Does Bariatric Surgery Cause Vitamin A, B1, C or E Deficiency? A Systematic Review
The restrictive and/or malabsorptive nature of bariatric surgery may increase the risk for micronutrient deficiencies. This systematic review aimed to identify and critique the evidence for vitamin A, B1, C or E deficiencies associated with bariatric surgery.
This review utilised PRISMA and MOOSE frameworks with NHMRC evidence hierarchy and the American Dietetic Association bias tool to assess the quality of articles.
Twenty-one articles were included and once critiqued all studies were of level IV grade and neutral or negative in quality. The relevance of measuring micronutrient supplementation and inflammatory markers for validity of serum vitamins is absent within the literature.
Future research is needed to investigate the risk of deficiency for these procedures with focus on confounders to serum micronutrients.
KeywordsBariatric surgery Micronutrient Vitamin Mineral Deficiency
This review was funded by the Health Practitioners Research Scheme, Queensland Health and the Royal Brisbane and Women’s Hospital Postgraduate Scholarship, Queensland Health.
Compliance with Ethical Standards
Conflict of Interest
Ms. Lewis has no conflict of interest to declare. Dr. de Jersey has no conflict of interest to declare. Dr. Hopkins reports personal fees from Johnson & Johnson and Medtronic, outside of this submitted work. Dr. Hickman has no conflict of interest to declare. Ms. Osland has no conflict of interest to declare.
This article does not contain any studies with human participants or animals performed by any of the authors.
Informed consent does not apply in this study.
- 1.Statistics ABo. National Health Survey: First Results, 2014-15. Australian Bureau of Statistics: Canberra, Australia; 2015.Google Scholar
- 3.Australian Institute of Health and Welfare. Australia’s health 2014. Canberra: AIHW; 2014.Google Scholar
- 5.Australian Institute of Health and Welfare. Weight loss surgery in Australia Canberra: AIHW; 2010.Google Scholar
- 6.Medicine SoPHaP. Bariatric Surgery Registry. Victoria, Australia: MONASH University & Obesity Surgery Society of Australia and New Zealand; 2016.Google Scholar
- 7.Lim RB, Jones DJ, Chen W. Bariatric procedures for the management of severe obesity: Descriptions2016. Available from: https://www.uptodate.com/contents/bariatric-procedures-for-the-management-ofsevere-obesitydescriptions?source=search_result&search=Bariatric%20procedures%20for%20the%20management%20of%20severe%20obesity:%20Descriptions&selectedTitle=1~150.
- 8.Mechanick JI, Youdim A, Jones DB, et al. Clinical practice guidelines for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient-2013 update: Cosponsored by American association of clinical endocrinologists, the obesity society, and American society for metabolic & bariatric surgery. Obesity. 2013;21(SUPPL. 1):S1–S27.CrossRefPubMedGoogle Scholar
- 9.Parrott J, Frank L, Rabena R, et al. American Society for Metabolic and Bariatric Surgery Integrated Health Nutritional Guidelines for the Surgical Weight Loss Patient 2016 Update: Micronutrients. Surg Obes Relat Dis. 2017;13(5):727–41. https://doi.org/10.1016/j.soard.2016.12.018.CrossRefPubMedGoogle Scholar
- 35.Dogan K, Aarts EO, Koehestanie P, et al. Optimization of vitamin suppletion after Roux-en-Y gastric bypass surgery can lower postoperative deficiencies: a randomized controlled trial. Medicine (Baltimore). 2014;93(25):e169. https://doi.org/10.1097/MD.0000000000000169.CrossRefPubMedCentralPubMedGoogle Scholar
- 36.National Health and Medical Research Council AGDoHaA, New Zealand Ministry of Health. Nutrient Reference Values for Australia and New Zealand. Including Recommended Dietary Intakes [Internet]. 2006.Google Scholar
- 37.Sabliov C, Chen H, Yada RY. Nanotechnology and functional foods effective delivery of bioactive ingredients / edited by Cristina M. Sabliov, Hongda Chen, Rickey Y. Yada. Chichester, West Sussex: John Wiley & Sons, Inc.; 2015.Google Scholar
- 38.Kushner RF, Cummings S, Herron DM. Bariatric Surgery: Postoperative nutritional management: UpToDate; 2017 [updated 10/10/2017; cited 2018 5th Feb].Google Scholar
- 39.Pazirandeh S, Burns DL. Overview vitamin E: UpToDate; 2016.Google Scholar
- 44.World Health Organisation. Serum retinol concentrations for determining the prevalence of vitamin A deficiency in populations. 2011.Google Scholar
- 45.Weise Prinzo Z, Organization WH. Scurvy and its prevention and control in major emergencies. 1999.Google Scholar
- 46.Weise Prinzo Z, Organization WH. Thiamine deficiency and its prevention and control in major emergencies. 1999.Google Scholar
- 49.Organization WH. C-reactive protein concentrations as a marker of inflammation or infection for interpreting biomarkers of micronutrient status. 2014.Google Scholar