Nutritional and Protein Deficiencies in the Short Term following Both Gastric Bypass and Gastric Banding

• Published in: PloS one Vol. 11; no. 2; p. e0149588
• Main Authors: Aron-Wisnewsky, Judith, Verger, Eric O, Bounaix, Carine, Dao, Maria Carlota, Oppert, Jean-Michel, Bouillot, Jean-Luc, Chevallier, Jean-Marc, Clément, Karine
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 18-02-2016; Public Library of Science (PLoS)
• Subjects: Adequacy; Adult; Analysis; Anthropometry; Banding; Bariatric Surgery - adverse effects; Biology and Life Sciences; Bypasses; Comorbidity; Diagnosis; Diet; Dietary Supplements; Energy Intake; Family medical history; Feeding Behavior; Female; Ferritins - blood; Food; Food and Nutrition; Food availability; Food intake; Gastric bypass; Gastric Bypass - adverse effects; Gastrointestinal surgery; Health aspects; Hemoglobins - metabolism; Hospitals; Humans; Hypoglycemia; Iron; Iron - blood; Iron deficiency; Laparoscopy; Life Sciences; Malnutrition; Malnutrition - blood; Malnutrition - etiology; Medicine and Health Sciences; Middle Aged; Minerals; Minerals - metabolism; Monitoring; Nutrient concentrations; Nutrient deficiency; Nutrients; Nutrition; Nutritional status; Obesity; Patients; Physical Sciences; Protein Deficiency - blood; Protein Deficiency - etiology; Proteins; Risk factors; Studies; Surgery; Thiamine; Time Factors; Vitamin deficiency; Vitamins; Vitamins - metabolism; Weight control; United States; France
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0149588

The number of morbidly obese patients undergoing bariatric surgery (BS) has increased dramatically in recent years. Therefore, monitoring food intake and its consequences in terms of nutritional status is necessary to prevent nutritional deficiencies. The aim of this study was to analyze the effect of food restriction on nutritional parameters in the short-term (≤3 months) period after BS in morbid obesity.
In a prospective study, we followed 22 obese women who underwent Roux-en-Y gastric bypass (GBP) or adjustable gastric banding (AGB) at baseline (T0) and 1 (T1) and 3 (T3) months after surgery. We evaluated food intake, nutrient adequacy and serum concentrations of vitamins and minerals known to be at risk for deficiency following BS.
Before surgery, we observed suboptimal food intakes, leading to a risk of micronutrient deficiencies. Serum analysis confirmed nutritional deficiencies for iron and thiamine for 27 and 23% of the patients, respectively. The drastic energy and food reduction seen in the short term led to very low probabilities of adequacy for nutrients equivalent across both surgeries. Serum analysis demonstrated a continuous decrease in prealbumin during the follow-up, indicating mild protein depletion in 21 and 57% of GBP patients and 50 and 63% of AGB patients, respectively, at T1 and T3. Regarding vitamins and minerals, systematic supplementation after GBP prevented most nutritional deficiencies. By contrast, AGB patients, for whom there is no systematic supplementation, developed such deficiencies.
Our results suggest that cautious monitoring of protein intake after BS is mandatory. Furthermore, AGB patients might also benefit from systematic multivitamin and mineral supplementation at least in the short term.