Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende
Erweiterte Suche
Anmelden
nach oben
Obesity Surgery
Erschienen in: Obesity Surgery 2/2016

01.02.2016 | Original Contributions

Micronutrient Deficiencies in Morbidly Obese Women Prior to Bariatric Surgery

verfasst von: Andrés Sánchez, Pamela Rojas, Karen Basfi-fer, Fernando Carrasco, Jorge Inostroza, Juana Codoceo, Alejandra Valencia, Karin Papapietro, Attila Csendes, Manuel Ruz

Erschienen in: Obesity Surgery | Ausgabe 2/2016

Einloggen, um Zugang zu erhalten

Abstract

Background

Although morbid obesity is related to excess of energy and macronutrient intake, it does not rule out the presence of micronutrient deficiencies. The aim of this study was to evaluate food intake and the prevalence of micronutrient deficiencies in a group of morbidly obese women seeking bariatric surgery.

Methods

A total of 103 morbidly obese women were studied prior to bariatric surgery. Anthropometry and body composition (dual-energy X-ray absorptiometry, DEXA) were performed on all subjects. Energy and nutrient intake was determined by food frequency questionnaire. Blood tests to assess micronutrients status, including plasma iron, ferritin, transferrin, zinc, copper, calcium, phosphorus, hemoglobin, hematocrit, mean corpuscular volume (MCV), and hair zinc, were performed. Folic acid, vitamin B12, vitamin D, and parathyroid hormone (PTH) were also assessed in 66 subjects.

Results

Mean energy intake was 2801 ± 970 kcal/day. Carbohydrate, protein, and lipid intake represented 55 ± 9.1, 13.9 ± 3.3, and 32.5 ± 8.2 % of total energy intake, respectively. Iron, calcium, and vitamin D intake was below the recommended dietary allowance. The prevalence of nutritional deficiencies were as follows: plasma iron 12.6 %, ferritin 8.7 %, transferrin 14.6 %, plasma zinc 2.9 %, calcium 3.3 %, phosphorus 2.3 %, hemoglobin 7.7 %, hematocrit 13.6 %, MCV 6.8 %, and hair zinc 15.7 %. In the subsample, 10.6 % had a vitamin B12 deficiency, 71.7 % showed low concentrations of vitamin D, and 66 % had high PTH levels. No folic acid or copper deficiencies were detected.

Conclusions

Despite high daily energy intake and adequate macronutrient distribution, morbidly obese Chilean women seeking bariatric surgery present with deficient intake of some micronutrients and a high prevalence of micronutrient deficiencies.
Literatur
1.
2.
3.
Wing RR, Phelan S. Long-term weight loss maintenance. Am J Clin Nutr. 2005;82 Suppl 1:222S–5.PubMed
4.
Sjöström L, Lindroos AK, Peltonen M, et al. Swedish Obese Subjects Study Scientific Group. Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med. 2004;351(26):2683–93.PubMedCrossRef
5.
Sjöström L, Narbro K, Sjöström CD, et al. Effects of bariatric surgery on mortality in swedish obese subjects. N Engl J Med. 2007;357(8):741–52.
6.
Shikora SA, Kim JJ, Tarnoff ME. Nutrition and gastrointestinal complications of bariatric surgery. Nutr Clin Pract. 2007;22(1):29–40.
7.
Poitou Bernert C, Ciangura C, Coupaye M, et al. Nutritional deficiency after gastric bypass: diagnosis, prevention and treatment. Diabetes Metab. 2007;33(1):13–24.PubMedCrossRef
8.
Xanthakos SA. Nutritional deficiencies in obesity and after bariatric surgery. Pediatr Clin North Am. 2009;56(5):1105–21.
9.
Toh SY, Zarshenas N, Jorgensen J. Prevalence of nutrient deficiencies in bariatric patients. Nutrition. 2009;25(11-12):1150–6.PubMedCrossRef
10.
Schweiger C, Weiss R, Berry E, et al. Nutritional deficiencies in bariatric surgery candidates. Obes Surg. 2010;20(2):193–7.
11.
Moizé V, Deulofeu R, Torres F, et al. Nutritional intake and prevalence of nutritional deficiencies prior to surgery in a spanish morbidly obese population. Obes Surg. 2011;21(9):1382–8.
12.
de Luis DA, Pacheco D, Izaola O, et al. Micronutrient status in morbidly obese women before bariatric surgery. Surg Obes Relat Dis. 2013;9(2):323–7.PubMedCrossRef
13.
Damms-Machado A, Friedrich A, Kramer KM, et al. Pre- and postoperative nutritional deficiencies in obese patients undergoing laparoscopic sleeve gastrectomy. Obes Surg. 2012;22(6):881–9.
14.
Rebolledo A. Food surveys. [Encuestas Alimentarias]. Rev Chil Nutr. 1998;25:28–34 [Spanish].
15.
Urteaga C, Pinheiro AC, Atalah E. Comparison of results from two dietary interview methods. [Comparación de los resultados de dos métodos de encuestas alimentarias]. Arch Latinoam Nutr. 2003;53(2):172–7 [Spanish].
16.
Urteaga C, Pinheiro AC. Food intake research: some practical considerations to improve reliability of the results. [Investigación Alimentaria: consideraciones practicas para mejorar la confiabilidad de los datos]. Rev Chil Nutr. 2003;30:235–42 [Spanish].CrossRef
17.
Schmidt-Hebbel, Pennacchiotti I, Masson L, Mella M. Food composition table for Chilean foods. [Tabla de composición química de alimentos Chilenos]. Facultad de Ciencias Químicas y Farmacéuticas, Universidad de Chile, Santiago. 1990. [Spanish].
18.
19.
Olivares M. Iron deficiency anemia: diagnosis and prevalence. [Anemia ferropriva: diagnóstico y prevalencia]. Santiago de Chile: Instituto de Nutrición and Tecnología de los Alimentos (INTA), Universidad de Chile; 2001. p. 1–28 [Spanish].
20.
Brown KH, Rivera JA, Bhutta Z, et al. International Zinc Nutrition Consultative Group (IZiNCG) Technical document #1. Assessment of the risk of zinc deficiency in populations and options for its control. Food Nutr Bull. 2004;25 suppl 2:S99–203.PubMed
21.
Takyi EE. Hair zinc status and its correlation with height indicator in pre-school and school children from a mixed income, low density (mild) community in southern Ghana. East Afr Med J. 2004;81(1):42–6.PubMed
22.
Holick MF, Binkley NC, Bischoff-Ferrari HA, et al. Endocrine Society. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2011;96(7):1911–30.
23.
Fischer DS, Price DC. A simple serum iron method using the new sensitive chromogen tripyridyl-s-triazine. Clin Chem. 1964;10:21–31.PubMedCrossRef
24.
International Anemia Consultative Group. Measurement of iron status: a report of the International Anemia Consultative Group. Washington: The Nutrition Foundation; 1985.
25.
Smith Jr JC, Butrimovitz GP, Purdy WC. Direct measurement of zinc in plasma by atomic absorption spectroscopy. Clin Chem. 1979;25(8):1487–91.PubMed
26.
Ruz M, Cavan KR, Bettger WJ, et al. Indices of iron and copper status during experimentally induced marginal zinc deficiency in humans. Biol Trace Elem Res. 1992;34(2):197–212.PubMedCrossRef
27.
Maggard MA, Shugarman LR, Suttorp M, et al. Metaanalysis: surgical treatment of obesity. Ann Intern Med. 2005;142(7):547–59.PubMedCrossRef
28.
Bloomberg RD, Fleishman A, Nalle JE, et al. Nutritional deficiencies following bariatric surgery: what have we learned? Obes Surg. 2005;15(2):145–54.PubMedCrossRef
29.
Ruz M, Carrasco F, Rojas P, et al. Iron absorption and iron status are reduced after Roux-en-Y gastric bypass. Am J Clin Nutr. 2009;90(3):527–32.PubMedCrossRef
30.
Carrasco F, Ruz M, Rojas P, et al. Changes in bone mineral density, body composition and adiponectin levels in morbidly obese patients after bariatric surgery. Obes Surg. 2009;19(1):41–6.
31.
Ruz M, Carrasco F, Rojas P, et al. Zinc absorption and zinc status are reduced after Roux-en-Y gastric bypass: a randomized study using 2 supplements. Am J Clin Nutr. 2011;94(4):1004–11.PubMedCrossRef
32.
Gasteyger C, Suter M, Gaillard RC, et al. Nutritional deficiencies after Roux-en-Y gastric bypass for morbid obesity often cannot be prevented by standard multivitamin supplementation. Am J Clin Nutr. 2008;87(5):1128–33.PubMed
33.
Flancbaum L, Belsley S, Drake V, et al. Preoperative nutritional status of patients undergoing Roux-en-Y gastric bypass for morbid obesity. J Gastrointest Surg. 2006;10(7):1033–7.
34.
Kaidar-Person O, Person B, Szomstein S, et al. Nutritional deficiencies in morbidly obese patients: a new form of malnutrition? Part A: vitamins. Obes Surg. 2008;18(7):870–6.PubMedCrossRef
35.
Kaidar-Person O, Person B, Szomstein S, et al. Nutritional deficiencies in morbidly obese patients: a new form of malnutrition? Part B: minerals. Obes Surg. 2008;18(8):1028–34.PubMedCrossRef
36.
Ernst B, Thurnheer M, Schmid SM, et al. Evidence for the necessity to systematically assess micronutrient status prior to bariatric surgery. Obes Surg. 2009;19(1):66–73.PubMedCrossRef
37.
Van Rutte PW, Aarts EO, Smulders JF, et al. Nutrient deficiencies before and after sleeve gastrectomy. Obes Surg. 2014;24(10):1639–46.
38.
Papamargaritis D, Aasheim ET, Sampson B, le Roux CW. Copper, selenium and zinc levels after bariatric surgery in patients recommended to take multivitamin-mineral supplementation. J Trace Elem Med Biol. 2015;31:167–72.
39.
Gobato RC, Seixas Chaves DF, Chaim EA. Micronutrient and physiologic parameters before and 6 months after RYGB. Surg Obes Relat Dis. 2014;10(5):944–51.PubMedCrossRef
40.
Ewang-Emukowhate M, Harrington DJ, Botha A, McGowan B, Wierzbicki AS. Vitamin K and other markers of micronutrient status in morbidly obese patients before bariatric surgery. Int J Clin Pract. 2015;69:638–42.
41.
Pizarro F, Olivares M, Kain J. Iron and zinc in the diet of the population of Santiago. [Hierro y zinc en la dieta de la poblacion de Santiago]. Rev Chil Nutr. 2005;32:1–8 [Spanish].CrossRef
42.
Gargallo MA, Ballesteros MD. Unorthodox diets. [Dietas Heterodoxas]. Rev Esp Obes. 2008;6(2):75–87 [Spanish].
43.
Aguirre ME, Ruz M, Carrasco F, et al. Effect of moderate energy-restricted diets on the nutritional status of selected minerals in obese women. [Efecto de dietas con restricción moderada de energía sobre el estado nutricional de algunos minerales en mujeres obesas]. Arch Latinoam Nutr. 2007;57(3):238–47 [Spanish].PubMed
44.
45.
Aasheim ET, Hofsø D, Hjelmesaeth J, et al. Vitamin status in morbidly obese patients: a cross-sectional study. Am J Clin Nutr. 2008;87:362–9.PubMed
46.
Ruz M, Cavan KR, Bettger WJ, et al. Development of a dietary model for the study of mild zinc deficiency in humans and evaluation of some biochemical and functional indices of zinc status. Am J Clin Nutr. 1991;53(5):1295–303.PubMed
47.
Lowe NM, Fekete K, Decsi T. Methods of assessment of zinc status in humans: a systematic review. Am J Clin Nutr. 2009;89(6):2040S–51.PubMedCrossRef
48.
Goldner W, Stoner J, Thompson J, et al. Prevalence of Vitamin D insufficiency and deficiency in morbidly obese patients: a comparison with non-obese controls. Obes Surg. 2008;18(2):145–50.
49.
Mujica-Coopman MF, Borja A, Pizarro F, et al. Prevalence of deficiency and dietary intake of iron, zinc and copper in Chilean childbearing age women. [Prevalencia de deficiencia y consume de hierro, zinc y cobre en mujeres chilenas en edad fértil]. Arch Latinoam Nutr. 2014;64(1):9–15 [Spanish].PubMed
50.
de la Maza MP, Leiva L, Barrera G, et al. Nutritional status, body composition and bone mineral density in gastric bypass females: impact of socioeconomic level. [Evaluación a largo plazo del estado nutricional, composición corporal y densidad mineral ósea en mujeres operadas de bypass gástrico: impacto del nivel socioeconómico]. Rev Med Chil. 2008;136(11):1415–23 [Spanish].PubMed
51.
González G, Alvarado JN, Rojas A, et al. High prevalence of vitamin D deficiency in Chilean healthy postmenopausal women with normal sun exposure: additional evidence for a worldwide concern. Menopause. 2007;14(3 Pt 1):455–61.PubMedCrossRef
52.
Hertrampf E, Cortés F, Erickson JD, et al. Consumption of folic acid-fortified bread improves folate status in women of reproductive age in Chile. J Nutr. 2003;133(10):3166–9.PubMed
Metadaten
Titel
Micronutrient Deficiencies in Morbidly Obese Women Prior to Bariatric Surgery
verfasst von
Andrés Sánchez
Pamela Rojas
Karen Basfi-fer
Fernando Carrasco
Jorge Inostroza
Juana Codoceo
Alejandra Valencia
Karin Papapietro
Attila Csendes
Manuel Ruz
Publikationsdatum
01.02.2016
Verlag
Springer US
Erschienen in
Obesity Surgery / Ausgabe 2/2016
Print ISSN: 0960-8923
Elektronische ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-015-1773-9

Weitere Artikel der Ausgabe 2/2016

Obesity Surgery 2/2016 Zur Ausgabe

Original Contributions

A Comparison of Bariatric Surgery in Hospitals With and Without ICU: a Linked Data Cohort Study

Review Article

Change in Sexual Dysfunction Following Bariatric Surgery

Letter to the Editor

Minimising Haemorrhagic Complications with Bariatric Surgery

Original Contributions

Exclusion of the Distal Ileum Cannot Reverse the Anti-Diabetic Effects of Duodenal-Jejunal Bypass Surgery

Original Contributions

Early Postoperative Progression to Solid Foods Is Safe After Roux-en-Y Gastric Bypass

Original Contributions

A Survey of Bariatric Surgery Patients’ Interest in Postoperative Interventions

Neu im Fachgebiet Chirurgie

23.04.2024 | Ablationstherapie | Nachrichten

Wie erfolgreich ist eine Re-Ablation nach Rezidiv?

23.04.2024 | Appendizitis | Nachrichten

Hinter dieser Appendizitis steckte ein Erreger

23.04.2024 | Operationsvorbereitung | Nachrichten

Mehr Schaden als Nutzen durch präoperatives Aussetzen von GLP-1-Agonisten?

19.04.2024 | EAU 2024 | Kongressbericht | Nachrichten

Ureterstriktur: Innovative OP-Technik bewährt sich
weitere anzeigen

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Aktuelle BDC Leitlinien-Webinare

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.