Evaluation of Vitamin and Trace Element Requirements after Sleeve Gastrectomy at Long Term

Obes Surg. 2017 Jul;27(7):1674-1682. doi: 10.1007/s11695-017-2557-1.


Background: Nutritional deficiencies are common after bariatric surgery, but data are scarce after sleeve gastrectomy (SG) at long term.

Methods: We performed a prospective nutritional status evaluation before and at 2 and 5 years after SG in morbid obese patients receiving mulvitamin and mineral supplementation at a Spanish university hospital. One hundred seventy-six patients (49.3 ± 9.1 years and 46.7 ± 7.4 kg/m2) were evaluated; 51 of them were followed during 5 years. Anthropometric, compliance supplementation intake, and micronutrient evaluation were performed.

Results: Baseline concentrations were below normal values for 25(OH) vitamin D (73%), folic acid (16.5%), cobalamin (6.9%), pyridoxine (12%), thiamine (3.4%), and copper (0.5%). Anemia was found in 23%. In 49% of the subjects, at least one micronutrient deficiency was found at 2 years after SG. Vitamin D deficiency persisted at 2 and 5 years higher than 30% of patients. Frequencies of deficiencies for folic acid, B12, B6, and B1 vitamins decreased significantly after 2 years with normalization at 5 years. Copper deficiency increased between 1 and 2 years and it persisted at 5 years after SG. Vitamin supplementation compliance decreased progressively from the first year after surgery (94.8 to 81% at 2 years and to 53% 5 years after surgery).

Conclusions: Vitamin D deficiency is the most prevalent long-term nutritional deficiency after SG. About half of patients show some micronutrient deficiency at medium long term, despite supplementation. A proactive follow-up is required to ensure a personalized and adequate supplementation in all surgically treated obese patients including those in which SG has been performed.

Keywords: Bariatric surgery; Nutritional deficiencies; Obesity; Sleeve gastrectomy; Vitamins supplementation.

MeSH terms

  • Adult
  • Anemia / blood
  • Anemia / diagnosis
  • Dietary Supplements
  • Female
  • Gastrectomy / adverse effects*
  • Humans
  • Male
  • Malnutrition / diagnosis*
  • Malnutrition / etiology
  • Micronutrients / blood
  • Micronutrients / deficiency
  • Middle Aged
  • Nutritional Status
  • Obesity, Morbid / blood
  • Obesity, Morbid / surgery*
  • Prospective Studies
  • Trace Elements / blood*
  • Trace Elements / deficiency*
  • Vitamin D Deficiency / blood
  • Vitamin D Deficiency / etiology
  • Vitamins / blood*


  • Micronutrients
  • Trace Elements
  • Vitamins