中国全科医学 ›› 2023, Vol. 26 ›› Issue (07): 800-809.DOI: 10.12114/j.issn.1007-9572.2022.0772

• 论著·减重代谢术后饮食管理专题研究 • 上一篇    下一篇

减重代谢术后患者食物偏好改变特征及预测因素分析

杨宁琍1, 花红霞1, 许勤2, 梁辉1,*()   

  1. 1.210029 江苏省南京市,南京医科大学第一附属医院 普外科减重代谢外科
    2.211166 江苏省南京市,南京医科大学护理学院
  • 收稿日期:2022-10-27 修回日期:2022-12-22 出版日期:2023-03-05 发布日期:2022-12-29
  • 通讯作者: 梁辉

  • 作者贡献:杨宁琍、花红霞、许勤、梁辉提出研究思路,设计研究方案;杨宁琍、花红霞负责论文的撰写,对主要结果进行分析解释并绘制表格;许勤对文章进行质量控制和审校;梁辉对文章整体负责。
  • 基金资助:
    江苏省社会发展面上项目--大数据背景下儿童青少年肥胖早期预警及干预:基于医院-社区-家庭联动的iNATURE智能平台构建与示范应用(BE2021722); 江苏高校优势学科建设工程项目"护理学"(苏政办发〔2018〕87号)

Characteristic and Predictive Factors of Food Preference Changes in Patients Undergoing Bariatric Surgery

YANG Ningli1, HUA Hongxia1, XU Qin2, LIANG Hui1,*()   

  1. 1. Department of General & Bariatric Surgery, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
    2. School of Nursing, Nanjing Medical University, Nanjing 211166, China
  • Received:2022-10-27 Revised:2022-12-22 Published:2023-03-05 Online:2022-12-29
  • Contact: LIANG Hui

摘要: 背景 减重代谢术后患者食物偏好的改变是影响其术后体质量减轻的重要原因,客观评估术后患者食物偏好改变的具体特征,并分析其预测因素尤为重要,基于现有研究结果间较大的差异性,难以指导术后体质量维护。 目的 对减重代谢术后患者的食物偏好改变特征及其对减重结局的影响进行调查,分析减重代谢术后食物偏好改变的预测因素。 方法 2022年2—8月,采用便利取样法抽取南京医科大学第一附属医院减重随访门诊收治的245例减重代谢术后患者,使用一般资料调查表、减重结局指标调查表、减重代谢术后患者食物偏好改变特征调查问卷对其进行调查。采用独立样本t检验比较减重代谢术后食物偏好改变对减重结局的影响,采用单因素分析及无序多分类Logistic回归分析探究术后食物偏好改变的预测因素。 结果 回收有效问卷237份(96.7%),97.0%的减重代谢术后患者食物偏好与术前相比发生改变。减重代谢术后食物偏好改变组患者的术后体质量及体质指数(BMI)下降值、总体体质量丢失率(TWL)与食物偏好不变组患者比较,差异有统计学意义(P<0.05)。无序多分类Logistic回归分析结果显示:术后时间是减重代谢术后患者对蔬菜水果偏好改变的预测因素(P<0.05);婚姻状况、术前合并症是减重代谢术后患者对优质蛋白食物偏好改变的预测因素(P<0.05);长期居住地是对减重代谢术后患者辛辣食物偏好改变的预测因素(P<0.05);性别、长期居住地、手术方式是对减重代谢术后患者咸味零食偏好改变的预测因素(P<0.05);性别、手术方式是对减重代谢术后患者高脂肪肉类偏好改变的预测因素(P<0.05);性别、术后时间是对减重代谢术后患者甜食偏好改变的预测因素(P<0.05);性别、手术方式是对减重代谢术后患者不含酒精的甜味饮料偏好改变的预测因素(P<0.05)。 结论 减重代谢术后患者食物偏好改变的发生率高,表现为对高热量食物偏好降低,对健康食物偏好增加的特点。性别、婚姻状况、长期居住地、术前合并症、手术方式及术后时间是减重代谢术后患者不同食物偏好改变特征的预测因素,减重专科医护人员须早期识别目标人群,加强术后饮食教育和指导,改善术后饮食体验,切实保障减重代谢术效果。

关键词: 减重代谢术, 肥胖, 体质量保持, 食物偏好, 预测因素, 护理

Abstract:

Background

The change of food preference after bariatric surgery is an important factor affecting postoperative weight loss. It is particularly important to assess the specific characteristics and predictive factors of food preference changes after the surgery. It is difficult to guide postoperative weight maintenance based on the large variability in results between available studies.

Objective

To investigate the characteristics of food preference change and its effect on weight loss outcomes in patients undergoing bariatric surgery, and to analyze the predictive factors of food preference change.

Methods

A convenient sampling method was used to select 245 patients undergoing bariatric surgery who were admitted to Outpatient Weight Loss Follow-up Department, the First Affiliated Hospital of Nanjing Medical University from February to August, 2022. The self-developed General Demographic Questionnaire, Weight Loss Outcome Questionnaire and Food Preference Change Features after Bariatric Surgery were used to collect relevant data. Independent samples t-test was used to compare the effects of changes of food preference after bariatric surgery on the weight loss outcome. Univariate analysis and disordered multi-class Logistic regression were performed to analyze the predictive factors of food preference changes after bariatric surgery.

Results

Two hundred and thirty-seven (96.7%) patients who returned responsive questionnaires were finally enrolled, and 97.0% of them had food preference changes after bariatric surgery. Patients with and without changes in food preferences after bariatric surgery had statistically significant differences in postoperative weight, body mass index drop value and total weight loss percentage (P<0.05) . Disordered multi-class Logistic regression analysis showed that postoperative time was the predictor of changes in preferences of patients undergoing bariatric surgery for vegetables and fruits (P<0.05) ; marital status and preoperative comorbidities were predictors of changes in preference of patients undergoing bariatric surgery for high-quality protein foods (P<0.05) ; place of residence (northern or southern China) was the predictor of changes in preference of patients undergoing bariatric surgery for spicy foods (P<0.05) ; gender, place of residence and bariatric surgery methods were predictors of changes in preferences of patients undergoing bariatric surgery for salty snacks (P<0.05) ; gender and bariatric surgery methods were predictors of changes in preferences of patients undergoing bariatric surgery for high-fat meat (P<0.05) ; gender and postoperative time were predictors of changes in preferences of patients undergoing bariatric surgery for sweet food (P<0.05) ; gender and bariatric surgery methods were predictors of changes in preferences of patients undergoing bariatric surgery for sweet drinks (P<0.05) .

Conclusion

The incidence of food preference changes in patients undergoing bariatric surgery is high, showing a decrease in their preference for high calorie foods and an increase in their preference for healthy foods. Gender, marital status, place of residence, preoperative comorbidities, bariatric surgery methods, and postoperative time are predictors of various food preference changes in patients undergoing bariatric surgery. Weight loss professionals should identify the target population at early stage, pay more attention to postoperative dietary education and guidance for patients, in order to improve the postoperative dietary experience and effectively ensure the effect of bariatric surgery.

Key words: Bariatric surgery, Obseity, Body weight maintenance, Food preference, Predictive factors, Nursing care