The Loser's Bench
Endocrine Society findings re: Fractures and Bariatric Patients
I received this information and wanted to share it with you. This is new data presented this week (June 10, 2009) at the annual meeting of the Endocrine Society in Washington DC. Doctors from the Mayo clinic looked at 97 patients from the past 20 years who have had bariatric surgery. They found that 21 of these patients had suffered a total of 31 fractures. Most fractures occurred an average of 7 years after surgery, with the primary locations being in the hands and feet. Other sites of fractures were the hip, spine and upper arm.
There are many risks for fracture in adults including age, gender, ethnicity, smoking and alcohol use, diseases like type 1 diabetes or rheumatoid arthritis, and use of medications such as steroids, antidepressants, and proton pump inhibitors (PPIs). But nutrition is also a serious risk. Inadequate calcium intake and poor vitamin D status are significant factors in the ability to maintain bone health after bariatric surgery.
The ASMBS recommended intakes for calcium after bariatric surgery are as follows:
These recommendations are for calcium intake over and above dietary intake. While it may sound like a lot it is terribly important that your body gets the amount of calcium it needs. You need calcium to keep your heart beating and your brain functioning (as well as for other things). So when the body does not get enough coming in each day, it takes calcium from your bones to supply it to the heart and brain. People will often not know this until they actually break a bone.
Generally, the ASMBS recommends that AGB and RNY patients get 400 to 800 IU of vitamin D3 daily and that DS patients get 2000 IU of vitamin D3 daily. There is a lot of data indicating that vitamin D deficiency is very common both before and after surgery, and that many patients require higher doses of D3 based on their lab findings. If you have not had your vitamin D levels tested, it is a good idea to know what they are. Your doctor or dietitian can help you determine the amount of vitamin D you need to take based on this test.
To read more about the Mayo Clinic findings, you can click on the links below:
There are many risks for fracture in adults including age, gender, ethnicity, smoking and alcohol use, diseases like type 1 diabetes or rheumatoid arthritis, and use of medications such as steroids, antidepressants, and proton pump inhibitors (PPIs). But nutrition is also a serious risk. Inadequate calcium intake and poor vitamin D status are significant factors in the ability to maintain bone health after bariatric surgery.
The ASMBS recommended intakes for calcium after bariatric surgery are as follows:
- Adjustable Gastric Band (AGB): 1500mg calcium
- Gastric Bypass (RNY): 1500 to 1800mg calcium as calcium citrate
- Duodenal Switch (DS): 1800 to 2400mg calcium as calcium citrate
These recommendations are for calcium intake over and above dietary intake. While it may sound like a lot it is terribly important that your body gets the amount of calcium it needs. You need calcium to keep your heart beating and your brain functioning (as well as for other things). So when the body does not get enough coming in each day, it takes calcium from your bones to supply it to the heart and brain. People will often not know this until they actually break a bone.
Generally, the ASMBS recommends that AGB and RNY patients get 400 to 800 IU of vitamin D3 daily and that DS patients get 2000 IU of vitamin D3 daily. There is a lot of data indicating that vitamin D deficiency is very common both before and after surgery, and that many patients require higher doses of D3 based on their lab findings. If you have not had your vitamin D levels tested, it is a good idea to know what they are. Your doctor or dietitian can help you determine the amount of vitamin D you need to take based on this test.
To read more about the Mayo Clinic findings, you can click on the links below:
- Mayo Clinic press release: http://www.mayoclinic.org/news2009-rst/5312.html
- Article in Science Daily: http://www.sciencedaily.com/releases/2009/06/090610124420.htm
Barbara
ObesityHelp Coach and Support Group Leader
http://www.obesityhelp.com/group/bcumbo_group/
High-264, Current-148, Goal-145
