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PubMed1993

Assessment of nutrient intake and associated factors in an Indian elderly population.

A group of 420 elderly people (163 women and 257 men with a mean age of 65 years) from urban and rural populations in India were selected for the study. The caloric intake of 93.3% was less than the recommended allowance, the mean daily caloric intake being 1191 kcal in men and 928 kcal in women. Except for calcium, all nutrients were deficient in their diet. Illiteracy (53%), lack of knowledge regarding daily allowances of nutrients (95%), poor economic background (46.7%), and breaking down of joint family system (63%) were possible associated factors examined.

Aged↗
PubMed2001

The effect of social desirability trait on self-reported dietary measures among multi-ethnic female health center employees.

PURPOSE: To evaluate the effect of social desirability trait, the tendency to respond in a manner consistent with societal expectations, on self-reported fruit, vegetable, and macronutrient intake. METHODS: A 61-item food frequency questionnaire (FFQ), 7-item fruit and vegetable screener, and a single question on combined fruit and vegetable intake were completed by 132 female employees at five health centers in eastern Massachusetts. Intake of fruit and vegetables derived from all three methods and macronutrients from the FFQ were fit as dependent variables in multiple linear regression models (overall and by race/ethnicity and education); independent variables included 3-day mean intakes derived from 24-hour recalls (24HR) and score on the 33-point Marlowe-Crowne Social Desirability scale (the regression coefficient for which reflects its effect on estimates of dietary intake based on the comparison method relative to 24HR). RESULTS: Results are based on the 93 women with complete data and FFQ-derived caloric intake between 450 and 4500 kcal/day. In women with college education, FFQ-derived estimates of total caloric were associated with under-reporting by social desirability trait (e.g., the regression coefficient for total caloric intake was -23.6 kcal/day/point in that group versus 36.1 kcal/day/point in women with education less than college) (difference = 59.7 kcal/day/point, 95% confidence interval (CI) = 13.2, 106.2). Except for the single question on which women with college education tended to under-report (difference =.103 servings/day/point, 95% CI = 0.003, 0.203), there was no association of social desirability trait with self-reported fruit and vegetable intake. CONCLUSIONS: The effect of social desirability trait on FFQ reports of macronutrient intake appeared to differ by education, but not by ethnicity or race. The results of this study may have important implications for epidemiologic studies of diet and health in women.

Adult↗
PubMed1983

Effects of alcohol ingestion in the pregnant rat on daily food intake, offspring growth and metabolic parameters.

1. Daily food intake, fluid consumption, offspring growth and metabolic parameters were studied in rats receiving ethanol in the drinking water before, during and after gestation. 2. Ethanol treatment always reduced daily food, liquid and caloric intake in the rat, except during gestation when total daily caloric intake was greater in rats receiving ethanol than in control animals. The increase in both food and liquid intake during lactation in controls was also observed in alcohol-deprived mothers but was significantly reduced in mothers maintained under alcohol treatment. 3. Offspring from alcohol-treated mothers were retarded in body weight and size compared with controls, the differences becoming greater as the suckling period advanced. 4. The 15 day-old pups from alcohol-treated mothers had reduced glucose and augmented beta-hydroxybutyrate levels in blood, and markedly reduced liver glycogen concentrations, indicating their acutely malnourished state. 5. In pups from mothers that received alcohol until the 21st day of gestation, body weight and size were normalized at the 15th day but skeletal maturation and liver glycogen concentration were reduced and blood acetoacetate and beta-hydroxybutyrate were augmented as compared with values in pups from control mothers. If these parameters are interrelated, metabolic changes may be used for early diagnosis of fetal alcohol syndrome.

Aging↗
PubMed1995

Taste and smell losses in HIV infected patients.

Human immunodeficiency virus (HIV-1) associated wasting is an increasingly common clinical manifestation of AIDS. The pathogenesis of wasting is multifactorial and includes reduced caloric intake as a major contributing mechanism. The perceptions of taste and smell play an important role in stimulating caloric intake and in optimizing nutrient absorption through cephalic phase reflexes. The purpose of this study was to evaluate the degree of losses in taste and smell function that occur in subjects infected with HIV. Taste and smell function was evaluated in 40 HIV infected individuals and 40 healthy control subjects matched for age, sex, race, smoking behavior, and number of years of education. Chemosensory tests administered to subjects included taste and smell detection thresholds, taste and smell memory tests, taste and smell discrimination tests, and taste and smell identification tasks. Significant differences were observed between experimental and control subjects in glutamic acid taste detection threshold (p < 0.001), quinine hydrochloride taste detection threshold (p < 0.001), menthol smell detection threshold (p < 0.001) and in the taste identification task (p = 0.006). Overall the results suggest abnormalities in the peripheral and central nervous systems, and subjective distortion of taste and smell. A significant correlation was not established between CDC classification of HIV infection and taste and smell function, although trends were observed suggesting worsening function with progression of HIV disease. These results document significant taste and smell losses in HIV infected subjects which may be of clinical significance in the development or progression of HIV associated wasting.

Acquired Immunodeficiency Syndrome↗
PubMed1996

Effect of 24 hours of starvation on plasma glucose and insulin concentrations in subjects with untreated non-insulin-dependent diabetes mellitus.

Adherence to a low-calorie diet often results in a decrease in blood glucose concentration in persons with non-insulin-dependent diabetes mellitus (NIDDM). Whether this is due to the resultant weight loss or to a decrease in caloric intake has been uncertain. We have obtained data previously that indicated a very short-term reduction in caloric intake (5 hours) resulted in a significant decrease in plasma glucose concentration in subjects with NIDDM. The purpose of the present study was to determine if a further decrease in glucose would occur if the fast was extended from 5 to 24 hours. Seven male subjects with untreated NIDDM were studied after an 11-hour overnight fast. For the subsequent 24-hour period, subjects were given only water. Blood was obtained for glucose, insulin, C-peptide, triglycerides, nonesterified fatty acids (NEFA) alpha-amino acid nitrogen, urea nitrogen, and glucagon at hourly intervals for 24 hours beginning at 8 AM. The amount of glycogen degraded was calculated based on the potassium balance. Plasma glucose decreased from 158 mg/dL at 8 AM to a nadir of 104 mg/dL at 7 PM. It then increased by 30 mg/dL. Corresponding changes occurred in insulin and C-peptide. Serum glucagon remained unchanged. Serum alpha-amino acid nitrogen and urea nitrogen decreased. Triglycerides and NEFA increased. The calculated glycogen utilized over this period was approximately 167 g. This would provide approximately 700 kcal energy. The elevated blood glucose concentration in mild to moderately severe untreated NIDDM subjects was normalized following short-term fasting. Plasma insulin concentrations also decreased to within normal limits. These decreases were highly significant. Glycogenolysis is an important source of fuel during this period.

Aged↗
PubMed1986

[Study of metabolism in critically ill patients by indirect calorimetry].

Indirect calorimetry was performed in 48 postsurgical critically ill patients including those with multiple organ failure. The patients were divided into two groups, organ failure group (OF group) and postsurgical control group (C group), according to the presence of postsurgical organ failure and severe infection. The following results were obtained. The ratio of energy expenditure to basal energy expenditure, reflecting a degree of hypermetabolism, was 1.44 +/- 0.38 in OF group and 1.26 +/- 0.23 in C group respectively. The change in respiratory quotient by caloric intake was greater in OF group than in C group, indicating that it is more important to maintain an adequate intake for the prevention of increased respiratory work and excess lipogenesis in OF group. When nitrogen intake as amino acids was sufficient (0.1-0.2 g/kg/day), nitrogen balance could be maintained around 0 by a caloric intake being equal to measured energy expenditure. A positive correlation was observed between arterial ketone body ratio reflecting energy charge in hepatocytes and respiratory quotient, indicating that in patients with impaired mitochondrial function in hepatocytes as shown by a decrease in ketone body ratio, glucose cannot be utilized effectively. These results let us conclude that calorimetry is indispensable in the management of critically ill patients and that adequate energy intake should be cautiously determined according to the calorimetry.

Calorimetry↗
PubMed1987

Weight regulation practices in athletes: analysis of metabolic and health effects.

Athletes engage in a number of dietary and weight control practices which may influence metabolism, health, and performance. This paper reviews the literature on these factors with special emphasis on athletes who show large, frequent, and rapid fluctuations in weight (wrestlers) and athletes who maintain low weight and low percent body fat (e.g., distance runners, gymnasts, and figure skaters). A theory is presented which relates these weight patterns and the accompanying dietary habits to changes in body composition, metabolism, metabolic activity of adipose tissue, and the distribution of body fat. Changes in these physiological variables may be manifested in enhanced food efficiency (weight as a function of caloric intake) as the body seeks to protect and replenish its energy stores. This may explain the surprisingly low caloric intakes of some athletes. The health status of the athlete is a concern in this regard because there may be changes in fat distribution, risk factors for cardiovascular disease, and hormonal factors associated with reproductive functioning in both females and males. Amenorrhea in female athletes may be mediated at least in part by regional fat distribution; depletion of femoral fat depots (lactational energy reserves) may be the stimulus for cessation or disruption of menses.

Adipose Tissue↗
PubMedDate not supplied

[Evaluation of the nutritional state of patients with maxillo-facial pathology].

We have studied 19 patients with maxillo-facial trauma from the nutritional point at view. We observed that subjects with serious multiple fractures need a high caloric intake (a positive nitrogen balance is achieved by 100% of patients only when their intake is greater than or equal to 46 cal./kg/day) while patients with less serious fractures need lower caloric intake. The A. underline the importance of nutritional therapy in the patients with "intramaxillar fixation" both for the practical and psychological problems connected with their feeding and for the relationship between nutritional conditions and "metabolic response".

Adolescent↗
PubMed2005

Body composition and time course changes in regional distribution of fat and lean tissue in unselected cancer patients on palliative care--correlations with food intake, metabolism, exercise capacity, and hormones.

BACKGROUND: Several investigations that yielded different results in terms of net changes in body composition of weight-losing cancer patients have been reported that employed a variety of methods based on fundamentally different technology. Most of those reports were cross-sectional, whereas to the authors' knowledge there is sparse information available on longitudinal follow-up measurements in relation to other independent methods for the assessment of metabolism and performance. METHODS: For the current report, the authors evaluated time course changes in body composition (dual-energy X-ray absorptiometry) with measurements of whole body and regional distribution of fat and lean tissue in relation to food and dietary intake, host metabolism (indirect calorimetry), maximum exercise capacity (walking test), and circulating hormones in cancer patients who were receiving palliative care during 4-62 months of follow-up. The entire cohort comprised 311 patients, ages 68 years +/- 3 years who were diagnosed with solid gastrointestinal tumors (84 colorectal tumors, 74 pancreatic tumors, 73 upper gastrointestinal tumors, 51 liver-biliary tumors, 3 breast tumors, 5 melanomas, and 21 other tumor types). RESULTS: Decreased body weight was explained by loss of body fat, preferentially from the trunk, followed by leg tissue and arm tissue, respectively. Lean tissue (fat-free mass) was lost from arm tissue, whereas trunk and leg tissue compartments increased, all concomitant with declines in serum albumin, increased systemic inflammation (C-reactive protein, erythrocyte sedimentation rate), increased serum insulin, and elevated daily caloric intake; whereas serum insulin-like growth factor 1 (IGF-1), resting energy expenditure, and maximum exercise capacity remained unchanged in the same patients. Serum albumin levels (P < 0.001), whole body fat (P < 0.02), and caloric intake (P < 0.001) predicted survival, whereas lean tissue mass did not. Daily intake of fat and carbohydrate was more important for predicting survival than protein intake. Survival also was predicted by serum IGF-1, insulin, leptin, and ghrelin levels (P < 0.02 - P < 0.001). Serum insulin, leptin, and ghrelin (total) levels predicted body fat (P < 0.001), whereas IGF-1 and thyroid hormone levels (T3, free T3) predicted lean tissue mass (P < 0.01). Systemic inflammation primarily explained variation in lean tissue and secondarily explained loss in body fat. Depletion of lean arm tissue was related most to short survival compared with the depletion of lean leg and trunk tissue. CONCLUSIONS: The current results demonstrated that body fat was lost more rapidly than lean tissue in progressive cancer cachexia, a phenomenon that was related highly to alterations in the levels of circulating classic hormones and food intake, including both caloric amount and diet composition. The results showed importance in the planning of efficient palliative treatment for cancer patients.

Adipose Tissue↗
PubMed2005

Meal patterns and body weight after nicotine in male rats as a function of chow or high-fat diet.

Studies of the effects of nicotine (NIC) on meal patterns in rats often employ chow pellet diets that contain little fat, whereas humans using NIC commonly consume diets relatively rich in fat. The aim of the present study was therefore to compare the impact of NIC administration and NIC cessation on meal pattern in adult male rats offered a standard powdered chow (CHOW: 10.9% fat by calories) diet or a palatable high-fat (HIFAT: 58.3% fat by calories) diet. Computerized meal pattern analyses were conducted for male rats treated for 14 days with injections of either saline or 1.4 mg/kg/day of NIC (as the free base given in 5 equal amounts) during the dark phase and continued for 10 days after NIC cessation. The suppression of daily caloric intake by NIC was larger in HIFAT-NIC rats than in CHOW-NIC rats (p < .01), such that NIC induced a greater suppression of body weight in HIFAT-NIC rats, relative to CHOW-NIC rats (p < 0.02). NIC administration reduced MS in both CHOW and HIFAT rats. CHOW fed rats showed a gradual increase in meal number in response to NIC, whereas HIFAT fed rats showed a significant initial suppression of meal number, which returned to control levels by day 4 of the 14 day NIC treatment period. In addition, NIC increased water intake more in HIFAT fed rats than in CHOW rats. Cessation of NIC resulted in transient increases in daily caloric intake in CHOW and in HIFAT rats. The present study demonstrates that NIC actions on food intake suppression, meal patterns, and weight reduction differ depending on whether the rats are fed low- or high-fat diets.

Animal Feed↗
PubMed1994

Continuous measurement of energy expenditure in ventilated burn patients: an analysis.

OBJECTIVE: To predict the daily total energy expenditure of ventilated burn patients, this study was designed to determine the contribution of different activities on energy expenditure over a 24-hr period. DESIGN: Cohort study. SETTING: Burn unit of an adult hospital. PATIENTS: Twenty clinically stable burn patients undergoing mechanical ventilation with 36.7 +/- 4.2 total % burn surface area. INTERVENTIONS: Patients were fed according to a previously validated equation which takes into account the Harris-Benedict equation, % burn surface area, caloric intake, body temperature, and the number of postburn days: Toronto Formula = -4343 + (10.5 x % burn surface area) + (0.23 x caloric intake) + (0.84 x Harris-Benedict equation) + (114 x body temperature) - (4.5 x postburn days). The total energy expenditure of patients was measured by indirect calorimetry and their activity levels were recorded over a 24-hr period. RESULTS: The calculated Toronto Formula was 2191 +/- 83 kcal/day and patients were fed 2276 +/- 40 kcal/day. The measured resting energy expenditure was 2149 +/- 102 kcal/day and was similar to the Toronto Formula (NS). The total energy expenditure was 2492 +/- 120 kcal/day. Altogether the activities contributed 27.3 +/- 1.3% to the total energy expenditure and did not correlate with the % burn surface area. The activity factor calculated as [total energy expenditure less resting energy expenditure] x 100/resting energy expenditure was 16.6 +/- 2.4% and calculated as [total energy expenditure less Toronto Formula]/Toronto Formula was 14.5 +/- 4.3%. CONCLUSIONS: These results suggest that in clinically stable, mechanically ventilated burn patients, the Toronto Formula accurately predicts the resting energy expenditure and that the Toronto Formula or the resting energy expenditure x 1.2 can be used to estimate the total daily energy requirements.

Activities of Daily Living↗
PubMed1988

Food intake in patients with cystic fibrosis on an ordinary diet.

The food intake was analysed by means of a 3-day diary in 35 patients with cystic fibrosis, aged 1-65 years. All patients were prescribed an ordinary diet, and all had normal height and weight. The reliability of the method was checked in two patients, who kept diaries twice during a 6-month period. The results were almost identical. Most patients had a satisfactory intake of calories (mean (+/- SD) 97 +/- 23%). Only in five cases was the intake of calories per kg body weight less than that recommended. Protein constituted 11-22 kcal%, the mean protein intake being 178 +/- 55% of the recommended dietary allowance (RDA), most patients having much higher amount per kg body weight than that recommended. The mean fat content of the diet was 37 +/- 6 kcal% (range, 24-59). The calcium was in most cases much more than recommended owing to a high milk intake, the mean intake of calcium being 177 +/- 72% of RDA (range, 89-350). One additional patient had an extremely unbalanced diet, resulting in a caloric intake of more than 300% of RDA. This was due to supplementation with large amounts of special carbohydrate solutions (doctor's prescription), constituting 78 kcal%. Patients with cystic fibrosis on a free normal diet seem to have a satisfactory caloric intake compared with healthy individuals. The protein intake was too high, similar to what hsa been found in healthy Swedish children. The implication of this protein load in a disease with kidney and liver involvement has to be considered.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed2004

Caloric restriction and incidence of breast cancer.

CONTEXT: Restricting caloric intake is one of the most effective ways to extend lifespan and to reduce spontaneous tumor occurrence in experimental animals, but whether similar associations hold in humans has not been appropriately studied. OBJECTIVE: To determine whether caloric restriction in early life reduces the risk of invasive breast cancer. DESIGN, SETTING, AND PARTICIPANTS: Retrospective cohort study using data from the Swedish Inpatient Registry, the Swedish Cancer Registry, the Swedish Death Registry, and the Swedish Fertility Registry. Participants were 7303 Swedish women hospitalized for anorexia nervosa prior to age 40 years between 1965 and 1998. Women were excluded (n = 31) if they were diagnosed with cancer prior to their first discharge from hospitalization for anorexia nervosa. MAIN OUTCOME MEASURE: Incidence of invasive breast cancer. RESULTS: Compared with the Swedish general population, women hospitalized for anorexia nervosa prior to age 40 years had a 53% (95% confidence interval [CI], 3%-81%) lower incidence of breast cancer; nulliparous women with anorexia nervosa had a 23% (95% CI, 79% higher to 75% lower) lower incidence, and parous women with anorexia nervosa had a 76% (95% CI, 13%-97%) lower incidence. CONCLUSIONS: Severe caloric restriction in humans may confer protection from invasive breast cancer. Low caloric intake prior to first birth followed by a subsequent pregnancy appears to be associated with an even more pronounced reduction in risk.

Adult↗
PubMed2004

Gustation as a factor in the ingestion of sweet and fat emulsions by the rat.

This paper was written to pay honor to Professor Gerard P. Smith because of his strong influence on me to study the ingestion of sweet and fat mixtures. Three experiments are reported here, in which the laboratory rat was given an emulsion of a glucose+saccharin mixture with corn oil. In the first experiment, a two-bottle, 24-h test was given comparing the emulsion with water. Over 6 weeks, the concentration of the corn oil was gradually increased. When given only food and water, or the glucose/saccharin solution, the rats regulated their caloric intake and grew at a normal rate. In contrast, when the corn oil was present, the rats significantly increased their caloric intake, resulting in a marked increase in body weight. In the second experiment, a detailed analysis of the ingestion revealed that the rate of licking the emulsion during drinking bouts increased in a linear manner as the concentration of the corn oil was increased. In the third experiment, a conditioned taste aversion to the sweet/fat emulsion generalized to the fat more than to the sweet solutions. The implications for a gustatory input are discussed.

Animals↗
PubMed1998

Influence of chronic alcohol abuse on body weight and energy metabolism: is excess ethanol consumption a risk factor for obesity or malnutrition?

OBJECTIVES: To evaluate the influence of chronic alcohol abuse on body composition and energy metabolism in patients affected by chronic alcoholism (group A) compared with a group of healthy social drinkers (group B). SETTING: A university hospital clinic in Italy. SUBJECTS: A total of 32 alcoholics without clinical or laboratory signs of liver cirrhosis and malabsorption. MEASUREMENTS: Body composition was assessed by anthropometric measurements. Resting energy expenditure (REE) and substrate oxidation rate was measured by indirect calorimetry. Daily caloric intake was computed on the basis of a food diary compiled over 7 days. RESULTS: Alcoholics showed a significantly lower body weight (P < 0.05) and a significant lower fat mass (P < 0.05) compared with controls. A higher waist-to-hip ratio was found in group A than in group B, both as a whole group (P < 0.01) or separated by gender (females, P < 0.01) and males, P < 0.001), indicating a prevalence of fat distribution in the abdominal region in alcoholics. REE was significantly higher in group A than in group B (P < 0.05). The non-protein respiratory quotient was significantly lower in group A than in group B (P < 0.001) with a consequent higher utilization of lipids (P < 0.01) and a lower carbohydrate oxidation (P < 0.05) in group A. The energy intake provided only by food ingestion was found to be significantly higher in group B (P < 0.01), whilst the total caloric intake, computed as food intake plus alcohol intake, was higher in group A (P < 0.01). CONCLUSIONS: Alcoholics, as compared with social drinkers, showed a lower body weight due essentially to a fat mass reduction, a higher REE value normalized by fat-free mass, and a preferential utilization of lipids as energy substrate. These findings might suggest that chronic ethanol abuse is able to determine an impairment of nutritional status due, at least in part, to an alteration of the substrate oxidation.

Abdomen↗
PubMedDate not supplied

Success of immediate intragastric feeding of patients with burns.

We evaluated our attempts to aggressively feed 45 adult patients with burns with the use of intragastric tube feedings. Patients were divided into three burn sizes (20% to 30% total body surface area, 31% to 44% total body surface area, and > 44% total body surface area). No attempts were made to place feeding tubes across the pylorus. Patients were fed as early as possible after admission. Mean caloric intake met calculated nutritional goals beginning on the second day after burn injury, and in the severely burned group, mean caloric intake was 2500+ kcal by the second day. Initiation of intragastric feedings within hours of burn injury results in the provision of high daily levels of nutrition and may obviate the necessity of placing a transpyloric feeding tube in the majority of patients with burns.

Burns↗
PubMed2006

[Relation between peptide YY 3-36 and dietary induced obesity resistant rats].

OBJECTIVE: To study the plasma concentration of peptide YY3 - 36 (PYY3-36) and the expression levels of PYY mRNA of ileum and colon in dietary induced obesity (DIO) and dietary induced obesity resistant (DIO-R) rats and the relation between PYY3-36 and DIO-R rats. METHODS: Thirty-six female SD rats were randomly divided into high-fat diet group (n = 27) and chow fed control group (n = 9), after 13 weeks of either a high-fat diet or chew fed diet, the high-fat diet group was subdivided into DIO and DIO-R group according to the final body weight. Weight gain, caloric intake, the concentration of PYY3-36 and the expression levels of PYY mRNA were measured and compared. RESULTS: The total caloric intake of DIO-R rats was lower than DIO rats (P < 0.01), while no significant difference was found between DIO-R and control rats (P > 0.05). The concentration of PYY3-36 and the expressions of PYY mRNA of ileum and colon in DIO-R rats were higher significantly than that of the DIO and control rats (P < 0.01), while no significant difference was found between DIO and control group (P > 0.05), except that PYY mRNA of ileum was advanced in DIO group (P < 0.01). CONCLUSION: On the High-fat diet, SD rats showed different susceptibility to obese and energy intake, increased levels of PYY3-36 and PYY mRNA might be related to dietary induced obesity resistant.

Animals↗
PubMed1992

Nutritional status seven years after Roux-en-Y gastric bypass surgery.

BACKGROUND: Nutritional deficiencies in patients after Roux-en-Y gastric bypass operations have been mainly attributed to dietary restriction. However, most of these studies have been performed during the period of greatest caloric restriction. METHODS: Two hundred patients who were morbidly obese were followed for 6 to 8 years (mean, 6.7 years) after Roux-en-Y gastric bypass surgery. Each underwent a thorough physical examination and behavioral and nutritional assessments, including hemoglobin, red blood cell indices, serum iron content, iron binding capacity, and serum vitamin B12 and folic acid concentrations. RESULTS: Data obtained from blood tests disclosed a significant gradual decrease of the mean serum hemoglobin (p less than or equal to 0.0000), mean corpuscular volume (p less than 0.001), and iron saturation (p less than or equal to 0.0000). Mean vitamin B12 concentration improved during the last 3 years of follow-up. The mean values of iron saturation and vitamin B12 were not correlated with the patients' weight loss. Meat intolerance was observed in 51%, 60.3%, 59.5%, and 55.1% of the patients during the 0 to 12 months, 13 to 24 months, 25 to 72 months, and 73 to 96 months after surgery, respectively. A significant correlation was found between the eating habits and the laboratory values. The mean serum iron saturation, vitamin B12, and folic acid were significantly higher in patients who eat meat than in patients who do not eat meat (piron less than 0.0046, pB12 less than 0.0052, folate less than 0.01). In addition, oral vitamin and mineral supplements significantly improved the nutritional status of the patients. The patients had no caloric malnutrition or protein deficiency. CONCLUSIONS: Roux-en-Y gastric bypass induces long-term changes in eating habits, independent of caloric intake. Iron continuously declines 6 to 8 years after surgery, depending (significantly) on the eating behavior, but not on the caloric intake.

Anastomosis, Roux-en-Y↗