Reported intake of energy and vitamins and minerals from diet and supplements 1 year following sleeve gastrectomy and Roux-en-Y gastric bypass was generally similar, according to an exploratory substudy of a randomized trial published in Obesity Surgery.
Researchers analyzed dietary and supplement intake among 285 patients enrolled in the Bypass Equipoise Sleeve Trial, a multicenter randomized controlled study conducted at seven metabolic and bariatric surgery centers in Sweden.
Daily energy intake did not differ between procedures, averaging about 1,670 kcal following sleeve gastrectomy and 1,650 kcal following Roux-en-Y gastric bypass.
The substudy included 148 patients who underwent sleeve gastrectomy and 137 who underwent Roux-en-Y gastric bypass. Patients had been randomized in the parent trial with a body mass index between 35 and 50 kg/m². Nutrient intake was assessed at the 1-year follow-up using 4-day food records in which patients weighed or measured intake, along with questionnaires documenting supplement use.
Dietary intake was analyzed using Dietist Net software based on the Swedish Food Agency database. The Goldberg cut-off method was used to identify implausible energy intake reports; approximately 40% of patients were classified as acceptable reporters. Analyses of dietary intake were based on this subset.
Across both procedures, dietary intake of several vitamins and minerals remained below recommended levels. Compared with national Swedish dietary survey data, patients who underwent bariatric surgery reported intake below recommended or adequate intake levels for a greater number of micronutrients.
Supplement use was common. Overall, 98% of patients reported using vitamin or mineral supplements 1 year following surgery. Vitamin B12 was used by 83% of patients following sleeve gastrectomy and 90% following Roux-en-Y gastric bypass, followed by calcium with vitamin D (83% vs 87%) and multivitamin tablets (84% vs 88%).
When intake from diet and supplements was combined, there were no statistically significant differences between procedures for most vitamins and minerals.
However, several small differences were observed. Dietary vitamin C intake averaged 53 mg following sleeve gastrectomy vs 72 mg following Roux-en-Y gastric bypass. Intake from supplements was higher in the Roux-en-Y gastric bypass group for vitamin A, averaging about 660 retinol equivalents vs 580 retinol equivalents following sleeve gastrectomy, and folic acid, averaging about 440 µg vs 370 µg. Total folic acid intake from diet and supplements was also higher following Roux-en-Y gastric bypass.
For most micronutrients, reported intake came mainly from supplements rather than diet, except for vitamin A and calcium, for which approximately half of intake came from dietary sources.
Despite similar reported energy intake, patients who underwent Roux-en-Y gastric bypass experienced greater weight loss and larger reductions in body mass index than those who underwent sleeve gastrectomy in the parent trial.
The study relied on self-reported dietary and supplement intake and did not include preoperative dietary assessments. Investigators noted that the 4-day food record may influence eating behavior and that underreporting of dietary intake is common. Because the study evaluated patients 1 year following surgery, longer-term differences between procedures remain uncertain.
“Reported intake of vitamins and minerals from diet and supplements was, in general, similar and satisfactory one year following sleeve gastrectomy and Roux-en-Y gastric bypass,” the authors wrote.
Disclosures can be found in the published study.
Source: Obesity Surgery
