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Bariatric Surgery

Usual dietary intake, physical activity, weight loss, and body composition after five years of Roux-en-Y gastric bypass



To estimate usual dietary intake (UDI), physical activity (PA), and their association with weight loss and body composition in patients who underwent Roux-en-Y gastric bypass (RYGB) after five years in the Federal District, Brazil.


We assessed anthropometry and body composition using bioimpedance, and dietary intake and PA with three nonconsecutive 24-h recalls. PC-Side was used to estimate UDI. Dietary patterns (DPs) were identified through principal component analysis, and association between UDI and PA with percentage of total weight loss (%TWL) and fat-free mass (FFM) through multinomial logistic regression.


Sample (n = 124) presented mean (SD) age of 48.9 (9.4) years, median (IQR) of 9 years (7–10) post RYGB, current BMI = 32.3 kg/m² (28.8–35.7), %TWL = 24.7% (10.9), and FFM = 45.1 kg (41.1–51.9). Mean usual energy intake of 1556 kcal/d, with adequate protein intake, poor fiber intake, and excessive carbohydrate, total fat, and added sugar intake, compared to dietary guidelines. Calcium, vitamins C, D, and E presented the greatest inadequacy (15%, 24%, 32%, and 49% of individuals, respectively, reported usual intake below EAR); 83 participants were considered active/very active, according PA. DP with high energy, protein, total fat, saturated fat, and sodium intake, was negatively associated with %TWL (OR = 0.545, p = 0.037). Protein intake was positively associated with FFM (OR = 1.091, p = 0.004). PA was not associated with %TWL or FFM.


Participants demonstrated intake of carbohydrate, fat, fiber, added sugar not in accordance with guidelines. A DP rich in energy, protein, total fat, saturated fat, and sodium appears to decrease TWL. However, protein intake appears to increase FFM.

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Fig. 1: Comparison of mean usual intake of energy and macronutrients between recommendation, food intake and total intake of patients with five or more years of Roux-en-Y gastric bypass.
Fig. 2: Path diagram of principal component analysis, grouping nutrients of total usual dietary intake of patients with five or more years of Roux-en-Y gastric bypass, into three dietary patterns (DP-I, DP-II, DP-III).


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The authors thank all of the CINTO team involved in conception, organization and execution of the project.


This study was funded by National Council for Scientific and Technological Development (CNPq, 408340/2017–7), and it was contemplated by public notice for financial aid to students for the development of dissertations and theses of Graduate Program in Human Nutrition – N°01/2019. Support research was granted to THMC (number 308630–2017–3) by CNPq.

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Study conception: KMBC, THMC. Data collection: LPSLB. Data analysis and interpretation: LPSLB, THMC. Manuscript elaboration: LPSLB, THMC. Manuscript revision and approval of final version: LPSLB, KMBC, THMC. Public responsibility for the content of the article: LPSLB, THMC.

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Correspondence to Lara Pereira Saraiva Leão Borges.

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Borges, L.P.S.L., de Carvalho, K.M.B. & da Costa, T.H.M. Usual dietary intake, physical activity, weight loss, and body composition after five years of Roux-en-Y gastric bypass. Int J Obes 47, 263–272 (2023).

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