Post by Guest Blogger Alex Sherman
Post-op is a crucial time for patients to maintain nutrient levels for successful recovery and to continue their weight-loss journey. We know that protein is important for muscle maintenance after surgery, but how about nerve function, or energy metabolism? Micronutrients are our vitamins, minerals, fatty acids and antioxidants. To maintain general health over the long-term, it is imperative that we maintain our micronutrient levels too. This can be difficult when portions are small and dietary levels are low. This is why your dietitian will recommend you supplements for these very important micronutrients.
We regularly prescribe a general multivitamin, as this able to cover some of your micronutrients needs. Your dietitian will then add further supplements on an individual basis depending on your needs.
These little nutrients can be very small, so what do they do, and why do we need them? Here is a run down on some of the micronutrients you may be supplemented with, and why.
Vitamin D: Vitamin D can be taken as a supplement, but mainly it is made by the body via a complex reaction with sunlight and cholesterol in the skin. Vitamin D regulates calcium absorption; hence why severe deficiency can lead to osteoporosis.
Calcium: Critical for bone density and support, calcium is a mineral. It is one of the many building blocks of the skeleton, bone marrow, and is a major contributor to many biochemical pathways. It can be found in dairy products, and alternative options such as calcium fortified nut milks and some fish. It is also found in green leafy vegetables, however comparatively, absorption is quite low. At around the age of 40, bone breakdown starts to exceed bone formation, which is why it is very important to maintain calcium intake to protect from osteoporosis.
Vitamin D and calcium go hand in hand, which is why supplementing vitamin D together with dietary calcium can aid in absorption!
Vitamin C: A very well known vitamin, vitamin C is found normally in oranges, mandarins and kiwi fruits, amongst other fruits and vegetables. It is a water soluble vitamin. Vitamin C deficiency is uncommon in Australia today, however, it can lead to dry and splitting hair, bleeding gums and lower immunity. Severe cases can lead to scurvy.
Iron: Iron in the body is converted to haemoglobin, and is used to transport oxygen around the body. Deficiency can lead to anaemia, which can cause fatigue, restlessness, and impaired immunity. Everybody has different functioning levels of iron; even people who have “low iron” may actually be very healthy. It is important to check what your healthy level is before potentially taking it in excess. Iron can be absorbed either as haem iron (from meat and animal products) and non-haem (plant sources). Haem iron is much more easily absorbed than non-haem iron. Iron is found in red meat, dark green leafy vegetables like such spinach, eggs, nuts and beans.
Absorption of iron can be increased by coupling iron and vitamin C together.
Vitamin A: Vitamin A begins as beta-carotene in dietary sources such as carrots, pumpkin and capsicum. The body then converts it to Vitamin A, also known as retinol, which is then converted into other forms for different functions. As retinoic acid, it is important for skin and tissue growth and protection, and as retinal, it is crucial for sight, being an important binding protein in the vision cycle.
B-vitamins: There are 8 B-vitamins essential for many biochemical pathways in the human body, most famously, the energy pathway where the body converts sugars, fats and protein into energy for cells. You have probably heard some of their names: B1 is also known as thiamine, B7 is biotin, and B9 is known as folic acid or folate, which is important during pregnancy for foetal neural development. Vitamin B12 is also important for red blood cell formation, and is particularly important for people you have had a gastric bypass. B-vitamins can be found in a variety of sources, including whole grains, fruits and vegetables, eggs, poultry, fish and dairy products. Deficiencies of these vitamins can range from brittle fingernails, hair loss, foggy memory and in severe cases, tingling and numbness of the extremities.
Overconsumption of some vitamin supplements can be harmless. For example, taking too much vitamin C won’t be too harmful, as it is a water soluble vitamin and will be flushed out in urine. However, too much vitamin A can be toxic, as can too much iron or calcium (a build-up can cause kidney stones). This is why consulting with your dietitian or GP is important, as everyone absorbs different vitamins at different levels. In most cases, the amount of food consumed post-surgery is too small to reach adequate levels of micronutrients. Supplementation post-surgery is a lifelong commitment, and an important one to ensure longevity and good health.
References:
Dietary reference intakes for thiamin, riboflavin, niacin, vitamin B6, folate, vitamin
B12, pantothenic acid, biotin, and choline (1998) / a report of the Standing Committee on the Scientific Evaluation of Dietary Reference Intakes and its Panel on Folate, Other B Vitamins, and Choline and Subcommittee on Upper Reference Levels of Nutrients, Food and Nutrition Board, Institute of Medicine.
Dietary reference intakes for vitamin A, vitamin K, arsenic, boron, chromium, copper,
iodine, iron, manganese, molybdenum, nickel, silicon, vanadium, and zinc (2001) / a report of the Panel on Micronutrients … [et al.], Standing Committee on the Scientific Evaluation of Dietary Reference Intakes, Food and Nutrition Board, Institute of Medicine.
https://www.hsph.harvard.edu/nutritionsource/vitamin-b/#bottom-line
