1 The Johns Hopkins Center for Bariatric Surgery, Baltimore, Maryland, USA.
2 Georgetown University School of Medicine, Washington, DC, USA.
Nutr Clin Pract. 2017 Aug;32(4):463-469. doi: 10.1177/0884533617712701. Epub 2017 Jun 21.
Obesity, defined as a body mass index >30 kg/m, is a growing worldwide epidemic currently effecting 1 in 10 adults, with rates as high as 40% in the United States. The only proven long-term treatment of severe obesity on a population level is surgical modification of the gastrointestinal anatomy to induce weight loss, termed bariatric surgery. With adequate physician guidance and appropriate candidate criteria, bariatric surgery is an option for effective long-term treatment of obesity and its related comorbidities. Complications of bariatric surgery can be seen in patients who are not compliant to the recommended lifestyle and dietary changes required following bariatric surgery, including nausea, vomiting, dumping syndrome, acid reflux, and nutrition deficiencies. Despite caloric density, the diet of patients prior to bariatric surgery is often of poor nutrition quality and does not meet recommended dietary guidelines for micronutrient intake, making this an at-risk population for micronutrient malnutrition. Currently, improvements are needed in standardization of nutrition assessment as well as micronutrient cutoffs for deficiency and insufficiency. In the meantime, utilizing our current tools to conduct nutrition assessment at baseline and implement supplementation where necessary may improve the nutrition status of patients undergoing bariatric surgery, both before and after surgery, which may improve their surgical outcomes.
肥胖定义为体质量指数（BMI）＞30kg/m²，是一种目前在全球范围内不断流行的疾病，目前全球每 10 个成年人中就有 1 人受到影响，在美国这一比例高达 40%。在人群层面上，唯一被证实可长期有效治疗重度肥胖的方法是通过手术改变胃肠道解剖结构以诱导体重减轻，即减重手术。在有足够的医生指导和适当的候选标准的情况下，减重手术是肥胖及其相关合并症的有效长期治疗选择。如果患者不遵守减重手术后建议的生活方式和饮食改变，可能会出现减重手术的并发症，包括恶心、呕吐、倾倒综合征、胃酸反流和营养缺乏。尽管热量密度较低，但患者在接受减重手术前的饮食通常营养质量较差，不符合推荐的微量营养素摄入量的饮食指南，这使他们成为微量营养素营养不良的高危人群。目前，需要改进营养评估的标准化以及微量营养素缺乏和不足的截断值。在此期间，利用我们目前的工具在基线进行营养评估，并在必要时进行补充，可能会改善接受减重手术患者的营养状况，无论是在手术前还是手术后，这可能会改善他们的手术结果。
