Food intake and nutritional status after gastrectomy

Area of Science:

• Nutritional Science
• Gastroenterology
• Endocrinology

Background:

• Gastrectomy, a surgical procedure involving stomach removal or resection, can significantly impact a patient's nutritional status and body composition.
• Long-term effects of gastrectomy on weight, body fat, and lean mass require thorough investigation to understand potential health consequences.
• Altered nutrient absorption and metabolism post-gastrectomy may lead to deficiencies in essential vitamins and minerals, affecting bone health.

Purpose of the Study:

• To assess the food intake and nutritional status of patients who underwent gastrectomy compared to a healthy control group.
• To investigate the relationship between gastrectomy, body composition, and serum levels of key nutrients like calcium, phosphorus, and vitamin D.
• To determine the efficacy of vitamin D supplementation in correcting deficiencies and mitigating potential bone health issues in gastrectomized individuals.

Main Methods:

• A comparative study involving 67 gastrectomized patients (2-30 years post-surgery) and a matched group of healthy controls.
• Assessment of body weight, fat-free mass, and fat mass using anthropometric measurements.
• Analysis of serum concentrations of alkaline phosphatase, calcium, phosphorus, and 25-hydroxyvitamin D.
• Evaluation of dietary intake of energy, protein, calcium, and vitamin D in both groups.

Main Results:

• Gastrectomized patients exhibited significantly lower body weight, with women showing reduced fat-free mass and men showing reduced fat mass compared to controls.
• Elevated serum alkaline phosphatase and reduced serum calcium, phosphorus, and 25-hydroxyvitamin D were observed in the gastrectomized group.
• Dietary intake of key nutrients did not differ between groups, suggesting malabsorption or metabolic changes rather than insufficient intake.
• Vitamin D supplementation significantly increased serum 25-hydroxyvitamin D levels, with a 10 microgram daily dose normalizing values.

Conclusions:

• Gastrectomy leads to significant alterations in body composition and nutritional status, including reduced bone mineral metabolism markers.
• Vitamin D deficiency is prevalent in gastrectomized patients and is linked to the degree of osteomalacia.
• A daily supplement of 10 micrograms of vitamin D is recommended for all gastrectomized patients to maintain adequate serum 25-hydroxyvitamin D levels and prevent bone disease.