Post-bariatric Surgery Weaning With Food for Special Medical Purposes to Increase Patient Compliance.

NCT ID: NCT06205017

Last Updated: 2024-01-12

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

NOT_YET_RECRUITING

Clinical Phase

NA

Total Enrollment

32 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-01-09

Study Completion Date

2024-08-09

Brief Summary

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Due to the reduced volume and postoperative gastric edema, ingestion of solid foods in the first few days after surgery is very difficult or impossible; following bariatric surgery there are anatomical changes in the vagus that may contribute to the alteration of taste perception. In order to facilitate patient weaning and improve the liking of the foods used in this semi-liquid phase, our Center intends to test some "Foods for Special Medical Purposes" (AFMS), in order to ensure a better intake of nutrition, including in terms of vitamin D3 and calcium, good palatability and thus a better adherence to the recommended nutritional indications in the immediate postoperative period than the homogenized foods used in the standard diet.

Detailed Description

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Primary goal: Patient compliance throughout the weaning period (4 weeks postintervention), assessed through product liking measurable by Sensory Questionnaire.

Secondary objective:

* Patient compliance throughout the weaning period (4 weeks postintervention), assessed through product liking measurable with test comparative
* Taste perception, liking, palatability and food preferences among the different products (Special Medical Purpose Foods-AFMS vs homogenized foods) and between pre and post bariatric surgery.
* Nutritional efficacy (assessment of blood levels of micronutrients such as. iron, ferritin, transferrin , calcium, vit D3, folic ac, vit B12 and of macronutrients such as total protein and protein electrophoresis; bioimpedance analysis for body composition assessment).

32 subjects with severe or morbid obesity ( BMI ≥ 35 kg/m2 in the presence of comorbidities and BMI ≥ 40 kg/m2 , respectively), male and female, candidates for bariatric surgery (Sleeve Gastrectomy and Roux-en-Y Gastric Bypass).

Two timepoints: T0 (pre-rev) and T1 (follow-up 1 month +/-7 days). Planned assessments at T0 and T1.

* Administration of the sensory questionnaire.
* Comparative test
* Hematochemical tests: iron, ferritin, transferrin, , vit D3, ac. Folic, vit B12 and macronutrients such as total protein + general hematochemicals (complete blood count complete, protein electrophoresis, AST, ALT, gamma GT, creatininemia, azotemia, col tot, HDL, LDL, triglycerides, blood glucose).
* Analysis of taste perception and variation by Taste Strips.
* Bioimpedance analysis (BIA)
* Anthropometric evaluations

Conditions

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Bariatric Surgery

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

The sample size was calculated in order to identify differences significant in the increase of liking in the study group compared with the control. According to the PI's experience, the frequency of liking in the group control is 5% and this is expected to increase to 70% in the study group.

Considering using a Fisher's exact test with alpha level=0.05, to obtain a power of 95%, 14 patients per group are needed. This number is increased by 10% in case of possible dropouts, for a total of 16 subjects per group and 32 total.
Primary Study Purpose

OTHER

Blinding Strategy

NONE

Study Groups

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Group A (AFSM)

16 subjects (Group A: intervention group) will take AFSMs in the immediate postoperative period (Appendix A). A weaning period with AFSM nutritional protocol of 4 weeks is planned, the weaning will cover the entire observation period T0 → T1.

Group Type EXPERIMENTAL

Foods for Special Medical Purposes

Intervention Type DIETARY_SUPPLEMENT

In order to facilitate patient weaning and to improve the enjoyment of foods used in this semi-liquid phase, our Center intends to test "Foods for Special Medical Purposes" (AFMS) to ensure better nutritional intake, including vitamin D3 and calcium, good palatability, and thus better adherence to the recommended nutritional indications in the immediate postoperative period than the homogenized foods used in the standard diet.

Group B (protocol in use with homogenized)

16 subjects (Group B: control group) will follow the standard weaning protocol i.e. with homogenized food (Appendix B). A weaning period with nutritional protocol, as per clinical protocol, of 4 weeks is planned, weaning will cover the entire observation period T0 → T1.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Foods for Special Medical Purposes

In order to facilitate patient weaning and to improve the enjoyment of foods used in this semi-liquid phase, our Center intends to test "Foods for Special Medical Purposes" (AFMS) to ensure better nutritional intake, including vitamin D3 and calcium, good palatability, and thus better adherence to the recommended nutritional indications in the immediate postoperative period than the homogenized foods used in the standard diet.

Intervention Type DIETARY_SUPPLEMENT

Eligibility Criteria

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Inclusion Criteria

* Age ≥18 and ≤ of 60
* Subjects with severe or morbid obesity (BMI ≥ 35 kg/m2 in the presence of comorbidities and BMI ≥ 40 kg/m2)
* Absence of diagnosis of primary obesity
* Absence of medical/psychiatric contraindications
* Signature of informed consent for the study
* Patients who are candidates by clinical practice for bariatric surgery (Sleeve Gastrectomy and Roux-en-Y Gastric Bypass).

Exclusion Criteria

* Presence of chronic diseases of the digestive system, such as chronic diseases intestinal, malabsorption syndrome, diverticulosis of the colon
* Current pregnancy (verified by self-declaration) and/or lactation
* Subjects with endocrine disorders (e.g., Cushing's m., thyroid disease uncontrolled)
* Presence of known renal insufficiency or creatinine levels greater than 1.8 mg/dl and eGFR \< 60 ml/min
* Presence of malignant pathology
* Alcohol or drug abuse
* Severe psychological/psychiatric disorders
* Difficulty adhering to the protocol due to language barriers or other reasons.
Minimum Eligible Age

18 Years

Maximum Eligible Age

60 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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I.R.C.C.S Ospedale Galeazzi-Sant'Ambrogio

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Other Identifiers

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AFMS_FOOD (L4190)

Identifier Type: -

Identifier Source: org_study_id

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