Bariatric Nutrition Guidelines for the Indian Population.
BACKGROUND
Bariatric surgery numbers have seen a sharp rise in India in the last decade. A country known for its undernourished population has seen economic growth and with it, greater influence of western culture and foods. The obesity epidemic is on the rise here and India is one of the 10 most obese nations of the world being second only to China in the number of type 2 diabetes. Nutritionists in India often rely on recommendations and guidelines meant for the Caucasian population. Religious and cultural practices influence the dietary habits and patterns of the Indian population to a great extent; because of which the nutritional requirements are very different. This document was put together with an aim to provide nutritionists with recommendations on how to manage the Indian bariatric patient.


METHODS
A bariatric nutrition round table meeting was initiated by the Centre for Obesity and Digestive Surgery (CODS) to bring together experts in the field of bariatric nutrition to review current data on nutritional deficiencies in the morbid obese and existing post-operative deficiencies and to formulate nutritional recommendations for bariatric/metabolic surgery specific to patients from India.


RESULTS
Percentage of nutritional deficiencies and reasons for the same were identified among the Indian population and recommendations were made to suit this particular population.


CONCLUSIONS
It is recommended that all patients undergo compulsory pre-operative nutritional counseling and nutritional investigations and that nutritional follow-up be continued lifelong. In addition, long-term implications like hypoglycemia, dumping syndrome, sugar cravings, and weight regain, need to be picked up and managed efficiently. Most importantly, post-operative supplementation is a must irrespective of type of surgery.
Centre for Obesity and Digestive Surgery, CODS, ground floor, Shiv Tapi building, H. Goregaonkar Road, Opp. Motor House, Opera House, 400007, Mumbai, India. carlyne@codsindia.com.
Carlyne
C
Remedios
Centre for Obesity and Digestive Surgery, CODS, ground floor, Shiv Tapi building, H. Goregaonkar Road, Opp. Motor House, Opera House, 400007, Mumbai, India.|Department of Minimal Access and Bariatric Surgery, Saifee Hospital, Mumbai, India.
Aparna Govil
AG
Bhasker
Department of Minimal Access and Bariatric Surgery, Saifee Hospital, Mumbai, India.
Neha
N
Dhulla
Centre for Obesity and Digestive Surgery, CODS, ground floor, Shiv Tapi building, H. Goregaonkar Road, Opp. Motor House, Opera House, 400007, Mumbai, India.
Shilpa
S
Dhar
Centre for Obesity and Digestive Surgery, CODS, ground floor, Shiv Tapi building, H. Goregaonkar Road, Opp. Motor House, Opera House, 400007, Mumbai, India.|Department of Minimal Access and Bariatric Surgery, Saifee Hospital, Mumbai, India.
Muffazal
M
Lakdawala
D050110:Bariatric Surgery / Q000009:adverse effects / Q000534:rehabilitation; D003677:Deficiency Diseases / Q000453:epidemiology / Q000517:prevention & control; D003924:Diabetes Mellitus, Type 2 / Q000178:diet therapy / Q000453:epidemiology / Q000601:surgery; D019587:Dietary Supplements; D005247:Feeding Behavior; D006801:Humans; D007194:India / Q000453:epidemiology; D008875:Middle Aged; D015596:Nutrition Assessment; D018673:Nutrition Policy; D009751:Nutritional Requirements; D009767:Obesity, Morbid / Q000178:diet therapy / Q000453:epidemiology / Q000601:surgery*; D011184:Postoperative Period
Bariatric nutrition; Deficiency; Indian; Morbid obesity; Nutritional recommendations; Supplementation