Nutritional Science for Bariatrics Flashcards

After a Roux-en-Y gastric bypass, which vitamin deficiency is most likely because its absorption depends on intrinsic factor and the bypassed duodenum?

Answer: Vitamin B12

B12 requires intrinsic factor and the bypassed portions of the stomach and duodenum, so deficiency is common after RYGB.

What is the recommended minimum daily protein intake commonly advised for most post-bariatric patients?

Answer: 60-80 g

Guidelines typically recommend 60-80 g of protein daily to preserve lean mass after surgery.

Which mineral deficiency after bariatric surgery is a leading cause of anemia, especially in menstruating women?

Answer: Iron

Reduced acid and duodenal bypass impair iron absorption, making iron-deficiency anemia common.

Why are chewable or liquid vitamin supplements often preferred in the early postoperative period?

Answer: They dissolve and absorb more reliably in the smaller stomach

Chewable and liquid forms dissolve more readily and absorb better while the stomach pouch heals.

Dumping syndrome after gastric bypass is most commonly triggered by which type of food?

Answer: Simple sugars and refined carbohydrates

Rapid entry of simple sugars into the small intestine causes fluid shifts and dumping symptoms.

Which fat-soluble vitamins require monitoring particularly after malabsorptive procedures like biliopancreatic diversion?

Answer: Vitamins A, D, E, and K

Fat malabsorption reduces uptake of the fat-soluble vitamins A, D, E, and K.

What hydration guidance is typically given to bariatric patients regarding fluids and meals?

Answer: Avoid fluids for 30 minutes before and after meals

Separating fluids from meals prevents overfilling the pouch and reduces early satiety loss and dumping.

Thiamine (B1) deficiency after bariatric surgery can cause which serious neurological condition, especially with persistent vomiting?

Answer: Wernicke encephalopathy

Thiamine depletion from vomiting or poor intake can precipitate Wernicke encephalopathy.

Which supplement combination should be spaced apart because they compete for absorption?

Answer: Calcium and iron

Calcium inhibits iron absorption, so these supplements should be taken at separate times.

Which form of calcium is preferred after gastric bypass due to reduced stomach acid?

Answer: Calcium citrate

Calcium citrate is absorbed well without gastric acid, unlike carbonate.

A patient reports hair loss around 3-6 months post-op. Which nutrient inadequacy is a common contributor alongside rapid weight loss?

Answer: Inadequate protein

Inadequate protein during rapid weight loss commonly contributes to telogen effluvium hair shedding.

Which eating behavior is recommended to prevent overfilling the small gastric pouch?

Answer: Taking small bites and chewing thoroughly

Small bites and thorough chewing prevent obstruction and overfilling of the pouch.

Protein sources are prioritized at meals primarily because protein does what?

Answer: Preserves lean body mass and increases satiety

Adequate protein preserves muscle during weight loss and promotes fullness.

Which lab is most appropriate to routinely monitor vitamin D status?

Answer: Serum 25-hydroxyvitamin D

25-hydroxyvitamin D is the standard marker of vitamin D stores.

Which dietary progression stage typically comes immediately after clear liquids following bariatric surgery?

Answer: Full liquids/pureed foods

The diet advances from clear liquids to full liquids and pureed foods before soft and solid textures.

Zinc deficiency after bariatric surgery may present with which sign?

Answer: Impaired wound healing and taste changes

Zinc is essential for wound healing and taste, so deficiency causes poor healing and dysgeusia.

Why should carbonated beverages generally be discouraged after bariatric surgery?

Answer: They can cause gas, discomfort, and pouch distension

Carbonation introduces gas that causes bloating and may distend the small pouch.

A patient plateaus in weight loss and reports grazing on small high-calorie snacks. What is the best counseling focus?

Answer: Structure planned protein-focused meals and reduce grazing

Structured protein-based meals reduce constant calorie intake from grazing and support continued loss.

Which condition can result from chronic vitamin D and calcium inadequacy after bariatric surgery?

Answer: Metabolic bone disease/osteoporosis

Long-term calcium and vitamin D deficiency leads to secondary hyperparathyroidism and bone loss.

What is the general recommendation on alcohol for post-bariatric patients?

Answer: Alcohol has stronger and faster effects and adds empty calories

After surgery alcohol is absorbed faster with heightened effects and provides empty calories, so caution is advised.