Evaluation of the Effects of Dietary Instruction after Gastrectomy on Postoperative BMI Change

Hideki Nagano, Shigekazu Ohyama, Mitsukuni Suenaga, Takahiro Sato, Yasuyuki Seto, Toshiharu Yamaguchi, Tetsuichiro Muto and Akio Yamaguchi*

Department of Surgery, Cancer Institute Hospital
1st Department of Surgery, Faculty of Medicine, University of Fukui*

Aim: We evaluated the effects of postgastrectomy dietary training on postoperative BMI change. Patients and methods: Subjects were 63 patients who had undergone curative gastric cancer surgery and had been instructed in dietary procedures postoperatively. After consulting an experienced clinical dietitian about the recommended diet after gastrectomy, we identified 20 foods not recommended early after gastrectomy. For each of the 20 foods, patients made selections from the following 4 questions: 1. not eaten since before surgery, 2. not eaten at all postoperatively, 3. eaten selectively, and 4. eaten as usual. We classified patients into 3 groups as follows: Group A: excluding foods in "1", foods in "2" more exceeded 50%; Group B intermediate between Group A and C; Group C: excluding foods in "1", foods in "4" exceeded 50%. We then calculated BMI change 3 months after surgery. Results: Among subjects, 30 were in Group A, 20 in Group B, and 13 in Group C. Group A lost 2.46 kg/m² compared to preoperative BMI, Group B lost 2.77 kg/m², and Group C lost 1.65 kg/m². Group C's BMI loss was significantly less than that of Group A or B. Conclusion: Overrestrictive dietary instruction may reduce postoperative quality of life (QOL), whereas more natural dietary habits may improve QOL.

Key words
gastric cancer, dietary instruction, body mass index, quality of life

Reprint requests
Hideki Nagano Department of Surgery, Tango Furusato Hospital
673 Kobama, Amino-cho, Kyotango-shi, Kyoto, 629-3113 JAPAN

Accepted
January 28, 2004

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