The aim of gastric bypass surgery is to make the patient lose weight and avoid the morbidities associated with obesity. The post-surgery diet is therefore designed to achieve that goal, without forgetting the essential role that nutritional education has on the learning of new dietary habits leading to maintenance of the weight loss over time. Counseling, monitoring, and gastric bypass supplements are thus essential for the treatment and prevention of nutritional and metabolic complications after bariatric surgery. A regular, simple exercise program and psychological support are often recommended to create a better self-image and a whole new attitude to food. Postoperative dietary patterns have to be adapted to new physiological conditions, either related with the volume of intakes or the characteristics of the macro- and micronutrients to be administered. In general, the gastric bypass diet includes foods that are high in protein, and low in fat, fiber, calories, and sugar. Important vitamins and minerals are provided as supplements Given that morbidly obese patients often have nutritional deficiencies, particularly of fat-soluble vitamins, folic acid and zinc, the risk of more severe deficiencies increases manifold after surgery. This is due to the reduction in the amount of food intake, which means a lesser supply of nutrients, and also its malabsorption. Anemia can be secondary to iron deficiency, folic acid deficiency and even to vitamin B12 deficiency. Neurological disorders such as encephalopathy and peripheral neuropathies due to thiamine deficiency may also be observed. Other deficiency syndromes include demineralization of bones due to vitamin D deficiency, hair loss secondary to zinc deficiency and ocular symptoms from vitamin A deficiency. Protein deficiency associated with a decrease in the fat-free mass can require parenteral nutritional support in extreme cases. Hence, gastric bypass supplements play a major role in maintaining the health of those people who have undergone gastric bypass surgeries. The most important among the supplements is iron. Men should take a daily dose of 100 to 200 milligrams of ferrous sulfate or ferrous gluconate, whereas menstruating women require up to 300 to 350 milligrams per day. The absorption of iron is enhanced by the presence of vitamin C, so a daily dose of 60 milligrams of vitamin C is also recommended. The therapeutic daily dosage of Vitamin C in patients of anemia is 500 milligrams. Vitamins from the B group are also very essential, especially vitamin B12. This vitamin is necessary to avoid pernicious anemia and to avoid the consequences of high levels of homocysteine, a naturally occurring amino acid, which include decreased memory power and thinking ability. A weekly dose of 1000 micrograms of vitamin B12, a daily dose of 300 milligrams of vitamin B6, and 5 milligrams of folic acid are recommended for two months in the immediate postoperative period. Calcium, Vitamin D and K are essential to maintain bone health and to avoid osteoporosis. Vitamin D regulates the level of calcium in the body and ensures that the calcium is used to make the bones strong. . The recommended daily dose of calcium is 600 milligrams. Vitamin D is readily available from some food items, and is also produced in the skin, as a result of sun exposure. There is no supplement for vitamin K, as it is produced in the body itself, but its production can be triggered by some food items. An alkali diet often helps in vitamin D and K function. Other important considerations when planning the nutritional intake of the patient are the postoperative nausea and vomiting, dehydration, dumping syndrome, food intolerance, stomach pain, ulcers, and gastritis. A basic rule of thumb when choosing gastric bypass supplements is to pick one that contains most of the vitamins and minerals essential for good health - but does not exceed the U.S. Recommended Daily Allowance by more than 150 percent, so as to avoid toxicity. Chewable tablets are unpalatable, especially for a patient already battling postoperative nausea. Capsules and gel formulations are a good choice because they are more likely to be absorbed quickly. Sustained-release tablets should be avoided, they dissolve slowly, and can pass through the shortened intestine without being absorbed. It is prudent to choose a gender and age specific formula: geriatric formulations often include chelated minerals for better absorption in addition to glucosamine to help with bones and joints and herbs to improve memory and wellness. It is therefore imperative that the dietary intake of the patient be under close supervision by a qualified nutritionist in consultation with the surgeon. This includes a regular monitoring of the blood levels of essential nutrients and altering the diet accordingly. Also, gastric bypass supplements can be individualized to best fit the nutritional needs on a case to case basis. The first sign of micro or macro nutrient deficiency requires intensive supplementation and close monitoring in order to avoid complications. Copyright (c) 2009 Alma Orozco
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