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Vitamin D deficiencies are common in the long-term after a Gastric Sleeve, even when standard supplements are used.

Nutritional deficiencies are common after bariatric surgery. Not much is known though about deficiencies after a Gastric Sleeve in the long term. To assess the prevalence of vitamin D deficiencies after a Gastric Sleeve, a prospective cohort study was conducted evaluating the nutritional status of 176 Gastric Sleeve patients over a 5-year follow-up period.

Micronutrient deficiencies in the first 2 years after surgery

Prior to surgery, the most prevalent deficiencies were for vitamin D (73%), folic acid (16,5%), vitamin B12 (6,9%) and vitamin B6 (12%). About half of patients showed at least one micronutrient deficiency after 2 years, despite supplementation. For most nutrients, blood levels normalized between 2 and 5 years. Copper deficiency (0,5% at baseline) prevalence increased between 1 and 2 years, and was nearly 10% at 5 years after a Gastric Sleeve.

Vitamin D deficiencies remain prevalent over time after a Gastric Sleeve

Before surgery, vitamin D deficiency was already found in 73% of the patients. Directly after surgery, patients were advised to take a standard multivitamin, with 1 gram of calcium and 800 IU (20 mcg) of vitamin D. Patients were interviewed during each follow-up to determine their compliance and if needed, reinforced. One year after surgery, vitamin D deficiencies were still found in 34% of the patients, although a standard food supplement was being used. This prevalence remained without change after 2 and 5 years of follow-up.

Vitamin D supplementation should be increased

51 and 49% of the patients showed at least one deficiency at 1 and 2 years after a Gastric Sleeve, respectively. This indicates that a standard multivitamin does not suffice for the prevention of nutritional deficiencies. Gastric Sleeve patients seem to have a special need for increased vitamin D dosages, to fit the specific nutritional needs ater their operation type.

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Pellitero S., Martínez E., Puig R. Leis A., Zavala R., Granada M.L. Pastor C., Moreno P., Tarascó J., Puig-Domingo M. (2017) Evaluation of Vitamin and Trace Element Requirements after Sleeve Gastrectomy at Long Term. OBES SURG (2017) 27:1674–1682 DOI 10.1007/s11695-017-2557-1

Link to full text: https://link.springer.com/article/10.1007%2Fs11695-017-2557-1