Evaluación nutricional en pacientes candidatos a cirugía bariátrica: estudio del patrón nutricional y prevalencia de deficiencias nutricionales antes de la cirugía en un centro de referencia

Abstract

Introduction

After surgery on severe obesity (BMI = 40 kg/m² or BMI > 35 kg/m² with at least 2 associated pathologies), the development of nutritional deficiencies which, in some cases, already existed before the surgical intervention, has been described.

Objective

To examine the dietetic intake and the prevalence of nutritional deficiencies in obese patients who are candidates for obesity surgery in the Barcelona Hospital Clinic (centre of reference for bariatric surgery).

Methodology

A consecutive evaluation was made of 272 obese patients who were candidates for obesity surgery between January, 2003 and December, 2005. These included 202 women (74.3%) and 70 men (25.7%) (p < 0.005) with an average age ± standard deviation of 45.8 ± 10.4 years and a body mass index (BMI) of 48.6 ± 6.8 kg/m². The evaluation of the intake was carried out by monitoring it for 4 days (one holiday and 3 working days), and was completed with a 24-hour follow-up. In order to assess the nutritional relacondition, the establishment of some analytical parameters was included. The data obtained were statistically analysed. The significance level was provided for a value of p < 0.05.

Results

The average energy intake was 2,553 ± 1,000 Kcal/day in men and 1,971 ± 728 Kcal/day in women (p < 0.05). The carbohydrate intake was 38.2 ± 10.9% in men and 40.0 ± 9.4% in women (p = NS). The lipid intake was 42.8 ± 10.4% in men and 41.6 ± 9.3% in women (p = NS). The protein intake was 19.09 ± 7.9% in men and 18.14 ± 5.1% in women (p = NS). The calcium intake in both genders and the iron intake in women of the group being studied were lower than the dietetic intakes of reference. Likewise, a deficit in the biochemical parameters of different vitamins and minerals can be seen.

Conclusions

The nutritional deficiencies observed in the obese group which is a candidate for obesity surgery could be due to following unbalanced, excessively restrictive and/or uncontrolled diets that they have been on during several periods of their lives until they came for surgical treatment. They could also be related to the lack of dietetic-nutritional education, social factors, the existence of food behaviour disorders or diseases associated with obesity. It is important to detect and correct these altered parameters before surgery, for after it has been performed (BPG) there is an increase in these deficits.