Can Composite Nutritional Supplement Based on the Current Guidelines Prevent Vitamin and Mineral Deficiency After Weight Loss Surgery?
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Nutritional deficiencies occur after weight loss surgery. Despite knowledge of nutritional risk, there is little uniformity of postoperative vitamin and mineral supplementation. The objective of this study was to evaluate a composite supplement based on the clinical practice guidelines proposed in 2008 regarding vitamin and mineral supplementation after Roux-en-Y gastric bypass. The composite included iron (Fe) and calcium as well.
A retrospective chart review of 309 patients undergoing laparoscopic Roux-en-Y gastric bypass (LRYGB) was evaluated for the development of deficiencies in iron and vitamins A, B1, B12, and D. Patients were instructed to take a custom vitamin and mineral supplement that was based on society-approved guidelines. The clinical practice guidelines were modified to include 1600 international units (IU) of vitamin D3 instead of the recommended 800 IU.
The compliant patients’ deficiency rates were significantly lower than those of the noncompliant patients for iron (p = 0.001), vitamin A (p = 0.01), vitamin B12 (p ≈ 0.02), and vitamin D (p < 0.0001). Women’s menstrual status did not significantly influence the development of iron deficiency.
Use of a composite based on guidelines proposed by the AACE, TOS, and the ASMBS appears to be effective for preventing iron and vitamins A, B1, B12, and D deficiencies in the LRYGB patients during the first postoperative year. Separation of calcium and Fe does not need to be mandatory. Even with simplification, compliance is far from universal.
KeywordsVitamin supplementation Gastric bypass Weight loss surgery Nutritional guidelines
The authors would like to acknowledge and thank the contribution of B. Alden Starnes PhD for the statistical analysis of the data.
Conflict of Interest
SB is the owner of Bari Life bariatric supplements. He also reports personal fees from Ethicon Endo-surgery Inc.
RG, KC, and JC declare no conflicts of interest.
MR is a teaching consultant for Johnson & Johnson Incorporated and Covidien Ltd. where he receives compensation. He is also in the scientific advisory board at SurgiQuest and ValenTx and has stocks options in them.
All procedures performed in this study were according to the standard clinical protocol. IRB approval was obtained prior to data collection.
For this type of study, formal consent is not required.
- 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. Surg Obes Relat Dis. 2013;9(2):159–91.CrossRefPubMedGoogle Scholar
- 15.Jaques J. Micronutrition for the weight loss surgery patient. Edgemont, PA: Matrix Medical Communications. 2006:p. 91.Google Scholar
- 18.Lonnerdal B. Does a high dietary intake of calcium adversely affect iron status in humans? Scand J Nutr. 1999;43(340):82–4.Google Scholar