While malnutrition is rare following bariatric surgery, it can be a severe and even life-threatening complication. Registered dietitians can help their bariatric clients avoid malnutrition and stay healthy by educating them about why meeting their supplement requirements matters.
Here’s a closer look at the issue, along with an overview of the vitamins and minerals that help prevent malnutrition and promote optimal nutritional outcomes.
People who struggle with obesity may have gained weight due to an overconsumption of calories, but this doesn’t mean their bodies are well-nourished. Quite the opposite, in fact: many candidates for bariatric surgery are actually malnourished. These preexisting nutritional deficiencies may put post-op patients at further risk of nutritional issues.
In addition to preoperative malnutrition, there are a number of other risk factors for malnutrition after bariatric surgery, according to research published in the journal Advances in Nutrition. These include:
Furthermore, while the importance of certain nutrients is acknowledged, others don’t receive the same degree of patient education, routine monitoring, and treatment strategies. So while the specifics pertaining to nutrition and supplementation will be determined specifically for the patient by his/her bariatric team, the imperative is the same for all.
Caution researchers: “In conclusion, the benefits of bariatric surgery are tempered by the high frequency of nutritional deficiencies that occur, some of which are under-recognized and left untreated and lead to devastating consequences to bone health and to the functioning of the immune, nervous, and muscular systems.”
“There are more than two dozen micronutrients that your body needs to stay healthy. For most of these, you need only a trace amount. Others, such as B vitamins and minerals like iron and calcium, require more than that and, consequently, are more likely to come up short, particularly among bariatric patients,” says Obesity Coverage.
Specifically, Obesity Coverage identifies thiamin, a.k.a. vitamin B1; vitamin B12; iron; calcium; and vitamin D as mandating special attention. Other critical supplements for bariatric patients include folate; copper; zinc; and vitamins A, E, and K.
The bad news: Failure to get enough of these micronutrients can result in a broad range of health issues, including fatigue, irritability, uneven sleep, abdominal discomfort, feelings of weakness, lightheadedness, muscle tingling, a fast heart rate and/or heart palpitations, brittle nails, memory loss, muscle spasms, and numbness.
The good news: “All of this stuff can easily be avoided with supplements,” says Obesity Coverage.
Of course, there are many different kinds of supplements on the market, and not all are equal in terms of the nutrients they provide. Obesity Coverage recommends avoiding gummy vitamins and most children’s vitamins because they’re “incomplete.”
“All-in-one” multivitamin containing calcium and iron, meanwhile, may require additional supplementation. Important note: Calcium and iron compete for the same absorption site and should be taken separately.
It’s also important to note that vitamins and minerals are not subject to the approval of the Food and Drug Administration (FDA). As a result, it’s wise to seek out trustworthy brands which are labeled as verified by third party agencies, such as NSF International, U.S. Pharmacopeia, Underwriters Laboratory, or Consumer Lab.
Explains Obesity Action, “These are 3rd party agencies that test to confirm that the supplements actually contain what is on the label. Be wary of vitamins and supplements that come from outside of the U.S. These may contain toxic substances or more filler than actual vitamins.”
At the same time, a high price tag may mean nothing. Tod Cooperman, M.D. and president of ConsumerLab.com, told Today, “Some of the highest priced products we've seen have been the worst.”
There's no denying that supplements matter tremendously for bariatric patients, but they’re far from a substitute for real food. Registered dietitians can also ensure that their clients are meeting their nutritional needs by encouraging them to eat nutrient-dense foods, such as Achieve from Rational Foods.
An innovative meal replacement option, Achieve not only contain 20 grams of protein and just 160 calories, but it’s also loaded with vitamins and minerals. For example, just one look at the nutrition label for Butternut Squash, Pear and Ginger Achieve reveals that a single pouch meets 20 percent of the daily recommended values for calcium and vitamin D; iron; vitamins A, E, and K; thiamin, riboflavin; vitamins B6 and B12; zinc; copper; biotin and many others.
For some bariatric patients, the high cost of vitamins and minerals, which can amount to as much as $70 per month, is an impediment to adherence, especially because taking supplements is a lifetime commitment. Reminding them that — like surgery — supplements are an investment in their health and wellness can help overcome this obstacle.