Format

Send to

Choose Destination
Obes Surg. 2016 Apr;26(4):833-8. doi: 10.1007/s11695-015-1844-y.

Malnutrition in Bariatric Surgery Candidates: Multiple Micronutrient Deficiencies Prior to Surgery.

Author information

1
The Johns Hopkins Center for Bariatric Surgery, 4940 Eastern Avenue, Baltimore, MD, 21224, USA. leighpeterson@jhmi.edu.
2
The Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA. cheskin@jhu.edu.
3
The Johns Hopkins Weight Management Center, The Global Obesity Prevention Center at Johns Hopkins, Baltimore, MD, 21205, USA. cheskin@jhu.edu.
4
The Johns Hopkins Bloomberg School of Public Health, 550 N Broadway, Baltimore, MD, 21205, USA. cheskin@jhu.edu.
5
The Johns Hopkins Bayview Department of Clinical Nutrition, American University of Antigua School of Medicine, 4940 Eastern Avenue, Baltimore, MD, 21224, USA.
6
, PO Box 572, Jonesborough, TN, 37659, USA.
7
The Johns Hopkins Center for Bariatric Surgery, 4940 Eastern Avenue, Baltimore, MD, 21224, USA.

Abstract

BACKGROUND:

Over 78 million American adults have obesity. Bariatric surgery is the leading means of durable weight loss. Nutritional deficiencies are commonly treated post-operatively but are often undiagnosed pre-operatively. Malnutrition is correlated with adverse surgical outcomes.

OBJECTIVES:

The aim of this study is to assess pre-operative nutritional status in our bariatric surgery candidates in a cross-sectional study.

METHODS:

We recruited 58 bariatric candidates approved to undergo the Roux-en Y gastric bypass. Nutritional status was determined for vitamins A, B12, D, E-α, and E-β/γ as well as thiamine, folate, and iron. We used clinical as well as frank deficiency cut-offs based on the Institute of Medicine and the World Health Organization guidelines.

RESULTS:

This cohort was largely female (77.6%) and white (63.8%). Median age was 42.2 years. Median body mass index (BMI) was 46.3 kg/m(2). Multiple comorbidities (MCM) were present in 41.4%, 54.0% hypertension, 42.0% diabetic, 34.0% sleep apnea. Men had more comorbidities, 69.2 % with MCM. Folate and iron saturation varied significantly by sex. Vitamins A, D, E-α, and thiamine significantly varied by race. Vitamin D negatively correlated with BMI (p = 0.003) and age (p = 0.030). Vitamin A negatively correlated with age (p = 0.001) and number of comorbidities (p = 0.003). These pre-operative bariatric candidates had significant malnutrition, particularly in vitamin D (92.9%) and iron (36.2 to 56.9 %). Multiple micronutrient deficiency (MMND) was more common in blacks (50.0 versus 39.7% overall). Number of comorbidities did not correlate with MMND.

CONCLUSIONS:

Malnutrition in one or multiple micronutrients is pervasive in this pre-operative bariatric cohort. The effect of pre-operative supplementation, especially vitamin D and iron, should be explored.

KEYWORDS:

Bariatric surgery; Malnutrition; Multiple micronutrient deficiency; Nutritional status

PMID:
26297429
DOI:
10.1007/s11695-015-1844-y
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Springer
Loading ...
Support Center