Nutrition Evidence Alert – February 2021 – Obesity

BANT is spearheading the ‘Food for your Health’ campaign to raise awareness of the benefits of personalised nutrition and to educate the public on making healthy food choices to prevent and manage metabolic conditions, including those associated with obesity. The timing of this campaign is crucial, with the majority of UK adults being deemed overweight or obese according to NHS statistics – 67% of men and 60% of women are overweight; of these, 26% of men and 29% of women are obese.

The links between obesity and metabolic disorders have been highlighted in earlier alerts on this page and it is clear that the causes of obesity are many and complex. According to the All-Party Parliamentary Group on Obesity that launched its inquiry into the ‘Current landscape of obesity services’ in February 2018, a whole system approach is needed at both the national and local level to address obesity and health related issues, yet provisions are currently inadequate.

Aside from personalised dietary and lifestyle measures that support a healthy weight (BMI and/or WC), bariatric surgery is recognised as the most clinically and cost‐effective treatment for people with severe and complex obesity. Critically, the role of Nutrition Practitioners is essential within the field of bariatric surgery. According to the British Obesity & Metabolic Surgery Society (BOMSS), all patients should have a comprehensive nutritional assessment prior to surgery, with continued support and education post-operatively. This is to ensure that people are able to meet nutritional needs after bariatric surgery and any nutritional deficiencies are identified and corrected.

The Lancet, recently published a paper warning that the uncertainty surrounding the effects and duration of the COVID-19 outbreak, combined with the progressive nature of obesity, diabetes and related conditions, may delay bariatric and metabolic surgery as a result of reduced capacity from lockdown measures that could increase the risks for morbidity and mortality in surgical candidates. Thus, a clear and urgent need exists for strategies to mitigate harm to obese patients during and after the COVID-19 pandemic with approaches including non-surgical interventions to optimise metabolic and weight control.

The Nutrition Evidence Database is a rich resource of information on this topic.  Click here to view material released in the last 5 years and see below for our Guest Editor’s pick of the research, which highlight the role of personalised nutrition in the support of obesity and specifically within the area of bariatric surgery.

These are Abir’s top picks of research:

Commissioning guidance for weight assessment and management in adults and children with severe complex obesityin Obesity Reviews 2018

Bariatric Surgery and Precision Nutrition in Nutrients. 2017

High Prevalence of Obesity in Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) Requiring Invasive Mechanical Ventilation in Obesity (Silver Spring, Md.). 2020

The Current Landscape of Obesity Services.  A Report from the All-Parliamentary Group on Obesity. 2018

American Society for Metabolic and Bariatric Surgery Integrated Health Nutritional Guidelines for the Surgical Weight Loss Patient 2016 Update: Micronutrients in Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery. 2017

Adolescent bariatric surgery: review on nutrition considerations in Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition. 2014

Dietary and Policy Priorities for Cardiovascular Disease, Diabetes, and Obesity: A Comprehensive Review in Circulation. 2016

Macrophage plasticity, polarization, and function in health and disease in Journal of Cellular Physiology. 2018

Public Health Nutrition special issue on ultra-processed foods in Public Health Nutrition. 2018

Nutritional Recommendations for Adult Bariatric Surgery Patients: Clinical Practice in Advances in Nutrition (Bethesda, Md.). 2017

British Obesity and Metabolic Surgery Society Guidelines on perioperative and postoperative biochemical monitoring and micronutrient replacement for patients undergoing bariatric surgery-2020 update in Obesity Reviews : an Official Journal of the International Association for the Study of Obesity. 2020

Bariatric and metabolic surgery during and after the COVID-19 pandemic: DSS recommendations for management of surgical candidates and postoperative patients and prioritisation of access to surgery in The Lancet. Diabetes & Endocrinology. 2020

A Scientific Perspective of Personalised Gene-Based Dietary Recommendations for Weight Management in Nutrients. 2019

Interventions to promote physical activity and dietary lifestyle changes for cardiovascular risk factor reduction in adults: a scientific statement from the American Heart Association in Circulation. 2010

Nutrition, immunity and COVID-19, Philip C Calder, BMJ Nutrition, Prevention and Health

Blog Posts and Podcasts:

Obesity: tackling the causes of the causes from The BMJ Opinion 2021

Episode 27: Clinical Conversations: Behavioral Interventions in Lifestyle Change from The Obesity Medicine Association 2021


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