Obesity is associated with reduced gut microbial diversity and a high rate of micronutrient deficiency. Bariatric surgery, the therapy of choice for severe obesity, produces sustained weight loss and improvements in obesity-related comorbidities. Also, it significantly alters the gut microbiota (GM) composition and function, which might have an important impact on the micronutrient status as GM is able to synthesize certain vitamins, such as riboflavin, folate, B12, or vitamin K2. However, recent data have reported that GM is not fully restored after bariatric surgery; therefore, manipulation of GM through probiotics represents a promising therapeutic approach in bariatric patients. In this review, we discuss the latest evidence concerning the relationship between obesity, GM and micronutrients, the impact of bariatric surgery on GM in relation with micronutrients equilibrium, and the importance of the probiotics’ supplementation in obese patients submitted to surgical treatment.

Early initiation of breastfeeding (EIBF), defined as putting newborns to the breast within 1 h of birth, may have important benefits for both infant and mother. The aim of this study was to assess EIBF practices and its determinants in northwestern Romania. This cross-sectional study was conducted from March to June 2019, based on a sample of 1399 mothers of children aged less than 24 months. The sample was recruited from the community, from 29 cities and 41 communes distributed across the six counties of the northwestern region of Romania. Mothers responded by face-to-face interviews to a structured questionnaire. Multivariate logistic regression was used to identify factors independently associated with EIBF. Only 24.3% of the mothers initiated breastfeeding within 1 h of birth. Delivering at a private hospital (adjusted odds ratio (AOR): 5.17, 95% confidence interval (CI) 3.87, 6.91), vaginal delivery (AOR: 4.39, 95% CI 3.29, 5.88), mother–newborn skin-to-skin contact for 1 h or more (AOR: 55.6, 95% CI 23.0, 134.2), and breastfeeding counseling during antenatal visits (AOR: 1.48, 95% CI 1.12, 1.97) were factors associated with increased likelihood of EIBF. Overall, the practice of EIBF was poor. Targeting modifiable factors associated with EIBF may be used to improve early initiation practice.

In terms of breastfeeding (BF) practices in Romania, there is a lack of up-to-date data. The aim of the present study was to assess current BF practices, and to investigate the factors associated with exclusive BF (EBF) under 6 months of age in northwestern Romania. A structured questionnaire was used to collect data among 1399 mothers of children aged 0–23 months, recruited between March and June 2019, from the community. BF practices were evaluated based on the World Health Organization indicators for assessing infant and young child feeding practices, whereas determinants of EBF were explored using logistic regression models. Almost all mothers (95.7%) breastfed their child at least once. The EBF rate was 46.7%, the continued BF rate at one year of age was 54.2%, and the continued BF rate at 2 years of age was 30.3%. The place of delivery and parental leave duration were strong determinants of EBF. The improving rates observed in this study for all the BF practices assessed suggest the continuation of efforts to develop effective national policies and programs for promoting, protecting, and supporting BF in Romania. Particular emphasis should be given to the creation in maternity hospitals of an environment that is supportive towards breastfeeding.

Obesity pandemic represents a threat to public health of paramount importance. Bariatric surgery represents the most effective and long-lasting treatment for severe obesity so far. The nutritional status of obese patients seeking bariatric surgery is impaired prior to surgery because of prevalent nutritional deficiencies. In addition, excess micronutrient levels may also occur, although this finding is not common. The onset of nutritional anomalies encountered in bariatric surgery candidates might stem from the following: obesity itself, poor quality food choices, preoperative weight loss or insufficient/excessive preoperative oral supplementation with vitamins and minerals. Nutritional management should begin preoperatively and should include a comprehensive assessment in order to identify those patients with clinical or subclinical deficiencies and hypervitaminoses. This paper provides background information on the nutritional status of bariatric surgery candidates, as well as on the prevalence and clinical significance of the most common micronutrient deficiencies and excess levels reported preoperatively among these patients.

Scopul lucrării: Obezitatea severă constituie o problemă serioasă de sănătate publică, chirurgia bariatrică reprezentând unicul tratament eficient al acesteia. Printre procedeele chirurgicale bariatrice, gastroplastia verticală cu inel de silicon (SRVG) s-a impus ca o metodă restrictivă sigură, care a fost utilizată cu succes în trecut. Actualmente, SRVG a fost abandonată în favoarea unor procedee laparoscopice. Scopul prezentului studiu a fost acela de a investiga efectul SRVG asupra reducerii ponderale, precum şi instalarea complicaţiilor tardive sau efectuarea reintervenţiilor chirurgicale în cazul unui lot de pacienţi cu obezitate severă, pe o perioadă de urmărire postoperatorie de 10 ani. Material şi Metode: Am efectuat o analiză retrospectivă pe un lot de 112 pacienţi cu obezitate severă care au fost supuşi intervenţiei de SRVG deschis, între anii 2008-2009, urmărind atât evoluţia indicelui de masă corporală (IMC) şi a procentajului IMC pierdut (%EBMIL), cât şi apariţia complicaţiilor chirurgicale tardive sau efectuarea reintervenţiilor chirurgicale. 41,96% dintre pacienţi au rămas înrolaţi în studiu după 10 ani. Rezultate: Media iniţială a IMC de 47,38±7,59 kg/m 2 s-a redus semnificativ statistic (p <0,001) în primul an după SRVG până la 31,05 ± 6,54 kg/m 2 . Valoarea IMC s-a menţinut relativ stabilă în primii 5 ani postoperator, crescând apoi progresiv până la 35,93 ± 7,20 kg/m 2 în al 10-lea an de monitorizare, dar rămânând, totuşi,