Poor Nutrition Can Affect Overweight, Obese Individuals

It’s a common misbelief that if you’re obese or overweight, you cannot suffer from poor nutrition.

Yet many people preparing for weight loss surgery are actually malnourished and lack proper nutrition, a small study has found.

Indeed, one in five patients preparing to undergo bariatric surgery had multiple nutritional deficiencies, according to research from Johns Hopkins published in the journal Obesity Surgery.

“Our results highlight the often-overlooked paradox that abundance of food and good nutrition are not one and the same,” says senior investigator Kimberley Steele, M.D., Ph.D., associate professor of surgery at the Johns Hopkins University School of Medicine. “Overweight and obese people can suffer from nutritional deficiencies, and those who care for them should be aware of it.”

The findings are critical for patients. Making nutrition a priority and correcting any deficiencies before surgery could help them avoid malnutrition after their weight loss surgery.

Additionally, proper nutrition is a vital part of losing weight after minimally invasive bariatric surgery.

“Correcting malnutrition is not only easier before surgery, but it may also play a role in reducing surgical complications in the short term and improving overall health in the long run,” says study first author Leigh Peterson, Ph.D., M.H.S., a nutritionist and postdoctoral research fellow at the Johns Hopkins Center for Bariatric Surgery.

The results contradict the commonly held belief that reduced food consumption following bariatric, or weight loss, surgery is the main driver of nutritional deficiencies, Steele says. Because the surgery works by reducing the amount of food absorbed by the body, patients get vitamin supplements as part of their standard postoperative care.

But the new findings, which reveal that more than 20 percent of patients preparing to undergo surgery have multiple deficiencies in nutrition, suggest that a nutritional workup should also be part of the pre-surgical care, the researchers say.

“Finding and correcting the problem before surgery would likely blunt or avert surgery-induced malnutrition in some patients,” she concludes.

For the study, investigators performed nutritional assessments in 58 patients, ages 18 to 65, scheduled to undergo bariatric surgery at Johns Hopkins. They analyzed blood levels of vitamins A, B12, D and E, as well as iron, folate and thiamine.

One in five patients had three or more deficiencies. The most prevalent were subpar levels of iron — in 36 percent — and vitamin D, in 71 percent.

By comparison, the average rate of iron deficiency in the general population is 2 percent for men and 9 percent for women.

Many Lack Vitamin D, Nutrition

The researchers say that an estimated 42 percent of the general population is deficient in vitamin D, adding that vitamin D deficiency is also a common metabolic aberration of obesity. Even so, the researchers say, the average vitamin D level among patients in the study was well below that seen in the average adult — 17 nanograms per milliliter of blood, compared with 22 in the general population.

And because nutrition deficits — notably vitamin D — are believed to precipitate problems such as inflammation, higher infection risk and delayed wound healing, addressing them early on is particularly important in patients before they undergo surgery, researchers say.

The investigators point out that a well-balanced, healthy diet should also be incorporated into the pre-surgical consult.

“While deficiencies require carefully dosed supplementation, eating nutritious, quality food should be at the core of all dietary interventions,” Peterson says.

Source: Johns Hopkins Medicine news release

+ Learn about the Nutritional Analysis program offered at Bon Secours In Motion. Our Registered Dietitians can teach you how to meet your nutritional needs and reach your weight loss goals.