Research Article

Evaluation of Dietary Quality (Healthy Eating Index-2015), Nutrient Intake and Anthropometric Measurements in Post-Bariatric Patients

Volume: 5 Number: 1 July 31, 2026
Gülşah Arda , Hülya Yılmaz *, Anıl Özmutlu

Evaluation of Dietary Quality (Healthy Eating Index-2015), Nutrient Intake and Anthropometric Measurements in Post-Bariatric Patients

Abstract

Objective: To systematically evaluate overall dietary quality and nutrient adequacy in post-bariatric surgery patients using the Healthy Eating Index-2015 (HEI-2015) and comparing daily intakes with Dietary Reference Values (DRVs). Material and Methods: This cross-sectional study evaluated 50 individuals who had undergone bariatric surgery, comprising 8 males and 42 females. The study included the measurement of current anthropometric data and the assessment of daily nutritional intake, determined through 3-day, 24-hour dietary recalls processed using BeBiS software. To assess dietary quality, the HEI-2015 scores were calculated, and the percentage of each nutrient intake meeting the DRVs was determined. Results: Despite significant anthropometric improvements, including a decrease in mean BMI from 41.8 ± 6.1 to 27.7 ± 4.5 kg/m², the mean HEI-2015 score was 55.6 ± 10.0, and 100% of the study population was classified as having a “poor” or “needs improvement” dietary status. Energy and protein intakes reached 28.7% and 43.4% of the recommended daily intake (DRV), respectively. The intake of critical micronutrients was extremely low particularly regarding the percentages of DRVs met for iron (32%), folate (30%), and calcium (23.6%). Macronutrient distribution revealed a high-fat preference (51.6% energy) and severe carbohydrate restriction (38.6 ± 18.3 g/day), inconsistent with recommended thresholds. Conclusion: These findings suggest that post-bariatric anthropometric improvement doesn’t consistently correspond with adequate dietary quality within this limited cohort. The integration of dietary quality monitoring with routine anthropometric assessment could enhance the care of post-bariatric patients.

Keywords

Dietary quality, HEI-2015, Metabolic bariatric surgery, Nutritional deficiency, Obesity management

Supporting Institution

Hasan Kalyoncu University

Ethical Statement

The study was approved by the Institutional Review Board of Hasan Kalyoncu University on 27.03.2024 (No: 2024/45). All procedures performed in this study were in accordance with the Declaration of Helsinki.

Thanks

We would like to thank all the participants.

References

  1. Aills, L., Blankenship, J., Buffington, C., Furtado, M., & Parrott, J. (2008). ASMBS Allied health nutritional guidelines for the surgical weight loss patient. Surgery for Obesity and Related Diseases, 4(5 Suppl), S73-108. https://doi.org/10.1016/j.soard.2008.03.002
  2. Ashwell, M., & Gibson, S. (2016). Waist-to-height ratio as an indicator of 'early health risk': Simpler and more predictive than using a 'matrix' based on BMI and waist circumference. BMJ Open, 6(3), e010159. https://doi.org/10.1136/bmjopen-2015-010159
  3. Ashwell, M., Gunn, P., & Gibson, S. (2012). Waist‐to‐height ratio is a better screening tool than waist circumference and BMI for adult cardiometabolic risk factors: Systematic review and meta‐analysis. Obesity Reviews, 13(3), 275-286. https://doi.org/10.1111/j.1467-789X.2011.00952.x
  4. Bond, D. S., Heinberg, L. J., Crosby, R. D., Laam, L., Mitchell, J. E., Schumacher, L. M., Gunstad, J., & Steffen, K. J. (2023). Associations between changes in activity and dietary behaviors after metabolic and bariatric surgery. Obesity Surgery, 33(10), 3062-3068. https://doi.org/10.1007/s11695-023-06682-4
  5. Boniecka, I., Czerwonogrodzka-Senczyna, A., Jeznach-Steinhagen, A., Paśnik, K., Szostak-Węgierek, D., & Zeair, S. (2023). Nutritional status, selected nutrients intake, and metabolic disorders in bariatric surgery patients. Nutrients, 15(11). https://doi.org/10.3390/nu15112479
  6. Bouchard, C. (2007). BMI, fat mass, abdominal adiposity and visceral fat: Where is the 'beef'? International Journal of Obesity, 31(10), 1552-1553. https://doi.org/10.1038/sj.ijo.0803653
  7. Bray, G. A., Frühbeck, G., Ryan, D. H., & Wilding, J. P. H. (2016). Management of obesity. The Lancet, 387(10031), 1947-1956. https://doi.org/10.1016/S0140-6736(16)00271-3
  8. Carvajal, C., Savino, P., Ramirez, A., Grajales, M., Nassar, R., & Zundel, N. (2017). Anthropometric assessment for bariatric procedures in the private practice of a registered dietitian in Colombia. Obesity Surgery, 27(6), 1612-1621. https://doi.org/10.1007/s11695-016-2521-5
  9. Cheung, H. C., Strodl, E., Musial, J., MacLaughlin, H. L., Byrnes, A., Lewis, C. A., & Ross, L. J. (2023). Associations between diet composition, dietary pattern, and weight outcomes after bariatric surgery: A systematic review. International Journal of Obesity, 47(9), 764-790. https://doi.org/10.1038/s41366-023-01333-1
  10. Coluzzi, I., Raparelli, L., Guarnacci, L., Paone, E., Del Genio, G., le Roux, C. W., & Silecchia, G. (2016). Food intake and changes in eating behavior after laparoscopic sleeve gastrectomy. Obesity Surgery, 26(9), 2059-2067. https://doi.org/10.1007/s11695-015-2043-6
APA
Arda, G., Yılmaz, H., & Özmutlu, A. (2026). Evaluation of Dietary Quality (Healthy Eating Index-2015), Nutrient Intake and Anthropometric Measurements in Post-Bariatric Patients. Farabi Medical Journal, 5(1). https://doi.org/10.59518/farabimedj.1951014
AMA
1.Arda G, Yılmaz H, Özmutlu A. Evaluation of Dietary Quality (Healthy Eating Index-2015), Nutrient Intake and Anthropometric Measurements in Post-Bariatric Patients. Farabi Medical Journal. 2026;5(1). doi:10.59518/farabimedj.1951014
Chicago
Arda, Gülşah, Hülya Yılmaz, and Anıl Özmutlu. 2026. “Evaluation of Dietary Quality (Healthy Eating Index-2015), Nutrient Intake and Anthropometric Measurements in Post-Bariatric Patients”. Farabi Medical Journal 5 (1). https://doi.org/10.59518/farabimedj.1951014.
EndNote
Arda G, Yılmaz H, Özmutlu A (July 1, 2026) Evaluation of Dietary Quality (Healthy Eating Index-2015), Nutrient Intake and Anthropometric Measurements in Post-Bariatric Patients. Farabi Medical Journal 5 1
IEEE
[1]G. Arda, H. Yılmaz, and A. Özmutlu, “Evaluation of Dietary Quality (Healthy Eating Index-2015), Nutrient Intake and Anthropometric Measurements in Post-Bariatric Patients”, Farabi Medical Journal, vol. 5, no. 1, July 2026, doi: 10.59518/farabimedj.1951014.
ISNAD
Arda, Gülşah - Yılmaz, Hülya - Özmutlu, Anıl. “Evaluation of Dietary Quality (Healthy Eating Index-2015), Nutrient Intake and Anthropometric Measurements in Post-Bariatric Patients”. Farabi Medical Journal 5/1 (July 1, 2026). https://doi.org/10.59518/farabimedj.1951014.
JAMA
1.Arda G, Yılmaz H, Özmutlu A. Evaluation of Dietary Quality (Healthy Eating Index-2015), Nutrient Intake and Anthropometric Measurements in Post-Bariatric Patients. Farabi Medical Journal. 2026;5. doi:10.59518/farabimedj.1951014.
MLA
Arda, Gülşah, et al. “Evaluation of Dietary Quality (Healthy Eating Index-2015), Nutrient Intake and Anthropometric Measurements in Post-Bariatric Patients”. Farabi Medical Journal, vol. 5, no. 1, July 2026, doi:10.59518/farabimedj.1951014.
Vancouver
1.Gülşah Arda, Hülya Yılmaz, Anıl Özmutlu. Evaluation of Dietary Quality (Healthy Eating Index-2015), Nutrient Intake and Anthropometric Measurements in Post-Bariatric Patients. Farabi Medical Journal. 2026 Jul. 1;5(1). doi:10.59518/farabimedj.1951014