human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background : Approximately 20 - 30 % of obese patients do not achieve successful weight outcomes after bariatric surgery . Objective : We examined whether short-term changes ( ≤0.5 y postsurgery ) in energy intake and macronutrient composition after bariatric surgery could predict 10-y weight change . Design : Participants were recruited from the Swedish Obese Subjects ( SOS ) study , which was a matched ( nonr and omized ) prospect i ve trial that compared bariatric surgery with usual care for obese patients . A total of 2010 patients who underwent bariatric surgery were included in the study .  Physical examinations ( e.g. , weight ) and question naires ( e.g. , dietary question naire ) were completed before and 0.5 , 1 , 2 , 3 , 4 , 6 , 8 , and 10 y after surgery . For the main analytic strategy , a linear mixed model was implemented , which included repeated measures with a r and om intercept and an unstructured covariance matrix . Results : Short-term changes in energy intake ( P < 0.001 ) and in relative proportions of energy from carbohydrates ( P < 0.001 ) , fat ( P < 0.001 ) , and protein ( P < 0.05 ) were associated with 10-y weight change after bariatric surgery . At the 10-y follow-up , men and women with the largest reductions in energy intake had lost 7.3 % and 3.9 % more weight , respectively , compared with that of subjects with the smallest intake reductions ( P < 0.001 ) . Greater weight loss was achieved in men and women who favored protein and carbohydrates over fat and in subjects who favored protein over carbohydrates than in individuals who favored the opposite changes in macronutrient composition ( P < 0.05 ) . Conclusions : The level of energy restriction that is achieved at 0.5 y after bariatric surgery predicts long-term weight loss . Weight loss is also associated with a changing dietary macronutrient composition . This trial was registered at clinical trials.gov as NCT01479452 Background Patients who have undergone bariatric surgery have increased risks of developing micronutrient deficiencies . Translational research investigating the actual micronutrient intake of bariatric patients is limited . We examined the  micronutrient intake  of a multicentre cohort of laparoscopic adjustable gastric b and ing patients 1 year post-surgery . These data were compared to micronutrient recommendations for the general population . Methods Consecutive patients from three bariatric surgery facilities in Melbourne , Australia , were invited to participate 12 months post-operatively . A vali date d food frequency question naire was posted to 215 prospect i ve participants . Results Of the 52 participants , micronutrient intakes from food and fluids alone were below population recommendations for calcium , folate , magnesium , potassium , retinol equivalents , thiamin and vitamin E. Males did not meet the recommended intakes for zinc , and iron intakes in pre-menopausal women were insufficient . Intakes lower than recommended levels for these micronutrients suggest inadequate intake of foods from vegetable , dairy , lean meat ( or alternatives ) and wholegrains . Micronutrient intakes below recommended levels in this patient group can be further explained by their macronutrient intakes that suggested diets of poor nutrient density . Recommendations for supplementation in this group have wide variations , usually having been developed through the presence of clinical and biochemical deficiencies . Conclusions Nutritional supplementation should be more extensive in scope and dosage than is currently recommended by some professional guidelines . Further long-term studies are needed to explore both macro- and micronutrient intakes on the morbidity and mortality of this patient population Background Data on gastrointestinal ( GI ) and dietary changes following bariatric surgery are scarce in the Middle Eastern region . The objective of this work was to retrospectively compare dietary intake , food preferences , and GI symptoms in subjects with extreme obesity after Roux-en-Y gastric bypass ( RYGB ) and sleeve gastrectomy ( SG ) . Methods Sixty subjects equally divided between RYGB and SG with a postoperative period of ≥6 months were recruited for a retrospective , non-r and omized , and observational study . All subjects completed three question naires ( GI symptoms , food preferences , and quantitative food frequency question naire ( FFQ ) ) and three 24-h recalls . Results At one year postoperatively , both surgical groups showed similar percentage of excess weight loss that exceeded 50 % . In addition , percentage of carbohydrate , protein , and sugar intake from total energy , frequency of daily consumption from the eight food categories and daily energy intake were comparable between surgical groups . RYGB subjects consumed significantly more fruits and juices from total energy ( P < 0.05 ) whereas SG subjects tended to consume more sweets and desserts . Heartburn ( P < 0.001 ) , regurgitation ( P < 0.01 ) , nausea ( P < 0.01 ) , vomiting ( P < 0.001 ) , and constipation ( P < 0.05 ) were significantly more frequent among SG subjects . Flatulence ( P < 0.001 ) and diarrhea ( P < 0.05 ) , as well as dizziness ( P < 0.001 ) , and fast heartbeat ( P < 0.05 ) after eating were significantly more frequent after RYGB . Conclusions There were no major differences in dietary intake and food preferences between RYGB and SG groups . There was a trend for sweet-eating in SG subjects with less dumping symptoms to suggest different mechanisms of action for each procedure , which might impact eating behavior Background Data on adherence to postoperative lifestyle recommendations by bariatric patients are scarce . Thus , the aim of this study was to evaluate adherence to selected recommendations during the first year following laparoscopic sleeve gastrectomy ( LSG ) surgery . Methods A prospect i ve cohort study with 12 months of follow-up on 100 LSG patients was conducted . Data were collected at baseline and at 3 ( M3 ) , 6 ( M6 ) , and 12 ( M12 ) months post-surgery and included anthropometrics , biochemical tests , food intake , food tolerance , common surgery-related side effects , physical activity ( PA ) , supplementation , and number of follow-up meetings with a dietitian .  Results Data were available for 77 patients ( 57.1 % women , mean age 43.1 ± 9.3 years and preoperative BMI 42.1 ± 4.8 kg/m2 ) . Only a minority of the patients adhered to the recommended protein intake ≥60 g/day at all time points ( ≤40.3 % ) and ≥6 meetings with a dietitian at M12 ( 41.6 % ) . Half of the patients performed ≥150 min/week of PA at all time points ( ≤50.6 % ) as recommended . PA of ≥150 min/week was associated with better lipid and glucose changes at M6 and M12 ( P ≤ 0.044 ) . Most of the patients adhered to the recommended supplementation at all time points ( ≥57.1 % ) . Adherence to supplementation at M12 was significantly associated with higher serum levels of folic acid , iron , hemoglobin , and vitamins D and B12 ( P ≤ 0.056 for all ) . Adherence to all recommendations was not significantly associated with excess weight loss ≥60 % at M12 ( P ≥ 0.195 for all ) . Conclusion Bariatric patients have medium to high adherence to the major lifestyle recommendations during the first year following LSG ; however , adherence to those recommendations was not related to better weight loss at short-term follow-up . Adherence to recommended supplementation was associated with better micronutrient status 1 year postoperatively OBJECTIVE The effects of food tolerance ( if any ) on diet quality several years post-surgery remain unclear . Our study aim ed to assess food tolerance and diet quality after three  bariatric  procedures ; adjustable gastric b and ing ( AGB ) , sleeve gastrectomy ( SG ) and Roux-en-Y gastric bypass ( RYGBP ) , 2â??4 years post-surgery . METHODS This prospect i ve , cross-sectional study assessed weight loss , food tolerance and diet quality in 130 subjects ( 14 obese pre-surgical controls , 13 AGB , 62 SG and 41 RYGBP ) . Inclusion criteria selected patients who underwent bariatric surgery between 1 January 2007 and 31 December 2008 , at a single bariatric clinic . Non-parametric tests ( Kruksalâ??Wallis and Mannâ??Whitney ) along with Spearman 's correlation coefficient analysis were used . RESULTS Superior food tolerance was reported by the control ( 24.5 ) , SG ( 24.0 ) and RYGBP ( 22.0 ) groups , compared with the AGB group ( 15.5 ; P < 0.001 ) . The control and AGB groups consumed significantly more high-calorie extra foods ( 9.2 and 7.7 daily serves respectively ) compared with the SG ( 3.4 serves ) and RYGBP ( 4.0 serves ) groups . There were several significant correlations between food tolerance and dietary intake including breads and cereals and meat and meat alternatives . CONCLUSION The control and AGB groups consumed significantly more high-calorie extra foods , a result that was paralleled by poor weight loss and food tolerance outcomes for the AGB group . A significant positive relationship between food tolerance and diet quality was established . Poor food tolerance and thus compromised diet quality need to be considered as post-surgical complications of the AGB procedure BACKGROUND Underreporting of food intake is common in obese subjects . OBJECTIVE One aim of this study was to assess to what extent underreporting by obese men is explained by underrecording ( failure to record in a food diary everything that is consumed ) or undereating . Another aim of the study was to find out whether there was an indication for selective underreporting . DESIGN Subjects were 30 obese men with a mean ( + /-SD ) body mass index ( in kg/m(2 ) ) of 34 + /- 4 .  Total food intake was measured over 1 wk . Energy expenditure ( EE ) was measured with the doubly labeled water method , and water loss was estimated with deuterium-labeled water .  Energy balance was checked for by measuring body weight at the start and end of the food-recording week and 1 wk after the recording week . RESULTS Mean energy intake and EE were 10.4 + /- 2.5 and 16.7 + /- 2 . 4 MJ/d , respectively ; underreporting was 37 + /- 16 % . The mean body mass loss of 1.0 + /- 1.3 kg over the recording week was significantly different ( P < 0.05 ) from the change in body mass over the nonrecording week , and indicated 26 % undereating . Water intake ( reported + metabolic water ) and water loss were significantly different from each other and indicated 12 % underrecording . The reported percentage of energy from fat was a function of the level of underreporting : percentage of energy from fat = 46 - 0.2 x percentage of underreporting ( r(2 ) = 0.28 , P = 0.003 ) . CONCLUSIONS Total underreporting by the obese men was explained by underrecording and undereating . The obese men selectively underreported fat intake Background Roux-en-Y gastric bypass ( GBP ) and sleeve gastrectomy ( SG ) have increased dramatically , potentially increasing the prevalence of nutritional deficiencies . The aim of this study was to analyze the effects of food restriction during the first year after  bariatric surgery ( BS ) on nutritional parameters . Methods Twenty-two and 30 obese patients undergoing GBP and SG  were prospect ively followed at baseline and 3 , 6 , and 12 months after BS ( N = 14 and N = 19 at T12 ) . We evaluated food intake and nutrient adequacy ( T0 , T3 , T12 ) , as well as serum vitamin and mineral concentration ( T0 , T3 , T6 , T12 ) . Results At baseline , GBP and SG patients had similar clinical characteristics , food intake , nutrient adequacy , and serum concentration . The drastic energy and food reduction led to very low probabilities of adequacy for nutrients similar in both models ( T3 , T12 ) . Serum analysis demonstrated a continuous decrease in prealbumin during the follow-up , indicating mild protein depletion in 37 and 38 % of GBP patients and 57 and 52 % of SG patients , respectively , at T3 and T12 . Conversely , despite the low probabilities of adequacy observed at T3 and T12 , systematic multivitamin and mineral supplementation after GBP and SG prevented most nutritional deficiencies . Conclusions GBP and SG have comparable effects in terms of energy and food restriction and subsequent risk of micronutrient and protein deficiencies in the first year post BS . Such results advocate for a cautious monitoring of protein intake after GPB and SG and a systematic multivitamin and mineral supplementation in the first year after SG Objective The purpose of this study was to learn whether preoperative eating habits can be used to predict outcome after  vertical b and ed gastroplasty ( VBG ) and Roux-en-Y gastric bypass ( 
    Output:
    
agent
The majority of studies were observational in nature and showed a reduction in energy intake following surgery , as well as inadequate intakes of micronutrients and protein , and an excessive intake of fats .
There was evidence of nutrient imbalances , suboptimal compliance with multivitamin and mineral supplementation , and limited follow-up of patients .
The current evidence base suggests that despite being effective in reducing energy intake , bariatric surgery can result in unbalanced diets , inadequate micronutrient and protein intakes , and excessive intakes of fats .
In combination with suboptimal adherence to multivitamin and mineral supplementation , this may contribute to nutritional deficiencies and weight regain .
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background : Approximately 20 - 30 % of obese patients do not achieve successful weight outcomes after bariatric surgery . Objective : We examined whether short-term changes ( ≤0.5 y postsurgery ) in energy intake and macronutrient composition after bariatric surgery could predict 10-y weight change . Design : Participants were recruited from the Swedish Obese Subjects ( SOS ) study , which was a matched ( nonr and omized ) prospect i ve trial that compared bariatric surgery with usual care for obese patients . A total of 2010 patients who underwent bariatric surgery were included in the study .  Physical examinations ( e.g. , weight ) and question naires ( e.g. , dietary question naire ) were completed before and 0.5 , 1 , 2 , 3 , 4 , 6 , 8 , and 10 y after surgery . For the main analytic strategy , a linear mixed model was implemented , which included repeated measures with a r and om intercept and an unstructured covariance matrix . Results : Short-term changes in energy intake ( P < 0.001 ) and in relative proportions of energy from carbohydrates ( P < 0.001 ) , fat ( P < 0.001 ) , and protein ( P < 0.05 ) were associated with 10-y weight change after bariatric surgery . At the 10-y follow-up , men and women with the largest reductions in energy intake had lost 7.3 % and 3.9 % more weight , respectively , compared with that of subjects with the smallest intake reductions ( P < 0.001 ) . Greater weight loss was achieved in men and women who favored protein and carbohydrates over fat and in subjects who favored protein over carbohydrates than in individuals who favored the opposite changes in macronutrient composition ( P < 0.05 ) . Conclusions : The level of energy restriction that is achieved at 0.5 y after bariatric surgery predicts long-term weight loss . Weight loss is also associated with a changing dietary macronutrient composition . This trial was registered at clinical trials.gov as NCT01479452 Background Patients who have undergone bariatric surgery have increased risks of developing micronutrient deficiencies . Translational research investigating the actual micronutrient intake of bariatric patients is limited . We examined the  micronutrient intake  of a multicentre cohort of laparoscopic adjustable gastric b and ing patients 1 year post-surgery . These data were compared to micronutrient recommendations for the general population . Methods Consecutive patients from three bariatric surgery facilities in Melbourne , Australia , were invited to participate 12 months post-operatively . A vali date d food frequency question naire was posted to 215 prospect i ve participants . Results Of the 52 participants , micronutrient intakes from food and fluids alone were below population recommendations for calcium , folate , magnesium , potassium , retinol equivalents , thiamin and vitamin E. Males did not meet the recommended intakes for zinc , and iron intakes in pre-menopausal women were insufficient . Intakes lower than recommended levels for these micronutrients suggest inadequate intake of foods from vegetable , dairy , lean meat ( or alternatives ) and wholegrains . Micronutrient intakes below recommended levels in this patient group can be further explained by their macronutrient intakes that suggested diets of poor nutrient density . Recommendations for supplementation in this group have wide variations , usually having been developed through the presence of clinical and biochemical deficiencies . Conclusions Nutritional supplementation should be more extensive in scope and dosage than is currently recommended by some professional guidelines . Further long-term studies are needed to explore both macro- and micronutrient intakes on the morbidity and mortality of this patient population Background Data on gastrointestinal ( GI ) and dietary changes following bariatric surgery are scarce in the Middle Eastern region . The objective of this work was to retrospectively compare dietary intake , food preferences , and GI symptoms in subjects with extreme obesity after Roux-en-Y gastric bypass ( RYGB ) and sleeve gastrectomy ( SG ) . Methods Sixty subjects equally divided between RYGB and SG with a postoperative period of ≥6 months were recruited for a retrospective , non-r and omized , and observational study . All subjects completed three question naires ( GI symptoms , food preferences , and quantitative food frequency question naire ( FFQ ) ) and three 24-h recalls . Results At one year postoperatively , both surgical groups showed similar percentage of excess weight loss that exceeded 50 % . In addition , percentage of carbohydrate , protein , and sugar intake from total energy , frequency of daily consumption from the eight food categories and daily energy intake were comparable between surgical groups . RYGB subjects consumed significantly more fruits and juices from total energy ( P < 0.05 ) whereas SG subjects tended to consume more sweets and desserts . Heartburn ( P < 0.001 ) , regurgitation ( P < 0.01 ) , nausea ( P < 0.01 ) , vomiting ( P < 0.001 ) , and constipation ( P < 0.05 ) were significantly more frequent among SG subjects . Flatulence ( P < 0.001 ) and diarrhea ( P < 0.05 ) , as well as dizziness ( P < 0.001 ) , and fast heartbeat ( P < 0.05 ) after eating were significantly more frequent after RYGB . Conclusions There were no major differences in dietary intake and food preferences between RYGB and SG groups . There was a trend for sweet-eating in SG subjects with less dumping symptoms to suggest different mechanisms of action for each procedure , which might impact eating behavior Background Data on adherence to postoperative lifestyle recommendations by bariatric patients are scarce . Thus , the aim of this study was to evaluate adherence to selected recommendations during the first year following laparoscopic sleeve gastrectomy ( LSG ) surgery . Methods A prospect i ve cohort study with 12 months of follow-up on 100 LSG patients was conducted . Data were collected at baseline and at 3 ( M3 ) , 6 ( M6 ) , and 12 ( M12 ) months post-surgery and included anthropometrics , biochemical tests , food intake , food tolerance , common surgery-related side effects , physical activity ( PA ) , supplementation , and number of follow-up meetings with a dietitian .  Results Data were available for 77 patients ( 57.1 % women , mean age 43.1 ± 9.3 years and preoperative BMI 42.1 ± 4.8 kg/m2 ) . Only a minority of the patients adhered to the recommended protein intake ≥60 g/day at all time points ( ≤40.3 % ) and ≥6 meetings with a dietitian at M12 ( 41.6 % ) . Half of the patients performed ≥150 min/week of PA at all time points ( ≤50.6 % ) as recommended . PA of ≥150 min/week was associated with better lipid and glucose changes at M6 and M12 ( P ≤ 0.044 ) . Most of the patients adhered to the recommended supplementation at all time points ( ≥57.1 % ) . Adherence to supplementation at M12 was significantly associated with higher serum levels of folic acid , iron , hemoglobin , and vitamins D and B12 ( P ≤ 0.056 for all ) . Adherence to all recommendations was not significantly associated with excess weight loss ≥60 % at M12 ( P ≥ 0.195 for all ) . Conclusion Bariatric patients have medium to high adherence to the major lifestyle recommendations during the first year following LSG ; however , adherence to those recommendations was not related to better weight loss at short-term follow-up . Adherence to recommended supplementation was associated with better micronutrient status 1 year postoperatively OBJECTIVE The effects of food tolerance ( if any ) on diet quality several years post-surgery remain unclear . Our study aim ed to assess food tolerance and diet quality after three  bariatric  procedures ; adjustable gastric b and ing ( AGB ) , sleeve gastrectomy ( SG ) and Roux-en-Y gastric bypass ( RYGBP ) , 2â??4 years post-surgery . METHODS This prospect i ve , cross-sectional study assessed weight loss , food tolerance and diet quality in 130 subjects ( 14 obese pre-surgical controls , 13 AGB , 62 SG and 41 RYGBP ) . Inclusion criteria selected patients who underwent bariatric surgery between 1 January 2007 and 31 December 2008 , at a single bariatric clinic . Non-parametric tests ( Kruksalâ??Wallis and Mannâ??Whitney ) along with Spearman 's correlation coefficient analysis were used . RESULTS Superior food tolerance was reported by the control ( 24.5 ) , SG ( 24.0 ) and RYGBP ( 22.0 ) groups , compared with the AGB group ( 15.5 ; P < 0.001 ) . The control and AGB groups consumed significantly more high-calorie extra foods ( 9.2 and 7.7 daily serves respectively ) compared with the SG ( 3.4 serves ) and RYGBP ( 4.0 serves ) groups . There were several significant correlations between food tolerance and dietary intake including breads and cereals and meat and meat alternatives . CONCLUSION The control and AGB groups consumed significantly more high-calorie extra foods , a result that was paralleled by poor weight loss and food tolerance outcomes for the AGB group . A significant positive relationship between food tolerance and diet quality was established . Poor food tolerance and thus compromised diet quality need to be considered as post-surgical complications of the AGB procedure BACKGROUND Underreporting of food intake is common in obese subjects . OBJECTIVE One aim of this study was to assess to what extent underreporting by obese men is explained by underrecording ( failure to record in a food diary everything that is consumed ) or undereating . Another aim of the study was to find out whether there was an indication for selective underreporting . DESIGN Subjects were 30 obese men with a mean ( + /-SD ) body mass index ( in kg/m(2 ) ) of 34 + /- 4 .  Total food intake was measured over 1 wk . Energy expenditure ( EE ) was measured with the doubly labeled water method , and water loss was estimated with deuterium-labeled water .  Energy balance was checked for by measuring body weight at the start and end of the food-recording week and 1 wk after the recording week . RESULTS Mean energy intake and EE were 10.4 + /- 2.5 and 16.7 + /- 2 . 4 MJ/d , respectively ; underreporting was 37 + /- 16 % . The mean body mass loss of 1.0 + /- 1.3 kg over the recording week was significantly different ( P < 0.05 ) from the change in body mass over the nonrecording week , and indicated 26 % undereating . Water intake ( reported + metabolic water ) and water loss were significantly different from each other and indicated 12 % underrecording . The reported percentage of energy from fat was a function of the level of underreporting : percentage of energy from fat = 46 - 0.2 x percentage of underreporting ( r(2 ) = 0.28 , P = 0.003 ) . CONCLUSIONS Total underreporting by the obese men was explained by underrecording and undereating . The obese men selectively underreported fat intake Background Roux-en-Y gastric bypass ( GBP ) and sleeve gastrectomy ( SG ) have increased dramatically , potentially increasing the prevalence of nutritional deficiencies . The aim of this study was to analyze the effects of food restriction during the first year after  bariatric surgery ( BS ) on nutritional parameters . Methods Twenty-two and 30 obese patients undergoing GBP and SG  were prospect ively followed at baseline and 3 , 6 , and 12 months after BS ( N = 14 and N = 19 at T12 ) . We evaluated food intake and nutrient adequacy ( T0 , T3 , T12 ) , as well as serum vitamin and mineral concentration ( T0 , T3 , T6 , T12 ) . Results At baseline , GBP and SG patients had similar clinical characteristics , food intake , nutrient adequacy , and serum concentration . The drastic energy and food reduction led to very low probabilities of adequacy for nutrients similar in both models ( T3 , T12 ) . Serum analysis demonstrated a continuous decrease in prealbumin during the follow-up , indicating mild protein depletion in 37 and 38 % of GBP patients and 57 and 52 % of SG patients , respectively , at T3 and T12 . Conversely , despite the low probabilities of adequacy observed at T3 and T12 , systematic multivitamin and mineral supplementation after GBP and SG prevented most nutritional deficiencies . Conclusions GBP and SG have comparable effects in terms of energy and food restriction and subsequent risk of micronutrient and protein deficiencies in the first year post BS . Such results advocate for a cautious monitoring of protein intake after GPB and SG and a systematic multivitamin and mineral supplementation in the first year after SG Objective The purpose of this study was to learn whether preoperative eating habits can be used to predict outcome after  vertical b and ed gastroplasty ( VBG ) and Roux-en-Y gastric bypass ( 
    Output:
    