Red meat intolerance in patients submitted to gastric bypass: a 4-year follow-up study

Nicoletti, Carolina Ferreira; Oliveira, Bruno Affonso Parenti de; Barbin, Renato; Marchini, Júlio Sérgio; Wilson, Steven E.; Nonino, Carla Barbosa

doi:10.1016/j.soard.2014.10.009

Cited by 33 publications

(21 citation statements)

References 12 publications

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“…Of the more healthy food types, red meat was reported most frequently. This has been described previously, and may contribute partly to the high prevalence of iron deficiency after LRYGB. There was a clear positive correlation between food intolerance and gastrointestinal complaints.…”

Section: Discussionsupporting

confidence: 69%

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Gastrointestinal symptoms and food intolerance 2 years after laparoscopic Roux-en-Y gastric bypass for morbid obesity

Boerlage

Laar

Westerlaken

et al. 2017

Journal of British Surgery

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BackgroundLaparoscopic Roux‐en‐ gastric bypass (LRYGB) is an effective treatment for morbid obesity, but might aggravate gastrointestinal complaints and food intolerance. The long‐term prevalence of these symptoms has not been well studied.MethodsIn a cross‐sectional study, all patients who underwent primary LRYGB from May to October 2012 were approached 2 years after surgery to complete a general health questionnaire, the Gastrointestinal Symptom Rating Scale (GSRS), and a food intolerance questionnaire. The results were compared with those for a control group of morbidly obese patients.ResultsA total of 249 patients were included for analysis, representing a response rate of 93·9 per cent. Mean(s.d.) total weight loss was 30·8(8·7) per cent. The total mean GSRS score was higher in patients who had LRYGB (median 2·19 versus 1·75 in unoperated patients; P < 0·001); the difference in symptoms of indigestion was most notable (P < 0·001). Food intolerance for specific products was reported by 70·7 (95 per cent c.i. 64·8 to 76·0) per cent of the postoperative patients, for a median of 4 foods. There was a positive correlation between food intolerance and score on the GSRS. There was no correlation between either food intolerance or the total mean GSRS score and weight loss, but there was a correlation between weight loss and abdominal pain.ConclusionAt 2 years after surgery, patients undergoing LRYGB for morbid obesity have more gastrointestinal complaints than obese controls. Food intolerance is a common side‐effect of LRYGB independent of degree of weight loss or the presence of other abdominal symptoms.

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Section: Discussionsupporting

confidence: 69%

“…LRYGB also has a profound influence on tolerance to food. Approximately two‐thirds of patients experience food intolerance, with red meat reported most often. However, studies on food intolerance generally suffer from the same flaws as those concerning gastrointestinal symptoms.…”

Section: Introductionmentioning

confidence: 99%

Gastrointestinal symptoms and food intolerance 2 years after laparoscopic Roux-en-Y gastric bypass for morbid obesity

Boerlage

Laar

Westerlaken

et al. 2017

Journal of British Surgery

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“…Also, iron-rich food intake after BS is considerably decreased due to both caloric restriction and food aversions, especially to red meat [120]. In a 2014 study including 72 individuals submitted to RYGB, Nicoletti et al reported that red meat intolerance occurred in 49.2%, 42.2%, 46.4%, and 39% of patients after 1, 2, 3, and 4 years postoperatively [152]. In addition, after RYGB, the most efficient area for iron absorption-the duodenum-is bypassed [104].…”

Section: Ironmentioning

confidence: 99%

Bariatric Surgery in Obesity: Effects on Gut Microbiota and Micronutrient Status

et al. 2020

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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.

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“…Metabolic surgery is also accompanied by a significant reduction in food intake, often compounded by anorexia, food aversion, and intolerance to red meat, an important source of haem iron . Dietary intake of total iron after surgery is also reduced usually below the recommended dietary allowance …”

Section: Factors Contributing To Postoperative Iron Deficiencymentioning

confidence: 99%

Metabolic surgery and iron homeostasis

et al. 2018

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Iron deficiency and anaemia after metabolic surgery, potentially modifiable nutritional complications, are becoming an increasing cause for concern as prevalence increases with time and there is limited evidence supporting the effectiveness of the current guidelines for prophylactic oral iron supplementation and treatment for deficiency.Abnormalities in iron nutrition predisposing to deficiency are common in severely obese patients, and the low-grade systemic inflammation, also common to these patients, reduces the effectiveness of oral iron supplementation. The surgical procedures result in alterations of foregut anatomy and physiology, which limit iron absorptive capacity and daily food intake. These alterations and the limited effects of oral iron supplementation explain the high prevalence of postoperative iron deficiency and anaemia. This review outlines current mechanisms concerning the pathogenesis of disordered iron nutrition in patients with severe obesity, current gaps in knowledge, and opportunities for quality improvement.

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Red meat intolerance in patients submitted to gastric bypass: a 4-year follow-up study

Cited by 33 publications

References 12 publications

Gastrointestinal symptoms and food intolerance 2 years after laparoscopic Roux-en-Y gastric bypass for morbid obesity

Gastrointestinal symptoms and food intolerance 2 years after laparoscopic Roux-en-Y gastric bypass for morbid obesity

Bariatric Surgery in Obesity: Effects on Gut Microbiota and Micronutrient Status

Metabolic surgery and iron homeostasis

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