Bariatric Nutrition Guidelines for the Indian Population

Abstract

Background

Bariatric surgery numbers have seen a sharp rise in India in the last decade. A country known for its undernourished population has seen economic growth and with it, greater influence of western culture and foods. The obesity epidemic is on the rise here and India is one of the 10 most obese nations of the world being second only to China in the number of type 2 diabetes. Nutritionists in India often rely on recommendations and guidelines meant for the Caucasian population. Religious and cultural practices influence the dietary habits and patterns of the Indian population to a great extent; because of which the nutritional requirements are very different. This document was put together with an aim to provide nutritionists with recommendations on how to manage the Indian bariatric patient.

Methods

A bariatric nutrition round table meeting was initiated by the Centre for Obesity and Digestive Surgery (CODS) to bring together experts in the field of bariatric nutrition to review current data on nutritional deficiencies in the morbid obese and existing post-operative deficiencies and to formulate nutritional recommendations for bariatric/metabolic surgery specific to patients from India.

Results

Percentage of nutritional deficiencies and reasons for the same were identified among the Indian population and recommendations were made to suit this particular population.

Conclusion

It is recommended that all patients undergo compulsory pre-operative nutritional counseling and nutritional investigations and that nutritional follow-up be continued lifelong. In addition, long-term implications like hypoglycemia, dumping syndrome, sugar cravings, and weight regain, need to be picked up and managed efficiently. Most importantly, post-operative supplementation is a must irrespective of type of surgery.

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Conflict of Interest

The authors declare that they have no competing interests.

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Correspondence to Carlyne Remedios.

Appendix

Appendix

• Dr. Cynthia Buffington

PhD, from The Metabolic Medicine and Surgery Institute, Florida Hospital Celebration Health

• Dr. John Dixon

Head of Clinical Research, Centre for Obesity Research and Education and Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia

• Ms. Wan-Ling Hsu

Nutritionist, Bariatric and Metabolic International Surgery Center, E-Da Hospital, Taiwan

• Ms. Huang, Ya-we

Case manager, Bariatric and Metabolic International Surgery Center, E-Da hospital, Taiwan

• Ms. Carlyne Remedios

Accredited practicing dietician (APD) from Dietitians association of Australia

Senior Nutritionist – Centre For Obesity and Digestive Surgery, Mumbai, India

• Dr. C Anjali Devi

Visiting professor Osmania University, Hyderabad, India

• Dr. Jagmeet Madan

Principal and Professor, Department of Food and Nutrition at SVT College of Home Science, SNDT Women’s University, Mumbai, India

Mumbai President, Indian Dietetics Association, Mumbai Chapter

• Ms. P. Aslesha

Assistant Professor, Department Food Science and Nutrition, Osmania University, Hyderabad, India

• Dr. Poonam Shah

Founder and Director of Laparo-Obeso Centre

Bariatric Physician, Ruby Hall Obesity Clinic, Pune

• Dr. Bhaskarachary

Scientist ‘C’ Division of Molecular Biology, National Institute of Nutrition, Hyderabad, India

National Vice President, Indian Dietetic Association

• Ms. Ritika Sammadar

HOD Dietetics, Max Healthcare, New Delhi

• Dr. Janaki Srinath

Hyderabad President, Indian Dietetics Association, Andhra Pradesh Chapter

Vice President AIAARO (All India Association for Advancing Research in Obesity)

• Ms. Neha Dhulla

Bariatric Nutritionist, Centre for Obesity and Digestive Surgery

• Ms. Shilpa Dhar

Bariatric Nutritionist, Centre for Obesity and Digestive Surgery

Certified Diabetic Educator

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Remedios, C., Bhasker, A.G., Dhulla, N. et al. Bariatric Nutrition Guidelines for the Indian Population. OBES SURG 26, 1057–1068 (2016). https://doi.org/10.1007/s11695-015-1836-y

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Keywords

  • Bariatric nutrition
  • Indian
  • Nutritional recommendations
  • Supplementation
  • Deficiency
  • Morbid obesity