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Post-RYBG activity

Majority of women and children insufficiently active after RYGB

There were great variations between individuals at three months before and nine and 48 months after maternal RYGB in levels of PA and ST, and furthermore in their differences over time

The majority of both women undergoing Roux-en-Y Gastric Bypass (RYGB) and children are insufficiently active 48 months after maternal RYGB, according to researchers from Sweden. The researchers reported that objectively measured physical activity (PA) in women remains unchanged while appurtenant children decrease time spent in moderate to vigorous PA (MVPA) and increase sedentary time (ST), from three months before through nine and 48 months after maternal RYGB.

The study, ‘Four years’ follow-up changes of physical activity and sedentary time in women undergoing roux-en-Y gastric bypass surgery and appurtenant children’, published in BMC Surgery sought to objectively assess longitudinal changes in PA and ST, among women undergoing RYGB and appurtenant children, from three months before to nine and 48 months after maternal surgery, as well as assess the prevalence of women and children meeting the current PA guidelines three months before and nine and 48 months after maternal surgery.

Levels of PA and ST were measured at all three time points with the GT3X+ monitor, which has been shown to assess PA and ST in adults with accuracy. The researchers analysed three dimensional vector magnitude (Vm) activity counts, recorded in 10-s epochs and then aggregated to counts per minutes (cpm), calculated as the square root of the sum of the counts on three axes. Fifty-six women (81%) and 75 (80%) children wore the accelerometer at the three months before and nine months post-surgery measurements. The study population in the present study included 30 (43%) women and 40 (42%) children with valid accelerometer data at all three measure points.

Descriptive and anthropometrical variables did not differ significantly between women (n=69) or and children (n=95) included in the original study population, versus women (n=30) and children (n=40) included in the present study who provided valid PA data at all three measure points.

Outcomes

The mean pre-surgery age was 39.7 (SD=6.3) years for women and 10.0 (SD=2.2) years for children, age range for children pre-surgery was 6.7–14.0 years. Fifty-three percent (n = 21) of the children participating at all three measure points were girls and there were no sex differences with regard to descriptive characteristics (data not published). There were no significant differences in the prevalence of overweight or obesity in children between pre- and nine months or 48 months post-maternal RYGB except from overweight and obesity pre-surgery compared to nine months after, 24 children vs. 18 (p=0.025).

Mean numbers of days the accelerometer was worn for more than ten hours per day were 6.6 (SD=0.9), 6.3 (SD=1.3) and 6.6 (SD=1.5) pre-, nine months and 48 months post-surgery, respectively in women, and 6.1 (SD=1.3), 5.7 (SD=1.4) and 6.1 (SD=1.3) pre-, nine months and 48 months post-surgery, respectively in children.

Accelerometer measurements of levels of PA and ST three months before and nine and 48 months after maternal RYGB displayed no significant differences in MVPA, LPA or ST, between any given measure point, in women. On the contrary, children decreased time spent in MVPA with 13.2 min/day (p=0.041), time spent in LPA with 82.2 min/day (p<0.001) and increased time spent sedentary with 110.5 min/day (p<0.001) from three months before to 48 months after maternal RYGB.

Mean cpm/day and LPA decreased significantly (p=0.002 and p < 0.001, respectively) and ST increased (p<0.001), from nine to 48 months after maternal RYGB. MVPA showed a non-statistically significant decrease from pre-surgery and nine months post-surgery (diff = −3.5 p=0.557) and from nine months and 48 months post-surgery (diff = −9.7 p=0.064). On average, women spent 3.8, 4.0 and 3.6%, whereas children spent 8.7, 8.2 and 7.0% of the day in MVPA, three months before and nine and 48 months after RYGB.

Fifteen women (50%) increased, whereas 15 women (50%) decreased their time spent in MVPA from three months before to 48 months after RYGB. In addition, 16 women (53%) increased, whereas the reaming 14 women (47%) decreased their time spent sedentary from three months before to 48 months after RYGB. Twenty-three (58%), 36 (90%) and six (15%) children decreased time spent in MVPA, LPA and ST, from three months before to nine and 48 months after maternal RYGB, respectively. Means of daily minutes spent in MVPA, LPA and ST three months before and nine and 48 months after maternal RYGB in women and children are shown graphically in Figures 1 and 2.

Figure 1: Means of light physical activity and sedentary time, in children and women three months before and nine and 48 months after maternal Roux-en-Y Gastric Bypass surgery

Figure 2: Means of moderate to vigorous physical activity, in children and women three months before and nine and 48 months after maternal Roux-en-Y Gastric Bypass surgery

Children five to 17 years of age are recommended to engage in at least 60 min of MVPA each day. This PA guideline is met by 60, 68 and 35% of children at three months before and nine and 48 months after maternal RYGB, respectively. There were great variations between individuals at three months before and nine and 48 months after maternal RYGB in levels of PA and ST, and furthermore in their differences over time.

“The prevalence of women undergoing RYGB meeting the PA guidelines is low three months before and nine and 48 months after maternal surgery, while 60% of appurtenant children met the PA guidelines before maternal RYGB and that number dropped to 35% after 48 months,” the researchers concluded. “The prevalence of women meeting the current PA guidelines are low before maternal RYGB and remain low nine and 48 months after surgery, while the prevalence of appurtenant children that meet the recommended guidelines decrease substantially from before to 48 months after maternal RYGB. This implies the need to incorporate effective pre- and post-surgery PA counselling specific to this population.”

To access this paper, please click here

https://bmcsurg.biomedcentral.com/articles/10.1186/s12893-017-0318-7

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