Table 8
Table 8: 2016 ASMBS Nutrition Supplementation Guidelines by Surgery Type (4)
Supplement |
AGB |
SG |
RNY |
BPD/DS |
Multivitamin (MVI) and minerals |
Recommended |
Recommended |
Recommended |
Recommended |
* Iron |
18 mg from MVI# Not with calcium |
18 mg form MVI OR 45-60 mg total from supplements Not with calcium |
45-60 mg total from supplements Not with calcium |
45-60 mg total from supplements Not with calcium |
* Folic acid |
400-800 mcg in MVI |
400-800 mcg in MVI |
400-800 mcg in MVI |
400-800 mcg in MVI |
* Folic acid (female, childbearing age) |
800-1,000 mcg total |
800-1,000 mcg total |
800-1,000 mcg total |
800-1,000 mcg total |
* Thiamin |
12 mg in MVI |
12 mg in MVI |
12 mg in MVI |
12 mg in MVI |
* Thiamin (at risk patients) |
50-100 mg total |
50-100 mg total |
50-100 mg total |
50-100 mg total |
* Copper |
100% RDA (1 mg) in MVI |
100% RDA (1 mg) in MVI |
200% RDA (2 mg) in MVI |
200% RDA (2 mg) in MVI |
* Zinc |
100% RDA (8-11 mg) in MVI |
100% RDA (8-11 mg) in MVI |
100-200% RDA (8-22 mg) in MVI |
200% RDA (16-22 mg) in MVI |
* Zinc-to-copper ratio |
To minimize the risk of copper deficiency in post-weight loss surgery patients, it is recommended that the supplementation protocol contain a zinc-to-copper raio of 8-15 mg of zinc per 1 mg of copper. |
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* Vitamin B12 |
Oral: 350-500 mcg/d Nasal: as directed by manufacturer Parenteral (intramuscular or subcutaneous): 1,000 mcg/mo |
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* Vitamin D |
At least 3,000 IU to maintain laboratory levels (D,25(OH)) greater than 30 ng/mL |
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* Vitamin A |
5,000 IU |
5,000-10,000 IU |
5,000-10,000 IU |
Additional 10,000 IU totalling 15,000-20,000 IU |
* Vitamin E |
15 mg (equivalent to 22.5 IU of natural vitamin E or 17 IU of synthetic vitamin E) |
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* Vitamin K |
90-120 mcg |
90-120 mcg |
90-120 mcg |
Additional 300 mcg totalling 390-420 mcg |
Calcium (all sources of food & supplements) |
1,200-1,500 mg Divided doses Carbonate w/ meals Citrate w/ or w/o meals |
1,200-1,500 mg Divided doses Carbonate w/ meals Citrate w/ or w/o meals |
1,200-1,500 mg Divided doses Carbonate w/ meals Citrate w/ or w/o meals |
1,800-2,400 mg Divided doses Carbonate w/ meals Citrate w/ or w/o meals |