title: Micronutrient and physiologic parameters before and 6 months after RYGB.
abstract: BACKGROUND
  Bariatric surgery is considered an effective method for sustained weight loss, but may cause various nutritional complications. The aim of this study was to evaluate the nutritional status of minerals and vitamins, food consumption, and to monitor physiologic parameters in patients with obesity before and 6 months after Roux-en-Y gastric bypass surgery (RYGB).
  
  
  METHODS
  Thirty-six patients who had undergone RYGB were prospectively evaluated before and 6 months after surgery. At each phase their weight, height, body mass index (BMI), Electro Sensor Complex (ES Complex) data, food consumption, and total protein serum levels, albumin, prealbumin, parathyroid hormone (PTH), zinc (Zn), B12 vitamin (VitB12), iron (Fe), ferritin, copper (Cu), ionic calcium (CaI), magnesium (Mg), and folic acid were assessed.
  
  
  RESULTS
  The mean weight loss from baseline to 6 months after surgery was 35.34±4.82%. Markers of autonomic nervous system balance (P<.01), stiffness index (P<.01), standard deviation of normal-to-normal R-R intervals (SDNN) (P<.01), and insulin resistance (P<.001) were also improved. With regard to the micronutrients measured, 34 patients demonstrated some kind of deficiency. There was a high percentage of Zn deficiency in both pre- (55.55%) and postoperative (61.11%) patients, and 33.33% of the patients were deficient in prealbumin postoperatively. The protein intake after 6 months of surgery was below the recommended intake (<70 g/d) for 88.88% of the patients. Laboratory analyses demonstrated an average decrease in total protein (P<.05), prealbumin (P = .002), and PTH (P = .008) between pre- and postsurgery, and a decrease in the percentage of deficiencies for Mg (P<.05), CaI (P<.05), and Fe (P = .021).
  
  
  CONCLUSIONS
  Despite improvements in the autonomic nervous system balance, stiffness index markers and insulin resistance, we found a high prevalence of hypozincemia at 6 months post-RYGB. Furthermore, protein supplements were needed to maintain an adequate protein intake up to 6 months postsurgery.
authors.affiliation: Nutricionist Postgraduate in Nutrition in the Digestive System (UNICAMP), Campinas, São Paulo, Brazil; Faculdade de Ciências Médicas- Departamento de Cirurgia do Hospital de Clínicas UNICAMP, Campinas, São Paulo, Brazil. Electronic address: rcgobato@gmail.com.
authors.forename: Renata Cristina
authors.initials: RC
authors.lastname: Gobato
authors.affiliation: Laboratório de Nutrição e Metabolismo- Departamento de Biodinâmica do Movimento Humano-Escola de Educação Física e Esporte - USP, São Paulo, Brazil.
authors.forename: Daniela Fojo
authors.initials: DF
authors.lastname: Seixas Chaves
authors.affiliation: Faculdade de Ciências Médicas- Departamento de Cirurgia do Hospital de Clínicas UNICAMP, Campinas, São Paulo, Brazil.
authors.forename: Elinton Adami
authors.initials: EA
authors.lastname: Chaim
mesh_terms: D000328:Adult; D001341:Autonomic Nervous System / Q000502:physiology; D015415:Biomarkers / Q000378:metabolism; D001794:Blood Pressure / Q000502:physiology; D015992:Body Mass Index; D003677:Deficiency Diseases / Q000209:etiology*; D019587:Dietary Supplements; D004435:Eating / Q000502:physiology; D005260:Female; D015390:Gastric Bypass / Q000009:adverse effects*; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology; D008297:Male; D018977:Micronutrients / Q000172:deficiency*; D008903:Minerals / Q000378:metabolism; D009752:Nutritional Status; D009765:Obesity / Q000601:surgery; D011182:Postoperative Care / Q000379:methods; D011300:Preoperative Care / Q000379:methods; D011446:Prospective Studies; D011488:Protein Deficiency / Q000209:etiology; D014805:Vitamin B 12 / Q000378:metabolism; D014804:Vitamin B Deficiency / Q000209:etiology; D015431:Weight Loss / Q000502:physiology; D015032:Zinc / Q000172:deficiency
chemical_list: D015415:Biomarkers; D018977:Micronutrients; D008903:Minerals; D015032:Zinc; D014805:Vitamin B 12
keywords: Bariatric surgery; Roux-en-Y gastric bypass surgery; autonomic nervous system balance; food intake; insulin resistance; micronutrient deficiency; obesity; stiffness index