Nutritional consequences of modified vertical gastroplasty in obese subjects

BACKGROUND: Gastroplasty results in a considerable reduction in food intake and dramatic weight loss. This is likely to have a nutritional impact, alt hough it is expected that this may be minimised by good advice and suppleme nt use. METHODS: Twenty six obese subjects were studied in detail before and after modified long vertical gastroplasty (MLVG), in a setting where comprehensiv e nutritional advice on symptom avoidance was readily available and multivi tamin supplements advised. Nutritional intake and anthropometry were measur ed preoperatively and at 2, 5 (n = 22) and 12 months (n = 11) postoperative ly. RESULTS: Mean weight loss was 13%, 22% and 31% of initial body weight at th e respective time points. Energy intake (El) was significantly reduced post operatively, with the mean protein intake being only 40 g/d. At 2 months, m ean intakes of iron, calcium and zinc from food were 40%, 71% and 39%, resp ectively, of the Australian recommended dietary intake (RDI), and iron and zinc intake remained below half the RDI at 5 months. Only regular adherence to the vitamin/mineral supplement, brought iron and calcium intakes close to RDI, but zinc remained low. Haemoglobin and serum ferritin concentration s did not alter significantly and remained within the reference range, but serum folate fell significantly between 5 months and 12 months. By 5 months, 60% of subjects never regurgitated or regurgitated less than o nce a week. Fresh bread was the least tolerated food. Frequency of regurgit ation was not correlated with adequacy of nutrient intake. CONCLUSIONS: The results emphasise the need for regular follow-up of MLVG p atients, and nutritional advice which includes diet quality as well as symp tom management, and regular intake of the vitamin/mineral supplement for at least a year postoperatively. Low protein intakes, however, remain of pote ntial long-term concern.