Impact of Deficient Nutrition in Bone Mass After Bariatric Surgery

Abstract

Background: Essential nutrients are considered for the prevention of the bone loss that occurs after bariatric surgery. Aim: Evaluate nutrients involved in bone metabolism, and relate to serum concentrations of calcium, vitamin D, and parathyroid hormone, and the use of supplements and sun exposure on the bone mass of patients who had undergone gastric bypass surgery. Methods: An observational study, with patients who had undergone the surgery 12 or more months previously, operated group (OG), compared to a control group (CG). Results: Were included 56 in OG and 27 in the CG. The mean age was 36.4±8.5 years. The individuals in the OG, compared to CG, consumed inadequate amounts of protein and daily calcium. The OG had a higher prevalence of low sun exposure, lower levels of 25OH Vitamin D (21.3±10.9 vs. 32.1±11.8 ng/dl), and increased serum levels of parathyroid hormone (68.1±32.9 vs. 39.9±11.9 pg/ml, p<0.001). Secondary hyperparathyroidism was present only in the OG (41.7%). The mean lumbar spine bone mineral density was lower in the OG. Four individuals from the OG had low bone mineral density for chronological age, and no one from the CG. Conclusion: The dietary components that affect bone mass in patients undergoing bariatric surgery were inadequate. The supplementation was insufficient and the sun exposure was low. These changes were accompanied by secondary hyperparathyroidism and a high prevalence of low bone mass in lumbar spine in these subjects.

The Relation Among the Physical Activity Level During Leisure Time, Anthropometry, Body Composition, and Physical Fitness of Women Underwent of Bariatric Surgery and an Equivalent Group With No Surgery

“…Studies previously demonstrated that there is a reduction on the skeletal muscle mass and bone mass through the years after the bariatric surgery. This fact may cause complications such as the decrease of the daily energy expenditure and impacts on the bone metabolism 5 , 8 , 31 , and consequently a decrease of the physical activity indexes; however, this last influence was not observed in the present study.…”

Vitamin D Deficiency and Paratohommonium Increase in Late Postoperative Gastric Bypass in Roux-en-Y

“…Regardless of the metabolic benefits stemming from gastric bypass 5 , many studies 11,14,19,26,27,31 have reported the impact of nutritional deficiencies after gastric bypass, including its effects on bone metabolism 1 , 4 , 7 , 8 , 10 , 17 , 18 , 22 , 28 , 30 , 33 , 34 .…”

Bariatric surgery and long-term nutritional issues

“…Bariatric surgery could impact bone metabolism and induce significant changes, such as decreased mechanical loading, calcium/vitamin D malabsorption with secondary hyperparathyroidism, nutritional deprivations, changes in fat mass and alterations in fat- and gut-derived hormones[ 25 - 27 ].…”