Presentation on theme: "Nutritional Considerations After Bariatric Surgery"— Presentation transcript:
1 Nutritional Considerations After Bariatric Surgery Michelle Lee, PhD, RD, LDNAssistant Professor-NutritionDepartment of Allied HealthCollege of Clinical and Rehabilitative SciencesETSU
2 Objectives:What are the short-term nutritional implications for individuals receiving bariatric surgery?What are the long-term nutritional implications for individuals receiving bariatric surgery?
3 Bariatric Surgery Trends Between 2003 and 2008, bariatric surgeries peaked in 2004 and has remained steady(1)Number of weight loss surgeries increased from 103,000 in 2003 to ~220,000 in 2008(2)Bariatric surgery in NOT a quick fix for morbid obesityThere are nutritional implications for any bariatric surgery
4 Types of Bariatric Surgery RestrictiveLaparoscopic adjustable gastric band (LAGB)Vertical banded gastroplasty (VBG)Intragastric balloonMalabsorptiveBilopancreatic diversion with duodenal switch (BPD/DS)Jejunoileal bypassBilopancreatic diversion (BPD)Primary Restrictive with a Malabsorptive ComponentRoux-en-Y gastric bypass (RYGB)
7 Nutritional Implications of Various Bariatric Surgeries(3,4) RYGBMalabsorption of Vit B12, Vit B1 (thiamin), Vit D, Vit K, Folate, Iron, CalciumLAGBFolic Acid deficiencyBPD and BPD/DSVit A, D, E, and K deficiency, Protein-Calorie Malnutrition, Malabsorption of Calcium, Zinc, Selenium, Sodium, Potassium, Chloride, Phosphorus, Magnesium
8 Sites of Nutrient Absorption(4) StomachWater, ethyl alcohol, copper, iodide, fluoride, molybdemum, intrinsic factorDuodenumCalcium, iron, phosphorus, magnesium, copper, selenium, thiamin, riboflavin, niacin, biotin, folate, vitamins A, D, E, K
9 Sites of Nutrient Absorption(4) JejunumThiamin, riboflavin, niacin, pantothenate, biotin, folate, vit B6, vit C, vit A, D, E, K, dipeptides, tripeptides, calcium, phosphorus, magnesium, iron, zinc, chromium, manganese, molybdenum, amino acidsIleumVit C, folate, vit B12, vit D, vit K, magnesium, bile salts/acids
12 Micronutrient Concerns IronCalcium and Vitamin DVitamin B12Folic acidThiaminZinc
13 Recommended Daily Supplements(4) Multivitamin with iron (prenatal vitamin will have adeq amount of folic acid)Calcium (citrate) with vitamin D ( mg calcium with IU vitamin D)Oral vitamin B12 ( mcg)Iron (65 mg/day in elemental form)Vitamin C (to increase absorption of Iron)Thiamin (10 mg/day)
15 Diet Recommendations(3) Reduce food volumeChew food very wellSlow pace of eatingNo liquids with mealsEncourage fruits and vegetables as diet progressesInclude high protein foods (at least 60g/day); may need protein supplements
16 ReferencesNguyen NT, Masoomi H, Magno CP, Nguyen XM, Laugenour K, Lane J. Trends in use of bariatric surgery J Am Coll Surg ;213(2):Weight-Control Information Network. Longitudinal assessment of bariatric surgery (LABS). NIH Publication No Accessed February 25, 2012.Tucker ON, Szomstein S, Rosenthal RJ. Nutritional consequences of weight-loss surgery. Med Clin N Am. 2007;91:Shikora SA, Kim JJ, Tarnoff ME. Nutrition and gastrointestinal complications of bariatric surgery. Nutr Clin Pract. 2007;22(1):29-40.Furtado LC. Nutritional management after Roux-en-Y gastric bypass. Br J Nurs. 2010;19(7):
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