Long-term dietary changes after vertical banded gastroplasty: Is the trade-off favorable?

Background: Insufficient data exist about the long-term health consequences of gastric restriction procedures used for treatment of obesity. The long-term nutritional changes that occur after vertical banded gastroplasty (VBG) were evaluated. Methods: All consecutive patients who underwent VBG surgery in one surgical ward were invited for a follow-up study 3-10 years after the surgery. Demographic and clinical characteristics were evaluated from the patients' medical charts. Dietary assessment was performed using a food frequency questionnaire, which included 52 frequently consumed food items. Results: Of the 122 patients who underwent VBG between 1986-1992, 75 (62%) participated in the follow-up study. The average time since surgery was 5.4±1.8 years, and the average weight loss was 24.9±12.4%. Most of the patients eat only one major meal daily, and only one-third regularly ingest solid foods. Dietary analysis revealed a decreased intake of most nutrients compared with pre-surgery, with the exception of dairy products, sweet foods and fluids. The greatest decrease was found in the consumption of fiber-rich fruits and vegetables, followed by meat, fish and complex carbohydrates. Conclusion: While the weight loss itself and the reduction in fat consumption that are seen after VBG are probably beneficial, the long-term effects of the decreased consumption of fruit, vegetables, other complex carbohydrates and fish may counterbalance these benefits. The net effect of this trade-off on future health is difficult to predict and requires long-term evaluation of clinical outcome.