Gastric Bypass is not Associated with Protein Malnutrition in Morbidly Obese Patients

Ritz, Patrick; Bécouarn, Guillaume; Douay, Olivier; Sallé, Agnès; Topart, Philippe; Rohmer, V.

doi:10.1007/s11695-008-9627-3

Cited by 22 publications

(13 citation statements)

References 30 publications

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“…As shown by others [18,19], in our cohort albumin and prealbumin levels decreased after bariatric surgery compared to the presurgical period. No individual in our cohort presented with a plasma albumin level <35 g/L.…”

Section: Discussionsupporting

confidence: 83%

Protein Intake, Body Composition, and Protein Status Following Bariatric Surgery

et al. 2010

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Section: Discussionsupporting

confidence: 83%

Protein Intake, Body Composition, and Protein Status Following Bariatric Surgery

et al. 2010

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“…In addition, these protein deficiencies were always mild. In protein-deficient patients the mean albumin level was 36.5 (36-37) g/l after LSG and 33 (26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37) g/l after LRYGB. Ritz et al observed that plasma concentration of albumin decreased after gastric bypass but returned to initial values after 12 months [32].…”

Section: Discussionmentioning

confidence: 96%

Fewer Nutrient Deficiencies After Laparoscopic Sleeve Gastrectomy (LSG) than After Laparoscopic Roux-Y-Gastric Bypass (LRYGB)—a Prospective Study

et al. 2010

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Background Deficiencies in micronutrients after bariatric operations are frequent, despite routine supplementation. Main outcome measures were pre-and postoperative frequency of nutrient deficiencies and success rate of their treatment. Between 5/2004 and 12/2006, 136 patients (m:f=0:4) with an average body mass index of 45 (35-58) kg/m 2 and age of 53 (21-66) years were prospectively analysed. Laparoscopic Roux-Y-gastric bypass (LRYGB) was performed in 86 patients and laparoscopic sleeve gastrectomy (LSG) was performed in 50 patients. The patients were examined before surgery as well as 3, 6, 12, 24, 30, and 36 months postoperatively using a standard protocol including laboratory tests. The mean follow-up time was 24.4 (12-40) months; the follow-up rate was 100%. Results Prior to surgery, 57% of the patients had at least one deficiency, 23% of whom had vitamin D 3 deficiency. Frequent postoperative deficiencies after LSG were zinc, vitamin D 3 , folic acid, iron, and vitamin B 12 ; after LRYGB, vitamin B 12 , vitamin D 3 , zinc, and secondary hyperparathyroidism. No vitamin B 1 or B 6 deficiencies were found. Calcium levels were normal in all patients. Treatment of the deficiencies was mostly successful. Conclusion Preoperatively, 57% of morbidly obese patients already had a deficiency. Postoperatively, significantly more vitamin B 12 and vitamin D deficiencies and hyperparathyroidism were found in patients who had undergone LRYGB. After LSG, folate deficiency was more frequent (but not significantly so). Calcium levels were normal in all patients; therefore, parathyroid hormone and vitamin D 3 levels are more sensitive markers for early detection of disorders of calcium metabolism. Iron deficiency anaemia is most efficiently treated by IV therapy. Methods

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“…Postoperative patients often have inadequate protein intake due to food intolerances and decreased caloric intake [10,24,25]. However, when only blood proteins are considered, the majority of patients do not appear to be malnourished [25,26]. Blood proteins are less sensitive indicators of nutritional status than physical examination that includes an assessment of muscle mass [27].…”

Section: Proteins and Nutritional Statusmentioning

confidence: 99%

Dietary Protein Intake and Bariatric Surgery Patients: A Review

Faria

Buffington

et al. 2011

OBES SURG

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Bariatric surgery, a highly successful treatment for obesity, requires adherence to special dietary recommendations to insure the achievement of weight loss goals and weight maintenance. Postoperative consumption of protein is linked to satiety induction, nutritional status, and weight loss. Hence, we conducted an extensive literature review to identify studies focused on the following: protein and nutritional status; recommendations for dietary protein intake; the effects of protein-rich diets; and associations between dietary protein intake and satiety, weight loss, and body composition. We found that there have been few studies on protein intake recommendations for bariatric patients. Dietary protein ingestion among this population tends to be inadequate, potentially leading to a loss of lean body mass, reduced metabolic rates, and physiological damage. Conversely, a protein-rich diet can lead to increased satiety, enhanced weight loss, and improved body composition. The quality and composition of protein sources are also very important, particularly with respect to the quantity of leucine, which helps to maintain muscle mass, and thus is particularly important for this patient group. Randomized studies among bariatric surgery patient populations are necessary to establish the exact quantity of protein that should be prescribed to maintain their nutritional status.

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Gastric Bypass is not Associated with Protein Malnutrition in Morbidly Obese Patients

Abstract: Malnutrition is difficult to diagnose in obese patients undergoing surgery. The large weight loss is most often not associated with protein malnutrition. Whether gastric bypass induces protein malnutrition remains to be established.

Cited by 22 publications

References 30 publications

Protein Intake, Body Composition, and Protein Status Following Bariatric Surgery

Protein Intake, Body Composition, and Protein Status Following Bariatric Surgery

Fewer Nutrient Deficiencies After Laparoscopic Sleeve Gastrectomy (LSG) than After Laparoscopic Roux-Y-Gastric Bypass (LRYGB)—a Prospective Study

Dietary Protein Intake and Bariatric Surgery Patients: A Review

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