title: Influence of diet and supplements on iron status after gastric bypass surgery.
abstract: BACKGROUND
  Iron deficiency is common after Roux-en-Y gastric bypass (RYGB) surgery, but there is no consensus on the optimal diet quality and quantity for restoring and preserving iron status.
  
  
  OBJECTIVE
  The authors explored the impact of dietary and supplemental sources of iron and absorptive factors on iron status.
  
  
  METHODS
  Academic, United States.
  
  
  METHODS
  In a cross-sectional cohort of individuals who underwent RYGB, nutrient intakes from food and supplements were measured using 3-day food records. Blood biomarkers of iron status, including concentrations of ferritin, total iron binding capacity, serum transferrin receptor (sTfR), and the sTfR:ferritin ratio, were assessed by a reference laboratory; iron deficiency was defined as having at least 2 abnormal measures. Associations between iron status biomarkers and dietary predictors were determined using regression analysis.
  
  
  RESULTS
  Of the 36 participants, 97% were female, the mean age was 45 years (95% confidence interval, 41-48 years), and body mass index was 32 (30-35) kg/m(2). Iron deficiency was found in 42% of participants. Dietary intake of heme iron, found in meats, was favorably associated with 3 iron status biomarkers (ferritin, β = .366; sTfR:ferritin ratio, β = -.459; and total iron binding capacity, β = -18.26; all P<.05), independent of obesity-induced inflammation. Intake of vitamin C from food contributed to iron status (ferritin, β = .010 and sTfR:ferritin ratio, β = -.011; P<.05). Use of supplementary non-heme iron, at doses recommended for prophylaxis (45 mg/d), was positively associated with serum ferritin (β = .964; P = .029).
  
  
  CONCLUSIONS
  For patients who have undergone RYGB, consuming high, but realistic amounts of heme iron in meat, vitamin C from food, and adherence to recommended iron supplements can prevent iron deficiency.
authors.affiliation: Department of Nutrition Science, Purdue University, West Lafayette, Indiana.
authors.forename: Renee A
authors.initials: RA
authors.lastname: Mischler
authors.affiliation: Department of Nutrition Science, Purdue University, West Lafayette, Indiana.
authors.forename: Seth M
authors.initials: SM
authors.lastname: Armah
authors.affiliation: Department of Nutrition Science, Purdue University, West Lafayette, Indiana.
authors.forename: Breanne N
authors.initials: BN
authors.lastname: Wright
authors.affiliation: Department of Surgery, Oregon Health and Science University, Portland, Oregon.
authors.forename: Samer G
authors.initials: SG
authors.lastname: Mattar
authors.affiliation: Department of Biological Sciences, Purdue University, West Lafayette, Indiana.
authors.forename: Arthur D
authors.initials: AD
authors.lastname: Rosen
authors.affiliation: Department of Nutrition Science, Purdue University, West Lafayette, Indiana. Electronic address: ngletsum@purdue.edu.
authors.forename: Nana
authors.initials: N
authors.lastname: Gletsu-Miller
mesh_terms: D000328:Adult; D001205:Ascorbic Acid / Q000008:administration & dosage; D015415:Biomarkers / Q000378:metabolism; D003430:Cross-Sectional Studies; D019587:Dietary Supplements; D005260:Female; D015390:Gastric Bypass / Q000009:adverse effects*; D006801:Humans; D000090463:Iron Deficiencies; D019266:Iron, Dietary / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid; D011446:Prospective Studies
chemical_list: D015415:Biomarkers; D019266:Iron, Dietary; D001205:Ascorbic Acid
keywords: Dietary intake; Iron deficiency; Iron supplementation; Nutritional complications