1.
Comparison of Bariatric Branded Chewable Multivitamin/Multimineral Formulations to the 2016 American Society for Metabolic and Bariatric Surgery Integrated Health Nutritional Guidelines.
Majumdar, MC, Reardon, C, Isom, KA, Robinson, MK
Obesity surgery. 2020;(4):1560-1563
Abstract
Postoperative vitamin and mineral supplementation are integral components of the management of the weight loss surgery patient. Supplements differ in type, amount, and salt form. No recent publication has compared bariatric branded commercially available products with current practice guidelines. Registered dietitians belonging to the New England Bariatric Dietitians LinkedIn group were surveyed to identify their recommendation practices. These results were then used to compare and discuss in a comprehensive fashion the most widely recommended bariatric branded chewable supplements to the 2016 American Society for Metabolic and Bariatric Surgery Integrated Health Nutritional Guidelines.
2.
American Society for Metabolic and Bariatric Surgery Integrated Health Nutritional Guidelines for the Surgical Weight Loss Patient 2016 Update: Micronutrients.
Parrott, J, Frank, L, Rabena, R, Craggs-Dino, L, Isom, KA, Greiman, L
Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery. 2017;13(5):727-741
Abstract
BACKGROUND Optimizing postoperative patient outcomes and nutritional status begins preoperatively. Patients should be educated before and after weight loss surgery (WLS) on the expected nutrient deficiencies associated with alterations in physiology. Although surgery can exacerbate preexisting nutrient deficiencies, preoperative screening for vitamin deficiencies has not been the norm in the majority of WLS practices. Screening is important because it is common for patients who present for WLS to have at least 1 vitamin or mineral deficiency preoperatively. OBJECTIVES The focus of this paper is to update the 2008 American Society for Metabolic and Bariatric Surgery Nutrition in Bariatric Surgery Guidelines with key micronutrient research in laparoscopic adjustable gastric banding, Roux-en-Y gastric bypass, laparoscopic sleeve gastrectomy, biliopancreatic diversion, and biliopancreatic diversion/duodenal switch. METHODS Four questions regarding recommendations for preoperative and postoperative screening of nutrient deficiencies, preventative supplementation, and repletion of nutrient deficiencies in pre-WLS patients have been applied to specific micronutrients (vitamins B1 and B12; folate; iron; vitamins A, E, and K; calcium; vitamin D; copper; and zinc). RESULTS Out of the 554 articles identified as meeting preliminary search criteria, 402 were reviewed in detail. There are 92 recommendations in this update, 79 new recommendations and an additional 13 that have not changed since 2008. Each recommendation has a corresponding graded level of evidence, from grade A through D. CONCLUSIONS Data continue to suggest that the prevalence of micronutrient deficiencies is increasing, while monitoring of patients at follow-up is decreasing. This document should be viewed as a guideline for a reasonable approach to patient nutritional care based on the most recent research, scientific evidence, resources, and information available. It is the responsibility of the registered dietitian nutritionist and WLS program to determine individual variations as they relate to patient nutritional care.
3.
Nutrition and metabolic support recommendations for the bariatric patient.
Isom, KA, Andromalos, L, Ariagno, M, Hartman, K, Mogensen, KM, Stephanides, K, Shikora, S
Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition. 2014;(6):718-39
Abstract
Managing the metabolic needs of the patient with obesity is a challenge unto itself without the added demands of accounting for an altered gastrointestinal tract. Nevertheless, with about 200,000 bariatric procedures being performed annually in the United States, clinicians must be prepared to manage the critically ill bariatric surgery patient. This article reviews the recent literature relating to nutrient needs and metabolic support for the bariatric patient. Bariatric patients are at risk for several micronutrient deficiencies, including vitamins D and B₁₂, calcium, and iron; some bariatric procedures affect macronutrient needs as well. Literature on nutrition support guidelines for the bariatric population is limited. However, with an understanding of the anatomical and physiological effects of bariatric surgery, recent guidelines for critically ill patients with obesity can be applied to the bariatric surgery population. The unique needs of the bariatric population, such as susceptibility to micronutrient deficiencies and specialized access routes, must be considered to provide safe and efficacious nutrition support. Further research is necessary to develop specific nutrition support recommendations for the bariatric population.