The nutritional status of patients 5 years later: why nutritional screening after a Gastric Sleeve is essential
The Gastric Sleeve, or Sleeve Gastrectomy, has become the most frequently performed bariatric procedure worldwide. Postoperatively, patients are at risk of developing micronutrient deficiencies, due to limited oral intake, food intolerances and malabsorption. To assess the need for nutritional screening after a Gastric Sleeve, was assessed in a retrospective study. Data was collected on the long-term nutritional status of 1793 Gastric Sleeve patients over a 5-year follow-up period.
Nutritional screening for deficiencies and hypervitaminosis
Prior to surgery, deficiencies were observed for vitamin D, vitamin B12, iron and ferritin, and these deficiencies still prevailed 5 years after surgery, accompanied by deteriorated anemia. In contrast, excess levels of vitamin B1, B2 and B6 were observed 1 year after operation. These gradually declined to normal levels, with only vitamin B6 still being in excess after 5 years.
|After 5 years||% deficient||% excess|
Tailored supplementation is required
The data shown in this study demonstrate that levels of multivitamins and minerals are continuously changing in the years after a Gastric Sleeve. This emphasizes the need for a regular nutritional screening and subsequent adequate supplementation, not only for the short term, but also for the longer term after surgery.
Gastric Sleeve patients benefit from specialized supplements
Smelt et al. found higher mean serum concentrations of ferritin, folic acid, vitamin B1 and vitamin D and less deficiencies in vitamin B12, ferritin, folic acid and vitamin B1 in Gastric Sleeve patients using WLS Optimum 1.0, compared to patients using standard food supplements. However, anemia was diagnosed more often in WLS Optimum users.
Comparison of deficiency prevalence
The comparison of micronutrient deficiency prevalence for bariatric patients after a Gastric Sleeve versus Roux-en-Y Gastric Bypass patients.
Vitamin D deficiencies after a Gastric Sleeve
Vitamin D deficiencies are common after a Gastric Sleeve, despite supplementation. This study shows the deficiency prevalence 2 to 5 years after surgery.
Al-Mutawa A., Al-Sabah S., Kojo Anderson A., Al-Mutawa M. (2018) Evaluation of nutritional status post laparoscopic sleeve gastrectomy – 5-year outcomes. Al-Mutawa, A et all, Obesity Surgery (2018) 28: 1473-1483.
Link to full text: https://link.springer.com/article/10.1007%2Fs11695-017-3041-7