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

PLoS One. 2016 Feb 18;11(2):e0149588. doi: 10.1371/journal.pone.0149588. eCollection 2016.

Abstract

Background: 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.

Method: 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.

Results: 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.

Conclusions: 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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anthropometry
  • Bariatric Surgery / adverse effects*
  • Diet
  • Dietary Supplements
  • Energy Intake
  • Feeding Behavior
  • Female
  • Ferritins / blood
  • Gastric Bypass / adverse effects*
  • Hemoglobins / metabolism
  • Humans
  • Iron / blood
  • Malnutrition / blood
  • Malnutrition / etiology*
  • Middle Aged
  • Minerals / metabolism
  • Protein Deficiency / blood
  • Protein Deficiency / etiology*
  • Time Factors
  • Vitamins / metabolism

Substances

  • Hemoglobins
  • Minerals
  • Vitamins
  • Ferritins
  • Iron

Grants and funding

This project has received funding from the European Union’s Seventh Framework Programme for research, technological development and demonstration under grant agreement HEALTH-F4-2012-305312 (Metacardis). It is also supported by the « Programme Hospitalier de Recherche Clinique » from Health ministry (PHRC Microbaria AOM10285/ P100111). JAW received a grant from Institut Appert and from Nestlé research. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.