Nutritional Deficiencies 3 Years After Sleeve Gastrectomy Can Be Limited by a Specialized Multivitamin Supplement

Obes Surg. 2022 Nov;32(11):3561-3570. doi: 10.1007/s11695-022-06256-w. Epub 2022 Aug 26.

Abstract

Purpose: Lifelong daily multivitamin supplementation is highly recommended after sleeve gastrectomy (SG). Based on previous research, a specialized multivitamin supplement (MVS) for SG patients was developed and optimized (WLS Optimum 1.0 and 2.0). This study presents its mid-term effectives and compares micronutrient status of SG patients using this specialized MVS to users of standard MVS (sMVS) and non-users of multivitamin supplementation during the first three years post-surgery.

Materials and methods: Of the 226 participants that were included at baseline, yearly follow-up blood tests were completed by 193 participants (85%) at 12 months, 176 participants (78%) at 24 months, and 140 participants (62%) at 36 months of follow-up. At each time point, participants were divided into four groups: (1) Optimum 1.0, (2) Optimum 2.0, (3) sMVS, and (4) non-users. Serum concentrations (linear mixed-effects models) and the prevalence of micronutrient deficiencies (chi-square tests) during follow-up were compared between the groups.

Results: Users of specialized MVS (Optimum 1.0 and 2.0) had higher serum concentrations of hemoglobin, folic acid, and vitamin D compared to sMVS users and non-users during follow-up. Serum concentrations of vitamin B12 and (corrected) calcium were also higher in specialized MVS users than in non-users. Overall, fewer deficiencies for folic acid and vitamin D were observed in the Optimum groups.

Conclusion: Although the perfect multivitamin supplement for all SG patients does not exist, WLS Optimum was more effective in sustaining normal serum concentrations than standard, over-the-counter supplementation. Non-users of MVS presented with most micronutrient deficiencies and will evidently develop poor nutritional status on the longer term.

Keywords: Bariatric Surgery; Deficiencies; Metabolic Surgery; Micronutrients; Minerals; SG; Sleeve Gastrectomy; Supplementation; Vitamins.

MeSH terms

  • Dietary Supplements
  • Folic Acid / therapeutic use
  • Gastrectomy
  • Humans
  • Malnutrition* / surgery
  • Micronutrients
  • Obesity, Morbid* / surgery
  • Vitamin D
  • Vitamins / therapeutic use

Substances

  • Vitamins
  • Micronutrients
  • Vitamin D
  • Folic Acid