Anna Laurenius1, Malin Werling2, Carel W le Roux3, Lars Fändriks2, Torsten Olbers2. 1. Department of Gastrosurgical Research and Education, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. Electronic address: anna.laurenius@vgregion.se. 2. Department of Gastrosurgical Research and Education, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. 3. Department of Gastrosurgical Research and Education, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Diabetes Complications Research Centre, Conway Institute, University College Dublin, Dublin, Ireland.
Abstract
BACKGROUND: Dumping syndrome after Roux-en-Y gastric bypass (RYGB) is traditionally associated with the consumption of refined carbohydrates, but the role of dietary fat is unclear. OBJECTIVES: This study compares symptoms after consumption of a carbohydrate-rich or fat-rich beverage to determine perceived symptoms, glycemic control, and pulse rate. SETTING:University hospital. METHODS: We assessed perceived symptoms (Sigstad's Dumping Index) and glycemic control (P-glucose and S-insulin) as well as autonomic nervous system activity (reflected by arterial pulse rate) after a standardized liquid meal test (440 kcal/300 mL carbohydrates [CARB] or fat [FAT]) in a randomized crossover blinded setting. Blood samples were drawn before and 1, 15, 30, and 60 minutes after finishing each meal and the area under the curve (AUC) was calculated. RESULTS:Twelve patients 42±10 months after undergoing RYGB were studied. AUC differed between drinks for glucose (P = .003) and insulin (P = .005). Pulse rate increased more after CARB than after FAT (P = .01). AUC for perceived symptoms in the Sigstad's Dumping Index were similar after meals (P = .79), yet the pattern of type of symptoms differed. CONCLUSION: In patients with RYGB, a meal with predominant fat content resulted in as much perceived dumping symptoms as a carbohydrate-profiled meal. As expected, an increase in glucose and insulin levels were found only after carbohydrate intake and the pulse rise was more pronounced for carbohydrates than fat. Dietary counseling in patients undergoing RYGB should address dietary fat as well as traditional information about carbohydrates to avoid dumping symptoms.
RCT Entities:
BACKGROUND:Dumping syndrome after Roux-en-Y gastric bypass (RYGB) is traditionally associated with the consumption of refined carbohydrates, but the role of dietary fat is unclear. OBJECTIVES: This study compares symptoms after consumption of a carbohydrate-rich or fat-rich beverage to determine perceived symptoms, glycemic control, and pulse rate. SETTING: University hospital. METHODS: We assessed perceived symptoms (Sigstad's Dumping Index) and glycemic control (P-glucose and S-insulin) as well as autonomic nervous system activity (reflected by arterial pulse rate) after a standardized liquid meal test (440 kcal/300 mL carbohydrates [CARB] or fat [FAT]) in a randomized crossover blinded setting. Blood samples were drawn before and 1, 15, 30, and 60 minutes after finishing each meal and the area under the curve (AUC) was calculated. RESULTS: Twelve patients 42±10 months after undergoing RYGB were studied. AUC differed between drinks for glucose (P = .003) and insulin (P = .005). Pulse rate increased more after CARB than after FAT (P = .01). AUC for perceived symptoms in the Sigstad's Dumping Index were similar after meals (P = .79), yet the pattern of type of symptoms differed. CONCLUSION: In patients with RYGB, a meal with predominant fat content resulted in as much perceived dumping symptoms as a carbohydrate-profiled meal. As expected, an increase in glucose and insulin levels were found only after carbohydrate intake and the pulse rise was more pronounced for carbohydrates than fat. Dietary counseling in patients undergoing RYGB should address dietary fat as well as traditional information about carbohydrates to avoid dumping symptoms.
Authors: Ben Gys; Philip Plaeke; Bas Lamme; Thierry Lafullarde; Niels Komen; Anthony Beunis; Guy Hubens Journal: Obes Surg Date: 2019-06 Impact factor: 4.129
Authors: Emidio Scarpellini; Joris Arts; George Karamanolis; Anna Laurenius; Walter Siquini; Hidekazu Suzuki; Andrew Ukleja; Andre Van Beek; Tim Vanuytsel; Serhat Bor; Eugene Ceppa; Carlo Di Lorenzo; Marloes Emous; Heinz Hammer; Per Hellström; Martine Laville; Lars Lundell; Ad Masclee; Patrick Ritz; Jan Tack Journal: Nat Rev Endocrinol Date: 2020-05-26 Impact factor: 43.330