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Recommendations Based on Evidence by the Andalusian Group for Nutrition Reflection and Investigation (GARIN) for the Pre- and Postoperative Management of Patients Undergoing Obesity Surgery

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Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Universitario Virgen del Rocío, 41013 Sevilla, Spain
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Endocrine Diseases Research Group, Institute of Biomedicine of Seville (IBiS), 41007 Sevilla, Spain
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Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Regional Universitario de Málaga/Universidad de Málaga, 29010 Málaga, Spain
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Instituto de Investigación Biomédica de Málaga (IBIMA), 29010 Málaga, Spain
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CIBERDEM (CB07/08/0019), Instituto de Salud Carlos III, 28029 Madrid, Spain
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Servicio de Endocrinología y Nutrición, Complejo Hospitalario de Jaén, 23007 Jaén, Spain
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Unidad de gestión Clínica de Endocrinología y Nutrición, Hospital Universitario Virgen de la Victoria, 29010 Málaga, Spain
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UGC Endocrinología y Nutrición, Hospital Universitario Valme, 41014 Sevilla, Spain
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UGC Endocrinología y Nutrición, Hospital Universitario Reina Sofía, 14004 Córdoba, Spain
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Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), 14004 Córdoba, Spain
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U. Nutrición y Dietética. Hospital General, Linares, 23700 Jaén, Spain
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Endocrinología y Nutrición, Hospital Universitario Virgen Macarena, 41009 Sevilla, Spain
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Servicio de Endocrinología y Nutrición, Hospital Juan Ramón Jiménez, 21005 Huelva, Spain
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Endocrinology and Nutrition Clinical Management Unit, University Hospital Virgen de las Nieves, 18014 Granada, Spain
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Servicio de Endocrinología y Nutrición, Hospital Puerta del Mar, 11009 Cádiz, Spain
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GARIN Group Coordinator, 41007 Seville, Spain
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Author to whom correspondence should be addressed.
Nutrients 2020, 12(7), 2002; https://doi.org/10.3390/nu12072002
Received: 12 May 2020 / Revised: 24 June 2020 / Accepted: 2 July 2020 / Published: 6 July 2020
(This article belongs to the Section Clinical Nutrition)
In order to develop evidence-based recommendations and expert consensus for nutrition management of patients undergoing bariatric surgery and postoperative follow-up, we conducted a systematic literature search using PRISMA methodology plus critical appraisal following the SIGN and AGREE-II procedures. The results were discussed among all members of the GARIN group, and all members answered a Likert scale questionnaire to assess the degree of support for every recommendation. Patients undergoing bariatric surgery should be screened preoperatively for some micronutrient deficiencies and treated accordingly. A VLCD (Very Low-Calorie Diet) should be used for 4–8 weeks prior to surgery. Postoperatively, a liquid diet should be maintained for a month, followed by a semi-solid diet also for one month. Protein requirements (1–1.5 g/kg) should be estimated using adjusted weight. Systematic use of specific multivitamin supplements is encouraged. Calcium citrate and vitamin D supplements should be used at higher doses than are currently recommended. The use of proton-pump inhibitors should be individualised, and vitamin B12 and iron should be supplemented in case of deficit. All patients, especially pregnant women, teenagers, and elderly patients require a multidisciplinary approach and specialised follow-up. These recommendations and suggestions regarding nutrition management when undergoing bariatric surgery and postoperative follow-up have direct clinical applicability. View Full-Text
Keywords: Bariatric surgery; obesity; nutrient deficiency Bariatric surgery; obesity; nutrient deficiency
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Martínez-Ortega, A.J.; Olveira, G.; Pereira-Cunill, J.L.; Arraiza-Irigoyen, C.; García-Almeida, J.M.; Irles Rocamora, J.A.; Molina-Puerta, M.J.; Molina Soria, J.B.; Rabat-Restrepo, J.M.; Rebollo-Pérez, M.I.; Serrano-Aguayo, M.P.; Tenorio-Jiménez, C.; Vílches-López, F.J.; García-Luna, P.P. Recommendations Based on Evidence by the Andalusian Group for Nutrition Reflection and Investigation (GARIN) for the Pre- and Postoperative Management of Patients Undergoing Obesity Surgery. Nutrients 2020, 12, 2002.

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