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Micronutrient and Protein Deficiencies After Gastric Bypass and Sleeve Gastrectomy: a 1-year Follow-up

Obesity Surgery volume 26, pages 785–796 (2016)Cite this article

Abstract

Background

Roux-en-Y gastric bypass (GBP) and sleeve gastrectomy (SG) have increased dramatically, potentially increasing the prevalence of nutritional deficiencies. The aim of this study was to analyze the effects of food restriction during the first year after bariatric surgery (BS) on nutritional parameters.

Methods

Twenty-two and 30 obese patients undergoing GBP and SG were prospectively followed at baseline and 3, 6, and 12 months after BS (N = 14 and N = 19 at T12). We evaluated food intake and nutrient adequacy (T0, T3, T12), as well as serum vitamin and mineral concentration (T0, T3, T6, T12).

Results

At baseline, GBP and SG patients had similar clinical characteristics, food intake, nutrient adequacy, and serum concentration. The drastic energy and food reduction led to very low probabilities of adequacy for nutrients similar in both models (T3, T12). Serum analysis demonstrated a continuous decrease in prealbumin during the follow-up, indicating mild protein depletion in 37 and 38 % of GBP patients and 57 and 52 % of SG patients, respectively, at T3 and T12. Conversely, despite the low probabilities of adequacy observed at T3 and T12, systematic multivitamin and mineral supplementation after GBP and SG prevented most nutritional deficiencies.

Conclusions

GBP and SG have comparable effects in terms of energy and food restriction and subsequent risk of micronutrient and protein deficiencies in the first year post BS. Such results advocate for a cautious monitoring of protein intake after GPB and SG and a systematic multivitamin and mineral supplementation in the first year after SG.

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Acknowledgments

The authors wish to thank Ms. Agathe Arlotti for the coordination of programs on bariatric surgery (BARICAN program), Ms. Valentine Lemoine for her help in the follow-up of the patients, and Dr. Florence Marchelli who contributed to clinical and biological database constitution.

Financial Support

This project is supported by the « Contrat de Recherche Clinique » from the Health Ministry (CRC Fibrota P100503 – IDRCB 2011-A00759-32, recorded on the clinical trial website (NCT: NCT01655017)), as well as by the European Union’s Seventh Framework Programme for research, technological development and demonstration under grant agreement HEALTH-F4-2012-305312 (Metacardis) and the National Agency of Research (Investissement D’Avenir, ANR-10-IAHU-05). JAW received a grant from Institut Appert and from Nestlé research.

Conflict of Interest

The authors declare that they have no competing interests.

Compliance with Ethical Standards

All procedures performed in this clinical protocol involving human participants (number P100503 – IDRCB 2011-A00759-32) and which was recorded on the clinical trial website (NCT: NCT01655017) were in accordance with the ethical standards of the Hotel-Dieu hospital ethics committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

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Author notes

    Affiliations

    1. Institute of Cardiometabolism and Nutrition, ICAN, Pitié-Salpêtrière Hospital, Nutrition Department, Assistance Publique-Hôpitaux de Paris, 75013, Paris, France

      Eric O. Verger, Judith Aron-Wisnewsky, Maria Carlota Dao, Brandon D. Kayser, Jean-Michel Oppert & Karine Clément

    2. INSERM, UMR_S U1166, NutriOmics team, 75013, Paris, France

      Eric O. Verger, Judith Aron-Wisnewsky, Maria Carlota Dao, Brandon D. Kayser & Karine Clément

    3. UPMC University Paris 06, UMR_S 1166 I, ICAN, Nutriomics team, Sorbonne Universités, 75005, Paris, France

      Judith Aron-Wisnewsky & Karine Clément

    4. Visceral Surgery Department, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, 92100, Boulogne-Billancourt, France

      Jean-Luc Bouillot

    5. Visceral Surgery Department, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris, 75013, Paris, France

      Adriana Torcivia

    Authors
    1. Eric O. Verger
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    Correspondence to Judith Aron-Wisnewsky or Karine Clément.

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    Eric O. Verger and Judith Aron-Wisnewsky contributed equally to this work.

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    Verger, E.O., Aron-Wisnewsky, J., Dao, M.C. et al. Micronutrient and Protein Deficiencies After Gastric Bypass and Sleeve Gastrectomy: a 1-year Follow-up. OBES SURG 26, 785–796 (2016). https://doi.org/10.1007/s11695-015-1803-7

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    • DOI: https://doi.org/10.1007/s11695-015-1803-7

    Keywords

    • Bariatric surgery
    • Roux-en-Y gastric bypass
    • Sleeve gastrectomy
    • Protein deficiency
    • Multivitamin and mineral supplementation