Publications by authors named "Iwona Boniecka"

14 Publications

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Validity and efficacy of diets used for preoperative weight reduction among patients qualified for bariatric surgery.

Pol Przegl Chir 2021 Mar;93(2):53-58

Department of Clinical Dietetics, Medical University of Warsaw, Poland.

Introduction: Bariatric surgery is the most effective method of weight reduction among patients suffering from morbid obesity. Reduction of body weight before surgery is an important element. The aim of the study was to present the current knowledge on preoperative weight reduction and diet for this purpose.

Material And Methods: To achieve the aims of the paper, articles available in the PubMed / MEDLINE database published in 2005-2020 were used, as well as the guidelines of societies such as Metabolic and Bariatric Surgery Chapter of the Association of Polish Surgeons, American Association of Clinical Endocrinologists, The Obesity Society and American Society for Metabolic & Bariatric Surgery, International Federation for Surgery of Obesity and Metabolic Disorders-European Chapter and European Association for the Study of Obesity.

Results: Studies show that even a modest reduction in weight in the early preoperative period facilitates surgery and reduces the number of complications. The available data do not support the effect of preoperative weight loss on increased postoperative weight loss. The use of balanced, energy-restricted diet in the preoperative period prepares the patient for changes in the way of nutrition, which improves the nutritional status of patient. Low calorie (LCD) or very low calorie (VLCD) diet can be an effective method of weight loss before surgery, however, this approach does not allow to modify eating habits. The use of a very low calorie ketogenic diet (VLCKD) remains under discussion.

Conclusions: There is a need for large randomized trials to assess short and long term benefits of preoperative weight loss and methods of weight loss among patients qualified for bariatric surgery, also the standardization of nutritional management in the preoperative period.
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http://dx.doi.org/10.5604/01.3001.0014.7953DOI Listing
March 2021

Metabolic and Bariatric Surgery Chapter of the Association of Polish Surgeons. Bariatric and metabolic surgery care standards.

Wideochir Inne Tech Maloinwazyjne 2020 Sep 5;15(3):391-394. Epub 2020 Aug 5.

Department of General, Gastroenterological, and Oncological Surgery, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Poland.

The Metabolic and Bariatric Surgery Chapter of the Association of Polish Surgeons (Polish acronym: SCMiB TCHP) is a Polish specialist scientific society representing bariatric surgeons as well as specialists from other disciplines and professions cooperating with them during the provision of services in the field of bariatric and metabolic surgery, as well as the entire care process before and after surgery. The following standards constitute the minimum requirements set by the SCMiB TCHP for good practice of the basic process of bariatric care throughout its entire period, which ensure satisfactory safety and effectiveness of the obesity treatment and its metabolic complications.
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http://dx.doi.org/10.5114/wiitm.2020.97935DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7457194PMC
September 2020

Assessment of health behaviors, nutritional behaviors, and self-efficacy in patients with morbid obesity.

Psychiatr Pol 2019 Oct 30;53(5):1125-1137. Epub 2019 Oct 30.

Klinika Chirurgii Ogólnej, Onkologicznej, Metabolicznej i Torakochirurgii Wojskowego Instytutu Medycznego w Warszawie.

Objectives: The objective of the study was to assess the frequency of health and nutritional behaviors concerning emotional, habitual, and restrictive eating as well as to evaluate self efficacy in patientswith morbid obesity and determine the correlation between patients'BMI index and their health behaviors as well as self-efficacy.

Methods: The study included 37 patients diagnosed with class two and three obesity, aged 18-62 (M = 39.94; SD = 12.20). Patients' BMI ranged from 36 to 60 kg/m2 (M = 43.50; SD = 5.36). Research tools used in the study: the Inventory of Lifestyle Behaviors (ILB), the Dietary Behaviors Questionnaire (DBQ), and the General Self-Efficacy Scale (GSES).

Results: Patients with morbid obesity were characterized by medium (men; a sten score of 5) and low (women; a sten score of 4) intensity of health behaviors. Subjects showed a tendency for negative nutritional behaviors, emotional and habitual eating as well as dietary restrictions. General self-efficacy ranged between sten scores of 4 to 10, with mean at a high level (a sten score of 7).

Conclusions: Patients with morbid obesity need health, nutritional, and psychological education.
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http://dx.doi.org/10.12740/PP/OnlineFirst/81182DOI Listing
October 2019

XXL-TYPE PERSONALITY. Personality traits promoting excess body weight.

Pol Przegl Chir 2019 Aug;91(5):1-4

Klinika Chirurgii Ogólnej, Onkologicznej, Metabolicznej i Torakochirurgii Wojskowy Instytut Medyczny w Warszawie.

The Aim Of The Study: The study aimed to determine whether persons suffering from obesity may be characterised by specific personality traits which promote the development of excess body weight. Additionally, the aim involved finding whether persons suffering from morbid obesity differed from healthy individuals and somatic patients as regards selected personality traits.

Material And Methods: The study enrolled 34 patients with the diagnosis of morbid obesity in the process of qualification for surgical treatment of obesity. The patients' BMI ranged from 35 to 54 kg/m2. Study participants completed NEO-FFI personality inventory (Costa, McCare; 1998) and the authors' questionnaire designed to collect demographic data and anthropometric measurements. R esults: The study showed that patients with morbid obesity significantly differed from healthy individuals and somatic patients as regards the analysed measurements of the Big Five. C onclusions: The traits which were significantly distinctive in morbidly obese patients included lowered conscientiousness and increased neuroticism. The results indicate that the above pattern of personality traits may promote the development of excessive body weight.
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http://dx.doi.org/10.5604/01.3001.0013.4177DOI Listing
August 2019

The association between proinflammatory cytokines and kidney function, body composition, and nutritional markers in nondialysis-dependent chronic kidney disease patients with diabetes mellitus type 2
.

Clin Nephrol 2019 Nov;92(5):237-242

Background: Chronic kidney disease (CKD) is associated with a subclinical inflammatory state, which contributes to increased mortality in CKD patients. The purpose of this study was to examine the association between chosen cytokines, such as IFN-γ, IL-10, IL-2p70, IL-6, and kidney function as well as the body composition and nutritional markers in patients with CKD and diabetes mellitus type 2.

Materials And Methods: 21 patients with diabetes mellitus type 2 and CKD stage 3b - 5, with estimated glomerular filtration rate (eGFR) lower than 45 mL/min/1.72m, not being treated with dialysis were included in the study. Body composition was assessed by bioimpedance spectroscopy (Body Composition Monitor - Fresenius Medical Care).

Results: Significant, negative correlations between lean tissue index (LTI) and IFN-γ concentrations (r = -0.52, p = 0.021) as well as IL-6 concentrations (r = -0.46, p = 0.047) were observed. Only the IL-6 levels significantly correlated with kidney function expressed by eGFR (r = -0.47, p = 0.034). We observed a significant positive correlation between IL-6 level and IFN-γ (r = 0.51, p = 0.019) as well as with high-sensitivity C-reactive protein (hsCRP) levels (r = 0.48, p = 0.029). The IL-10 level significantly correlated with hsCRP (r = 0.53, p = 0.015).

Conclusion: In CKD patients with diabetes mellitus type 2 during conservative treatment, IL-6 levels were associated with kidney function expressed by eGFR. IL-6 levels and IFN-γ levels negatively correlated with the amount of muscle mass. Cytokines did not show any association with the amount of fat tissue this study.
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http://dx.doi.org/10.5414/CN109846DOI Listing
November 2019

Bulimia nervosa in obese patients qualified for bariatric surgery - clinical picture, background and treatment.

Wideochir Inne Tech Maloinwazyjne 2019 Sep 16;14(3):408-414. Epub 2019 Jan 16.

Department of General, Oncological, Metabolic and Thoracic Surgery, Military Institute of Medicine, Warsaw, Poland.

Eating is a basic human physiological need which is necessary to keep the body alive. Eating disorders are diagnosed when eating (or not eating) and associated body weight gain anxiety become the main interest of an individual and all other spheres of life depend on it. Bulimia nervosa is a psychiatric disorder which is more and more commonly diagnosed in patients suffering from obesity and in patients after surgical treatment of obesity. In patients eligible for bariatric surgery this disorder should be diagnosed appropriately early and treated successfully before the procedure, because bulimia nervosa does not regress spontaneously. When untreated, it may last for years, reducing the efficacy of a surgical treatment of obesity, or even lead to complications that are health- and life-threatening for patients.
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http://dx.doi.org/10.5114/wiitm.2019.81312DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6748054PMC
September 2019

Dietary and Pharmacological Treatment of Nonalcoholic Fatty Liver Disease.

Medicina (Kaunas) 2019 May 20;55(5). Epub 2019 May 20.

Department of Internal Diseases and Endocrinology, Medical University of Warsaw, 02-097 Warsaw, Poland.

Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease in the developed world. Simple hepatic steatosis is mild, but the coexistence of steatohepatitis (NASH) and fibrosis increases the risk of hepatocellular carcinoma. Proper dietary and pharmacological treatment is essential for preventing NAFLD progression. The first-line treatment should include dietary intervention and increased physical activity. The diet should be based on the food pyramid, with a choice of products with low glycemic index, complex carbohydrates in the form of low-processed cereal products, vegetables, and protein-rich products. Usage of insulin-sensitizing substances, pro- and prebiotics, and vitamins should also be considered. Such a therapeutic process is intended to support both liver disease and obesity-related pathologies, including insulin resistance, diabetes, dyslipidemia, and blood hypertension. In the pharmacological treatment of NAFLD, apart from pioglitazone, there are new classes of antidiabetic drugs that are of value, such as glucagon-like peptide 1 analogs and sodium/glucose cotransporter 2 antagonists, while several other compounds that target different pathogenic pathways are currently being tested in clinical trials. Liver biopsies should only be considered when there is a lack of decline in liver enzymes after 6 months of the abovementioned treatment. Dietary intervention is recommended in all patients with NAFLD, while pharmacological treatment is recommended especially for those with NASH and showing significant fibrosis in a biopsy.
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http://dx.doi.org/10.3390/medicina55050166DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6571590PMC
May 2019

Content of fatty acids in a diet and the homocysteine levels in women with fertility disorders.

Neuro Endocrinol Lett 2018 Mar;39(1):56-64

Department of Clinical Dietetics, Medical University of Warsaw, Ciołka St. 27, 01-445 Warsaw, Poland.

Objectives: Assessment of the effects of consumption of fatty acids on the homocysteine levels in women with fertility disorders.

Methods And Results: The study included 286 women at the age between 23 and 46 years (the mean 33.13±4.21 years) with a fertility disorders. We measured: levels of homocysteine [μmol/L] (n=171), body weight and height (n=286). Body mass index (BMI) was calculated. A diet was assessed by 3-day dietary food records method including one day of the weekend. The mean homocysteine (Hcy) levels were 10.02±2.98 μmol/L. Body weight excess was observed in 29.3% of subjects. The percentage of fatty acids in the total energy [%E] it was demonstrated that the mean rate of MUFAs and PUFAs was statistically significantly lower in diets of women with the homocysteine levels >15 μmol/L compared to the group with the Hcy <10 μmol/L. Based on the results of a correlation between the homocysteine levels and consumption of n-6 fatty acids and n-3 fatty acids it is possible to conclude that there are negative correlations observed indicating that higher consumption of these acids is associated with lower levels of homocysteine.

Conclusion: Increased consumption of PUFAs, including α-linoleic acid, in a diet seems to be an important factor preventing from hyperhomocysteinemia.
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March 2018

[Dietetary recommendation for non-alcoholic fatty liver disease].

Pol Merkur Lekarski 2017 Dec;43(258):281-286

Department of Clinical Nutrition, Medical University od Warsaw, Poland.

Non-alcoholic Fatty Liver Disease (NAFLD) is currently the most common chronic liver disease in the developed world. Nowadays, in the adult population of Europe it is estimated at 14% to 21%. Its most important risk factors are obesity and metabolic syndrome. Introducing lifestyle changes such as: dietary intervention and increased physical activity are the first-line treatment and are intended to support not only NAFLD but also associated diseases such as obesity, insulin resistance, diabetes and dyslipidemia. Dietary management focuses on weight reduction of overweight or obese people by decreasing energy in diet. It is recommended to limit the intake of saturated fats and trans fatty acids as well as cholesterol. Instead, it is important to increase the proportion of polyunsaturated fatty acid diets, mainly from the n-3 family, which exhibit anti-inflammatory activity. It is also beneficial to eat nuts, despite their high energy value, as a source of alpha linolenic acid, which lowers LDL cholesterol. It is important to increase the share of vegetable protein (eg. soya) and limit the intake of fat meat, milk and the dairy products. A key role in the treatment and prevention of NAFLD is also a reduction of simple sugars and total exclusion of added sugar in the diet. The rise of NAFLD in developed countries is analogous to the increase of fructose consumption, which high intake is directly indicated as the main cause of the disease. Choosing foods with high fiber content, low glycemic index and meals composed with low glycemic load, is conducive to weight reduction. An important role in supporting NAFLD treatment is also attributed to vitamin D, C and E supplementation and some probiotic bacteria, as well as cinnamon and turmeric, which improve insulin sensitivity. Daily physical activity is strongly recommended as the supplement of healthy lifestyle.
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December 2017

[Non-alcoholic liver disease - diagnosis and treatment].

Pol Merkur Lekarski 2017 Nov;43(257):237-242

Department of Clinical Nutrition, Medical University of Warsaw, Poland; Department of General and Metabolic Surgery, Military Institute of Medicine, Warsaw, Poland.

Non-alcoholic fatty liver disease (NAFLD) is currently the most common chronic liver disease in the developed world (15% to 40% of the adult population). Introduction of lifestyle changes including dietary intervention and increased physical activity is most often the first-line treatment and is intended to support not only the treatment of liver disease, but also for diseases associated with obesity, insulin resistance, diabetes and dyslipidemia. In addition to well-known metformin, there are new classes of antidiabetic drugs, including GLP-1analog, SGLT-2 antagonist, pioglitazon. In addition, statins, vitamin E and pentoxyfiline are also recommended. In the absence of improvement of liver enzymes during the 6 months of treatment, liver biopsy should be considered. Simple hepatic steatosis (NAFL) is mild, but steatohepatitis (NASH) and fibrosis chance the prognosis and the risk of hepatocellular carcinoma (HCC) is higher.
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November 2017

Stress as a factor contributing to obesity in patients qualified for bariatric surgery - studies in a selected group of patients (a pilot study).

Wideochir Inne Tech Maloinwazyjne 2017 13;12(1):60-67. Epub 2017 Jan 13.

Department of General, Oncologic, Metabolic and Thoracic Surgery, Military Institute of Medicine, Warsaw, Poland.

Introduction: Recently, the incidence of obesity, especially extreme obesity, has significantly increased. It is connected with inappropriate lifestyle, including a high calorie diet, psychological and genetic factors, some medications, diseases or infectious factors. Nowadays, the consumption of food is not only to satisfy a physiological need, but also fulfils psychological needs. The most effective method of morbid obesity treatment is metabolic surgery. Moreover, food is considered to be a reward and method of coping with stress. In order to improve the efficiency of the surgical treatment, it seems significant to assess the effects of psychological factors on eating behaviours.

Aim: To evaluate the effects of stress on eating habits that increase the risk of extreme obesity.

Material And Methods: The study included 50 subjects qualified for bariatric surgery. The authors' own questionnaire and standardised PSS-10 questionnaire by Cohen, Kamarcki and Mermelstein adapted by Juczyński and Ogińska-Bulik were used.

Results: These questionnaires indicated that patients felt a moderate levels of stress but with a tendency for high levels. The majority of respondents declared an increased appetite due to stress-causing factors. Reasons for snacking most frequently included negative emotions and feeling like eating something. Consumption of additional snacks was a way of coping with stress. Most frequently the subjects ate sweets and salty snacks, but also sandwiches, nuts, fruit and alcohol beverages.

Conclusions: Psychological support may help morbidly obese people both to change nutritional habits and to cope with stress.
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http://dx.doi.org/10.5114/wiitm.2016.65078DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5397539PMC
January 2017

[Selected lifestyle characteristic of patients with extreme obesity qualified for bariatric surgery].

Rocz Panstw Zakl Hig 2009 ;60(3):279-84

Zakład Zywienia Czlowieka,Warszawski Uniwersytet Medyczny, Warszawa.

The aim of the study was the analysis of chosen nutritional habits and physical activity among patients qualified for bariatric surgery. The research was conducted by questionnaire method. The results of the study show that number and regularity of meals was improper. Everybody snack, eg. sweets. About 50% of researched read information on the food packages, but only few participants paid attention to the nutritional and energy value of food products. TV and radio were the main source of nutritional information. Nutritional behaviors men and women were different. The level of physical activity was low.
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February 2010

[Nutritional behavior of chosen group of school children in aspect of obesity risk].

Przegl Lek 2009 ;66(1-2):49-51

Zakład Zywienia Człowieka Warszawskiego Uniwersytetu Medycznego, Warszawa.

The research was conducted by questionnaire method among children aged 7-9 y. and teenagers aged 13-15 y. The results of the study show that regularity of meals was better in children group. Dietary habits linked to obesity are large volumes of sweets, sweetened drinks, few vegetables, milk products and fish. Taking results into consideration it is probably schoolchildren are at obesity risk. The most important prevention factor is nutrition education.
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September 2009

Pro-health nutritional behaviors of selected group of students of the Medical University of Warsaw.

Rocz Panstw Zakl Hig 2007 ;58(1):273-8

Department of Human Nutrition, Warsaw Agricultural University, 02-776 Warsaw.

The aim of the study was the analysis of pro-health nutritional behaviors among 100 female students Medical University of Warsaw tested by the questionnaire method. The results of the study show that nutritional behaviors of students who learned human nutrition were significantly better in accordance with dietary guidelines. The most frequent consumed group of products were fruits and dairy products. Consumption of vegetables, number and regularity of meals had been better among dietetics students then among midwifery and nursing students.
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January 2008