BACKGROUND: Bariatric surgery (including gastric bypass) is associated with long-term deficiencies in vitamins and minerals, which may have deleterious effects on physiology. The American Association of Clinical Endocrinologists' (AACE) guidelines regarding post-operative vitamin supplementation have recently been endorsed by the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO). Supplements have cost implications. Non-branded multivitamins may have similar compositions to branded multivitamins, but at a lower cost. This study assesses multivitamin supplementation following bariatric gastric bypass in England against AACE guidelines. It also examines the composition and cost of branded and non-branded multivitamins. METHODS: Micronutrient amounts in common multivitamin preparations were obtained from product literature. Costs were collected from a standard retailer. To determine vitamin prescribing patterns, the 37 NHS hospitals performing bariatric gastric bypasses in England were contacted. Practice was assessed against AACE guidelines. RESULTS: All non-branded multivitamins met AACE guidelines for composition. Most had similar compositions to branded multivitamins, and all were cheaper. There was no standard practice regarding post-operative supplementation among the 35 responding hospitals. Only 7/35 (20%) hospitals followed the guidance for two-tablet doses of multivitamins. Immediately post-operatively, 25/35 (71%) hospitals administered calcium carbonate and vitamin D (none recommended calcium citrate, as recommended by AACE to improve absorption), and only 9/35 (26%) hospitals recommended iron to all patients. CONCLUSION: Most non-branded multivitamins are lower cost alternatives to branded multivitamins, with similar compositions. The AACE recommendation for two-tablet doses of multivitamins is not being met by most English centres. Calcium and iron supplementation is also inadequate.
BACKGROUND: Bariatric surgery (including gastric bypass) is associated with long-term deficiencies in vitamins and minerals, which may have deleterious effects on physiology. The American Association of Clinical Endocrinologists' (AACE) guidelines regarding post-operative vitamin supplementation have recently been endorsed by the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO). Supplements have cost implications. Non-branded multivitamins may have similar compositions to branded multivitamins, but at a lower cost. This study assesses multivitamin supplementation following bariatric gastric bypass in England against AACE guidelines. It also examines the composition and cost of branded and non-branded multivitamins. METHODS: Micronutrient amounts in common multivitamin preparations were obtained from product literature. Costs were collected from a standard retailer. To determine vitamin prescribing patterns, the 37 NHS hospitals performing bariatric gastric bypasses in England were contacted. Practice was assessed against AACE guidelines. RESULTS: All non-branded multivitamins met AACE guidelines for composition. Most had similar compositions to branded multivitamins, and all were cheaper. There was no standard practice regarding post-operative supplementation among the 35 responding hospitals. Only 7/35 (20%) hospitals followed the guidance for two-tablet doses of multivitamins. Immediately post-operatively, 25/35 (71%) hospitals administered calcium carbonate and vitamin D (none recommended calcium citrate, as recommended by AACE to improve absorption), and only 9/35 (26%) hospitals recommended iron to all patients. CONCLUSION: Most non-branded multivitamins are lower cost alternatives to branded multivitamins, with similar compositions. The AACE recommendation for two-tablet doses of multivitamins is not being met by most English centres. Calcium and iron supplementation is also inadequate.
Authors: Jeffrey I Mechanick; Robert F Kushner; Harvey J Sugerman; J Michael Gonzalez-Campoy; Maria L Collazo-Clavell; Safak Guven; Adam F Spitz; Caroline M Apovian; Edward H Livingston; Robert Brolin; David B Sarwer; Wendy A Anderson; John Dixon Journal: Surg Obes Relat Dis Date: 2008-08-19 Impact factor: 4.734
Authors: J Salas-Salvadó; P García-Lorda; G Cuatrecasas; A Bonada; X Formiguera; D Del Castillo; M Hernández; J M Olivé Journal: Clin Nutr Date: 2000-10 Impact factor: 7.324
Authors: Kamal K Mahawar; Ken Clare; Mary O'Kane; Yitka Graham; Lindes Callejas-Diaz; William R J Carr Journal: Obes Surg Date: 2019-05 Impact factor: 4.129
Authors: Antonio J Martínez-Ortega; Gabriel Olveira; José L Pereira-Cunill; Carmen Arraiza-Irigoyen; José M García-Almeida; José A Irles Rocamora; María J Molina-Puerta; Juan B Molina Soria; Juana M Rabat-Restrepo; María I Rebollo-Pérez; María P Serrano-Aguayo; Carmen Tenorio-Jiménez; Francisco J Vílches-López; Pedro P García-Luna Journal: Nutrients Date: 2020-07-06 Impact factor: 5.717