Provision Of Ready-To-Drink Protein Following Bariatric Surgery: An Evaluation Of Tolerability, Body Composition, And Metabolic Rate

Summary Background & Aims It is recommended that patients consume at least 60 grams of dietary protein per day to attenuate loss of fat-free mass (FFM) following bariatric surgery. To date, research on the effectiveness and tolerability of protein supplementation in bariatric patients is limited. The purpose of the current study was to determine if provision of 12-weeks of daily protein supplementation was an effective and tolerable method of facilitating higher protein intakes in bariatric surgery patients. A secondary aim was to evaluate the effects of protein supplementation on body composition, metabolic rate, and functional outcomes. An exploratory aim was to compare body composition estimates from bioelectrical impedance spectroscopy and dual-energy x-ray absorptiometry. Methods Bariatric surgery patients (n=49; 88% female) (mean ± standard deviation; Age: 43.7 ± 10.7 yrs; BMI: 51.2 ± 13.7 kg·m-2) were provided with either a 12-week supply of ready-to-drink protein shakes (PRO; n=25) or instructed to follow standard-of-care recommendations (SOC; n=24) following surgery. Patients completed measures of body composition (fat mass [FM], percent body fat [%BF], FFM; bioelectrical impedance [BIS] and/or dual-energy x-ray absorptiometry [DXA]), resting metabolic rate (RMR; indirect calorimetry), a 30-second chair stand, and 3-day food logs prior to surgery (base), 3-weeks, 12-weeks, and 24-weeks post-surgery. Results About 80% of all patients achieved the recommended intake of 60 grams per day, with no significant differences in protein intake between groups (p 0.05). The number of sit-to-stand trials increased at each testing session after the first 3 weeks (p Conclusions Patients were able to achieve the recommended 60 grams of protein per day post-surgery, but the provision of ready-to-drink protein shakes may help bariatric patients achieve higher post-surgery protein intakes. Both groups experienced significant decreases in weight, BMI, and body composition; results varied depending on the method of body composition used. Changes in FFM measured by BIS may reflect greater changes in TBW as opposed to actual muscle mass. Registered at ClinicalTrials.gov , ID#NCT02951663.