Table 4 Grading of Evidence for associations between dietary intakes (Between 12 and 24months) and weight loss (up to five-years – 4 studies) or weight recurrence (up to 18-months – one study)*.
Grading of Evidence for associations between dietary intakes (Between 12 and 24months) and weight loss (up to five-years – 4 studies) | ||||
|---|---|---|---|---|
Macronutrient Composition | Food Pattern | |||
Carbohydrate | Protein | Fat | Nil studies | |
Study Findings | Inverse Association (1 study, total N = 75, up to 2-years) Level III: 1 HR study [31] (N = 75) No Association (2 studies, total N = 290, up to 5-years) | Positive Association (1 study, total N = 75, up to 2-years) Level III: 1 HR study [31] (N = 75) Inverse Association (1 study, total N = 375, up to 2-years) [41] Level IV: 1 LR study [41] (N = 375) No Association (2 studies, total N = 290, up to 5-years) | Positive Association (1 study, total N = 375, up to 2-years) [41] Level IV: 1 LR study [41] (N = 375) No Association (3 studies, total N = 365, up to 5-years) | |
NHMRC Body of Evidence Framework | ||||
Evidence Statement | An evidence statement could not be made due to inconsistent evidence. | - | ||
Evidence Base | D - Poor. Level III to IV (cohort) studies with low to high risk of bias. | - | ||
Consistencies | D – Poor. Study findings highly inconsistent. Multiple study designs with varied risk of bias, outcome measures and duration of follow-up. | |||
Clinical Impact | D – Poor. Inconsistent study findings and design have affected ability to apply to practice. Non-diet moderators to weight change not always addressed. | |||
Generalizability | B – Good. All studies in adults at least one-year post-bariatric surgery in an outpatient setting. | |||
Applicability | B – Good. Most studies were conducted with population from the Western context like the Australian bariatric context. | |||
RECOMMENDATION | GRADE OF RECOMMENDTION | |||
No recommendations could be drawn. More well designed RCTs or prospective cohort studies may help with clarifying whether and what associations may be present between weight and diet within 12 and 24 months post-bariatric surgery. | - | |||
Grading of Evidence for associations between dietary intakes (Between 12 and 24months) and weight recurrence (up to 18-months – one study) | ||||
Macronutrient Composition | Food Pattern | |||
Carbohydrate | Protein | Fat | Fruit and Vegetables | |
Study Findings | No Association with intakes of 1-5 exchanges a day (1 study, total N = 50, up to 18-months) Level III: 1 HR study [42] (N = 50) | Nil studies | Inverse Association with intakes of 3–5 exchanges a day (1 study, total N = 50, up to 18-months) Level III: 1 HR study [42] (N = 50) | Inverse Association with intakes of 3–5 exchanges a day (1 study, total N = 50, up to 18-months) Level III: 1 HR study [42] (N = 50) |
NHMRC Body of Evidence Framework | ||||
Evidence Statement | An evidence statement could not be made due to inadequate information from study (unknown portion size for each exchange; unknown outcomes of participants with intakes lower or higher than the specified range of food exchanges) to determine the associations between weight recurrence and dietary intakes. | |||
Evidence Base | D – Poor. Level III cohort study with high risk of bias. | |||
Consistencies | N/A Evidence derived from single cohort study. | |||
Clinical Impact | D – Poor. Weak evidence base have affected ability to apply to practice. No description of the portion size of a single exchange, which have prevented the determination of the potential associations between weight and dietary intakes. | |||
Generalizability | D – Poor. All studies in adults at least one-year post-bariatric surgery in an outpatient setting. Insufficient dietary information to allow reproducibility. | |||
Applicability | C – Limited. Study was conducted in the Middle Eastern context which may warrant some caveats to adapt to the Australian bariatric context. | |||
RECOMMENDATION | GRADE OF RECOMMENDTION | |||
No recommendations could be drawn. More well designed RCTs or prospective cohort studies may help with clarifying whether and what associations may be present between weight and diet within 12 and 24 months post-bariatric surgery. | - | |||
