Surgery For Obesity And Related Diseases
September/October 2008
Official Journal of the American Society for Metabolic and Bariatric Surgery
American Association of Clinical Endocrinologists, The Obesity Society, and American Society for Metabolic & Bariatric Surgery Medical Guidelines for Clinical Practice for the Perioperative Nutritional, Metabolic, and Nonsurgical Support of the Bariatric Patient
"Minimal nutritional supplementation includes 1-2 adult multivitamin-mineral supplements containing iron, 1200-1500mg of calcium, and a vitamin B-complex preparation". Pg. S121
The Levels of Calcium and Zinc that Are Found Naturally in Foods or in Calcium-Fortified Foods Do Not Affect Iron Absorption
Dr. Penelope Nestel and Dr. Ritu Nalubola
Iron and Calcium's inhibition of absorption however, has not been found in long-term (6 months or longer) intervention studies.3,4 An adaptive response, possibly involving an up-regulation in the efficiency of iron absorption, may prevent prolonged inhibition of iron absorption or the development of inadequate iron status when supplemental doses of calcium are taken.3,6 The inhibitory effect of calcium on iron absorption has not been observed with calcium fortification or naturally occurring calcium in foods.
Effect of calcium supplementation on daily nonheme-iron absorption and long-term iron status.
Minihane AM, Fairweather-Tait SJ.
Institute of Food Research, Norwich Research Park, Colney, United Kingdom.
The long-term effect of consuming calcium supplements with meals (1200 mg Ca/d) on body iron (functional and storage iron) was investigated in 11 iron-replete adults over a 6-mo period. An unsupplemented control group (n = 13) was also monitored to correct for any seasonal changes in the biochemical measurements. There were no changes in any of the hematologic indexes, including hemoglobin, hematocrit, zinc protoporphyrin, and plasma ferritin resulting from the calcium supplementation. The results clearly show that long-term supplementation with calcium did not reduce plasma ferritin concentrations in iron-replete adults consuming a Western-style diet containing moderate to high amounts of calcium in most meals.
Why Do I Need A Chewable Multi-vitamin?
Vitamin and mineral supplementation after gastric bypass surgery is critical in maintaining proper health and nutrition. Micro-nutrient deficiency is the most common side effect from this procedure do to the malabsorptive component of gastric bypass. This typically occurs in approximately 21% of patients. Some frequently seen deficiencies include: iron, B12, folate, and calcium. Side affects when lacking in these important nutrients include: easy bruising, loss of hair, lack of energy etc . Taking a chewable multivitamin is the easiest and most effective way of reducing the risk of micro nutrient deficiencies in the body after gastric bypass surgery. A chewable vitamin ensures success of absorption by beginning the digestive process in the mouth . Chewing breaks down the multivitamin to its most biologically available form and gives your digestive tract a distinct advantage of absorbing all the vitamins and minerals possible. Taking a capsule delays the absorption of supplements being taken. The shell of the capsule must be broken down in the digestive tract before absorption can occur. When and where this takes place cannot be determined with 100% accuracy. You must find a vitamin and mineral formulation that is made specifically for patients who have had gastric bypass surgery. This formulation should have dramatically higher percentages of vitamins A-E, B12, Folic Acid and Calcium. It must also include iron and chelated forms of minerals which increase your chance of absorption. Those patients taking anti-coagulants such as warfarin and coumadin must be sure to avoid formulations containing Vitamin K. Patients who suffer from migranes should consider a product that is sweetened with sucralose (splenda) rather then aspartame. Be sure that your surgeon or primary doctor routinely checks your blood-work for early detection of any underlying deficiencies.
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