Optimizing Multivitamin Supplementation for Sleeve Gastrectomy Patients

Heusschen, Laura; Berendsen, A. M.; Cooiman, Mellody I.; Deden, Laura N.; Hazebroek, Eric J.; Aarts, Edo O.

doi:10.1007/s11695-021-05282-4

Cited by 12 publications

(10 citation statements)

References 24 publications

(26 reference statements)

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“…Our findings are in line with other reports describing elevated plasma vitamin B6 levels in postbariatric patients upon regular multivitamin intake 16,[18][19][20][21][22][23][24] , challenging the assumption that the postbariatric status per se is associated with a risk for vitamin B6 deficiency. This is supported by the observation that postbariatric vitamin B6 deficiency was mainly reported in patient collectives where a deficiency was already present before surgery 13,25,26 .…”

Section: Discussionsupporting

confidence: 92%

“…While supplementation of various macro-and micronutrients is important to prevent deficiencies after bariatric surgery 30 and recommended by various society guidelines 15 , a substantial body of evidence points towards an over-supplementation of post-bariatric patients by daily vitamin B6 intake 16,[18][19][20][21][22][23][24]27,28 . Thus, prospective, multicenter studies are needed to unravel, if multivitamin formulations recommended to post-bariatric patients should be adapted regarding their vitamin B6 content to avoid over-supplementation and possible associated side effects in the future.…”

Section: Discussionmentioning

confidence: 99%

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Regular intake of energy drinks and multivitamin supplements is associated with elevated plasma vitamin B6 levels in post-bariatric patients

Tynes

Hepprich

Timper

2021

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The aim of the present survey was to analyze plasma vitamin B6 levels in post-bariatric patients and to elucidate the causal factors associated with elevated plasma vitamin B6 levels. This is a retrospective analysis of electronic patient data of all post-bariatric patients evaluated at the endocrine outpatient clinic of the University Hospital Basel in 2017, for which plasma vitamin B6 values were assessed during regular follow-up visits. In total, 205 patients were included in the study, whereof a minority of 43% had vitamin B6 levels in the normal range. 50% of the patients had vitamin B6 levels up to fourfold higher than the upper normal limit and 7% had levels more than fourfold above the upper normal limit. Vitamin B6 deficiency was not observed in any patient. While multivitamin supplementation in general was associated with elevated plasma vitamin B6 levels, the highest vitamin B6 levels were found after biliopancreatic diversion (BPD) and in patients who reported daily energy drink intake. Elevated plasma vitamin B6 levels up to fourfold above the upper normal limit are common in postbariatric patients and are associated with regular multivitamin supplementation, while highly elevated plasma vitamin B6 levels were seen primarily upon regular energy drink intake. Thus, a regular follow-up of vitamin B6 plasma levels and critical evaluation of vitamin B6 supplementation, either as part of the multivitamin preparation or related to regular energy drink intake, is highly warranted and should be an integral part of the routine post-bariatric follow-up.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Regular intake of energy drinks and multivitamin supplements is associated with elevated plasma vitamin B6 levels in post-bariatric patients

Tynes

Hepprich

Timper

2021

Sci Rep

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“…Seventy-five percent of all participants reports taking MVS 12 years after surgery, and there is no difference between FA and IFA. Heusschen et al reported a compliance rate of 55% at 12 months even though the participants received the MVS for free the first year after surgery [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

The Long-Term Impact of Postoperative Educational Programs on Weight Loss After Roux-en-Y Gastric Bypass

et al. 2022

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Purpose Roux-en-Y gastric bypass (RYGB) is a well-documented treatment of severe obesity. Attending postoperative educational programs may improve the outcome. The aim of this study was to evaluate whether participation in educational programs lasting 2–3 years after RYGB influences long-term weight loss, weight regain, physical activity, and compliance to multivitamin supplements. Materials and Methods The Bariatric Surgery Observation Study (BAROBS) is a multicenter retrospective, cross-sectional study 10–15 years after primary RYGB. Four hundred and ninety-seven participants answered questions regarding participation in postoperative educational programs. Participants were divided into frequent attendees (FA) and infrequent attendees (IFA) at the educational programs. Results Ten to 15 years after surgery, a total weight loss (TWL) of 23.2 ± 11.6% were seen in the FA group vs 19.5 ± 12.6% in the IFA group, p < 0.001. Percent excess weight loss (%EWL) was 55.7 ± 28.9% vs 46.0 ± 31.1%, p < 0.001. Weight regain in percent of maximal weight loss for the FA was 32.1 ± 32.8% vs IFA 38.4 ± 40.0%, p = 0.052. No difference between the groups in compliance to multivitamin and physical activity. Conclusion Participants with frequent participation in group-based educational programs had better weight loss outcomes 10–15 years after RYGB and tended to have less weight regain. There was no difference between the two groups in participants compliance to recommended multivitamin supplements and physical activity. Graphical abstract

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“…reason, a specialized multivitamin supplement specifically targeted to the needs of SG patients was developed (WLS Optimum; FitForMe, Rotterdam, the Netherlands). The composition of WLS Optimum was previously evaluated in a randomized controlled trial and optimized afterwards [11,12]. The first version of WLS Optimum (1.0) was effective in reducing the prevalence of anemia and improving serum levels of folic acid, PTH, and vitamin B1 1 year after SG in comparison to a standard, over-the-counter multivitamin supplement (sMVS) [11].…”

Section: Introductionmentioning

confidence: 99%

“…The first version of WLS Optimum (1.0) was effective in reducing the prevalence of anemia and improving serum levels of folic acid, PTH, and vitamin B1 1 year after SG in comparison to a standard, over-the-counter multivitamin supplement (sMVS) [11]. The optimized version of WLS Optimum (2.0) additionally improved serum levels of vitamin B12, vitamin B6, and zinc, and resulted in less deficiencies for vitamin B12 and phosphate during the first year after SG, in comparison to WLS Optimum 1.0 [12]. However, the effectiveness of such specialized MVS on the longer term after SG is still unknown.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2022

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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. Graphical abstract

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Optimizing Multivitamin Supplementation for Sleeve Gastrectomy Patients

Cited by 12 publications

References 24 publications

Regular intake of energy drinks and multivitamin supplements is associated with elevated plasma vitamin B6 levels in post-bariatric patients

Regular intake of energy drinks and multivitamin supplements is associated with elevated plasma vitamin B6 levels in post-bariatric patients

The Long-Term Impact of Postoperative Educational Programs on Weight Loss After Roux-en-Y Gastric Bypass

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

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