Identifier

etd-10312011-102824

Degree

Master of Science (MS)

Department

Human Ecology

Document Type

Thesis

Abstract

The purpose of these studies was to explore the roles of dietary strategies and bariatric surgery in obesity treatment. The breakfast study was a randomized, crossover trial used to evaluate the role of egg proteins, and a retrospective chart review was conducted to obtain comparative information about two different bariatric surgeries. The breakfast study included 20 subjects who were randomized to receive an egg breakfast (EB) or a cereal breakfast (CB) matched for energy density and macronutrient composition but different protein quality for one week. Following a washout period, each subject was crossed over to receive the opposite breakfast for one week. The EB resulted in lower cumulative lunchtime food intake (p=0.05), reduced hunger on day 1 (p=0.001), greater feelings of fullness on days 1 and 7 (p=0.02), and decreased desire to eat on day 1 (p=0.03). Acylated ghrelin was lower on day 1 of the EB compared to the CB (p=0.005) but not on day 7. PYY was greater at 120 minutes (p=0.006) and 180 minutes (p=0.001) on day 1 and at 180 minutes on day 7 (p=0.03) after the EB. The bariatric surgery studies examined 835 Roux-en-Y gastric bypass (RYGB) patients and 766 vertical sleeve gastrectomy (VSG) patients. Study one focused on patients diagnosed with type 2 diabetes (T2D). The acute effect bariatric surgery had on resolving T2D was measured by calculating the number of patients who discontinued their hypoglycemic medication use post-operatively. Upon discharge, 95 of the 123 (77.2%) RYGB patients and 107 of the 139 (77.0%) VSG patients had been taken off their medication. Eight weeks post-operatively, 30 of the 38 (~79%) RYGB patients and 59 of the 71 (83%) VSG patients with follow-up data remained off medication. Study two examined differences in weight loss, early post-operative surgical complications, and insurance coverage between RYGB and VSG patients. RYGB patients lost more weight at one and two years (p<0.001 for both). There was no significant difference in the percentage of weight loss or complications in insured versus self-pay patients. RYGB patients experienced a higher incidence of major complications than VSG patients (p<0.001).

Date

2011

Document Availability at the Time of Submission

Release the entire work immediately for access worldwide.

Committee Chair

O'Neil, Carol

Included in

Human Ecology Commons

Share

COinS