2015
DOI: 10.1002/jbmr.2707
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The Impact of Vitamin D, Calcium, Protein Supplementation, and Physical Exercise on Bone Metabolism After Bariatric Surgery: The BABS Study

Abstract: Laparoscopic Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) are common and effective methods to treat severe obesity, but these procedures can adversely influence bone metabolism and areal bone mineral density (aBMD). This was a prospective 24-month single-center interventional two-arm study in 220 women and similarly aged men (median age 40.7 years) with a body mass index (BMI) >38 kg/m 2 after RYGB and SG procedures. Patients were randomized into: 1) an intervention group receiving: 28,000 IU ch… Show more

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Cited by 151 publications
(171 citation statements)
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“…Also, as with diet-induced weight loss, there have been some attempts to attenuate bone loss with physical exercise. In a 24-month, randomized, controlled study evaluating the effects of an intervention including a combination of high vitamin D and calcium supplementation with exercise post-bariatric surgery, the intervention group had attenuated increase in bone turnover markers and less pronounced bone loss as compared with the non-intervention group [128]. In another study, a weightbearing and aerobic exercise intervention program postbariatric surgery resulted in less pronounced bone loss which was associated with preservation of muscle mass [129].…”
Section: Effects Of Bariatric Surgery On Fracture Riskmentioning
confidence: 99%
“…Also, as with diet-induced weight loss, there have been some attempts to attenuate bone loss with physical exercise. In a 24-month, randomized, controlled study evaluating the effects of an intervention including a combination of high vitamin D and calcium supplementation with exercise post-bariatric surgery, the intervention group had attenuated increase in bone turnover markers and less pronounced bone loss as compared with the non-intervention group [128]. In another study, a weightbearing and aerobic exercise intervention program postbariatric surgery resulted in less pronounced bone loss which was associated with preservation of muscle mass [129].…”
Section: Effects Of Bariatric Surgery On Fracture Riskmentioning
confidence: 99%
“…Bariatric surgery patients, who are predominantly premenopausal women, routinely lose ∼30% of preoperative weight, and dramatic skeletal changes are well documented in prospective cohort studies, particularly after Roux‐en‐Y gastric bypass surgery. Reported changes include BMD decreases of 5% to 10% at the hip by DXA, decreases of 5% to 7% at the spine by QCT, and alterations in trabecular and cortical microarchitecture associated with decreased bone strength . Bariatric surgery not only causes more extreme mechanical unloading of the skeleton and more pronounced changes in adipokines than nonsurgical weight loss, but also, particularly for Roux‐en‐Y gastric bypass, induces substantial changes in gut‐secreted hormones such as peptide YY and leads to malabsorption of nutrients including calcium .…”
mentioning
confidence: 99%
“…When dietary strategies have been considered, both higher calcium intake and, separately, higher protein intake have attenuated declines in BMD during caloric restriction. (In the bariatric surgery population, a multipronged intervention of exercise, calcium, vitamin D, and protein supplementation was recently shown to attenuate postoperative declines in BMD …”
mentioning
confidence: 99%
“…Studies have demonstrated that sufficient intake of protein and iron, can realistically be obtained from diet especially if it is nutrient dense 115,141 . Use of dietary supplements is also an effective way to manage status of protein 142 , calcium, iron 141,143 , and vitamins D 115 and B 12 144 after gastric bypass. For treatment of deficiencies, although clinical trial are limited, data suggest that high-dose supplementation of iron 145 , vitamins D 142,146 and B 12 and protein 117 is effective.…”
Section: Introductionmentioning
confidence: 99%
“…Use of dietary supplements is also an effective way to manage status of protein 142 , calcium, iron 141,143 , and vitamins D 115 and B 12 144 after gastric bypass. For treatment of deficiencies, although clinical trial are limited, data suggest that high-dose supplementation of iron 145 , vitamins D 142,146 and B 12 and protein 117 is effective. Taken together, since oral ingestion of food and supplements can be used to prevent and treat malnutrition, this suggests that sufficient capacity of the gut remains for digestion and absorption of micronutrients after surgery.…”
Section: Introductionmentioning
confidence: 99%