Energy and Micronutrient Intake After Sleeve Gastrectomy and Roux-en-y Gastric Bypass – 1 Year Results From a Randomized Trial

Introduction/Purpose Sleeve Gastrectomy (SG) and Roux-en-Y Gastric Bypass (RYGB) entail risks of vitamin and mineral deficiencies, and guidelines recommend lifelong supplementation. It remains unclear if postoperative intake of micronutrients differs between surgical methods. This exploratory substudy aimed to evaluate whether the reported intake of vitamins and minerals in diet and supplements differs between SG and RYGB one year after surgery. Methods Between April 2017 and May 2023, 285 participants from the randomized controlled multicenter trial “ Bypass Equipoise Sleeve Trial ” (BEST) were consecutively included at seven metabolic bariatric surgery centers in Sweden. The intake of vitamins and minerals from diet and supplements was self-reported at one-year follow-up and calculated in Dietist Net®. The Goldberg cut-off method was used to exclude under-reporters. Results One year after surgery, the reported daily energy intake was 1673 kcal and 1651 kcal, after SG and RYGB, respectively. Compared with reference data on Swedish dietary habits from 2010–2011, participants reported daily intakes from diet below the daily recommended intake (RI) for a greater number of micronutrients. The reported intake of Vitamin C from diet was 53 mg (SG) versus 72 mg (RYGB) (p = 0.001). Following both procedures most participants reported supplement intake consistent with the recommendations. The reported intake from supplements was 580 Retinol equivalents (RE) (SG) versus 656 RE (RYGB) for Vitamin A (p = 0.017), and 374 µg (SG) versus 436 µg for Folic Acid (p = 0.014). Conclusion In general, the reported intake of energy and vitamins and minerals from diet and supplements did not differ between SG and RYGB one year after bariatric surgery, except for a higher intake of vitamin C from diet, and vitamin A and folic acid from supplements after RYGB. These differences may reflect healthier food choices and better adherence to vitamin and mineral supplements following RYGB.