Original article
New look at nutritional care for obese patient candidates for bariatric surgery

https://doi.org/10.1016/j.soard.2011.08.010Get rights and content

Abstract

Background

The combination of preoperative deficiencies and the restrictions and malabsorption possibly induced by bariatric surgery could lead patients to experience important nutritional deficits during the late postoperative period. Our objective was to characterize the eating, anthropometric, and biochemical profiles of obese candidates for bariatric surgery at a bariatric surgery center of a university hospital.

Methods

A retrospective study with the analysis of medical records of candidates for bariatric surgery from 2007 to 2008 was performed. A total of 80 adult patients, aged 45 ± 11 years, were included in the present study.

Results

The mean patient weight was 145 ± 24 kg, and the mean body mass index was 54 ± 8 kg/m2. Of the 80 patients, 78% had ≥1 co-morbidities related to obesity. The reported daily energy intake before surgery was 1981 ± 882 kcal, with 48% ± 11% consisting of carbohydrate, 29% ± 8% of lipids, and 23% ± 8% of protein. The mean number of daily meals was 4 ± 1. Patients with a greater body mass index ingested a smaller amount of calories per kilogram of current weight. The occurrence of hyperglycemia, hyperuricemia, and dyslipidemia and of nutritional deficiencies, among them magnesium (19%), vitamin A (15%), vitamin C (16%), iron (9%), β-carotene (3%), and vitamin B12 (3%), was high.

Conclusion

The high occurrence of micronutrient deficiency detected by biochemical analysis in morbidly obese candidates for bariatric surgery, representing a disabsorptive process, might involve a poorer prognosis during the late postoperative period. A preoperative evaluation of the nutritional parameters and the food intake pattern is recommended for these patients, together with the necessary interventions.

Section snippets

Participants and procedures

A retrospective study was conducted by analyzing the medical records of 80 candidates for bariatric surgery at the center of bariatric surgery of the university hospital, from 2007 to 2008. During this period, we had a waiting list of 165 patients. The Research Ethics Committee of the institution approved the project. All patients underwent the same surgical technique of Roux-en-Y gastric bypass [8]. The study did not interfere with the medical-nutritional routine the patients followed.

Data collection

The

Results

A total of 80 patients were analyzed at random, all of whom were candidates for bariatric surgery. Of the 80 patients, 19% were men and 81% were women. The mean age, weight, and BMI was 45 ± 11 years, 145 ± 24 kg, and 54 ± 8 kg/m2, respectively. The socioeconomic and educational level, physical activity, smoking status, and alcohol intake are listed in Table 1. The marital status was single for 29% of the patients, married or cohabitating for 55%, divorced for 11%, and widowed for 5%.

Of the

Discussion

Women predominated among the patients studied, a typical characteristic of patients who seek bariatric surgery [4], [10]. The prevalence of women in the present sample might have been related to concern about body esthetics and to the availability of time because most of the women included were housewives [11].

No association was observed between the BMI and variables related to schooling, socioeconomic level, or practice of physical activity. Investigators have demonstrated that women with a

Conclusion

The present results indicate a high prevalence of micronutrient deficiency in morbidly obese candidates for bariatric surgery. Such deficiencies could aggravate the nutritional status of the patients after bariatric surgery, resulting in a poorer prognosis. Thus, a preoperative evaluation of the nutritional parameters and the food intake pattern is recommended for these patients, together with the necessary interventions. The limitations of our study included the lack of data regarding ethnic

Disclosures

The authors have no commercial associations that might be a conflict of interest in relation to this article.

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