POST-BARIATRIC SURGERY NUTRITIONAL REQUIREMENTS – Part 2 (Recommendation of macro and micronutrients and Nutritional Therapy)

In order to minimize nutritional complications and create conditions for greater long-term success, it is important to predict, prevent and correct nutritional changes in pre-post surgery, with careful monitoring and nutritional supplementation according to guidelines. Priorities are the nutritional education of the patient/family, aiming at good eating habits, within their lifestyle and socioeconomic and cultural conditions. Nutrients Regular follow-up with a specialized nutritionist is essential to facilitate adequate weight loss and to assess the intake of micronutrients that may be inadequate due to the gastric restriction of the gastric band (BG) and sleeve gastrectomy (GV) techniques; of gastric restriction and dysabsorption in gastric bypass (BGYR) and minor gastric restriction and major dysabsorption in biliopancreatic bypass (BPD) and duodenal switch (BPD-DS). The latter 2 carry greater risk for protein malnutrition and micronutrient deficiencies. In all techniques except BG, there are functional and hormonal changes involved in the control of hunger and appetite, food intake, satiety, metabolic glucose change and changes in intestinal hormones such as ghrelin, GLP-1 and PYY.