Abstract
Background
Dietary carotenoids have attracted a great deal of attention due to their potential clinical relevance in conditions such as age-related maculopathy, osteoporosis, cardiovascular disease, and cancer. Surgical procedures have become the primary treatment of severe obesity, although nutrient deficiencies are common and long-term metabolic sequelae remain unknown. Thus, our aim was to assess the carotenoid status in serum of subjects after obesity surgery.
Methods
We evaluated the status of lutein, zeaxanthin, α- and β-cryptoxanthin, lycopene, α- and β-carotene, and fat-soluble vitamins by a quality-controlled high-performance liquid chromatography method in serum of 53 patients. Subjects were consecutively included as they were monitored for nutritional status after Roux-en-Y gastric bypass (RYGBP) or biliopancreatic diversion (BPD). Average follow-up time was 18 and 14 months for each protocol, respectively.
Results
After obesity surgery, a consistent and continuous decline in all carotenoids to almost undetectable levels occurs, especially in those who underwent BPD diversion who, on average, displayed serum levels about one half to one third of those found in RYGBP patients.
Conclusion
The hypocarotenemia observed after bariatric surgery may compromise the availability of carotenoids to tissues and the vitamin A status, reducing the fat-soluble antioxidant capacity and constituting an additional risk factor for several clinical conditions. Given the emerging role of carotenoids in disease prevention, dietary advice on carotenoid-rich and fortified foods or the use of supplements in these patients should be considered.
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References
Elder K, Wolfe BM. Bariatric surgery: a review of procedures and outcomes. Gastroenterology. 2007;132:2253–71.
Alvarez-Leite JL. Nutrient deficiencies secondary to bariatric surgery. Curr Opin Clin Nutr Metab Care. 2004;7(5):569–75.
Ledoux S, Msika S, Moussa F, et al. Comparison of nutritional consequences of conventional therapy of obesity, adjustable gastric banding and gastric bypass. Obes Surg. 2006;16(8):1041–9.
Bloomberg RD, Fleishman A, Nalle J, et al. Nutritional deficiencies following bariatric surgery: what have we learned? Obes Surg. 2005;15(2):145–54.
Johnson J, Maher J, Samuel I, et al. Effects of gastric bypass procedures on bone mineral density, calcium, parathyroid hormone and vitamin D. J Gastrointest Surg. 2005;9:1106–11.
Guedea ME, Arribas del Amo D, Solanas JA, et al. Results of biliopancreatic diversion alter five years. Obes Surg. 2006;14(6):766–72.
Lee WB, Hamilton SM, Harris JP, et al. Ocular complications of hypovitaminosis A after bariatric surgery. Ophthalmology. 2005;112(6);1031–4.
Slater GH, Ren CJ, Siegel N, et al. Serum fat-soluble vitamin deficiency and abnormal calcium metabolism after malabsorptive bariatric surgery. J Gastrointest Surg. 2004;8(1):48–55.
Bendich A, Olson JA. Biological actions of carotenoids. FASEB J. 1989;3:1927–32.
Russell R. The multifunctional carotenoids: insights into their behaviour. J Nutr. 2006;136;1690S–2692S.
Granado F, Olmedilla B, Blanco I. Nutritional and clinical relevance of lutein in human health. Br J Nutr. 2003;90:487–502.
Stahl W, Sies H. Bioactivity and protective effects of natural carotenoids. Biochim Biophys Acta. 2005;1740;101–7.
Yamaguchi M. Regulatory mechanisms of food factors in bone metabolism and prevention of osteoporosis. Yakugaku Zasshi. 2006;126(11):1117–37.
Fraser M, Lee AH, Binns CW. Lycopene and prostate cancer: emerging evidence. Expert Rev Anticancer Ther. 2005;5(5):847–54.
Rao LG, Mackinnon ES, Josse RG, et al. Lycopene consumption decreases oxidative stress and bone resorption markers in postmenopausal women. Osteoporos Int. 2007;18:109–15.
Johnson EJ. Obesity, lutein metabolism and age-related macular degeneration: a web of connections. Nutr Rev. 2005;63(1):9–15.
Rock CL, Swenseid ME. Plasma carotenoid levels in anorexia nervosa and in obese patients. Methods Enzymol. 1993;214:116–24.
Olmedilla B, Granado F, Gil-Martínez E, et al. Reference levels of retinol, α-tocopherol and main carotenoids in serum of control and insulin-dependent diabetic Spanish subjects. Clin Chem. 1997;43(6):1066–71.
Institute of Medicine. Carotenoids. In: Dietary reference intakes for vitamin C, vitamin E, selenium, and carotenoids. Washington, D.C.: National Academy Press; 2000. p. 325–83.
Bretón I, Cuerda C, Camblor M, et al. Effects of surgery for morbid obesity on serum retinol, a-tocopherol and main carotenoid levels: preliminary results from a long-term follow-up study (Abstract). Proc Nutr Soc. 2000;59:A133.
Bischoff-Ferrari HA, Giovannucci E, Willet W, et al. Estimation of optimal serum concentrations of 25-hydroxyvitamin D for multiple health outcomes. Am J Clin Nutr. 2006;84:18–28.
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The authors are indebted to Martha Messman for preparing the manuscript.
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Granado-Lorencio, F., Herrero-Barbudo, C., Olmedilla-Alonso, B. et al. Hypocarotenemia After Bariatric Surgery: A Preliminary Study. OBES SURG 19, 879–882 (2009). https://doi.org/10.1007/s11695-008-9476-0
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DOI: https://doi.org/10.1007/s11695-008-9476-0