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Prevention of Vitamin and Mineral Deficiencies After Bariatric Surgery: Evidence and Algorithms

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Bariatric surgery is widely accepted as first-choice treatment of morbid obesity and has also shown promising results in the treatment of diabetes and the metabolic syndrome. The number of operations each year is increasing, as well as, consequently, the urgent need for a coordinated nutritional approach, as micronutrient deficiencies occur frequently in these patients. Official guidelines on chronic use of multivitamins and minerals are, yet, unavailable in bariatric medicine. The current review provides an algorithm that supports bariatric teams to guarantee adequate nutrition after the operation.

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  1. Santry HP, Gillen DL, Lauderdale DS. Trends in bariatric surgical procedures. JAMA. 2005;294:1909–17.

    Article  PubMed  CAS  Google Scholar 

  2. Huang HY, Caballero B, Chang S, et al. Multivitamin/mineral supplements and prevention of chronic disease. Evid Rep Technol Assess (Full Rep). 2006;139:1–117.

    Google Scholar 

  3. Tang BM, Eslick GD, Nowson C, et al. Use of calcium or calcium in combination with vitamin D supplementation to prevent fractures and bone loss in people aged 50 years and older: a meta-analysis. Lancet. 2007;370:657–66.

    Article  PubMed  CAS  Google Scholar 

  4. Lot WJ, Li TY, Taylor PR, et al. Nutrition intervention trials in Linxian, China: supplementation with specific vitamin/mineral combinations, cancer incidence, and disease-specific mortality in the general population. J Natl Cancer Inst. 1993;85:1483–92.

    Article  Google Scholar 

  5. Hercberg S, Galan P, Preziosi P, et al. The SU.VI.MAX study: a randomized, placebo-controlled trial of the health effects of antioxidant vitamins and minerals. Arch Intern Med. 2004;164:2335–42.

    Article  PubMed  CAS  Google Scholar 

  6. Singh S, Kumar A. Wernicke encephalopathy after obesity surgery: a systematic review. Neurology. 2007;68:807–11.

    Article  PubMed  Google Scholar 

  7. Flancbaum L, Belsley S, Drake V, et al. Preoperative nutritional status of patients undergoing Roux-en-Y gastric bypass for morbid obesity. J Gastrointest Surg. 2006;10:1033–7.

    Article  PubMed  Google Scholar 

  8. Tucker ON, Szomstein S, Rosenthal RJ. Nutritional consequences of weight-loss surgery. Med Clin North Am. 2007;91:499–514, xii.

    Article  PubMed  CAS  Google Scholar 

  9. Navarro M, Wood RJ. Plasma changes in micronutrients following a multivitamin and mineral supplement in healthy adults. J Am Coll Nutr. 2003;22:124–32.

    PubMed  CAS  Google Scholar 

  10. Patrini C, Griziotti A, Ricciardi L. Obese individuals as thiamin storers. Int J Obes Relat Metab Disord. 2004;28:920–4.

    Article  PubMed  CAS  Google Scholar 

  11. Thornalley PJ, Babaei-Jadidi R, Al Ali H, et al. High prevalence of low plasma thiamine concentration in diabetes linked to a marker of vascular disease. Diabetologia. 2007;50:2164–70.

    Article  PubMed  CAS  Google Scholar 

  12. Tallaksen CM, Bell H, Bohmer T. Thiamin and thiamin phosphate ester deficiency assessed by high performance liquid chromatography in four clinical cases of Wernicke encephalopathy. Alcohol Clin Exp Res. 1993;17:712–6.

    Article  PubMed  CAS  Google Scholar 

  13. Harper C. Thiamine (vitamin B1) deficiency and associated brain damage is still common throughout the world and prevention is simple and safe! Eur J Neurol. 2006;13:1078–82.

    Article  PubMed  CAS  Google Scholar 

  14. Brolin RE, Leung M. Survey of vitamin and mineral supplementation after gastric bypass and biliopancreatic diversion for morbid obesity. Obes Surg. 1999;9:150–4.

    Article  PubMed  CAS  Google Scholar 

  15. Butler CC, Vidal-Alaball J, Cannings-John R, et al. Oral vitamin B12 versus intramuscular vitamin B12 for vitamin B12 deficiency: a systematic review of randomized controlled trials. Fam Pract. 2006;23:279–85.

    Article  PubMed  Google Scholar 

  16. Brolin RE, Gorman JH, Gorman RC, et al. Prophylactic iron supplementation after Roux-en-Y gastric bypass: a prospective, double-blind, randomized study. Arch Surg. 1998;133:740–4.

    Article  PubMed  CAS  Google Scholar 

  17. Nishiyama S, Irisa K, Matsubasa T, et al. Zinc status relates to hematological deficits in middle-aged women. J Am Coll Nutr. 1998;17:291–5.

    PubMed  CAS  Google Scholar 

  18. Brolin RE, LaMarca LB, Kenler HA, et al. Malabsorptive gastric bypass in patients with superobesity. J Gastrointest Surg. 2002;6:195–203.

    Article  PubMed  Google Scholar 

  19. Halverson JD. Micronutrient deficiencies after gastric bypass for morbid obesity. Am Surg. 1986;52:594–8.

    PubMed  CAS  Google Scholar 

  20. Schweitzer DH. Mineral metabolism and bone disease after bariatric surgery and ways to optimize bone health. Obes Surg. 2007;17:1–7.

    Article  Google Scholar 

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We are greatly indebted to Mrs. Nienke ten Hoor-Aukema and Niki van den Doel, nutritionists, and Mrs. Myra Danielson for the pieces of advice in writing this review. There is no commercial interest in the content of this work.

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Correspondence to Dave H. Schweitzer.

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Schweitzer, D.H., Posthuma, E.F. Prevention of Vitamin and Mineral Deficiencies After Bariatric Surgery: Evidence and Algorithms. OBES SURG 18, 1485–1488 (2008).

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