inversely Associated with Change in Weight and Body Fat 6 Months Following-up to Bariatric Surgery

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Abstract

Objective

To evaluate whether the baseline Dietary Inflammatory Index (DII®) was associated with weight loss and body composition change after bariatric surgery.

Methodology

This longitudinal study included 132 women with obesity (BMI ≥ 35 kg/m2, 43.0 ± 9.7 years), followed up for 6 months after bariatric surgery. The DII® was calculated from dietary data collected using 24-h dietary recall interviews. Anthropometric variables, socio demographic variables, health-related habits, history of disease, as well as gastrointestinal symptoms, both in the preoperative period (baseline) and 6 months after bariatric surgery were collected from the patients’ medical records.

Results

Individuals with a more pro-inflammatory diet (DII > 0.35 median value) preoperatively experienced smaller weight loss (− 22.7% vs. − 25.3%, p = 0.02) and fat mass loss (− 31.9 vs. − 36.2%, p = 0.026), with no difference in lean mass (p = 0.14). In a linear regression model, the baseline DII score was negatively associated with percentage change in weight and fat mass and positively associated with weight and fat mass in the sixth month after surgery. In addition, a pro-inflammatory baseline DII score was correlated with a lower intake of fruit (r = − 0.26, p = 0.006), vegetables (r = − 0.47, p = 0.001), and legumes (r = − 0.21, p = 0.003) in the postoperative period.

Conclusion

In this longitudinal study, a pro-inflammatory diet at baseline was associated with smaller reductions in weight and body fat and poorer dietary quality (reduced consumption of fruits, vegetables, and legumes) 6 months after bariatric surgery.

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References

  1. Yamashita JM, de Moura-Grec PG, de Freitas AR, et al. Assessment of oral conditions and quality of life in morbid obese and normal weight individuals: a cross-sectional study. PLoS One. 2015;10(7):e0129687.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. NCD Risk Factor Collaboration. Trends in adult body-mass index in 200 countries from 1975 to 2014: a pooled analysis of 1698 population-based measurement studies with 19.2 million participants. Lancet. 2016;387(10026):1377–96.

    Article  Google Scholar 

  3. Tirado R, Masdeu MJ, Vigil L, et al. Impact of bariatric surgery on heme oxygenase-1, inflammation, and insulin resistance in morbid obesity with obstructive sleep apnea. Obes Surg. 2017:1–9.

  4. Angrisani L, Santonicola A, Iovino P, et al. Bariatric surgery worldwide 2013. Obes Surg. 2015;25(10):1822–32.

    Article  CAS  PubMed  Google Scholar 

  5. Fox B, Chen E, Suzo A et al. Dietary and psych predictors of weight loss after gastric bypass. J Surg Res 2015, 197(2), 283–290.

  6. Al-Khyatt W, Ryall R, Leeder P, et al. Predictors of inadequate weight loss after laparoscopic gastric bypass for morbid obesity. Obes Surg. 2017;27(6):1446–52.

    Article  PubMed  Google Scholar 

  7. Steinbeisser M, McCracken J, Kharbutli B. Laparoscopic sleeve gastrectomy: preoperative weight loss and other factors as predictors of postoperative success. Obes Surg. 2017;27(6):1508–13.

    Article  PubMed  Google Scholar 

  8. Bressan J, Hermsdorff HH, Zulet MA, et al. Impacto hormonal e inflamatório de diferentes composições dietéticas: ênfase em padrões alimentares e fatores dietéticos específicos. Arq Bras Endocrinol Metabol. 2009;53(5):572–81.

    Article  PubMed  Google Scholar 

  9. Freire RH, Borges MC, Alvarez-Leite JI, et al. Food quality, physical activity, and nutritional follow-up as determinant of weight regain after Roux-en-Y gastric bypass. Nutrition. 2012;28(1):53–8.

    Article  PubMed  Google Scholar 

  10. Hermsdorff HHM, Zulet MÁ, Puchau B, et al. Fruit and vegetable consumption and proinflammatory gene expression from peripheral blood mononuclear cells in young adults: a translational study. Nutr Metab. 2010;7(1):42.

    Article  CAS  Google Scholar 

  11. Hermsdorff HH, Mansego ML, Campion J, et al. TNF-alpha promoter methylation in peripheral white blood cells: relationship with circulating TNFα, truncal fat and n-6 PUFA intake in young women. Cytokine. 2013;64(1):265–71.

    Article  CAS  PubMed  Google Scholar 

  12. Kong LC, Holmes BA, Cotillard A, et al. Dietary patterns differently associate with inflammation and gut microbiota in overweight and obese subjects. PLoS One. 2014;9(10):e109434.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Mazidi M, Kengne AP. Nutrient patterns and their relationship with general and central obesity in US adults. Eur J Clin Investig. 2017;

  14. Hermsdorff HHM, Zulet MÁ, Abete I, et al. Discriminated benefits of a Mediterranean dietary pattern within a hypocaloric diet program on plasma RBP4 concentrations and other inflammatory markers in obese subjects. Endocrine. 2009;36(3):445–51.

    Article  CAS  PubMed  Google Scholar 

  15. Shivappa N, Steck SE, Hurley TG, et al. Designing and developing a literature-derived, population-based dietary inflammatory index. Public Health Nutr. 2014;17(8):1689–96.

    Article  PubMed  Google Scholar 

  16. Ruiz-Canela M, Zazpe I, Shivappa N, et al. Dietary inflammatory index and anthropometric measures of obesity in a population sample at high cardiovascular risk from the PREDIMED (PREvencion con DIetaMEDiterranea) trial. Br J Nutr. 2015;113(6):984–95.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Ramallal R, Toledo E, Martínez JA, et al. Inflammatory potential of diet, weight gain, and incidence of overweight/obesity: the SUN cohort. Obesity. 2017;25(6):997–1005.

    Article  PubMed  Google Scholar 

  18. Lima DM et al. Tabela brasileira de composição de alimentos-TACO: versão IV. NEPA-UNICAMP: Campinas; 2011.

    Google Scholar 

  19. USDA United States Department of Agriculture. Food Composition Databases [Accessed on 20 May 2017]. Disponívelem: https://ndb.nal.usda.gov/ndb/.

  20. Jelliffe, D. B., & World Health Organization. Evaluación del estado de nutrición de la comunidad (con especial referencia a las encuestas en las regiones en desarrollo). 1968.

  21. World Health Organization. Physical status: The use of and interpretation of anthropometry, Report of a WHO Expert Committee. 1995.

  22. World Health Organization. Obesity: preventing and managing the global epidemic. Report of a WHO Consultation presented at the World Health Organization, June 3–5, 1997, Geneva, Switzerland. Geneva, Switzerland: WHO. 1997.

  23. Carraro JCC, Hermsdorff HHM, Mansego ML, et al. Higher fruit intake is related to TNF-α hypomethylation and better glucose tolerance in healthy subjects. J Nutrigenet Nutrigenomics. 2016;9(2–4):95–105.

    Article  CAS  Google Scholar 

  24. Willett WC. Nutritional epidemiology. 2nd ed. New York: Oxford University Press; 1998.

    Book  Google Scholar 

  25. Hermsdorff HHM, Puchau B, Volp ACP, et al. Dietary total antioxidant capacity is inversely related to central adiposity as well as to metabolic and oxidative stress markers in healthy young adults. Nutr Metab. 2011;8(1):59.

    Article  CAS  Google Scholar 

  26. García-Fernández E, Rico-Cabanas L, Rosgaard N, et al. Mediterranean diet and cardiodiabesity: a review. Nutrients. 2014;6(9):3474–500.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Soltani S, Shirani F, Chitsazi MJ, et al. The effect of dietary approaches to stop hypertension (DASH) diet on weight and body composition in adults: a systematic review and meta-analysis of randomized controlled clinical trials. Obes Rev. 2016;17(5):442–54.

    Article  PubMed  Google Scholar 

  28. Cocate PG, Natali AJ, de Oliveira A. Fruit and vegetable intake and related nutrients are associated with oxidative stress markers in middle-aged men. Nutrition. 2014;30(6):660–5.

    Article  CAS  Google Scholar 

  29. Rocha DM, Lopes LL, da Silva A, et al. Orange juice modulates proinflammatory cytokines after high-fat saturated meal consumption. Food Funct. 2017;8:4396–403.

    Article  CAS  PubMed  Google Scholar 

  30. Venn BJ, Mann JI. Cereal grains, legumes and diabetes. Eur J Clin Nutr. 2004;58(11):1443–61.

    Article  CAS  PubMed  Google Scholar 

  31. Cavallo DN, Horino M, McCarthy WJ. Adult intake of minimally processed fruits and vegetables: associations with cardiometabolic disease risk factors. J Acad Nutr Diet. 2016;116(9):1387–94.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Hermsdorff HHM, Zulet MÁ, Abete I, et al. A legume-based hypocaloric diet reduces proinflammatory status and improves metabolic features in overweight/obese subjects. Eur J Nutr. 2011;50(1):61–9.

    Article  CAS  PubMed  Google Scholar 

  33. Kim SJ, de Souza RJ, Choo VL. Effects of dietary pulse consumption on body weight: a systematic review and meta-analysis of randomized controlled trials. Am J Clin Nutr. 2016;103(5):1213–23.

    Article  CAS  PubMed  Google Scholar 

  34. Jastrzebska-Mierzynska M, Ostrowska L, Dadan J. Dietary habits of obese patients qualified for bariatric procedures. RocznikiPaństwowegoZakładuHigieny2014, 65(1).

  35. Wirth J, di Giuseppe R, Boeing H, et al. A Mediterranean-style diet, its components and the risk of heart failure: a prospective population-based study in a non-Mediterranean country. Eur J Clin Nutr. 2016;70(9):1015–21.

    Article  CAS  PubMed  Google Scholar 

  36. Johnson LK, Andersen LF, Hofsø D, et al. Dietary changes in obese patients undergoing gastric bypass or lifestyle intervention: a clinical trial. Br J Nutr. 2013;110(1):127–34.

    Article  CAS  PubMed  Google Scholar 

  37. Soares FL, De Sousa LB, Corradi-Perini C, et al. Food quality in the late postoperative period of bariatric surgery: an evaluation using the bariatric food pyramid. Obes Surg. 2014;24(9):1481–6.

    Article  PubMed  Google Scholar 

  38. Heber D, Greenway FL, Kaplan LM, et al. Endocrine and nutritional management of the post-bariatric surgery patient: an endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2010;95(11):4823–43.

    Article  CAS  PubMed  Google Scholar 

  39. Flancbaum L, Choban PS, Bradley LR, et al. Changes in measured resting energy expenditure after Roux-en-Y gastric bypass for clinically severe obesity. Surgery. 1997;122(5):943–9.

    Article  CAS  PubMed  Google Scholar 

  40. Shankar P, Boylan M, Sriram K. Micronutrient deficiencies after bariatric surgery. Nutrition. 2010;26(11):1031–7.

    Article  CAS  PubMed  Google Scholar 

  41. Bordalo LA, Teixeira TFS, Bressan J, et al. Cirurgia bariátrica: como e por que suplementar. Rev Assoc Méd Bras. 2011;57(1):113–20.

    Article  PubMed  Google Scholar 

  42. Dagan SS, Tovim TB, Keidar A, et al. Inadequate protein intake after laparoscopic sleeve gastrectomy surgery is associated with a greater fat free mass loss. Surg Obes Relat Dis. 2017;13(1):101–9.

    Article  Google Scholar 

  43. Shivappa N, Hébert JR, Rietzschel ER, et al. Associations between dietary inflammatory index and inflammatory markers in the Asklepios study. Br J Nutr. 2015;113(4):665–71.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  44. Shivappa N, Steck SE, Hurley TG, et al. A population-based dietary inflammatory index predicts levels of C-reactive protein in the seasonal variation of blood cholesterol study (SEASONS). Public Health Nutr. 2014;17(8):1825–33.

    Article  PubMed  Google Scholar 

  45. Hermsdorff HHM, Zulet MÁ, Puchau B, et al. Central adiposity rather than total adiposity measurements are specifically involved in the inflammatory status from healthy young adults. Inflammation. 2011;34(3):161–70.

    Article  CAS  PubMed  Google Scholar 

  46. Hébert JR, Hurley TG, Steck SE, et al. Considering the value of dietary assessment data in informing nutrition-related health policy. Adv Nutr. 2014;5(4):447–55.

    Article  PubMed  PubMed Central  Google Scholar 

  47. Shivappa N, Steck SE, Hussey JR, et al. Inflammatory potential of diet and all-cause, cardiovascular, and cancer mortality in National Health and Nutrition Examination Survey III Study. Eur J Nutr. 2017;56(2):683–92.

    Article  CAS  PubMed  Google Scholar 

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Acknowledgments

We thank the participants of this study and the Equipe de Terapia Nutricional da Obesidade Grave (ETNO) of the Hospital das Clínicas – UFMG for excellent technical assistance. HHM Hermsdorff and JIA Leite are CNPq Research Productivity Fellows.

Funding

PA Andrade was provided Master’s grant from CAPES (MEC/Brazil), and this study received financial support from the FAPEMIG (State of Minas-Gerais, Brazil). Drs. Shivappa and Hébert were supported by grant number R44DK103377 from the United States National Institute of Diabetes and Digestive and Kidney Diseases.

Author information

Authors and Affiliations

  1. Department of Nutrition and Health, Universidade Federal de Viçosa, Viçosa, Minas Gerais, 36570-900, Brazil

    Patrícia Amaro Andrade, Helen Hermana M. Hermsdorff & Carla de Oliveira Barbosa Rosa

  2. Universidade Federal de Viçosa, Viçosa, Brazil

    Patrícia Amaro Andrade

  3. Departamento de Bioquímica e Imunologia-ICB, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, 31270-901, Brazil

    Jacqueline Isaura Alvarez Leite

  4. Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, 29208, USA

    Nitin Shivappa & James R. Hébert

  5. Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA

    Nitin Shivappa & James R. Hébert

  6. Connecting Health Innovations LLC, Columbia, SC, 29201, USA

    Nitin Shivappa & James R. Hébert

  7. Escola de Enfermagem, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, 30130-100, Brazil

    Hirla Karen Fialho Henriques

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  1. Patrícia Amaro Andrade
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Corresponding author

Correspondence to Patrícia Amaro Andrade.

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Declaration

JRH owns controlling interest in Connecting Health Innovations LLC (CHI), a company planning to license the right to his invention of the dietary inflammatory index (DII) from the University of South Carolina in order to develop computer and smart phone applications for patient counseling and dietary intervention in clinical settings. NS is an employee of CHI. The subject matter of this paper will not have any direct bearing on that work, nor has that activity exerted any influence on this project.

Conflict of Interest

The authors declared no conflict of interest. However, we do wish to disclose that Dr. James R. Hébert owns controlling interest in Connecting Health Innovations LLC (CHI), a company planning to license the right to his invention of the dietary inflammatory index (DII) from the University of South Carolina in order to develop computer and smart phone applications for patient counseling and dietary intervention in clinical settings. Dr. Nitin Shivappa is an employee of CHI.

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Andrade, P.A., Hermsdorff, H.H.M., Leite, J.I.A. et al. Baseline Pro-inflammatory Diet Is Inversely Associated with Change in Weight and Body Fat 6 Months Following-up to Bariatric Surgery. OBES SURG 29, 457–463 (2019). https://doi.org/10.1007/s11695-018-3530-3

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  • DOI: https://doi.org/10.1007/s11695-018-3530-3

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