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Nutrition Guidelines for Bariatric Surgery Patients

A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Nutrition and Public Health".

Deadline for manuscript submissions: closed (5 August 2025) | Viewed by 6420

Special Issue Editors


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Guest Editor
Department of Clinical Dietetics, Faculty of Health Sciences, Medical University of Warsaw, E. Ciołka Str. 7, 01-445 Warsaw, Poland
Interests: nutrition; dietetics; nutritional epidemiology; cardiovascular diseases; dyslipidemia; diabetes; obesity; pregnancy; aging
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Guest Editor
Department of General Surgery and Transplantology, Medical University of Warsaw, 02-005 Warsaw, Poland
Interests: obesity in transplant recipients; bariatric surgery; emerging surgical procedures in metabolic surgery; metabolic dysfunction-associated fatty liver disease (MAFLD); ESLD for MAFLD
Special Issues, Collections and Topics in MDPI journals

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Guest Editor Assistant
Department of Clinical Dietetics, Faculty of Health Sciences, Medical University of Warsaw, E. Ciołka Str. 7, 01-445 Warsaw, Poland
Interests: nutrition; dietetics; obesity; bariatric dietetics; bariatric surgery; cardiovascular diseases; dyslipidemia; diabetes; kidney disease
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

We are pleased to invite you to submit manuscripts for a new Special Issue of the journal Nutrients entitled “Nutrition Guidelines for Bariatric Surgery Patients”. Surgical treatment is now considered the most effective treatment for obesity. However, without proper dietary management, it does not achieve the expected results. Improper dietary management causes complications, such as severe nutritional deficiencies and intolerances, which in turn can promote a poor nutritional status and its consequences (decreased immunity, impaired wound healing and decreased basal metabolism). With the increasing prevalence of obesity, the number of people undergoing this form of treatment is steadily increasing, so it is necessary to clarify dietary and postoperative supplementation recommendations, considering special groups of patients, including children and adolescents, pregnant and lactating women and patients before and after organ transplantation. We encourage the submission of both review papers and original research articles.

Prof. Dr. Dorota Szostak-Węgierek
Prof. Dr. Wojciech Lisik
Guest Editors

Dr. Iwona Boniecka
Guest Editor Assistant

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

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Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • bariatric surgery
  • nutrition guidelines
  • proteins
  • carbohydrates
  • fats
  • vitamins
  • minerals
  • supplementation
  • nutrition support
  • dietary intake
  • diet
  • nutritional deficiencies
  • malnutrition

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Published Papers (4 papers)

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Research

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12 pages, 753 KB  
Article
The Global Leadership Initiative on Malnutrition (GLIM) Tool for Nutritional Assessment of Adult Patients After Sleeve Gastrectomy: Is It the Recommended Tool?
by Amani N. Alotaibi, Fahad Bamehriz, Nadia A. Aljomah, Khalid Almutairi, Shabana Tharkar, May Al-Muammar, Adel Alhamdan, Dara Aldisi and Mahmoud M. A. Abulmeaty
Nutrients 2025, 17(6), 1074; https://doi.org/10.3390/nu17061074 - 19 Mar 2025
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Abstract
Background/Objectives: Malnutrition frequently occurs following bariatric surgery and can lead to higher morbidity rates, hospitalizations, and extended hospital stays. Nutritional assessment tools such as the Global Leadership Initiative on Malnutrition (GLIM) are not validated for diagnosis of malnutrition following bariatric surgery. This [...] Read more.
Background/Objectives: Malnutrition frequently occurs following bariatric surgery and can lead to higher morbidity rates, hospitalizations, and extended hospital stays. Nutritional assessment tools such as the Global Leadership Initiative on Malnutrition (GLIM) are not validated for diagnosis of malnutrition following bariatric surgery. This study aimed to assess the validity of GLIM criteria in evaluating the nutritional status of post-sleeve gastrectomy patients compared to the Subjective Global Assessment (SGA). Methods: A total of 47 adult patients who underwent sleeve gastrectomy (SG) from 6 months to 2 years prior were evaluated using the GLIM and SGA. Additionally, multiple pass 24 h recall was collected for two days, and macronutrient analyses were conducted using ESHA software (version 11.11.x). Agreement between both tools was determined using Kappa (κ) statistics, and the Receiver Operating Characteristics (ROC) curve was used to establish sensitivity and specificity. Results: The study found that malnutrition was diagnosed in 48.9% and 42.6% of patients according to the GLIM and SGA criteria, respectively. The GLIM criteria exhibited inadequate accuracy (AUC = 0.533; 95% CI, 0.38–0.72) with a sensitivity and specificity of 55.0% and 55.6%, respectively. The agreement between both tools was determined to be poor (κ = 0.104). Conclusions: GLIM did not show sufficient agreement with SGA. Consequently, the criteria of GLIM may need revision for better diagnosis of malnutrition in post-sleeve gastrectomy patients. Full article
(This article belongs to the Special Issue Nutrition Guidelines for Bariatric Surgery Patients)
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8 pages, 238 KB  
Article
Initial Study on the Impact of Probiotics on Postoperative Gastrointestinal Symptoms and Gut Microbiota after Sleeve Gastrectomy: A Placebo-Controlled Study
by Natalia Dowgiałło-Gornowicz, Dominika Mysiorska, Ewelina Sosnowska-Turek, Anna Botulińska and Paweł Lech
Nutrients 2024, 16(20), 3498; https://doi.org/10.3390/nu16203498 - 15 Oct 2024
Cited by 4 | Viewed by 2722
Abstract
Background: Sleeve gastrectomy (SG) has become the predominant bariatric surgery, leading to significant weight loss and reductions in obesity-related complications. However, postoperative gastrointestinal symptoms such as constipation and bloating are common. This study aims to evaluate the impact of probiotic supplementation on postoperative [...] Read more.
Background: Sleeve gastrectomy (SG) has become the predominant bariatric surgery, leading to significant weight loss and reductions in obesity-related complications. However, postoperative gastrointestinal symptoms such as constipation and bloating are common. This study aims to evaluate the impact of probiotic supplementation on postoperative gastrointestinal symptoms in patients undergoing SG. The secondary aim is to analyze laboratory and stool test results. Materials and methods: This prospective, placebo-controlled study included patients undergoing SG at a single center. Participants were adults without specific gastrointestinal diseases. They were randomly assigned to either the Probiotics or Controls group. Gastrointestinal symptoms and laboratory and stool tests were assessed before surgery and one month after. Results: Thirty-one patients participated, with 15 in the Probiotics group and 16 in the Controls group. Probiotic supplementation significantly increased the number of stools per week (p = 0.027) and reduced constipation incidence (p = 0.002). Patients in the Probiotics group reported easier defecation and greater bowel movement completeness (p = 0.015, p = 0.004). No significant differences in weight loss or laboratory tests were observed between the groups. Stool microbiota analysis showed a return to normal levels of Enterococcus faecalis, Enterococcus faecium, and Clostridium perfringens in the Probiotics group and an increase in the Controls group. Conclusions: Probiotic supplementation after SG significantly reduces constipation without adverse effects. These findings suggest that incorporating probiotics into postoperative care protocols can enhance patient comfort and recovery. Full article
(This article belongs to the Special Issue Nutrition Guidelines for Bariatric Surgery Patients)

Review

Jump to: Research

23 pages, 992 KB  
Review
Dumping Syndrome After Bariatric Surgery: Advanced Nutritional Perspectives and Integrated Pharmacological Management
by Raquel Cano, Daniel Rodríguez, Pablo Duran, Clímaco Cano, Diana Rojas-Gómez, Diego Rivera-Porras, Paola Barboza-González, Héctor Fuentes-Barría, Lissé Angarita, Arturo Boscan and Valmore Bermúdez
Nutrients 2025, 17(19), 3123; https://doi.org/10.3390/nu17193123 - 30 Sep 2025
Viewed by 966
Abstract
Dumping Syndrome (DS) is a significant complication following bariatric surgery, particularly Roux-en-Y gastric bypass (RYGB). This condition is characterised by gastrointestinal and vasomotor symptoms resulting from altered anatomy and hormonal dysregulation, notably accelerated gastric emptying and an exaggerated release of gut peptides. Based [...] Read more.
Dumping Syndrome (DS) is a significant complication following bariatric surgery, particularly Roux-en-Y gastric bypass (RYGB). This condition is characterised by gastrointestinal and vasomotor symptoms resulting from altered anatomy and hormonal dysregulation, notably accelerated gastric emptying and an exaggerated release of gut peptides. Based on the timing of symptom onset after food ingestion, DS is classified as early (EDS) or late (LDS). The critical roles of peptides such as GLP-1, GIP, insulin, and YY peptide are highlighted, along with the involvement of neuroendocrine pathways in symptom manifestation. Diagnosis relies on a combination of clinical evaluation and dynamic testing, with the oral glucose tolerance test (OGTT) often considered a key reference standard for diagnosis. Initial management involves dietary modifications, emphasising the glycaemic index of foods and meal distribution. In cases where nutritional interventions are insufficient, pharmacotherapy with agents such as acarbose, somatostatin analogues (octreotide and pasireotide), GLP-1 receptor agonists (liraglutide), calcium channel blockers (verapamil), and emerging therapies, including herbal medicine, may be considered. For refractory cases, surgical options like bypass reversal or partial pancreatectomy are reserved, although their efficacy can be variable. Despite advancements in understanding and treating DS, further large-scale, randomised controlled trials are essential to validate novel strategies and optimise long-term management. This review provides an updated and comprehensive overview of the aetiology, pathophysiological mechanisms, diagnostic approaches, and current management strategies for DS. Full article
(This article belongs to the Special Issue Nutrition Guidelines for Bariatric Surgery Patients)
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15 pages, 239 KB  
Review
Food Intolerance After Bariatric Surgery: A Narrative Review of Prevalence, Mechanisms, and Dietary Management
by Karolina Brzostek and Iwona Boniecka
Nutrients 2025, 17(19), 3118; https://doi.org/10.3390/nu17193118 - 30 Sep 2025
Viewed by 571
Abstract
Background: Bariatric surgery (BS) is the most effective long-term treatment for severe obesity, but many patients develop food intolerances that either reduce protein and micronutrient intake or shift consumption toward easily tolerated, calorie-dense “safe” foods (e.g., sweets, ice cream, sugar-sweetened beverages, refined-flour snacks), [...] Read more.
Background: Bariatric surgery (BS) is the most effective long-term treatment for severe obesity, but many patients develop food intolerances that either reduce protein and micronutrient intake or shift consumption toward easily tolerated, calorie-dense “safe” foods (e.g., sweets, ice cream, sugar-sweetened beverages, refined-flour snacks), compromising nutrient adequacy and weight-loss maintenance. This narrative review summarizes evidence on the prevalence, mechanisms, and clinical impact of food intolerances after BS, focusing on red meat, dairy, water, cereal, and vegetables, and offers practical nutritional management strategies. Methods: A targeted literature search of PubMed and Cochrane Library from the past 10 years was conducted. Studies were selected based on relevance and quality. Results: Intolerance patterns vary by food type and surgical method. Red meat is the most frequently problematic food, with some patients symptomatic for years despite gradual improvement. Dairy products cause gastrointestinal discomfort in some cases, partly due to lactose intolerance. Cereal products may initially cause swallowing difficulties but are generally well tolerated two years postoperatively. Water intolerance mainly occurs shortly after sleeve gastrectomy (SG), linked to sleeve aperistalsis and edema, resolving within weeks. Cooked vegetables are overall well tolerated across procedures. Mechanisms behind intolerance include mechanical restriction, altered gastric emptying, exaggerated entero-hormonal responses, and new taste aversions. Conclusions: Food intolerances are a common, procedure-specific consequence of BS, requiring systematic assessment and personalized dietary management. Early management—modification of consistency, portion control, and supplementation—can improve product tolerance, prevent nutritional deficiencies, and support sustainable weight loss. However, further prospective studies on the mechanisms of food intolerances are needed. Full article
(This article belongs to the Special Issue Nutrition Guidelines for Bariatric Surgery Patients)
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