title: Twelve key nutritional issues in bariatric surgery.
abstract: In morbidly obese patients, i.e. body mass index ≥35, bariatric surgery is considered the only effective durable weight-loss therapy. Laparoscopic Roux-en-Y gastric bypass (LRYGBP), laparoscopic sleeve gastrectomy (LSG), and biliopancreatic diversion with duodenal switch (BPD-DS) are associated with risks of nutritional deficiencies and malnutrition. Therefore, preoperative nutritional assessment and correction of vitamin and micronutrient deficiencies, as well as long-term postoperative nutritional follow-up, are advised. Dietetic counseling is mandatory during the first year, optional later. Planned and structured physical exercise should be systematically promoted to maintain muscle mass and bone health. In this review, twelve key perioperative nutritional issues are raised with focus on LRYGBP and LSG procedures, the most common current bariatric procedures.
authors.affiliation: Nutrition Unit, Geneva University Hospital, rue Gabrielle-Perret-Gentil 4, CH-1211 Geneva 14, Switzerland.
authors.forename: Ronan
authors.initials: R
authors.lastname: Thibault
authors.affiliation: Department of Visceral Surgery, Geneva University Hospital, rue Gabrielle-Perret-Gentil 4, CH-1211 Geneva 14, Switzerland.
authors.forename: Olivier
authors.initials: O
authors.lastname: Huber
authors.affiliation: Bariatric and Minimally Invasive Surgery, Stanford University School of Medicine, 300 Pasteur Drive, H3680A, Stanford, CA 94305-5655, USA.
authors.forename: Dan E
authors.initials: DE
authors.lastname: Azagury
authors.affiliation: Nutrition Unit, Geneva University Hospital, rue Gabrielle-Perret-Gentil 4, CH-1211 Geneva 14, Switzerland. Electronic address: claude.pichard@unige.ch.
authors.forename: Claude
authors.initials: C
authors.lastname: Pichard
mesh_terms: D050110:Bariatric Surgery / Q000009:adverse effects* / Q000379:methods; D015904:Biliopancreatic Diversion / Q000009:adverse effects / Q000379:methods; D001823:Body Composition; D015992:Body Mass Index; D001842:Bone and Bones / Q000187:drug effects / Q000378:metabolism; D004040:Dietary Carbohydrates / Q000008:administration & dosage; D019587:Dietary Supplements; D004046:Dietetics / Q000592:standards*; D015444:Exercise; D005743:Gastrectomy / Q000009:adverse effects; D015390:Gastric Bypass / Q000009:adverse effects; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects; D044342:Malnutrition / Q000178:diet therapy* / Q000517:prevention & control; D018977:Micronutrients / Q000008:administration & dosage / Q000097:blood* / Q000172:deficiency; D009767:Obesity, Morbid / Q000178:diet therapy / Q000601:surgery*; D011182:Postoperative Care; D011300:Preoperative Care; D016032:Randomized Controlled Trials as Topic; D015431:Weight Loss
chemical_list: D004040:Dietary Carbohydrates; D018977:Micronutrients
keywords: Fat-free mass; Malnutrition; Micronutrient; Roux-en-Y gastric bypass; Sleeve gastrectomy; Vitamin