title: Short-Term Changes in Body Composition and Response to Micronutrient Supplementation After Laparoscopic Sleeve Gastrectomy.
abstract: BACKGROUND
  We evaluated dietary intakes, body composition, micronutrient deficiency, and response to micronutrient supplementation in 47 patients before and for 6 months after laparoscopic sleeve gastrectomy (LSG).
  
  
  METHODS
  Before, 3, and 6 months after LSG, we measured dietary intakes with food-frequency questionnaires, body composition with bioimpedance analysis (BIA) and bioelectrical vector analysis (BIVA), and plasma concentrations of iron, Zn, water-, and lipo-soluble vitamins.
  
  
  RESULTS
  After LSG, energy intake significantly decreased and patients lost weight, fat mass, and free-fat mass. BIVA showed a substantial loss of soft tissue body cell mass (BCM) with no change in hydration. Before surgery, 15 % of patients were iron deficient, 30 % had low levels of zinc and/or water-soluble vitamins, and 32 % of vitamin 25(OH)-D3. We treated iron deficiency with ferrous sulfate, isolated folate deficiency with N5-methyiltetrahydrofolate-Ca-pentahydrate, and deficiencies in vitamin B1, B12, or Zn, with or without concomitant folate deficiency, with multivitamin. No supplementation was given to vitamin 25(OH)-D3 deficient patients. At first follow-up, 7 % of patients developed new deficiencies in iron, 7 % in folic acid (n = 3), and 36 % in water-soluble vitamins and/or zinc whereas no new deficit in vitamin 25(OH)-D3 occurred. At final follow-up, deficiencies were corrected in all patients treated with either iron or folate but only in 32 % of those receiving multivitamin. Vitamin 25(OH)-D3 deficiency was corrected in 73 % of patients even though these patients were not supplemented.
  
  
  CONCLUSIONS
  LSG-induced weight loss is accompanied by a decrease in BCM with no body fluid alterations. Deficiencies in water-soluble vitamins and Zn respond poorly to multivitamin supplementation.
authors.affiliation: Department of Clinical Medicine and Surgery, Division of Physiology, Federico II University of Naples, Via Pansini n 5, 80131, Naples, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Belfiore
authors.affiliation: Division of Pharmacology, Department of Neuroscience, Reproductive and Odontostomatologic Sciences, Federico II University of Naples, Naples, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Cataldi
authors.affiliation: Department of Clinical Medicine and Surgery, Division of Physiology, Federico II University of Naples, Via Pansini n 5, 80131, Naples, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Minichini
authors.affiliation: Department of Clinical Medicine and Surgery, Division of Physiology, Federico II University of Naples, Via Pansini n 5, 80131, Naples, Italy.
authors.forename: M L
authors.initials: ML
authors.lastname: Aiello
authors.affiliation: Department of Clinical Medicine and Surgery, Division of Physiology, Federico II University of Naples, Via Pansini n 5, 80131, Naples, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Trio
authors.affiliation: Division of General Surgery, Department of Surgery, Second University of Naples, Naples, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Rossetti
authors.affiliation: Department of Clinical Medicine and Surgery, Division of Physiology, Federico II University of Naples, Via Pansini n 5, 80131, Naples, Italy. bguida@unina.it.
authors.forename: B
authors.initials: B
authors.lastname: Guida
mesh_terms: D000328:Adult; D001361:Avitaminosis / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D001823:Body Composition / Q000502:physiology*; D019587:Dietary Supplements; D005260:Female; D005492:Folic Acid / Q000097:blood; D005494:Folic Acid Deficiency / Q000209:etiology; D005743:Gastrectomy / Q000009:adverse effects; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects; D008297:Male; D018977:Micronutrients / Q000008:administration & dosage* / Q000494:pharmacology; D008875:Middle Aged; D044623:Nutrition Therapy; D009767:Obesity, Morbid / Q000178:diet therapy* / Q000453:epidemiology / Q000378:metabolism / Q000601:surgery*; D011183:Postoperative Complications / Q000517:prevention & control; D011184:Postoperative Period; D012189:Retrospective Studies; D014131:Trace Elements / Q000097:blood; D014815:Vitamins / Q000097:blood; D055815:Young Adult
chemical_list: D018977:Micronutrients; D014131:Trace Elements; D014815:Vitamins; D005492:Folic Acid
keywords: Bioimpedence analysis; Body composition; Folic acid; Iron; Laparoscopic sleeve gastrectomy; Trace metals; Vitamin A; Vitamin B1; Vitamin B12; Vitamin D; Vitamin E; Zinc