Obese Patients Have Inadequate Protein Intake Related to Protein Intolerance Up to 1 Year Following Roux-en-Y Gastric Bypass

Background: Inadequate protein intake is a concern following Roux-en-Y gastric bypass (RYGBP). The small gastric pouch and bypass restrict energy intake and may lead to insufficient protein intake and absorption, and excess loss of lean tissue.

Methods: We evaluated protein intake in 93 (77 F, 16 M) morbidly obese individuals (BMI = 52.0 +/- 12.9 [SD]) who underwent RYGBP at our medical center. Participants completed 24-hr food recalls and received nutritional counseling at 3, 6, and 12 months following surgery.

Results: Daily energy intake (kcal/day) increased from 849 +/- 329 (SD) at 3 months to 1,101 +/- 400 at 12 months (P = .009). Protein intake also increased (g/day) from 45.6 +/- 14.2 at 3 months to 58.5 +/- 17.1 at 12 months (P = .04), and as a percentage of goal protein intake from 55.1% +/- 23.0 at 3 months to 73.5% +/- 38.0 at 12 months (P = .02). Although energy and protein intake increased significantly over the 12-month period, protein intake at 12 months remained significantly lower (P = .01) than the daily recommended guidelines (1.5 g/kg IBW) for a low-energy restrictive diet. Energy intake did not differ in those who reported food intolerances at 3 months (P = .77) or 6 months (P = .65), but was lower in them at 12 months (trend, P = .06). Also at 12 months, protein intake (P = .02) and percentage of protein intake goal (P = .04) were significantly lower in those with protein intolerance.

Conclusions: These results suggest that postoperative patients consume insufficient amounts of protein, possibly mediated by protein intolerance. Protein supplementation following RYGBP deserves further consideration.