Food Tolerance and Eating Behavior After Roux-en-Y Gastric Bypass Surgery

Background: Roux-en-Y gastric bypass (RYGB) surgery often leads to food intolerance, especially protein intake.

Aim: This is to investigate the association of food intolerance with protein intake and chewing parameters in patients who underwent RYGB surgery 2 years prior.

Methods: An observational study was carried out in 30 patients aged between 18 and 60 years old with at least a 2-year postoperative period since undergoing RYGB surgery. A specific questionnaire was applied to obtain a food tolerance score; a masticatory efficiency, chewing cycles, and time were evaluated with a standard test based on the size of the fragmentation of almonds and of meat after a certain chewing time. Protein intake was evaluated by 24-h dietary recall.

Results: Mean age was 42.3 ± 11.2 years; mean body mass index was 33 ± 6 kg/m²; and mean time since surgery was 4.9 years. The food tolerance score was 23.4 ± 3.3 points. There was no evidence of an association between food tolerance and chewing efficiency for meat (p = 0.28) nor between food tolerance and protein intake (Spearman correlation coefficient 0.03, p = 0.86). Regarding chewing efficiency with almonds, tolerance was higher in patients with optimal efficiency than among those with good and acceptable efficiency (p = 0.01).

Conclusions: In the evaluation of mastication using almonds, food tolerance increased with the number of chewing cycles and with greater chewing efficiency; the same association was not found in the evaluation using red meat.