SEARCHCROSS-SECTIONALclinical nutrition, micronutrients

cross-sectional·clinical nutrition, micronutrients, vitamins, minerals, internal medicine·PMC10514116

Vitamin and Mineral Deficiency 12 Years After Roux-en-Y Gastric Bypass a Cross-Sectional Multicenter Study

Obesity Surgery · 11 authors, 9 centres

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TL;DR

This cross-sectional study of 490 patients 12 years after Roux-en-Y gastric bypass found that adherence to recommended vitamin and mineral supplements decreases the probability of deficiency but does not eliminate it.

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The primary aim was to examine the association between self-reported adherence to recommended supplementation and blood levels of vitamins and minerals. Key results showed that while adherence was generally high (e.g., 95% for vitamin B12, 74% for multivitamins), deficiencies were still common. For example, among patients adherent to multivitamin supplements, 11% had folate deficiency, 29% had vitamin B2 deficiency, and 17% had vitamin B6 deficiency. Deficiency rates were significantly higher among non-adherent patients. Even among those adherent to calcium/vitamin D supplements, 52% had sub-optimal vitamin D levels. The study concludes that adherence reduces deficiency risk but is insufficient to prevent it entirely, likely due to the use of over-the-counter supplements with sub-optimal doses compared to current recommendations.

STUDY TYPE

cross-sectional

SPECIALTY

clinical nutrition

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ORIGINAL PAPER

PMC10514116

Vitamin and Mineral Deficiency 12 Years After Roux-en-Y Gastric Bypass a Cross-Sectional Multicenter Study

Obesity Surgery

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ABSTRACT

Abstract Purpose Micronutrient deficiencies are common after Roux-en-Y gastric bypass (RYGB). This study explores whether vitamin and mineral deficiency was associated with adherence to recommended supplementation 12 years after RYGB. Materials and Methods The cross-sectional Bariatric Surgery Observation Study (BAROBS) was conducted in 2018–2020 at three hospitals in Central Norway. We report data on 490 patients’ self-reported adherence to recommended supplements and vitamin and mineral levels in the blood. The patients, who had RYGB between 2003 and 2009, were recommended an over-the-counter multivitamin-mineral supplement, calcium/vitamin D (1000 mg/20 µg) and vitamin B 12 injections (reimbursed), since bariatric supplements were not available then. Results Mean (SD) age was 40.1 ± 9 years at RYGB, and time to follow-up 11.7 ± 1.6 years. Of 490 patients, 393 (80%) were women. Among 361 (74%) patients’ adherent to multivitamin-mineral supplements; folate, vitamin B 2, and vitamin B 6 deficiency were present in 39 (11%), 103 (29%), and 63 (17%) patients, respectively. The same deficiencies occurred in 44 (34%), 67 (52%), and 67 (52%) patients’ non-adherent to recommendations. Although 466 (95%) patients reported adherence to vitamin B 12 supplements, sub-optimal levels were found in 73 (16%) patients. Though 336 (69%) patients adhered to calcium/vitamin D supplements (1000 mg/20 µg), sub-optimal vitamin D levels (< 75 nmol/l) were found in 174/336 (52%) adherent patients and 120/154 (78%) non-adherent patients. Conclusion Twelve years after RYGB, adherence to supplements, though in sub-optimal doses of new recommendations, decreases the probability of vitamin and mineral deficiency, especially for thiamine, vitamin B 2 , vitamin B 6 , folate, vitamin B 12 , and vitamin D, but does not eliminate it. Graphical Abstract Supplementary Information The online version contains supplementary material available at 10.1007/s11695-023-06787-w. Keywords: Gastric Bypass, Vitamin and mineral deficiency, Long-term follow-up, Vitamin D, Vitamin B 12

CITATION EXPORT

Kirsti K Bjerkan, Jorunn Sandvik, Siren Nymo et al.. Vitamin and Mineral Deficiency 12 Years After Roux-en-Y Gastric Bypass a Cross-Sectional Multicenter Study. Obesity Surgery. (2023). https://doi.org/10.1007/s11695-023-06787-w

AUTHORS

11 · 9 CENTRES

Kirsti K Bjerkan, Jorunn Sandvik, Siren Nymo, Halvor Græslie, Gjermund Johnsen, Ronald Mårvik, Åsne A Hyldmo, Bård Eirik Kulseng, Sandra Sommerseth, Kjetil Laurits Høydal, Dag Arne L Hoff

1Faculty of Social Science and History, Volda University College, Joplassvegen 1, Volda, 6103 Norway
2Department of Surgery, Møre and Romsdal Hospital Trust, Ålesund, Norway
3Centre for Obesity Research, Clinic of Surgery, St. Olav’s University Hospital, Trondheim, Norway
4Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
5Clinic of Surgery, Namsos Hospital, Nord-Trøndelag Hospital Trust, Namsos, Norway
6Norwegian National Advisory Unit On Advanced Laparoscopic Surgery, Clinic of Surgery, St. Olav’s University Hospital, Trondheim, Norway
7Department of Neuromedicine and Movement Science, Faculty and Medicine and Health Sciences, NTNU, Trondheim, Norway
8Department of Physical Education, Faculty of Arts and Physical Education, Volda University College, Volda, Norway
9Department of Research and Innovation, Møre and Romsdal Hospital Trust, Ålesund, Norway