Kamal Faiza A, Fernet Lucas Y, Rodriguez Miguel, Kamal Fatima, Da Silva Naofal K, Kamal Omar A, Ayala Aguilar Alberto, Arruarana Victor S, Martinez Ramirez Marily
General Practice, University of Nottingham, Nottingham, GBR.
Surgery, Universidad de Oriente, Houston, USA.
Cureus. 2024 Feb 27;16(2):e55062. doi: 10.7759/cureus.55062. eCollection 2024 Feb.
Nutritional deficiencies represent a prevalent concern among individuals with obesity, stemming from suboptimal dietary habits, chronic inflammation, and preoperative weight reduction efforts. Bariatric surgical interventions, employing either restrictive, malabsorptive or a combination of the two methods, further compound these deficiencies. Commonly observed nutritional deficits following bariatric surgeries include vitamin B, vitamin D, thiamine, folate, iron, and protein deficiencies. These deficiencies are further complicated by disparities in healthcare resources and income that distinguish low, medium, and high-income countries. The escalating rates of obesity in low- and medium-income countries are primarily attributed to the increasing availability of cheap, nutritionally depleted, and processed foods, coupled with limited access to healthcare. The provision of bariatric surgical interventions in such regions is hindered by the lack of appropriately trained medical personnel and adequate infrastructure. Additionally, the crucial facets of postoperative care, including diligent follow-up, precise weight loss monitoring, and the administration of appropriate nutritional supplements, often remain lacking. This narrative review provides a comprehensive examination of the prevention and treatment of nutritional deficiencies before and after bariatric surgery in the context of varying healthcare resources and income levels. Bariatric procedures and their global prevalence are discussed, and the prevalence, symptoms, and management strategies of specific nutritional deficiencies are explained. This review also outlines practical strategies for providing more equitable care in low- and medium-income countries.
营养缺乏是肥胖人群普遍关注的问题，其源于不良饮食习惯、慢性炎症以及术前减重措施。减肥手术干预采用限制摄入、吸收不良或两者结合的方法，进一步加剧了这些营养缺乏问题。减肥手术后常见的营养缺乏包括维生素B、维生素D、硫胺素、叶酸、铁和蛋白质缺乏。低收入、中等收入和高收入国家在医疗资源和收入方面的差异使这些营养缺乏问题更加复杂。低收入和中等收入国家肥胖率不断上升，主要归因于廉价、营养匮乏的加工食品供应增加，以及获得医疗保健的机会有限。这些地区提供减肥手术干预受到缺乏经过适当培训的医务人员和充足基础设施的阻碍。此外，术后护理的关键方面，包括认真随访、精确监测体重减轻以及给予适当的营养补充剂，往往也很欠缺。本叙述性综述全面审视了在不同医疗资源和收入水平背景下减肥手术前后营养缺乏的预防和治疗。讨论了减肥手术程序及其全球流行情况，并解释了特定营养缺乏的流行情况、症状和管理策略。本综述还概述了在低收入和中等收入国家提供更公平护理的实用策略。
