Bradley Morgan, Melchor Julian, Carr Rachel, Karjoo Sara
Florida State University College of Medicine, 1115 W Call St, Tallahassee, FL, 32304, USA.
Johns Hopkins All Children's Hospital, 601 5th St. S. Suite 605, St. Petersburg, FL, 33701, USA.
Obes Pillars. 2023 Sep 7;8:100087. doi: 10.1016/j.obpill.2023.100087. eCollection 2023 Dec.
In the U.S., children and adults are consuming more low-nutrient foods with added sugar and excess fats as compared to healthy, high-quality calories and micronutrients. This diet is increasing the prevalence of malnutrition and nutritional deficiencies, despite high calorie intake. This is a review of the common micronutrient deficiencies, the risk factors for malnutrition, dietary plans, and the health consequences in children and adults with obesity in the U.S.
This clinical review of literature was performed on the MEDLINE (PubMed) search engine. A total of 1391 articles were identified and after review, a total of 130 were found to be most pertinent.
The most common micronutrient deficiencies found in patients with obesity were vitamin A, thiamine (B1), folate (B9), cobalamin (B12), vitamin D, iron, calcium, and magnesium, especially prior and after bariatric surgery. Diets that produced the most weight reduction also further puts these individuals at risk for worsening malnutrition. Malnutrition and micronutrient deficiencies can worsen health outcomes if not properly managed.
Adequate screening and awareness of malnutrition can improve the health outcomes in patients with obesity. Physiologic changes in response to increased adiposity and inadequate intake increase this population's risk of adverse health effects. Malnutrition affects the individual and contributes to worse public health outcomes. The recommendations for screening for malnutrition are not exclusive to individuals undergoing bariatric procedures and can improve the health outcomes of any patient with obesity. However, clearly, improved nutritional status can assist with metabolism and prevent adverse nutritional outcomes post-bariatric surgery. Clinicians should advise on proper nutrition and be aware of diets that worsen deficiencies.
在美国，与健康的高热量、高质量卡路里及微量营养素相比，儿童和成人正在摄入更多添加糖和过量脂肪的低营养食品。尽管热量摄入较高，但这种饮食方式却在增加营养不良和营养缺乏的患病率。本文综述了美国肥胖儿童和成人中常见的微量营养素缺乏、营养不良的风险因素、饮食计划以及健康后果。
本临床文献综述在MEDLINE（PubMed）搜索引擎上进行。共识别出1391篇文章，经筛选，共发现130篇最为相关。
肥胖患者中最常见的微量营养素缺乏包括维生素A、硫胺素（B1）、叶酸（B9）、钴胺素（B12）、维生素D、铁、钙和镁，尤其是在减肥手术前后。减重效果最佳的饮食也会使这些人面临营养不良恶化的风险。如果管理不当，营养不良和微量营养素缺乏会使健康状况恶化。
对营养不良进行充分筛查并提高认识可改善肥胖患者的健康状况。因肥胖增加和摄入不足而产生的生理变化会增加该人群产生不良健康影响的风险。营养不良会影响个体，并导致更差的公共卫生结果。营养不良筛查建议并非仅适用于接受减肥手术的个体，可改善任何肥胖患者的健康状况。然而，显然改善营养状况有助于新陈代谢，并预防减肥手术后出现不良营养后果。临床医生应就适当营养提供建议，并了解会加重营养缺乏的饮食。
