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The Nutritional Management of the Pre- and Post-surgery Obesity Patients

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Behavior, Chronic Disease and Health Promotion".

Deadline for manuscript submissions: closed (30 September 2022) | Viewed by 11791

Special Issue Editor

Special Issue Information

Dear Colleagues,

Clinically severe obesity can have serious health consequences for patients. Bariatric surgery has been established as the most effective treatment for morbidly obese patients, with a substantial reduction in mortality, risk of developing comorbidities, and costs.

  • Bariatric patients require scrupulous assessment and counseling in order to prolong weight loss and prevent nutritional deficiencies. The life-long metabolic and nutritional observance is suggested after bariatric surgery, mainly because pre-surgical deficiencies are common in morbidly obese patients and can be aggravated by restrictive or malabsorptive procedures.
  • Nutritional requirements in patients who have undergone bariatric surgery are frequently not met, and various nutritional deficiencies (vitamin B12, vitamin D, iron, calcium, etc.) are frequently observed as well. Accordingly, the adherence of patients to long-term supplementation regimens is poor in most cases.
  • Over the last ten years, clinical research on bariatric surgery has grown exponentially, mostly focusing on weight loss and reduction in comorbidities, but leaving gaps in the nutritional and health status of the subject after surgery in the long term.
  • This Special Issue of the International Journal of Environmental Research and Public Health (IJERPH) focuses on the current state of knowledge on The Nutritional Management of Pre- and Post-Surgery Obesity Patients. New research papers and reviews are welcome to this Issue.

Potential topics may include, but are not limited to:

  1. Preoperative nutritional management of patients with morbid obesity;
  2. Post-surgery diet progression;
  3. Perioperative nutritional, metabolic, and nonsurgical support of bariatric surgery patients;
  4. Micronutrient deficiencies after bariatric surgery;
  5. Nutritional outcomes after bariatric surgery and differences in racial and ethnic groups;
  6. Bone mineral density changes after bariatric surgery and relationship to vitamin D.

Best regards,

Dr. Mauro Lombardo
Guest Editor

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Keywords

  • nutritional deficiencies
  • bariatric surgery
  • nutrition prehabilitation
  • sleeve gastrectomy
  • nutrition care
  • dietary supplements

Published Papers (3 papers)

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Research

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11 pages, 2836 KiB  
Article
Fat-Free Mass and Skeletal Muscle Mass Gain Are Associated with Diabetes Remission after Laparoscopic Sleeve Gastrectomy in Males but Not in Females
by Ngan Thi Kim Nguyen, Nguyen-Phong Vo, Shih-Yi Huang and Weu Wang
Int. J. Environ. Res. Public Health 2022, 19(2), 978; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19020978 - 16 Jan 2022
Cited by 4 | Viewed by 1777
Abstract
Besides massive body weight loss, laparoscopic sleeve gastrectomy (LSG) causes massive lean mass, including fat-free mass (FFM) and skeletal muscle mass (SM) that present higher metabolic rates in males. This study examines sex differences in FFM and SM changes of type 2 diabetes [...] Read more.
Besides massive body weight loss, laparoscopic sleeve gastrectomy (LSG) causes massive lean mass, including fat-free mass (FFM) and skeletal muscle mass (SM) that present higher metabolic rates in males. This study examines sex differences in FFM and SM changes of type 2 diabetes (T2D) remission at 12 months post-LSG. This cohort study recruited 119 patients (53.7% females) with T2D and obesity (body mass index 42.2 ± 7.0 kg/m2) who underwent LSG. Fat-mass (FM) loss was higher in males than in females (−12.8 ± 6.2% vs. −9.9 ± 5.0%, p = 0.02) after one-year post-operation. Regardless of the weight-loss difference, males had higher FFM and SM gain than did females (12.8 ± 8.0 vs. 9.9 ± 5.0% p = 0.02 and 6.5 ± 4.3% vs. 4.9 ± 6.2%, p = 0.03, respectively). Positive correlations of triglyceride reduction with FM loss (r = 0.47, p = 0.01) and SM gain (r = 0.44, p = 0.02) over 12 months post-operation were observed in males who achieved T2D remission. The T2D remission rate significantly increased 16% and 26% for each additional percentage of FFM and SM gain one year after LSG, which only happened in males. Increased FFM and SM were remarkably associated with T2D remission in males, but evidence lacks for females. Full article
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9 pages, 647 KiB  
Article
Long-Term Iron and Vitamin B12 Deficiency Are Present after Bariatric Surgery, despite the Widespread Use of Supplements
by Mauro Lombardo, Arianna Franchi, Roberto Biolcati Rinaldi, Gianluca Rizzo, Monica D’Adamo, Valeria Guglielmi, Alfonso Bellia, Elvira Padua, Massimiliano Caprio and Paolo Sbraccia
Int. J. Environ. Res. Public Health 2021, 18(9), 4541; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18094541 - 25 Apr 2021
Cited by 11 | Viewed by 4171
Abstract
There are few long-term nutritional studies in subjects undergoing bariatric surgery that have assessed weight regain and nutritional deficiencies. In this study, we report data 8 years after surgery on weight loss, use of dietary supplements and deficit of micronutrients in a cohort [...] Read more.
There are few long-term nutritional studies in subjects undergoing bariatric surgery that have assessed weight regain and nutritional deficiencies. In this study, we report data 8 years after surgery on weight loss, use of dietary supplements and deficit of micronutrients in a cohort of patients from five centres in central and northern Italy. The study group consisted of 52 subjects (age: 38.1 ± 10.6 y, 42 females): 16 patients had Roux-en-Y gastric bypass (RYGB), 25 patients had sleeve gastrectomy (SG) and 11 subjects had adjustable gastric banding (AGB). All three bariatric procedures led to sustained weight loss: the average percentage excess weight loss, defined as weight loss divided by excess weight based on ideal body weight, was 60.6% ± 32.3. Despite good adherence to prescribed supplements, 80.7% of subjects (72.7%, AGB; 76.7%, SG; 93.8 %, RYGB) reported at least one nutritional deficiency: iron (F 64.3% vs. M 30%), vitamin B12 (F 16.6% vs. M 10%), calcium (F 33.3% vs. M 0%) and vitamin D (F 38.1% vs. M 60%). Long-term nutritional deficiencies were greater than the general population among men for iron and among women for vitamin B12. Full article
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Review

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16 pages, 418 KiB  
Review
Nutritional Management in Bariatric Surgery Patients
by Andrea Deledda, Stefano Pintus, Andrea Loviselli, Michele Fosci, Giovanni Fantola and Fernanda Velluzzi
Int. J. Environ. Res. Public Health 2021, 18(22), 12049; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182212049 - 17 Nov 2021
Cited by 12 | Viewed by 5003
Abstract
The obesity epidemic, mainly due to lifestyle changes in recent decades, leads to serious comorbidities that reduce life expectancy. This situation is affecting the health policies of many nations around the world. Traditional measures such as diet, physical activity, and drugs are often [...] Read more.
The obesity epidemic, mainly due to lifestyle changes in recent decades, leads to serious comorbidities that reduce life expectancy. This situation is affecting the health policies of many nations around the world. Traditional measures such as diet, physical activity, and drugs are often not enough to achieve weight loss goals and to maintain the results over time. Bariatric surgery (BS) includes various techniques, which favor rapid and sustained weight loss. BS is a useful and, in most cases, the best treatment in severe and complicated obesity. In addition, it has a greater benefit/risk ratio than non-surgical traditional therapies. BS can allow the obese patient to lose weight quickly compared with traditional lifestyle changes, and with a greater probability of maintaining the results. Moreover, BS promotes improvements in metabolic parameters, even diabetes remission, and in the quality of life. These changes can lead to an increase of life expectancy by over 6 years on average. The nutrition of people before and after BS must be the subject of indications from a trained staff, and patients must be followed in the subsequent years to reduce the risk of malnutrition and the associated problems. In particular, it is still debated whether it is necessary to lose weight prior to surgery, a procedure that can facilitate the surgeon’s work reducing the surgical risk, but at the same time, lengthens preparation times increasing the risks associated with concomitant pathologies. Furthermore, preventing nutritional deficiencies prior to the intervention can improve the results and reduce short- and long-term mortality. Full article
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