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Nutrition

Nutritional guidance is essential post-surgery

Study sought to evaluate the dietary intake of macro- and micronutrients in patients before and after RYGB

The intake of macronutrients increases three months post-surgery but the micronutrient intake remains at a ‘worryingly low level’ and it is essential that nutritional guidance is provided to patients following bariatric surgery, according to researchers from Belgium.

The investigators from Leuven University College, University Hospitals Leuven and KU Leuven/University Hospitals Leuven, Leuven, Belgium, said that although bariatric surgery remains the sole medical intervention that achieves considerable and sustained weight loss, it is associated with nutritional deficiencies. As a result, their study sought to evaluate the dietary intake of macro- and micronutrients in patients before and after Roux-en-Y gastric bypass (RYGB).

Reporting the findings during a poster presentation at the Proceedings of the Fourth Belgian Nutrition Society Symposium 2014, Brussels, the prospective observational study recruited 32 patients who were asked to compete a dietary record of two non-consecutive days before RYGB and one and three months after RYGB. Intake of macronutrients and micronutrients was calculated for the different time-points.

They report that intake of macro- and micronutrients is markedly decreased one month after RYGB. At three months post-surgery, the intake of macronutrient increases (Table 1) but the micronutrient intake remains identical at a worryingly low level (Table 2).

Table 1: Intake of macronutrients at different time-points, shown as mean±SD.

n=22

Intake pre-RYGB

Intake 1 month post-RYGB

Intake 3 months post-RYGB

Significance


Carbohydrates (g)

245.2±72.4

81.8±39.1

110.9±51.42

1,2


Proteins (g)

87.3±23.8

37.2±16.6

48.0±14.4

1,2,3


Fat (g)

92.2±40.4

20.5±12.6

36.3±16.2

1,2,3


1 p<0.01:pre-op vs post-op 1 month; 2 p<0.01:pre-op vs post-op 3 months; 3 p<0.01:post-op 1 month vs post-op 3 months

Table 2: Intake of micronutrients at different time-points, shown as mean±SD.

Intake pre-RYGB (32 patients)

Intake 1 month post-RYGB (28 patients)

Intake 3 months post-RYGB (26 patients)

Significance


Ca (mg)

970.4±519.6

638.4±287.9

695.1±352.3


Fe (mg)

12.6±3.7

5±2.9

6.0±1.8

1,2


Cu (mg)

2.1±1.5

1.0±0.9

4.9±18.6


Zn (mg)

46.6±92.1

10.2±21.1

6.6±3.7


Vitamin A (µg)

962.8±405.2

721.5±490.0

787.5±716.6


Vitamin B1 (mg)

1.7±0.7

0.6±0.3

0.8±0.3

1,2


Vitamin B12 (µg)

5.4±2.5

2.3±1.5

3.3±1.8

1,2


Vitamin C (mg)

138.9±83.8

70.3±56.7

85.1±52.2

1,2


Vitamin D (µg)

8.4±5.1

5.2±3.3

4.2±3.2


1 p<0.01:pre-op vs post-op 1 month; 2 p<0.01:pre-op vs post-op 3 months; 3 p<0.01:post-op 1 month vs post-op 3 months

“Our data clearly suggest that nutritional guidance is essential following bariatric surgery,” the conclude.

The study was published in the Achives of Public Health, as a part of an educational supplement 'Proceedings of the Fourth Belgian Nutrition Society Symposium 2014: Genes and nutrition, is personalised nutrition the next realistic step' from the meeting.

Please click here, to view the supplement.

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