Annals of Clinical Nutrition and Metabolism

Review

Changes in perceptions of taste after bariatric surgery: a narrative review: Young Suk Park; Ann Clin Nutr Metab 2024;16(3):120-124. Published online December 1, 2024; DOI: https://doi.org/10.15747/ACNM.2024.16.3.120

Abstract PDF ePub: Purpose: Bariatric surgery effectively treats severe obesity, leading to significant weight loss and improved comorbidities. However, many patients experience postoperative alterations in taste perception, affecting food selection and eating behavior. This narrative review examines the current understanding of taste perception changes following bariatric surgery, including patterns, potential mechanisms, impact on weight loss outcomes, and implications for patient care.
Current concept: Changes in taste perception are frequently reported after bariatric procedures, with prevalence rates from 36% to 72%. Common alterations involve decreased preference and increased sensitivity to sweet and fatty tastes, potentially leading to reduced calorie intake and healthier food choices. Persistence of these changes varies and may depend on surgery type, with Roux-en-Y gastric bypass patients often experiencing more substantial effects than sleeve gastrectomy patients. Potential mechanisms include alterations in gut hormone secretion (e.g., GLP-1, peptide YY, ghrelin), modifications in neural pathways (e.g., vagus nerve), and shifts in the gut microbiome. These factors may collectively influence taste sensitivity and preferences, contributing to weight loss outcomes. Altered reward processing may reduce the appeal of high-calorie foods.
Conclusion: Alterations in taste perception are common after bariatric surgery and may significantly impact dietary behaviors, weight loss, and quality of life. While exact mechanisms are not fully understood, changes in gut hormones, neural pathways, and microbiota are likely involved. Patient counseling and postoperative management of bariatric surgery patients should address potential changes in taste. Further research is needed to elucidate the long-term impacts of taste alterations on weight-loss maintenance and nutritional status.

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Original Articles

Development and Internal/External Validation of a Prediction Model for Weight Loss Following Gastric Cancer Surgery: A Multicenter Retrospective Study: Ji-Hyeon Park, Seong-Ho Kong, Do Joong Park, Han-Kwang Yang, Jong Won Kim, Ki Bum Park, In Cho, Sun-Hwi Hwang, Dong-Wook Kim, Su Mi Kim, Seung-Wan Ryu, Seong Chan Gong, Pil Young Jung, Hoon Ryu, Sung Geun Kim, Chang In Choi, Dae-Hwan Kim, Sung-IL Choi, Ji-Ho Park, Dong Jin Park, Gyu-Yeol Kim, Yunhee Choi, Hyuk-Joon Lee; Ann Clin Nutr Metab 2022;14(2):55-65. Published online December 1, 2022; DOI: https://doi.org/10.15747/ACNM.2022.14.2.55

Abstract PDF ePub: Purpose: To develop an individualized model for predicting the extent of unintentional weight loss following gastrectomy in patients with gastric cancer based on related risk factors and to externally validate this model using multicenter clinical data in Korea.
Materials and Methods: Among gastric cancer patients who underwent curative gastrectomy at 14 different gastric cancer centers, clinical data from patients with more than one weight measurement during the three-year follow-up period were retrospectively collected. Risk factors associated with weight loss in gastric cancer patients after gastrectomy were analyzed, and a predictive model was developed. Internal and external validation were performed.
Results: The data from 2,649 patients were divided into a derivation set (n=1,420 from Seoul National University Hospital) and validation set (n=1,229 from 13 different gastric cancers). Postoperative duration (six vs. 12, 24, or 36 months), sex (female vs. male), age, preoperative body mass index, type of surgery (pylorus-preserving vs. total, distal or proximal gastrectomy), and cancer stage (I vs. II or III) were included in the final prediction model. The model showed approximately 20% accuracy in predicting weight loss at each period: R2 at six, 12, 24 and 36 months after gastrectomy in internal validation=0.20, 0.21, 0.17, and 0.18, respectively, and in external validation=0.20, 0.22, 0.18, and 0.18, respectively. Calibration slopes of internal and external validation were 0.95 and 1.0, respectively.
Conclusion: Although predictive accuracy of the model did not reach an acceptable level, repeated external validation measurements showed high reliability. The model may serve as a basic reference in clinical practice.

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Postoperative Weight Changes, Nutritional Status and Clinical Significance of Colorectal Cancer Patients: Sun Young Kim, Ji Sun Kim, Eon Chul Han; Surg Metab Nutr 2019;10(2):46-53. Published online December 30, 2019; DOI: https://doi.org/10.18858/smn.2019.10.2.46

Abstract PDF ePub: Purpose:
Although weight loss is an important factor for assessing the nutritional status, patient counselling or management is limited due to fewer studies on weight loss after colorectal cancer surgery.
Materials and Methods:
Totally, 374 patients were included in the analysis (between August 2010 to December 2016). Patients’ weight was determined before surgery, and at 1 week, 6 weeks, 3 months, and 6 months after surgery. Change in weight was reviewed based on the gender and administration of chemotherapy. Severe weight loss is defined as greater than 5% weight loss after surgery.
Results:
The weight changes post-surgery at 1 week (−2.56±2.62 vs. −3.36±2.68, P<0.005), 6 weeks (−3.23±3.82 vs. −4.57±3.96, P=0.001), and 3 months (−0.93±5.01 vs. −2.79±4.86, P<0.001) were significantly greater in male subjects, as compared to female patients. However, at 6 months post-surgery, most patients showed weight gain with no statistical significance between the genders (1.11±4.64 vs. 1.94±6.26, P=0.143). Weight change based on treatment (with or without chemotherapy) reveal significant differences between the genders at 3 months post-surgery only (−1.33±4.65 vs. −2.52 ±5.15, P=0.027). Multivariate analysis for factors of severe weight loss show that the male gender [adjusted odds ratio (OR): 1.83, P=0.027)], adjuvant chemotherapy (adjusted OR 2.11, P=0.008), and presence of post-operative complications (adjusted OR 2.12, P=0.029) were significant factors.
Conclusion:
In postoperative colorectal cancer patients, the weight and nutritional status require careful monitoring for at least 2 months after surgery, in order to prevent hindrance to chemotherapy. (Surg Metab Nutr 2019;10:-53)

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