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Öğe Enhancing nutritional health and patient satisfaction five years after metabolic bariatric surgery with targeted supplementation(Bmc, 2025) Gorini, Stefania; Camajani, Elisabetta; Franchi, Arianna; Cava, Edda; Gentileschi, Paolo; Bellia, Alfonso; Karav, SercanBackground This study analyzes the long-term outcomes of metabolic bariatric surgery (MBS), focusing on weight loss, nutritional deficiencies, and patient satisfaction. We evaluate different surgical techniques to identify their impact on these outcomes. Methods A five-year retrospective analysis was conducted on 249 patients who underwent MBS at a specialized center. Baseline characteristics included an average age of 38.5 years, weight of 118.5 kg, and BMI of 43.2 kg/m(2). Weight loss outcomes were assessed using mean excess weight loss (%EWL) at 60 months. Surgical techniques included laparoscopic sleeve gastrectomy (LSG), one anastomosis gastric bypass (OAGB), and Roux-en-Y gastric bypass (RYGB). Nutritional deficiencies and patient-reported quality of life were also evaluated. Results The mean %EWL at 60 months was 92.1% +/- 25.8% (p = 0.013). While LSG and OAGB showed similar weight loss patterns, RYGB resulted in further weight reduction from the third year onwards. Patients revised from LSG to RYGB had significantly greater weight loss (102.1%) compared to those revised to mini-gastric bypass (MGB) (84.6%, p < 0.05). Nutritional deficiencies were prevalent, with 41.2% of revised LSG patients experiencing iron deficiency and 14.3% developing new vitamin D deficiencies (p < 0.05). Most patients (85%) reported improvements in quality of life, and 85% expressed a willingness to undergo surgery again (p = 0.0028). Conclusions MBS resulted in substantial and sustained weight loss, particularly in RYGB patients. Surgical revisions, especially from LSG to RYGB, were associated with greater weight loss but also increased nutritional risks. Persistent iron and vitamin D deficiencies highlight the necessity of individualized supplementation and long-term monitoring. Type-targeted supplementation represents an innovative approach to optimizing long-term nutritional support in bariatric patients. Future studies with larger cohorts and validated tools are needed to confirm these findings and strengthen clinical guidelines.Öğe Exploring Gender Differences in the Effects of Diet and Physical Activity on Metabolic Parameters(MDPI, 2025) Gorini, Stefania; Camajani, Elisabetta; Feraco, Alessandra; Armani, Andrea; Karav, Sercan; Filardi, Tiziana; Aulisa, GiovanniBackground: Gender differences in metabolic response to lifestyle interventions remain poorly explored. This study aimed to evaluate the impact of a six-month Mediterranean diet (MD) intervention combined with regular physical activity on metabolic parameters in overweight adults. Methods: A prospective cohort study was conducted in an obesity clinic in Rome, Italy, involving overweight adults (BMI >= 25 kg/m2) motivated to improve their lifestyle. Participants (n = 205; 107 men and 98 women) self-selected into physical activity groups (aerobic, anaerobic, combined or no activity). Gender-specific metabolic changes were assessed, including lipid profiles, liver markers and fasting glucose. Results: Significant gender differences in metabolic results were observed. Men showed greater reductions in total cholesterol (TC) and LDL, as well as significant reductions in alanine aminotransferase (ALT). Women showed a significant increase in HDL cholesterol. Fasting blood glucose decreased significantly in both sexes, with no differences between the sexes. Activity-specific analysis revealed that anaerobic activity significantly improved lipid metabolism in men, while aerobic activity produced the greatest benefits in women, including increased HDL and improved liver marker profiles. Conclusions: Therapeutic strategies combining MD and physical activity must take into account gender-specific physiological differences and the type of sport activity to optimise metabolic benefits. Personalised approaches may improve the management of cardiovascular risk factors in overweight individuals. Study registration: This study is registered on ClinicalTrials.gov (NCT06661330).Öğe Gender Differences in Dietary Patterns and Eating Behaviours in Individuals with Obesity(Mdpi, 2024) Feraco, Alessandra; Armani, Andrea; Gorini, Stefania; Camajani, Elisabetta; Quattrini, Chiara; Filardi, Tiziana; Karav, SercanBackground/Objectives: Obesity is a global health problem with significant chronic disease risks. This study examined gender differences in eating behaviour, body composition, eating frequency and time of hunger in an Italian cohort with obesity (BMI >= 30) to inform gender-specific management strategies. Methods: A retrospective analysis of 720 adults (51.5% female, mean age 44.4 +/- 13.8 years) assessed body composition and eating behaviour using principal component analysis (PCA) to classify eating profiles (structured, irregular, social and disordered/impulsive eaters). Results: Males showed higher weight, abdominal circumference and fat mass, while females showed higher fat mass percentages (p < 0.001). Gender differences were observed in the frequency of meals (e.g., 54.7% of males and 64.7% of females consumed 4-5 meals per day, p = 0.0018) and the time of hunger (males: before dinner; females: morning hunger, p = 0.005). The PCA profiles revealed that the 'structured eaters' had a healthier body composition, whereas the 'disordered/impulsive eaters' had a higher fat mass. Irregular eaters were predominantly male (41.0%), while disordered eaters were predominantly female (39.9%) (p = 0.0016). Conclusions: Gender-specific eating patterns influence obesity outcomes. Structured eating was associated with healthier profiles, whereas impulsive or irregular patterns were related to higher fat mass. The retrospective design and non-validated questionnaire for dietary behaviour assessment limit generalisability, warranting further research for tailored interventions. Registration: ClinicalTrials.gov (NCT06654674).Öğe Gender differences in dietary patterns and physical activity: an insight with principal component analysis (PCA)(BMC, 2024) Feraco, Alessandra; Gorini, Stefania; Camajani, Elisabetta; Filardi, Tiziana; Karav, Sercan; Cava, Edda; Strollo, RockyBackgroundGender differences in dietary patterns and physical activity are known to influence metabolic health, but research exploring these differences using principal component analysis (PCA) is limited. This study aims to identify distinct patterns of eating behaviour, body composition and physical activity between men and women, in order to develop tailored interventions.MethodsA cross-sectional study was conducted on 2,509 adults attending a metabolic health centre. Data on eating habits, physical activity and body composition were collected by means of questionnaires and bioimpedance analysis. PCA was used to identify patterns of eating behaviour and physical activity. Statistical analyses were performed to explore gender-specific differences.ResultsBased on the PCA, five distinct groups of participants were identified: Balanced Eaters, Focused on Home Cooking, Routine Eaters, Restaurant Lovers and Varied Eaters. Significant gender differences in food preferences were observed, with men consuming more meat and women more vegetables. Men also reported greater participation in strength and endurance sports, while women showed a more structured eating routine.ConclusionsThis study, using principal component analysis (PCA), revealed gender-specific patterns in diet, physical activity and body composition. PCA identified five distinct behavioural groups, revealing that men tended to consume more meat and engage in strength training, while women adhered to structured, vegetable-rich diets. The application of PCA provided more insight than traditional analysis, highlighting the complexity of gender-specific behaviour. These results emphasize the need for tailored interventions, focusing on increasing vegetable intake in men and encouraging strength training in women. Future research should exploit PCA to explore behavioural patterns longitudinally for more refined and personalised health strategies.Clinical trials registeredThis study is registered on ClinicalTrials.gov (NCT06654674).
