Evaluation of Nutritional Status Post Laparoscopic Sleeve
Alfred Kojo Anderson
Published online: 1 December 2017
Springer Science+Business Media, LLC, part of Springer Nature 2017
Introduction Obesity is considered a public health problem and has led to advancements in bariatric surgery. Laparoscopic sleeve
gastrectomy (LSG) had become the most performed procedure worldwide; however, its consequences on nutritional status in the
short and long term are of concern.
Methods A retrospective analysis of medical records and bariatric database of patients who underwent LSG from October 2008–
September 2015 at Al-Amiri Hospital, Kuwait, was performed. Data regarding nutritional status along with demographic data
were collected over a 5-year follow-up period.
Results One thousand seven hundred ninety-three patients comprising of 74% females and 26% males were included. The greatest
% total body weight loss (%TBWL) was at 18 months post-LSG (33%), corresponding to a % excess weight loss (%EWL) of
73.8%. With regard to nutritional status, vitamin B1 showed a significant drop at 3–5 years post-op in comparison to pre-op value,
but stayed within the normal range throughout the study. Red blood cells count, hemoglobin, and hematocrit also showed a
significant drop starting from 6 months post-op until the fifth year of follow-up. On the other hand, vitamins B6 and B12 showed a
significant increase at 6 months post-op and decreased afterwards, but did not reach pre-op values. Vitamin D also showed a
significant increase throughout the study period from deficient value at the pre-op time, but remained insufficient. Albumin,
transferrin, folate, ferritin, iron, and vitamin B2 showed no significant changes at 5 years post-LSG compared to pre-op values.
Conclusion Little is known about the nutritional status and optimal nutritional care plan post-LSG, especially in the longer term.
Nutritional deficiencies were prevalent prior and post-LSG. Some of the nutritional parameters improved and even reached the
abnormal high level post-LSG. These observations highlight the importance of pre- and post-operative nutritional assessment and
tailored supplementation to ensure optimal nutritional status.
Keywords Nutritional status
Obesity is a serious public health problem which has been
radically increasing for decades , and Kuwait is one of the
countries that is notably reflecting this health problem. About
77% of the Kuwaiti population was classified as overweight
and 40% as obese in 2014 .
Obesity is associated with multiple comorbidities that
markedly impairs life quality, reduces life expectancy, and
increases health care cost [3–5]. As obesity and its related
comorbidities have massively increased, so have the efforts
to address this problem, with bariatric surgery appearing to
be the most effective and durable approach to cope with
this epidemic [6, 7]. Laparoscopic sleeve gastrectomy
(LSG) was shown to be the most frequently performed
bariatric procedure in Kuwait as of 2011 . LSG
The original article has been revised to correct the order of the author
* Salman Al-Sabah
Alfred Kojo Anderson
Department of Surgery, College of Medicine, Hospital, Kuwait
University, Kuwait City, Kuwait
Department of Food Science and Nutrition, College of Life Sciences,
Kuwait University, Kuwait City, Kuwait
Department of Computer Science, College of Computing Sciences
and Engineering, Kuwait University, Kuwait City, Kuwait
Obesity Surgery (2018) 28:1473–1483