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The Influence of Different Cholecalciferol Supplementation Regimes on 25(OH) Cholecalciferol, Calcium and Parathyroid Hormone after Bariatric Surgery
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Assessment of Physical Fitness after Bariatric Surgery and Its Association with Protein Intake and Type of Cholecalciferol Supplementation

Department of Surgery, Catharina Hospital, 5623 EJ Eindhoven, The Netherlands
Obesity Center, Catharina Hospital, 5623 EJ Eindhoven, The Netherlands
Department of Surgery, Haaglanden Medical Center, 2512 VA The Hague, The Netherlands
Metabolic Surgery Clinic, Sisli, 34340 Istanbul, Turkey
Center for Medical Weight Loss & Metabolic Control, Rowan University, Stratford, NJ 08084, USA
Author to whom correspondence should be addressed.
Medicina 2019, 55(6), 281;
Received: 17 March 2019 / Revised: 6 June 2019 / Accepted: 12 June 2019 / Published: 17 June 2019
(This article belongs to the Special Issue The Role of Vitamin D in Obesity)
PDF [283 KB, uploaded 24 June 2019]


Background and objectives: Several studies showed that there is a relationship between vitamin and mineral status and muscle strength. In particular this is the case for handgrip strength (HS) and vitamin D deficiency. In bariatric surgery there is a risk of decrease in muscle strength after surgery and also vitamin and mineral deficiencies are not uncommon. The aim of this study is to assess the effect of low vitamin 25 (OH) cholecalciferol levels, high dose cholecalciferol supplementation regime and protein intake on physical fitness, measured using handgrip strength (HS) and the shuttle walk run test (SWRT). Materials and Methods: For this retrospective study, 100 patients who have had bariatric surgery were included. Group A (n = 50) used 800 IU oral cholecalciferol per day. Group B (n = 50) used 800 IU oral cholecalciferol daily and 50,000 IU liquid cholecalciferol monthly lifelong. Both groups were matched on common variables. To measure physical fitness, we used the HS manometer of Jamar and the Shuttle Walk Run Test (SWRT) to assess physical capacity. Results: No significant differences in HS and SWRT outcomes were found between patients with serum 25 (OH) cholecalciferol < 75 nmol/L or >75 nmol/L. The postoperative HS is significantly influenced by protein intake (p = 0.017) and no significant influence was seen in outcomes of the SWRT (p = 0.447). Conclusion: We have found that serum 25 (OH) cholecalciferol and different cholecalciferol supplementation regimes do not have a significant effect on HS and SWRT before, three and 6 months after surgery. It seems that protein intake plays a more important role in maintaining adequate muscle strength. View Full-Text
Keywords: physical fitness; shuttle walk run test; handgrip strength; vitamin D physical fitness; shuttle walk run test; handgrip strength; vitamin D
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).

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Smelt, H.J.M.; Pouwels, S.; Celik, A.; Gupta, A.; Smulders, J.F. Assessment of Physical Fitness after Bariatric Surgery and Its Association with Protein Intake and Type of Cholecalciferol Supplementation. Medicina 2019, 55, 281.

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