For bariatric patients, ensuring optimal nutrition is paramount. The American Society for Metabolic and Bariatric Surgery (ASMBS) provides definitive guidelines on vitamin supplementation post-surgery. Here’s an in-depth look at the ASMBS and its vitamin recommendations for all bariatric surgeries (ie. gastric sleeve, gastric bypass, duodenal switch, and lap band).
Who is ASMBS?
The ASMBS, founded in 1983 by visionary American bariatric surgeons, has grown to become the nation’s foremost society for bariatrics. Their main mission is to continue the advancement of weight loss surgery, standards, and quality. It developed into an industry-leading organization with educational and support programs for surgeons and integrated health professionals.
The organization’s mission encompasses:
- The progression of weight loss surgical methods.
- Upholding the highest standards and quality in bariatric care.
- Providing indispensable educational resources and support programs for both surgeons and integrated health professionals.
Both patients and medical professionals benefit significantly from the resources ASMBS offers. Before and after surgery, we encourage all bariatric patients to access ASMBS’s comprehensive website for pertinent information.
ASMBS Nutrition Guidelines
To streamline your vitamin intake post-surgery, refer to the following chart. This chart, structured according to the latest 2016 ASMBS guidelines, delineates the multivitamin needs for various surgical procedures:
| Multivitamin | Gastric Sleeve | Gastric Bypass | Duodenal Switch | Gastric Banding |
|---|---|---|---|---|
| Thiamin | At least 12 mg/day | At least 12 mg/day | At least 12 mg/day | At least 12 mg/day |
| Thiamin (at risk patients) | At least 50-100 mg/day | At least 50-100 mg/day | At least 50-100 mg/day | At least 50-100 mg/day |
| Folic Acid | 400-800 mcg/day | 400-800 mcg/day | 400-800 mcg/day | 400-800 mcg/day |
| Folic Acid (female, child bearing age) | 800-1000 mcg/day | 800-1000 mcg/day | 800-1000 mcg/day | 800-1000 mcg/day |
| Copper | 1 mg/day | 2 mg/day | 2 mg/day | 1 mg/day |
| Zinc | 8-11 mg/day | 8-22 mg/day | 16-22 mg/day | 8-11 mg/day |
| B12 | Oral: 350-500 mcg/day | Oral: 350-500 mcg/day | Oral: 350-500 mcg/day | Oral: 350-500 mcg/day |
| Vitamin D | 3000 IU/day | 3000 IU/day | 3000 IU/day | 3000 IU/day |
| Vitamin A | 5000-10000 IU/day | 5000-10000 IU/day | 10000 IU/day | 5000-10000 IU/day |
| Vitamin E | 15 mg/day | 15 mg/day | 15 mg/day | 15 mg/day |
| Vitamin K | 90-120 mcg/day | 90-120 mcg/day | 300 mcg/day | 90-120 mcg/day |
| Iron (males and patients w/o anemia) | 18 mg/day | 18 mg/day | 18 mg/day | 18 mg/day |
| Iron (menstruating females, patients w/anemia) | 45-60 mg/day | 45-60 mg/day | 45-60 mg/day | 18 mg/day |
| Calcium (divided dosages cannot take w/ Iron) | 1200-1500 mg/day | 1200-1500 mg/day | 1800-2400 mg/day | 1200-1500 mg/day |
Use the above bariatric vitamin guideline chart to be sure your needs are met in your multivitamin, with the possible need of additional supplementation.
Why ASMBS Nutrition Guidelines Matter
Recent studies have highlighted a concerning rise in micronutrient deficiencies among post-operative bariatric patients, especially as follow-ups dwindle. While the guidelines offered by ASMBS serve as a reliable foundation, it remains essential for patients to consult nutritionists or dietitians post-surgery.
Regular lab tests post-surgery are crucial, allowing patients to ascertain and meet their specific nutritional requirements.
Choosing ASMBS-Compliant Bariatric Vitamins
- The Label Matters: Start with a “Bariatric Multivitamin.” Such products generally contain vitamins in higher dosages suited for post-operative needs.
- ASMBS Standards: Does the brand adhere to ASMBS guidelines? Always compare the product label to the above chart, taking note of any discrepancies and necessary supplements.
- Optimal Forms: Post-surgery, drinkable, chewable, or soft-chew vitamins are preferable due to their ease of absorption in the initial 3-6 months. It’s advisable to steer clear of vitamin patches as their absorption efficacy remains unproven.
Dietary Guidelines by ASMBS
Post-surgery, ASMBS suggests a daily protein intake ranging from 60 to 100 grams. This range depends on various factors including the specific surgical procedure, prevailing medical conditions, and individual activity levels. Additionally, a daily water intake of at least 64 ounces is recommended.
Lifetime Vitamin Intake
For those undergoing gastric procedures, like the gastric sleeve, RNY bypass, or duodenal switch, the necessity for vitamins is lifelong. Proper adherence to these guidelines ensures a healthier post-operative life.
