Protein intake compliance of morbidly obese patients undergoing bariatric surgery and its effect on weight loss and biochemical parameters

Background: Grade D evidence supports a daily protein intake (DPI) of >60 g/d after Roux-en-Y gastric bypass. However, the physiologic effects of this recommendation have yet to be elucidated. The primary aim of the present study was to assess the effects of DPI after laparoscopic Roux-en-Y gastric bypass on weight loss, leptin levels, and albumin levels. The setting was a 617-acute inpatient bed university-affiliated teaching hospital. Methods: The data from 427 consecutive bariatric surgery patients were prospectively collected from December 2007 to April 2011. The data were analyzed using Pearson's correlation, the chi-square test, the paired t test, analysis of covariance, and hierarchical linear regression analysis. Results: Of the 427 patients, 167 (39.1%) had complete data at 3, 6, and 12 months of follow-up and were used for the present analysis. Of the 427 patients, 140 (83.8%) were women with a mean age and preoperative body mass index (BMI) of 42.7 +/- 11 years and 47.3 +/- 8.1 kg/m(2), respectively. Of the 427 patients, 71.3% were compliant with a DPI of >= 1 g/kg/d at 12 months postoperatively. The patients had a mean percentage of excess weight loss of 74.9% +/- 16.7% and a mean BMI of 29.4 +/- 5.4 kg/m(2) at 12 months. When controlling for the preoperative BMI, carbohydrate violations, and exercise increase, DPI was associated with a greater percentage of excess weight loss (P = .001), BMI change (P < .0001), and percentage of lean mass (P = .003), and a lower percentage of body fat (P < .0001) at 12 months. Conclusion: Excellent compliance with a DPI of >= 1 g/kg/d at 12 months after laparoscopic Roux-en-Y gastric bypass is feasible and might result in the benefits of increased weight loss, a decreased percentage of body fat, and improved percentage of lean mass. (Surg Obes Relat Dis 2011;7:733-742.) (C) 2011 American Society for Metabolic and Bariatric Surgery. All rights reserved.