Nutritional Considerations After Bariatric Surgery Michelle Lee, PhD, RD, LDN Assistant...
-
Upload
stephon-bloxham -
Category
Documents
-
view
214 -
download
1
Transcript of Nutritional Considerations After Bariatric Surgery Michelle Lee, PhD, RD, LDN Assistant...
![Page 1: Nutritional Considerations After Bariatric Surgery Michelle Lee, PhD, RD, LDN Assistant Professor-Nutrition Department of Allied Health College of Clinical.](https://reader035.fdocuments.in/reader035/viewer/2022070306/551918bd55034626428b4a12/html5/thumbnails/1.jpg)
Nutritional Considerations After Bariatric SurgeryMichelle Lee, PhD, RD, LDNAssistant Professor-NutritionDepartment of Allied HealthCollege of Clinical and Rehabilitative SciencesETSU
![Page 2: Nutritional Considerations After Bariatric Surgery Michelle Lee, PhD, RD, LDN Assistant Professor-Nutrition Department of Allied Health College of Clinical.](https://reader035.fdocuments.in/reader035/viewer/2022070306/551918bd55034626428b4a12/html5/thumbnails/2.jpg)
Objectives:
•What are the short-term nutritional implications for individuals receiving bariatric surgery?
•What are the long-term nutritional implications for individuals receiving bariatric surgery?
![Page 3: Nutritional Considerations After Bariatric Surgery Michelle Lee, PhD, RD, LDN Assistant Professor-Nutrition Department of Allied Health College of Clinical.](https://reader035.fdocuments.in/reader035/viewer/2022070306/551918bd55034626428b4a12/html5/thumbnails/3.jpg)
Bariatric Surgery Trends•Between 2003 and 2008, bariatric surgeries
peaked in 2004 and has remained steady(1)
•Number of weight loss surgeries increased from 103,000 in 2003 to ~220,000 in 2008(2)
•Bariatric surgery in NOT a quick fix for morbid obesity
•There are nutritional implications for any bariatric surgery
![Page 4: Nutritional Considerations After Bariatric Surgery Michelle Lee, PhD, RD, LDN Assistant Professor-Nutrition Department of Allied Health College of Clinical.](https://reader035.fdocuments.in/reader035/viewer/2022070306/551918bd55034626428b4a12/html5/thumbnails/4.jpg)
Types of Bariatric Surgery• Restrictive
▫Laparoscopic adjustable gastric band (LAGB)▫Vertical banded gastroplasty (VBG)▫Intragastric balloon
• Malabsorptive▫Bilopancreatic diversion with duodenal switch
(BPD/DS)▫Jejunoileal bypass▫Bilopancreatic diversion (BPD)
• Primary Restrictive with a Malabsorptive Component▫Roux-en-Y gastric bypass (RYGB)
![Page 5: Nutritional Considerations After Bariatric Surgery Michelle Lee, PhD, RD, LDN Assistant Professor-Nutrition Department of Allied Health College of Clinical.](https://reader035.fdocuments.in/reader035/viewer/2022070306/551918bd55034626428b4a12/html5/thumbnails/5.jpg)
Laparoscopic Adjustable Gastric Band
![Page 6: Nutritional Considerations After Bariatric Surgery Michelle Lee, PhD, RD, LDN Assistant Professor-Nutrition Department of Allied Health College of Clinical.](https://reader035.fdocuments.in/reader035/viewer/2022070306/551918bd55034626428b4a12/html5/thumbnails/6.jpg)
Roux-en-Y Gastric Bypass
![Page 7: Nutritional Considerations After Bariatric Surgery Michelle Lee, PhD, RD, LDN Assistant Professor-Nutrition Department of Allied Health College of Clinical.](https://reader035.fdocuments.in/reader035/viewer/2022070306/551918bd55034626428b4a12/html5/thumbnails/7.jpg)
Nutritional Implications of Various Bariatric Surgeries(3,4)
•RYGB▫Malabsorption of Vit B12, Vit B1 (thiamin),
Vit D, Vit K, Folate, Iron, Calcium•LAGB
▫Folic Acid deficiency•BPD and BPD/DS
▫Vit A, D, E, and K deficiency, Protein-Calorie Malnutrition, Malabsorption of Calcium, Zinc, Selenium, Sodium, Potassium, Chloride, Phosphorus, Magnesium
![Page 8: Nutritional Considerations After Bariatric Surgery Michelle Lee, PhD, RD, LDN Assistant Professor-Nutrition Department of Allied Health College of Clinical.](https://reader035.fdocuments.in/reader035/viewer/2022070306/551918bd55034626428b4a12/html5/thumbnails/8.jpg)
Sites of Nutrient Absorption(4)
•Stomach▫Water, ethyl alcohol, copper, iodide,
fluoride, molybdemum, intrinsic factor•Duodenum
▫Calcium, iron, phosphorus, magnesium, copper, selenium, thiamin, riboflavin, niacin, biotin, folate, vitamins A, D, E, K
![Page 9: Nutritional Considerations After Bariatric Surgery Michelle Lee, PhD, RD, LDN Assistant Professor-Nutrition Department of Allied Health College of Clinical.](https://reader035.fdocuments.in/reader035/viewer/2022070306/551918bd55034626428b4a12/html5/thumbnails/9.jpg)
Sites of Nutrient Absorption(4)
•Jejunum▫Thiamin, riboflavin, niacin, pantothenate,
biotin, folate, vit B6, vit C, vit A, D, E, K, dipeptides, tripeptides, calcium, phosphorus, magnesium, iron, zinc, chromium, manganese, molybdenum, amino acids
•Ileum▫Vit C, folate, vit B12, vit D, vit K,
magnesium, bile salts/acids
![Page 10: Nutritional Considerations After Bariatric Surgery Michelle Lee, PhD, RD, LDN Assistant Professor-Nutrition Department of Allied Health College of Clinical.](https://reader035.fdocuments.in/reader035/viewer/2022070306/551918bd55034626428b4a12/html5/thumbnails/10.jpg)
![Page 11: Nutritional Considerations After Bariatric Surgery Michelle Lee, PhD, RD, LDN Assistant Professor-Nutrition Department of Allied Health College of Clinical.](https://reader035.fdocuments.in/reader035/viewer/2022070306/551918bd55034626428b4a12/html5/thumbnails/11.jpg)
Macronutrient Concerns
•Protein•Carbohydrates•Fat
![Page 12: Nutritional Considerations After Bariatric Surgery Michelle Lee, PhD, RD, LDN Assistant Professor-Nutrition Department of Allied Health College of Clinical.](https://reader035.fdocuments.in/reader035/viewer/2022070306/551918bd55034626428b4a12/html5/thumbnails/12.jpg)
Micronutrient Concerns
•Iron•Calcium and Vitamin D•Vitamin B12
•Folic acid•Thiamin•Zinc
![Page 13: Nutritional Considerations After Bariatric Surgery Michelle Lee, PhD, RD, LDN Assistant Professor-Nutrition Department of Allied Health College of Clinical.](https://reader035.fdocuments.in/reader035/viewer/2022070306/551918bd55034626428b4a12/html5/thumbnails/13.jpg)
Recommended Daily Supplements(4)
•Multivitamin with iron (prenatal vitamin will have adeq amount of folic acid)
•Calcium (citrate) with vitamin D (1200-1500 mg calcium with 800-1000 IU vitamin D)
•Oral vitamin B12 (500-1000 mcg)•Iron (65 mg/day in elemental form)
▫Vitamin C (to increase absorption of Iron)•Thiamin (10 mg/day)
![Page 14: Nutritional Considerations After Bariatric Surgery Michelle Lee, PhD, RD, LDN Assistant Professor-Nutrition Department of Allied Health College of Clinical.](https://reader035.fdocuments.in/reader035/viewer/2022070306/551918bd55034626428b4a12/html5/thumbnails/14.jpg)
Diet Progression After Bariatric Surgery(5)
•Clear Liquids•Full liquids•Pureed food•Mechanical soft food•Soft food•Regular diet
![Page 15: Nutritional Considerations After Bariatric Surgery Michelle Lee, PhD, RD, LDN Assistant Professor-Nutrition Department of Allied Health College of Clinical.](https://reader035.fdocuments.in/reader035/viewer/2022070306/551918bd55034626428b4a12/html5/thumbnails/15.jpg)
Diet Recommendations(3)
•Reduce food volume•Chew food very well•Slow pace of eating•No liquids with meals•Encourage fruits and vegetables as diet
progresses•Include high protein foods (at least
60g/day); may need protein supplements
![Page 16: Nutritional Considerations After Bariatric Surgery Michelle Lee, PhD, RD, LDN Assistant Professor-Nutrition Department of Allied Health College of Clinical.](https://reader035.fdocuments.in/reader035/viewer/2022070306/551918bd55034626428b4a12/html5/thumbnails/16.jpg)
References1. Nguyen NT, Masoomi H, Magno CP, Nguyen XM, Laugenour K,
Lane J. Trends in use of bariatric surgery. 2003-2008. J Am Coll Surg. 2011;213(2):261-266.
2. Weight-Control Information Network. Longitudinal assessment of bariatric surgery (LABS). NIH Publication No. 04-5573. http://win.niddk.nih.gov/publications/PDFs/LABS_FactSheet.pdf. Accessed February 25, 2012.
3. Tucker ON, Szomstein S, Rosenthal RJ. Nutritional consequences of weight-loss surgery. Med Clin N Am. 2007;91:499-514.
4. Shikora SA, Kim JJ, Tarnoff ME. Nutrition and gastrointestinal complications of bariatric surgery. Nutr Clin Pract. 2007;22(1):29-40.
5. Furtado LC. Nutritional management after Roux-en-Y gastric bypass. Br J Nurs. 2010;19(7):428-436.
![Page 17: Nutritional Considerations After Bariatric Surgery Michelle Lee, PhD, RD, LDN Assistant Professor-Nutrition Department of Allied Health College of Clinical.](https://reader035.fdocuments.in/reader035/viewer/2022070306/551918bd55034626428b4a12/html5/thumbnails/17.jpg)
Questions