Supplementation recommendations for patients after a Biliopancreatic Diversion with or without Duodenal Switch.
Within 3 years after a Biliopancreatic Diversion (BPD) or BPD with Duodenal Switch (BPD/DS), up to 90% of all patients develop nutritional deficiencies. With this study, Homan and colleagues increase the knowledge needed to develop supplementation recommendations and doses to maintain nutritional health after BDP or BDP/DS.
The need for a tailored food supplement
Prior to this retrospective observational study, there was no multivitamin available tailored to the needs of BPD or BPD/DS patients. Therefore, 34 patients obtained WLS Forte, a multivitamin that effectively prevents deficiencies in Roux-en-Y Gastric Bypass (RYGB) patients. During one year after surgery, nutritional deficiencies were monitored and treated.
Exceptionally high supplementation needed
The doses of vitamin B1, B6, B9 and B12 in WLS Forte were effective in preventing vitamin B deficiencies in BDP or BDP/DS patients. However, 85% of the patients continued to develop new or recurrent deficiencies of vitamin A, vitamin D, iron, calcium or zinc, despite the fact that the supplied multivitamin doses of micronutrients in WLS Forte highly exceeded the standard daily requirements. These results indicate the need for a specialized multivitamin with even higher levels of vitamin A, vitamin D, iron, calcium and zinc, specifically developed for patients after BPD or BPD/DS.
In summary, the authors of the study suggest the following recommendations to prevent nutritional deficiencies among BPD/DS patients:
|Iron||100 mg/day for men and postmenopausal women. 200mg/day for premenopausal women.|
|Vitamin B1||2,75 mg/day|
|Vitamin B6||980 µg/day|
|Folic acid||600 µg/day|
|Vitamin B12||350 µg/day|
|Vitamin A||50000 IU/week, to be adjusted when needed based on serum levels|
|Vitamin D||50000 IU/week|
|Calcium||2000 mg/day, with correction of vitamin D deficiencies|
For more information about the article, get in touch with us by clicking the button below.
Homan J., Schijns W., Aarts E.O., Janssen I.M.C., Berends F.J., de Boer H. (2018) Treatment of Vitamin and Mineral Deficiencies After Biliopancreatic Diversion With or Without Duodenal Switch: a Major Challenge. OBES SURG (2018) 28:234–241
Link to full text: https://link.springer.com/article/10.1007%2Fs11695-017-2841-0