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Objective: To assess whether a healthy dietary pattern or physical activity after bariatric surgery mediates the effects of surgery on weight loss, the quality of life, or food tolerance. Methods: A prospective observational study conducted in the context of a randomized controlled trial. We assessed the extent to which increasing or decreasing adherence to the Mediterranean diet (MedDiet)—assessed by MEDAS (Mediterranean Diet Adherence Screener)—and of increasing or decreasing physical activity (PA)—assessed with the Short Questionnaire of International PA (IPAQ-Short Q)—after bariatric surgery affected changes in weight, body mass index (BMI), quality of life (Moorehead-Arlet Questionnaire), and food tolerance (Suter test). Assessments were recorded at baseline and quarterly up to 12 months of surgery. Results: Seventy-eight morbidly obese participants undergoing bariatric surgery were assessed up to 1 year after surgery. Those individuals who increased adherence to MedDiet showed a significantly higher mean of total weight loss percentage than those who decreased or maintained their adherence during follow-up: 37.6% (35.5–39.8) versus 34.1% (31.8–36.5) (p = 0.036). No significant differences were observed in changes in weight or BMI comparing individuals who increased their PA versus those who maintained or decreased PA, nor in quality of life or food tolerance between those individuals who increased versus those who decreased adherence to MedDiet or PA during the follow-up. Conclusions: After bariatric surgery, morbidly obese subjects present greater weight loss if they adhere to the MedDiet. PA after surgery is not associated with the magnitude of weight loss nor the quality of life and tolerance to diet. [ABSTRACT FROM AUTHOR]

Objective: To assess which type of preoperative dietary strategy is most effective in reducing liver volume and assessing its influence on different biochemical parameters and on surgical complications in individuals undergoing bariatric surgery.Methods: Parallel randomized trial comparing the effect of a very low calorie diet (VLCD) and a low calorie diet (LCD) for a period of 21 days before surgery on hepatic volume, anthropometric and biochemical parameters. Compliance and tolerance to the diets, surgical complications, and hospital stay were also determined.Results: Eighty-six morbid obese participants undergoing bariatric surgery were randomized. The hepatic volume was significantly reduced in both intervention groups, but no differences in changes between groups were detected. The reduction in the hepatic volume was higher in those patients with a baseline hepatic volume > 3 L compared to those with < 3 L (adjusted P value < 0.001). The percentages of total weight lost were 5.8 and 4.2% (adjusted P value = 0.004) for participants on the VLCD and LCD, respectively. There were no differences between groups for any of the biochemical parameters analyzed, nor in the number of surgical complications nor the length of hospital stay. Adherence to the diet was good; nevertheless, participants in the VLCD intervention showed worse tolerance.Conclusions: In subjects with morbid obesity undergoing bariatric surgery, compared to a LCD, a preoperative 21-day intervention with VLCD is more effective in terms of reducing total body weight but not in terms of reducing the liver volume. Both types of preoperative diets have similar effects on clinical biochemical parameters, rate of surgical complications, and hospital length stay. [ABSTRACT FROM AUTHOR]