一项双盲随机对照试验的结果：补充乳清蛋白在一次吻合胃旁路术后的作用。

IF 2.6 Q3 NUTRITION & DIETETICS

Clinical nutrition ESPEN Pub Date : 2025-07-29 DOI:10.1016/j.clnesp.2025.07.1122

Keivan Sabooni , Farnaz Farsi , Shiva Safari , Mohammad Mahjoubi , Amir Hossein Davarpanah Jazi , Delaram Moosavi , Zahra Gholi , Mohammad Kermansaravi , Shahab Shahabi

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引用次数: 0

摘要

背景：代谢与减肥手术（MBS）是治疗病态肥胖的有效干预手段。然而，快速的体重下降通常表明术后早期，这可能包括瘦体重的大量减少。一种吻合胃旁路术（OAGB）应用较多；然而，关于补充乳清蛋白在这种特殊手术中的术后效果的数据仍然有限。目的：本双盲、随机对照试验（RCT）旨在研究补充乳清蛋白对OAGB患者体重减轻、身体成分和营养指标的影响。方法：78名接受原发性OAGB的参与者（BMI 40-50 kg/m2）随机接受每日纯乳清蛋白(2 × 15 g勺；~ 22.6 g蛋白质/天)或视觉上相同的安慰剂，持续三个月。在基线（术前）和术后1、3个月进行人体测量、生物电阻抗分析（身体成分）和实验室评估。为所有参与者提供了标准的复合维生素和矿物质补充剂。通过日记和定期随访电话来监测依从性。结果：术后三个月，两组患者均表现出明显的体重减轻和空腹血糖、糖化血红蛋白和血脂水平的改善。两组之间在总减重百分比或关键营养指标（如白蛋白）方面没有显著差异。然而，与安慰剂组相比，乳清蛋白组的无脂量、肌肉量和总体内水分的减少量显著降低（p < 0.05）。结论：在接受OAGB的患者中，补充乳清蛋白在三个月内并没有显著改变总体重减轻或生化指标；然而，它确实有助于保持瘦体重。虽然成本和依从性仍然是潜在的障碍，乳清蛋白补充可能提供一个实用的，可容忍的选择，以支持术后早期的肌肉质量保留。

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The role of whey protein supplementation after one-anastomosis gastric bypass: Results of a double-blind randomized controlled trial

Background

Metabolic and bariatric surgery (MBS) is an effective intervention for morbid obesity. Yet, rapid weight loss often indicates the early postoperative period, which can include substantial reductions in lean body mass. One Anastomosis Gastric Bypass (OAGB) is being used more frequently; however, data on the postoperative effects of whey protein supplementation in this specific procedure are still limited.

Objective

This double-blind, randomized controlled trial (RCT) aimed to investigate the effects of whey protein supplementation on weight loss, body composition, and nutritional markers in patients undergoing OAGB.

Methods

Seventy-eight participants (BMI 40–50 kg/m²) undergoing primary OAGB were randomized to receive either daily pure whey protein (2 × 15 g scoops; ∼22.6 g protein/day) or a visually identical placebo for three months. Anthropometric measurements, bioelectrical impedance analysis (body composition), and laboratory assessments were performed at baseline (preoperative) and 1 and 3 months postoperatively. Standard multivitamins and mineral supplementation were provided to all participants. Adherence was monitored through diaries and regular follow-up calls.

Results

Both groups demonstrated significant weight loss and improved fasting blood glucose, HbA1C, and lipid profiles three months post-surgery. No significant differences between groups emerged in total weight loss percentage or key nutritional markers (e.g., albumin). However, the whey protein group exhibited significantly lower reductions in fat-free mass, muscle mass, and total body water compared to the placebo group (p < 0.05).

Conclusion

In patients undergoing OAGB, whey protein supplementation did not substantially alter total weight loss or biochemical markers within three months; however, it did help preserve lean body mass. While cost and adherence remain potential barriers, whey protein supplementation may offer a practical, tolerable option to support muscle mass retention in the early postoperative period.

Registration

This research was registered (30-04-2024) in the https://irct.behdasht.gov.ir with registration number: IRCT20240209060949N1.

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来源期刊

Clinical nutrition ESPEN NUTRITION & DIETETICS-

CiteScore

4.90

自引率

3.30%

发文量

512

期刊介绍： Clinical Nutrition ESPEN is an electronic-only journal and is an official publication of the European Society for Clinical Nutrition and Metabolism (ESPEN). Nutrition and nutritional care have gained wide clinical and scientific interest during the past decades. The increasing knowledge of metabolic disturbances and nutritional assessment in chronic and acute diseases has stimulated rapid advances in design, development and clinical application of nutritional support. The aims of ESPEN are to encourage the rapid diffusion of knowledge and its application in the field of clinical nutrition and metabolism. Published bimonthly, Clinical Nutrition ESPEN focuses on publishing articles on the relationship between nutrition and disease in the setting of basic science and clinical practice. Clinical Nutrition ESPEN is available to all members of ESPEN and to all subscribers of Clinical Nutrition.