Enhancing Bone Health After Bariatric Surgery: Essential Guidelines and Nutritional Tips
The Impact of Obesity on Joint Health
Overweight and obesity strain your joints and makes them weak and painful. Constant pain reduces mobility and worsens obesity. Obesity alone has been associated with altered levels of calcium, vitamin D, and parathyroid hormone in all ages.
Benefits of Shedding Extra Kilos
Shedding extra kilos will make your joints stronger, help in getting relief in aches, and also reduce risks of fracture especially the hip joint. Losing weight also decreases the possibility of getting a joint transplant done.
Bariatric surgery is a proven tool to help obese people get all these benefits and improve their quality of life.
Nutritional Assessment and Follow-Up
Despite the undoubted health benefits, bariatric surgery requires an extensive preoperative nutritional assessment and also calls for a life-long commitment from the patient for follow-up to focus on weight loss maintenance and compliance with aftercare recommendations. In general, gastric bypass procedures will have greater potential risk of micronutrient deficiency than a gastric sleeve surgery.
Screening for Vitamin D Deficiency
All patients preparing for bariatric surgery should be screened for the presence of vitamin D deficiency and hyperparathyroidism. DEXA scan for all obese patients is not recommended, however, women aged more than 65 years or younger post-menopausal females, and men 70 years or older may be advised by the bariatric surgeon based on their clinical risk factor profile.
Calcium and Vitamin D Deficiency Post-Surgery
After bariatric surgery calcium and vitamin D deficiency may develop due to reduced dietary intake and decreased intestinal absorption, though research studies do not conclusively support any increased incidence of osteoporosis or increased fracture risk after bariatric surgery. It is important to focus on bone health after bariatric surgery to prevent these potential deficiencies.
Dietary Recommendations for Bone Health After Bariatric Surgery
I always advise my bariatric surgery patients to include naturally rich or fortified food sources in their diet to get enough of calcium and vitamin D. To get good amounts of calcium including milk and milk products, fish, green leafy vegetables, ragi, kidney beans and almonds in the daily diet is a good idea.
For vitamin D, fortified dairy products and cereals, fish (sardines, salmon, and mackerel), and egg yolks make a great choice, also exposing to the sun between 10 am to 3 pm for 15 to 30 minutes in minimal clothing is good for producing vitamin D in the skin.
Importance of Follow-Up and Supplementation
Regular, long-term follow-up and nutritional supplementation are important to prevent and overcome already existing deficiencies and should be provided according to the type of procedure and the individual patient’s risk for bone loss.
Recommended Calcium and Vitamin D Intake
People undergoing bariatric surgery require 1200–2400mg calcium per day, depending on the type of procedure, to be taken into 2–3 divided doses. In our practice, we prefer Calcium Citrate Malate (CCM) tablets in chewable form as they possess the highest bioavailability and don’t require stomach acid for absorption.
To prevent vitamin D deficiency 60,000 IU of vitamin D is required once a week for 8 weeks. Severe deficiencies can be treated with higher doses of up to 60,000 IU 3 times a day. Vitamin D supplements are easily available in different forms such as powder, syrup, or soft gels, any of them can be taken.
Regular Monitoring
It is important to stay in regular touch with your bariatric surgeon and dietician for annual monitoring of bone health after bariatric surgery and to correct the causes in time to prevent further damage.
Looking for post-surgery consultation? Consult us at ‘Smart Cliniqs’, as we have the best bariatric surgeon in Delhi for you.
Healthy bones are happy bones….
