Evaluation of Nutritional Status Post Laparoscopic Sleeve Gastrectomy—5-Year Outcomes

Al-Mutawa, Aliaa; Al-Sabah, Salman; Anderson, Alfred K.; Al-Mutawa, Mohammad

doi:10.1007/s11695-017-3041-7

Cited by 62 publications

(47 citation statements)

References 41 publications

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“…The presence of hypervitaminosis of pyridoxine after surgery doubled, achieving 47.5%. Even in another study [56], authors noticed that throughout the whole population of the study, only one case of vitamin B6 deficiency was identified before surgery. On the contrary, excess data was the most remarkable (24.1%).…”

Section: The Perioperative Concentration Of Vitamins B6 B12 and Folatementioning

confidence: 92%

“…The result is in line with the findings of Aarts et al [57], Moizé et al [58], and Gehrer et al [59] who reported no cases of vitamin B6 deficiency 1, 3, and 5 years post-operatively. In contrast, excess level of pyridoxine was noticed in 38.7%, 42.6%, and 23.3% 1, 3, and 5 year post-operatively, respectively [56]. This effect might have been a result of the use of multivitamin products that included high doses of vitamin B6 in their content.…”

Section: The Perioperative Concentration Of Vitamins B6 B12 and Folatementioning

confidence: 92%

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Nutritional Deficiencies, Bariatric Surgery, and Serum Homocysteine Level: Review of Current Literature

Komorniak

Szczuko

Kowalewski³

et al. 2019

OBES SURG

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Obesity is currently one of the biggest global health problems. In the case of severe obesity, bariatric surgeries are considered to be the most important method of treatment. The 2 most commonly performed bariatric surgery procedures include Roux-en-Y gastric bypass and sleeve gastrectomy. However, these methods are not free from complications, and the most common ones (moderately long or long term) are micronutrient deficiencies. The deficiency of vitamins B6, B12, and folic acid as cofactors of the folate cycle contributes to the development of hyperhomocysteinemia. It seems that apart from nutritional factors, there are other aspects that have a significant influence on the concentration of homocysteine in blood, such as the type of conducted bariatric surgery, the post-surgical concentration of betaine and creatinine, and the clearance of methionine (i.e., the mutations of the gene that encodes the MTHFR reductase as well as other genes associated with the process of methylation, e.g., methionine synthase). Their presence might be one of the causes of the increased concentration of homocysteine after surgery despite the fact that patients take vitamin-mineral supplementation.

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Section: The Perioperative Concentration Of Vitamins B6 B12 and Folatementioning

confidence: 92%

Section: The Perioperative Concentration Of Vitamins B6 B12 and Folatementioning

confidence: 92%

Nutritional Deficiencies, Bariatric Surgery, and Serum Homocysteine Level: Review of Current Literature

Komorniak

Szczuko

Kowalewski³

et al. 2019

OBES SURG

View full text Add to dashboard Cite

show abstract

“…We observed iron deficiency, expressed in low serum ferritin levels, in seven patients (5.1%). After surgery, reduced secretion of HCl, use of proton-pump inhibitors (PPI), and faster gastric emptying may limit absorption [13,14,21,24]. Besides low absorption, reduced oral intake and intolerance to iron-rich sources such as red meat might be a cause of iron deficiency post-sleeve [14,21].…”

Section: Anemia and Iron Deficiencymentioning

confidence: 99%

“…However, short and midterm studies found that in SG patients, deficiencies are as common as in RYGB patients [9][10][11][12]. Especially deficiencies for iron, folic acid, vitamin B12, and vitamin D are frequently reported [7,[13][14][15][16][17]. Standard MVS are probably not sufficient to prevent nutritional deficiencies after SG.…”

Section: Introductionmentioning

confidence: 99%

The True Story on Deficiencies After Sleeve Gastrectomy: Results of a Double-Blind RCT

et al. 2019

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Background Since a few years, the laparoscopic sleeve gastrectomy (SG) has become the most performed bariatric operation worldwide. However, as with all bariatric procedures, SG also leads to vitamin and mineral deficiencies post-operatively and standard multivitamin supplements are probably not sufficient. Objective The present study evaluates the effectiveness of a specialized multivitamin supplement for SG patients (WLS Optimum 1.0, FitForMe, Rotterdam, the Netherlands), compared to a standard multivitamin supplement (sMVS). Design A double-blind randomized controlled trial was performed. For 12 months, patients in the intervention group received WLS Optimum, containing elevated doses of multiple vitamins and minerals. Patients in the control group were provided with sMVS, containing 100% of the recommended dietary allowance. Results In total, 139 patients were available for analysis (WLS Optimum, n = 69; sMVS, n = 70). Intention-to-treat analyses revealed more folic acid deficiencies and higher serum vitamin B1 levels in the WLS Optimum group. Per protocol analyses showed that in patients using WLS Optimum, serum folic acid and vitamin B1 levels were higher, serum PTH levels were lower, and only one patient (2.6%) was anemic compared to 11 patients (17.5%) using a sMVS (p < 0.05 for all). No differences were found in prevalence of deficiencies for iron, vitamin B12, vitamin D, and other vitamins and minerals. Conclusions This optimized multivitamin supplement only affected serum levels of folic acid, PTH and vitamin B1, and anemia rates compared to a sMVS. There is a clear need to further optimize multivitamin supplementation for SG patients. Besides, noncompliance with multivitamin supplements remains an important issue that should be dealt with. Clinical Trial Registry The study protocol was registered at the clinical trials registry of the National Institutes of Health (ClinicalTrials.gov; identifier NCT01609387).

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“…Some long-term follow-up studies demonstrated that the laparoscopic SG (LSG) procedure could induce vitamin B12 insufficiency [37]. A retrospective study showed that the level of vitamin B1 declined significantly during a 3-to 5-year follow-up period after LSG compared with that before the operation, while albumin, folate, iron, and vitamin B2 underwent insignificant variations, and vitamins B6 and B12 decreased after 6 months postoperation [38].…”

Section: Nutrition and Energy Metabolismmentioning

confidence: 99%

Potential mechanisms of sleeve gastrectomy for reducing weight and improving metabolism in patients with obesity

Huang

Ding

et al. 2019

Surgery for Obesity and Related Diseases

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Obesity is a severe medical problem endangering the health of individuals worldwide. Sleeve gastrectomy (SG), one of the most commonly performed bariatric procedures, has been widely applied to the treatment of such patients. Currently, the potential mechanisms underlying the significant weight loss and metabolic improvement after SG have been well studied. First, and most importantly, by removing a large volume of stomach, the SG directly or indirectly restricts food intake. Then, there are alterations in the absorption and metabolism of both macro-and micronutrients, which may benefit or worsen the patients' well-being. Another profound change is enhanced secretion of the satiety gut hormone and reduced secretion of the hunger hormone as a consequence of the operation. Additionally, adjustment of gastrointestinal motility, alteration in the gut microbial community, and an inflammatory response were found after surgery. Therefore, the purpose of the present review was focused on such hypotheses and to compile the accumulated facts on the physiologic mechanism of bariatric surgery so that these results can help improve the understanding of how SG produces substantial weight loss and a significant improvement in the metabolism of patients with metabolic syndrome.

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Evaluation of Nutritional Status Post Laparoscopic Sleeve Gastrectomy—5-Year Outcomes

Cited by 62 publications

References 41 publications

Nutritional Deficiencies, Bariatric Surgery, and Serum Homocysteine Level: Review of Current Literature

Nutritional Deficiencies, Bariatric Surgery, and Serum Homocysteine Level: Review of Current Literature

The True Story on Deficiencies After Sleeve Gastrectomy: Results of a Double-Blind RCT

Potential mechanisms of sleeve gastrectomy for reducing weight and improving metabolism in patients with obesity

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