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Surg Obes Relat Dis. 2016 Mar-Apr;12(3):651-658. doi: 10.1016/j.soard.2015.09.007. Epub 2015 Sep 21.

Influence of diet and supplements on iron status after gastric bypass surgery.

Author information

1
Department of Nutrition Science, Purdue University, West Lafayette, Indiana.
2
Department of Surgery, Oregon Health and Science University, Portland, Oregon.
3
Department of Biological Sciences, Purdue University, West Lafayette, Indiana.
4
Department of Nutrition Science, Purdue University, West Lafayette, Indiana. Electronic address: ngletsum@purdue.edu.

Abstract

BACKGROUND:

Iron deficiency is common after Roux-en-Y gastric bypass (RYGB) surgery, but there is no consensus on the optimal diet quality and quantity for restoring and preserving iron status.

OBJECTIVES:

The authors explored the impact of dietary and supplemental sources of iron and absorptive factors on iron status.

SETTING:

Academic, United States.

METHODS:

In a cross-sectional cohort of individuals who underwent RYGB, nutrient intakes from food and supplements were measured using 3-day food records. Blood biomarkers of iron status, including concentrations of ferritin, total iron binding capacity, serum transferrin receptor (sTfR), and the sTfR:ferritin ratio, were assessed by a reference laboratory; iron deficiency was defined as having at least 2 abnormal measures. Associations between iron status biomarkers and dietary predictors were determined using regression analysis.

RESULTS:

Of the 36 participants, 97% were female, the mean age was 45 years (95% confidence interval, 41-48 years), and body mass index was 32 (30-35) kg/m(2). Iron deficiency was found in 42% of participants. Dietary intake of heme iron, found in meats, was favorably associated with 3 iron status biomarkers (ferritin, β = .366; sTfR:ferritin ratio, β = -.459; and total iron binding capacity, β = -18.26; all P<.05), independent of obesity-induced inflammation. Intake of vitamin C from food contributed to iron status (ferritin, β = .010 and sTfR:ferritin ratio, β = -.011; P<.05). Use of supplementary non-heme iron, at doses recommended for prophylaxis (45 mg/d), was positively associated with serum ferritin (β = .964; P = .029).

CONCLUSIONS:

For patients who have undergone RYGB, consuming high, but realistic amounts of heme iron in meat, vitamin C from food, and adherence to recommended iron supplements can prevent iron deficiency.

KEYWORDS:

Dietary intake; Iron deficiency; Iron supplementation; Nutritional complications

PMID:
26806728
DOI:
10.1016/j.soard.2015.09.007
[Indexed for MEDLINE]
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