Gastric banding patients do not meet recommended daily requirements for important nutrients such as protein, vitamin D and calcium, despite receiving nutritional counselling over a three-month period, according to the outcomes of a study by UT Southwestern Medical Center researchers.
“Our study clearly shows that there are issues regarding nutritional intake in gastric banding patients,” said Dr Abhimanyu Garg, Chief of the Division of Nutrition and Metabolic Diseases at UT Southwestern and senior author of the study. “They may need not only supplementation, but also counseling and constant evaluation.”
The study, published in the Journal of Investigative Medicine, assessed whether dietary counselling improves micronutrient and macronutrient intakes for gastric banding patients.
The researchers followed 23 gastric banding patients who received dietary and behavioural counselling for 12 weeks to limit energy intake and improve nutrient intakes. Food intake was assessed by three-day food record at baseline and six and 12 weeks.
At baseline, more than 50% of the subjects reported inadequate dietary intakes of 13 nutrients but overconsumption of sodium and percent energy from saturated and trans–fatty acids.
After 12 weeks, the investigators found that the patients had a significant reduction in energy (Pp=0.0007), absolute protein (p=0.04), cholesterol (p=0.045), and potassium (p=0.01) intake and an increase in vitamin K (p=0.03) intake and percent energy from protein (p=0.005).
In addition, a McNemar test showed a reduction in the proportion of the subjects with an inadequate intake of vitamin K (p=0.008) but an increase in the proportion of the subjects with an inadequate intake of thiamin (p=0.03) at 12 weeks.
Although there were some improvements in nutrition over the test period, the study participants still had nutritional deficiencies. At least 86 percent did not meet recommended requirements for calcium and vitamin D and many were slightly anaemic at 12 weeks.
The authors note that a proportion of the subjects who did not meet the nutrient requirements for the remaining 27 nutrients was ‘generally high and remained unchanged’.
“Over the past 10 years, the popularity of bariatric surgery has escalated. In banding surgery, it’s presumed there aren’t as many nutritional precautions needed as with some more invasive bariatric surgery options,” said Garg. “But what the study showed is that many banding patients are prone to nutritional deficiency post-surgery, despite taking supplements and receiving nutritional counselling.
Garg recommended that patient’s consume more protein-rich foods to meet the body’s daily protein requirement and to increase the intake of vitamins and minerals as well. Tis includes fatty fish in the diet to increase the intake of omega-3 fatty acids, as well as more fruit, vegetables, whole grains, and nuts to boost dietary fibre intake.
He added that the results results indicate that nutritional counselling beyond 12 weeks is warranted in banding patients to improve their dietary nutrient intakes.