Photographic Food Recognition and Meal Size Estimation Before and After Roux-en-Y Gastric Bypass

NCT04600596 | Completed

• 1 other identifier: 2019-00952
• Study Type: observational
• Target: 54
• Locations: 1 country
• Sites: 1

Brief Summary

Direct measurements of changes in food selection in humans after RYGB have been limited by the unreliability of patients, which poses significant methodological and conceptual challenges to researchers and study design. Self-monitoring requires time and effort, and many find tracking of dietary intake tedious, which contributes to attrition. Direct measurements, however, represent an essential component in the attempt to understand how RYGB alters eating and food preferences, but laboratory settings preclude a real-life environment. The aim of this study is to investigate changes in food preferences, total energy intake of the three primary macronutrients and meal patterns between obese women (BMI ≥ 35) before and after Roux-en-Y gastric bypass and lean (BMI ≤ 25) and obese (BMI ≥ 35) controls by means of photographic food recognition with a mobile application.

Conditions

Obesity, Morbid; Bariatric Surgery; Roux-en-Y Gastric Bypass; Food Preferences

Keywords

Photographic Food Recognition; Morbid Obesity; Bariatric Surgery; RYGB; Food Preferences

Outcome Measures

Primary Outcomes (1)

• Changes in total energy intake of the three primary macronutrients before and after RYGB.

  Difference in changes of total energy intake of the three primary macronutrients within RYGB patients and between patients and controls.

  Baseline, 3, 6, and 12 month post surgery.

Secondary Outcomes (6)

• Changes in food groups preferences before and after RYGB.

  Baseline, 3, 6, and 12 month post surgery.

• Changes in meal speed before and after RYGB.

  Baseline, 3, 6, and 12 month post surgery.

• Changes in number of meals per day before and after RYGB.

  Baseline, 3, 6, and 12 month post surgery.

• Changes in meal size before and after RYGB.

  Baseline, 3, 6, and 12 month post surgery.

• Correlation of energy (kcal) and type of macronutrients consumed (kcal/24h) with % weight loss before and after RYGB.

  Baseline, 3, 6, and 12 month post surgery.

Study Arms (3)

Roux-en-Y gastric bypass patients

Severely obese non-diabetic adult female patients scheduled for RYGB.

Behavioral: Recording of food intake.

Obese (BMI ≥ 35) controls

Severely obese non-diabetic adult female patients not undergoing surgery.

Behavioral: Recording of food intake.

Lean (BMI ≤ 25) controls

Lean healthy non-diabetic adult females.

Behavioral: Recording of food intake.

Interventions

Recording of food intake. BEHAVIORAL

The food intake is recorded with a photographic food recognition mobile application. The total energy expenditure is recorded with the DLW method.

Also known as: Double labeled water (DLW) method.

Lean (BMI ≤ 25) controls; Obese (BMI ≥ 35) controls; Roux-en-Y gastric bypass patients

Eligibility Criteria

• Age: 18 Years - 65 Years
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Morbid obesity subjects (n=40) will be recruited at the bariatric outpatient clinic of the department of Surgery at University Hospital Zurich during one of their preoperative visits. The lean control group (n=20) will be recruited by internal advertisement to students and employees.

You may qualify if:

• Adult aged \>18;
• Obese and non-obese group:
• Obese person BMI \> 35 kg/m2 with no history of bariatric surgery;
• Healthy normal weight controls (BMI \< 25 kg/m2) with no history of bariatric surgery.
• Independently mobile;
• Digital literacy;
• Ability to communicate fluently in German;
• Capacity to consent to participate;

You may not qualify if:

• Diabetes;
• Pregnancy/lactation;
• Inability to understand instructions;
• Systemic or gastrointestinal condition which may affect food intake or preference;
• Diabetes Mellitus (type I and II);
• Pregnancy or lactation ;
• Weight loss diet or weight gain diet;
• Active and significant psychiatric illness including substance misuse;
• Suffering from heart or kidney failure or malabsorption;
• Significant cognitive or communication issues;
• Medications with documented effect on food intake or food preference;
• History of significant food allergy and certain dietary restrictions;
• Participants who have travelled (overnight trip of more than 200 miles) within 2 weeks before or after dose administration of isotopes;
• Participants that need to have intravenous fluids during 2 weeks before and after the study period will be excluded.

Sponsors & Collaborators

• Marco Bueter: lead

Study Sites (1)

University Hospital of Zurich

Zurich, 8091, Switzerland

Location

Related Publications (20)

• Mathes CM, Spector AC. Food selection and taste changes in humans after Roux-en-Y gastric bypass surgery: a direct-measures approach. Physiol Behav. 2012 Nov 5;107(4):476-83. doi: 10.1016/j.physbeh.2012.02.013. Epub 2012 Feb 16.

  PMID: 22366157 BACKGROUND

• Mathes CM, Letourneau C, Blonde GD, le Roux CW, Spector AC. Roux-en-Y gastric bypass in rats progressively decreases the proportion of fat calories selected from a palatable cafeteria diet. Am J Physiol Regul Integr Comp Physiol. 2016 May 15;310(10):R952-9. doi: 10.1152/ajpregu.00444.2015. Epub 2016 Feb 10.

  PMID: 26864811 BACKGROUND

• Bueter M, Miras AD, Chichger H, Fenske W, Ghatei MA, Bloom SR, Unwin RJ, Lutz TA, Spector AC, le Roux CW. Alterations of sucrose preference after Roux-en-Y gastric bypass. Physiol Behav. 2011 Oct 24;104(5):709-21. doi: 10.1016/j.physbeh.2011.07.025. Epub 2011 Jul 30.

  PMID: 21827777 BACKGROUND

• le Roux CW, Bueter M, Theis N, Werling M, Ashrafian H, Lowenstein C, Athanasiou T, Bloom SR, Spector AC, Olbers T, Lutz TA. Gastric bypass reduces fat intake and preference. Am J Physiol Regul Integr Comp Physiol. 2011 Oct;301(4):R1057-66. doi: 10.1152/ajpregu.00139.2011. Epub 2011 Jul 6.

  PMID: 21734019 BACKGROUND

• Miras AD, Seyfried F, Phinikaridou A, Andia ME, Christakis I, Spector AC, Botnar RM, le Roux CW. Rats fed diets with different energy contribution from fat do not differ in adiposity. Obes Facts. 2014;7(5):302-10. doi: 10.1159/000368622. Epub 2014 Oct 1.

  PMID: 25277969 BACKGROUND

• Mathes CM, Bohnenkamp RA, Blonde GD, Letourneau C, Corteville C, Bueter M, Lutz TA, le Roux CW, Spector AC. Gastric bypass in rats does not decrease appetitive behavior towards sweet or fatty fluids despite blunting preferential intake of sugar and fat. Physiol Behav. 2015 Apr 1;142:179-88. doi: 10.1016/j.physbeh.2015.02.004. Epub 2015 Feb 3.

  PMID: 25660341 BACKGROUND

• Mathes CM, Bohnenkamp RA, le Roux CW, Spector AC. Reduced sweet and fatty fluid intake after Roux-en-Y gastric bypass in rats is dependent on experience without change in stimulus motivational potency. Am J Physiol Regul Integr Comp Physiol. 2015 Oct 15;309(8):R864-74. doi: 10.1152/ajpregu.00029.2015. Epub 2015 Aug 19.

  PMID: 26290100 BACKGROUND

• Mathes CM, Bueter M, Smith KR, Lutz TA, le Roux CW, Spector AC. Roux-en-Y gastric bypass in rats increases sucrose taste-related motivated behavior independent of pharmacological GLP-1-receptor modulation. Am J Physiol Regul Integr Comp Physiol. 2012 Mar 15;302(6):R751-67. doi: 10.1152/ajpregu.00214.2011. Epub 2011 Dec 14.

  PMID: 22170618 BACKGROUND

• Seyfried F, Miras AD, Bueter M, Prechtl CG, Spector AC, le Roux CW. Effects of preoperative exposure to a high-fat versus a low-fat diet on ingestive behavior after gastric bypass surgery in rats. Surg Endosc. 2013 Nov;27(11):4192-201. doi: 10.1007/s00464-013-3020-6. Epub 2013 May 30.

  PMID: 23719976 BACKGROUND

• Miras AD, Jackson RN, Jackson SN, Goldstone AP, Olbers T, Hackenberg T, Spector AC, le Roux CW. Gastric bypass surgery for obesity decreases the reward value of a sweet-fat stimulus as assessed in a progressive ratio task. Am J Clin Nutr. 2012 Sep;96(3):467-73. doi: 10.3945/ajcn.112.036921. Epub 2012 Jul 25.

  PMID: 22836034 BACKGROUND

• Miras AD, le Roux CW. Mechanisms underlying weight loss after bariatric surgery. Nat Rev Gastroenterol Hepatol. 2013 Oct;10(10):575-84. doi: 10.1038/nrgastro.2013.119. Epub 2013 Jul 9.

  PMID: 23835488 BACKGROUND

• Behary P, Miras AD. Food preferences and underlying mechanisms after bariatric surgery. Proc Nutr Soc. 2015 Nov;74(4):419-25. doi: 10.1017/S0029665115002074. Epub 2015 May 20.

  PMID: 25990312 BACKGROUND

• Elmadfa I, Meyer AL. Developing suitable methods of nutritional status assessment: a continuous challenge. Adv Nutr. 2014 Sep;5(5):590S-598S. doi: 10.3945/an.113.005330.

  PMID: 25469404 BACKGROUND

• Martin CK, Nicklas T, Gunturk B, Correa JB, Allen HR, Champagne C. Measuring food intake with digital photography. J Hum Nutr Diet. 2014 Jan;27 Suppl 1(0 1):72-81. doi: 10.1111/jhn.12014. Epub 2013 Jul 15.

  PMID: 23848588 BACKGROUND

• Zhang W, Yu Q, Siddiquie B, Divakaran A, Sawhney H. "Snap-n-Eat": Food Recognition and Nutrition Estimation on a Smartphone. J Diabetes Sci Technol. 2015 May;9(3):525-33. doi: 10.1177/1932296815582222. Epub 2015 Apr 21.

  PMID: 25901024 BACKGROUND

• Schoeller DA, Ravussin E, Schutz Y, Acheson KJ, Baertschi P, Jequier E. Energy expenditure by doubly labeled water: validation in humans and proposed calculation. Am J Physiol. 1986 May;250(5 Pt 2):R823-30. doi: 10.1152/ajpregu.1986.250.5.R823.

  PMID: 3085521 BACKGROUND

• Schoeller DA. Measurement of energy expenditure in free-living humans by using doubly labeled water. J Nutr. 1988 Nov;118(11):1278-89. doi: 10.1093/jn/118.11.1278.

  PMID: 3142975 BACKGROUND

• Boushey CJ, Spoden M, Delp EJ, Zhu F, Bosch M, Ahmad Z, Shvetsov YB, DeLany JP, Kerr DA. Reported Energy Intake Accuracy Compared to Doubly Labeled Water and Usability of the Mobile Food Record among Community Dwelling Adults. Nutrients. 2017 Mar 22;9(3):312. doi: 10.3390/nu9030312.

  PMID: 28327502 BACKGROUND

• Racette SB, Schoeller DA, Luke AH, Shay K, Hnilicka J, Kushner RF. Relative dilution spaces of 2H- and 18O-labeled water in humans. Am J Physiol. 1994 Oct;267(4 Pt 1):E585-90. doi: 10.1152/ajpendo.1994.267.4.E585.

  PMID: 7943308 BACKGROUND

• Serra M, Alceste D, Hauser F, Hulshof PJM, Meijer HAJ, Thalheimer A, Steinert RE, Gerber PA, Spector AC, Gero D, Bueter M. Assessing daily energy intake in adult women: validity of a food-recognition mobile application compared to doubly labelled water. Front Nutr. 2023 Sep 22;10:1255499. doi: 10.3389/fnut.2023.1255499. eCollection 2023.

  PMID: 37810925 DERIVED

Biospecimen

Retention: SAMPLES WITHOUT DNA

Urine samples collected after ingestion of double labeled water (DLW).

MeSH Terms

Conditions

Obesity, Morbid; Food Preferences

Interventions

Methods

Condition Hierarchy (Ancestors)

Obesity; Overweight; Overnutrition; Nutrition Disorders; Nutritional and Metabolic Diseases; Body Weight; Signs and Symptoms; Pathological Conditions, Signs and Symptoms; Feeding Behavior; Behavior

Intervention Hierarchy (Ancestors)

Investigative Techniques

Study Officials

• Marco Bueter, MD, PhD

  University of Zurich

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Assistant Professor, PhD, Head of Bariatric Surgery

Study Record Dates

• First Submitted: October 7, 2020
• First Posted: October 23, 2020
• Study Start: June 1, 2019
• Primary Completion: January 16, 2023
• Study Completion: January 16, 2023
• Last Updated: August 18, 2023

Record last verified: 2023-08

Data Sharing

• IPD Sharing: Will not share

Locations

CH (1)