Early postoperative participation in a 6-month resistance training and protein supplementation protocol after bariatric surgery did not significantly improve muscle strength at 5 years compared to usual care.
RCT (n=54)
Open-label
Randomly assigned at the time of surgery
No
Does early postoperative resistance training and protein supplementation improve long-term muscle strength and body composition in female patients undergoing Roux-en-Y gastric bypass?
Early postoperative resistance training and protein supplementation after bariatric surgery does not provide long-term preservation of muscle strength at 5 years, though higher physical activity levels are associated with better weight maintenance.
Absolute Event Rate: -55.5% vs -49.9%
p-value: p=0.806
BACKGROUND AND OBJECTIVES: We previously showed in a 6-month randomized controlled trial that resistance training and protein supplementation after bariatric surgery (Roux-en-Y gastric bypass, RYGB) improved muscle strength without significant effect on weight loss and body composition changes. We performed a 5-year follow-up study in these subjects with the aim 1) to assess the long-term effect of this exercise training intervention and 2) to analyze associations between habitual physical activity (PA) and weight regain at 5 years. METHODS: Fifty-four out of 76 initial participants (follow-up rate of 71%) completed the 5-year follow-up examination (controls, n = 17; protein supplementation, n = 22; protein supplementation and resistance training, n = 15). We measured body weight and composition (DXA), lower-limb strength (leg-press one-repetition maximum) and habitual PA (Actigraph accelerometers and self-report). Weight regain at 5 years was considered low when <10% of 12-month weight loss. RESULTS: Mean (SD) time elapse since RYGB was 5.7 (0.9) y. At 5 years, weight loss was 32.8 (10.1) kg, with a mean weight regain of 5.4 (SD 5.9) kg compared with the 12-month assessment. Moderate-to-vigorous PA (MVPA) assessed by accelerometry did not change significantly compared with pre-surgery values (+5.2 SD 21.7 min/d, P = 0.059), and only 4 (8.2%) patients reported participation in resistance training. Muscle strength decreased over time (overall mean SD: -49.9 53.5 kg, respectively, P<0.001), with no statistically significant difference between exercise training intervention groups. An interquartile increase in MVPA levels was positively associated with lower weight regain (OR 95% CI: 3.27 1.41;9.86). CONCLUSIONS: Early postoperative participation in a resistance training protocol after bariatric surgery was not associated with improved muscle strength after 5 years of follow-up; however, increasing physical activity of at least moderate intensity may promote weight maintenance after surgery. PA may therefore play an important role in the long-term management of patients with obesity after undergoing bariatric procedure.
Bellicha et al. (Fri,) conducted a rct in Severe obesity undergoing Roux-en-Y gastric bypass (n=54). Resistance training and protein supplementation vs. Usual care was evaluated on Change in absolute lower-limb muscle strength (leg-press 1-RM) at 5 years (p=0.806). Early postoperative participation in a 6-month resistance training and protein supplementation protocol after bariatric surgery did not significantly improve muscle strength at 5 years compared to usual care.
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