Bottom line?
A study just published in the May issue of
the American Journal of Clinical Nutrition shows that the majority of
gastric bypass patients cannot maintain their nutritional health on a
basic multivitamin supplement. The study followed 137 gastric bypass
patients for two years.
By the end of year one, 59% of the
participants required additional supplements and by the end of year
two, this number had increased to 98%.
The most common
additional supplements needed were B12, folic acid, calcium, iron and
vitamin D. Much less commonly, they identified deficiency of thiamine,
zinc, magnesium and B6. The authors concluded that basic multivitamins
are not effective at preventing deficiency in gastric bypass, and
typical supplementation to keep a gastric bypass patient health
averages about $420.00/year when additional nutrients are accounted
for.
They also encouraged further study and the use of routine post-operative labs to assess nutritional status.
Source:
American Journal of Clinical Nutrition, Vol. 87, No. 5, 1128-1133,
May 2008
© 2008 American Society for Nutrition
Nutritional deficiencies after Roux-en-Y gastric bypass for morbid obesity often cannot be prevented by standard multivitamin supplementation1,2
1 From the Division of Endocrinology, Diabetology, and Metabolism (CG, RCG, and VG) and the Department of Visceral Surgery (MS), Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
Background: Despite the increasing use of Roux-en-Y gastric bypass (RYGBP) in the treatment of morbid obesity, data about postoperative nutritional deficiencies and their treatment remain scarce.
Objective: The aim of this study was to evaluate the efficacy of a standard multivitamin preparation in the prevention and treatment of nutritional deficiencies in obese patients after RYGBP.
Design: This was a retrospective study of 2 y of follow-up of obese patients after RYGBP surgery. Between the first and the sixth postoperative months, a standardized multivitamin preparation was prescribed for all patients. Specific requirements for additional substitutive treatments were systematically assessed by a biologic workup at 3, 6, 9, 12, 18, and 24 mo.
Results: A total of 137 morbidly obese patients (110 women and 27 men) were included. The mean (±SD) age at the time of surgery was 39.9 ± 10.0 y, and the body mass index (in kg/m2) was 46.7 ± 6.5. Three months after RYGBP, 34% of these patients required at least one specific supplement in addition to the multivitamin preparation. At 6 and 24 mo, this proportion increased to 59% and 98%, respectively. Two years after RYGBP, a mean amount of 2.9 ± 1.4 specific supplements had been prescribed for each patient, including vitamin B-12, iron, calcium + vitamin D, and folic acid. At that time, the mean monthly cost of the substitutive treatment was $34.83.
Conclusion: Nutritional deficiencies are very common after RYGBP and occur despite supplementation with the standard multivitamin preparation. Therefore, careful postoperative follow-up is indicated to detect and treat those deficiencies.
