“Food Tolerance and Eating Behavior After Roux-en-Y Gastric Bypass Surgery”

Background: Roux-en-Y gastric bypass (RYGB) is among the most performed bariatric surgery techniques. One known complication of RYGB surgery is food intolerance, which may limit the intake of protein.
Objective: To investigate the relationship of food intolerance after RYGB surgery with masticatory efficiency, chewing time and cycles, and consumption of protein and red meat.
Methods: Case-control study in subjects with and without food intolerance (regurgitation and/or vomiting more than once a week) aged over 18 years-old who underwent RYGB more than 2 years previously, with absence of no more than 2 dental units and normal oral motor system evaluation. Masticatory efficiency was evaluated by the granulometry of red meat chewed by the study subject according to a predefined protocol using a sieving technique and classified from very poor to excellent. Protein and red meat consumption were evaluated by usual food recall and 3-day dietary diary.
Results: The study population consisted of 24 cases (37.7±7.57 years-old, 79.2% females) and 68 controls (38.0±8.75 years-old, 61.8% females). There was a statistically significant association (p=0.001 by the ranksum test) between food intolerance and masticatory efficiency, with 58.3% of cases and 23.5% of controls showing very poor masticatory efficiency. No evidence was found of an association of food intolerance with chewing time, chewing cycles, and low protein or red meat consumption.
Conclusion: The results indicate that masticatory inefficiency is one of the factors leading the patient after RYGB surgery to have difficulty in food adaptation and to complain of food intolerance.