The Optimal Nutritional Programme for Bariatric and Metabolic Surgery
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HEALTH SERVICES AND PROGRAMS (R WELBOURN AND C BORG, SECTION EDITORS)
The Optimal Nutritional Programme for Bariatric and Metabolic Surgery Julie M. Parrott 1 & Lillian Craggs-Dino 2 & Silvia Leite Faria 3 & Mary O’Kane 4
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose of Review Bariatric surgery is the most effective treatment for severe and complex obesity; however, the risk of developing nutrient deficiencies varies based upon the type of surgery, degree of malabsorption, and level of nutrition intervention. There are numerous factors that can impact the nutrition status of a patient during their pre- and postoperative journey. We review the critical components and considerations needed in order to provide optimal nutrition care for patients with bariatric surgery. Recent Findings A dietitian, specializing in bariatric surgery, is the best equipped healthcare provider to prepare and support patients in achieving and maintaining optimal nutrition status. We present best practices for both the pre- and postoperative nutrition-related phases of a patient’s journey. Summary The dietitian specialist is integral in the assessment and ongoing nutrition care of patients with bariatric surgery. Further consideration should be given to enable access for lifelong follow-up and monitoring. Keywords Nutritional management . Micronutrients and macronutrients . Bariatric surgery . Malabsorption . Vitamins and minerals . Perioperative nutrition
Introduction Obesity is a pervasive worldwide disease and continues to be the leading cause of chronic co-morbidities, decreasing quality of life and increasing mortality. While bariatric and metabolic surgery is recognized as the most effective treatment to ameliorate obesity and improve associated diseases, the patient’s success is greatly influenced by a patient-centred Julie M. Parrott, Lillian Craggs-Dino, Silvia Leite Faria and Mary O’Kane contributed equally to this work. This article is part of the Topical Collection on Health Services and Programs * Mary O’Kane [email protected] 1
Metabolic and Bariatric Surgery Program, Penn Medicine, Clinical Practices of the University of Pennsylvania, Philadelphia, PA 19104, USA
2
Cleveland Clinic Florida, Weston, FL, USA
3
Gastrocirurgia de Brasilia/University of Brasilia, Brasilia, DF, Brazil
4
Department of nutrition and dietetics, The General Infirmary at Leeds, Great George Street, Leeds, West Yorkshire LS1 3EX, UK
approach involving a comprehensive and interdisciplinary team of healthcare specialists including registered dietitians (RD). All bariatric procedures can potentially pose a nutritional risk if the patient is not properly assessed and subsequently educated on the nutritional requirements postoperatively. Contributors to this nutritional risk include the health status of the bariatric surgical candidate prior to surgery, the status of obesity as a disease that presents with many micronutrient deficiencies, and the restricting and/or malabsorptive nature of the bariatr
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