A Properly Balanced Reduction Diet and/or Supplementation Solve the Problem with the Deficiency of These Vitamins Soluble in Water in Patients with PCOS.

Polycystic ovary syndrome (PCOS) is an increasingly common problem for women in the reproductive age throughout the entire world. A reduction diet with a low glycaemic index (GI) has proved to support the treatment of PCOS. The aim of the study was to analyse the influence of the diet on the level of vitamins soluble in water. The study included 55 women, 40 of which suffered from PCOS (identified by means of the Rotterdam Criteria) and 15 healthy women of the Caucasian race. The level of vitamins before and after the dietary intervention was measured. The diet was a reduction diet with a reduced glycaemic index (GI). Biochemical analyses were made on the basis of liquid chromatography-Infinity 1260 Binary liquid chromatography (LC) Agilent Technology. The level of vitamins in the serum was analysed together with the consumption before and after the dietary intervention. A higher level of vitamin C in the plasma was observed before and after the dietary intervention in the PCOS group in comparison to the control group despite the lower intake of this vitamin in the PCOS group. The remaining vitamins were at a comparable or lower level (B1, B3, B5, B6 and B12). After the dietary intervention, only B1 and B9 were at a clearly lower level (a trend of p = 0.093 and p = 0.085). A properly balanced reduction diet with reduced GI improves the supply of vitamins in women with PCOS. An additional recommendation should be the additional supplementation of B1, niacinamide and the combination of folates with inositol. The level of vitamin C in the plasma may not be a good marker of its supply in the PCOS group.

Prolonging healthy aging: Longevity vitamins and proteins.

It is proposed that proteins/enzymes be classified into two classes according to their essentiality for immediate survival/reproduction and their function in long-term health: that is, survival proteins versus longevity proteins. As proposed by the triage theory, a modest deficiency of one of the nutrients/cofactors triggers a built-in rationing mechanism that favors the proteins needed for immediate survival and reproduction (survival proteins) while sacrificing those needed to protect against future damage (longevity proteins). Impairment of the function of longevity proteins results in an insidious acceleration of the risk of diseases associated with aging. I also propose that nutrients required for the function of longevity proteins constitute a class of vitamins that are here named "longevity vitamins." I suggest that many such nutrients play a dual role for both survival and longevity. The evidence for classifying taurine as a conditional vitamin, and the following 10 compounds as putative longevity vitamins, is reviewed: the fungal antioxidant ergothioneine; the bacterial metabolites pyrroloquinoline quinone (PQQ) and queuine; and the plant antioxidant carotenoids lutein, zeaxanthin, lycopene, α- and ß-carotene, ß-cryptoxanthin, and the marine carotenoid astaxanthin. Because nutrient deficiencies are highly prevalent in the United States (and elsewhere), appropriate supplementation and/or an improved diet could reduce much of the consequent risk of chronic disease and premature aging.

Dietary factors in the etiology and therapy of attention deficit/hyperactivity disorder.

PURPOSE OF REVIEW: The purpose of this study is to discuss the role of dietary factors in the etiology and therapy of attention deficit/hyperactivity disorder (ADHD). Relevant literature published from January 2016 to January 2017 was included in this review. RECENT FINDINGS: Unhealthy prenatal diet may be associated with ADHD in the offspring through an increase in epigenetic changes. The few-foods diet may have some efficacy, but requires further investigation before firm conclusions can be drawn. The efficacy of the supplementation of polyunsaturated fatty acids in the therapy of ADHD is probably small and may be confined to patient subgroups. It is unclear whether vitamin deficiency plays a role in the etiology of ADHD. SUMMARY: There is no clear evidence supporting a role of food or nutrient-based intervention strategies in the etiology and therapy of ADHD. The investigation of the inter-relationship between diet and other lifestyle interventions may be a promising approach.

An Animal-Source Food Supplement Increases Micronutrient Intakes and Iron Status among Reproductive-Age Women in Rural Vietnam.

Background: Few studies have examined the impact of local animal-source foods (ASFs) on the nutritional status of reproductive-age women in developing countries.Objective: We hypothesized that a midmorning snack of local ASF for 6 mo would reduce dietary micronutrient deficiencies [usual intake less than the estimated average requirement (EAR)] and improve blood biomarkers of iron, zinc, and vitamins A and B-12 status among nonpregnant, reproductive-age women in rural Vietnam.Methods: One hundred seventeen women, 18-30 y old, were randomly assigned to receive either an ASF (mean: 144 kcal, 8.9 mg Fe, 2.7 mg Zn, 1050 µg retinoic acid equivalent vitamin A, and 5.5 µg vitamin B-12) or a control snack (mean: 150 kcal, 2.0 mg Fe, 0.9 mg Zn, 0 µg retinoic acid equivalent vitamin A, and 0 µg vitamin B-12) 5 d/wk for 6 mo. Usual nutrient intakes were estimated by repeated 24-h dietary recalls. Blood samples were collected at baseline and 3 and 6 mo. Because of the relation between nutritional status and inflammation, serum C-reactive protein, α-1-acid-glycoprotein, and urinary tract infections (UTIs) were also monitored.Results: Eighty-nine women (47 in the ASF group and 42 controls) completed the study. In the ASF group, intakes of iron and vitamins A and B-12 below the EAR were eliminated, and the prevalence of a low zinc intake was reduced to 9.6% compared with 64.7% in controls (P < 0.001). At 6 mo, a modest increase (P < 0.05) in hemoglobin and iron status occurred in the ASF group compared with the control group, but plasma zinc, retinol, and serum vitamin B-12 concentrations did not differ. UTI relative risk was 3.9 (P < 0.05) among women assigned to the ASF group who had a low whole-body iron status at baseline.Conclusions: Adding a small amount of locally produced ASF to the diets of reproductive-age Vietnamese women improved micronutrient intakes and iron status. However, the increased UTI incidence in women in the ASF group with initially lower iron stores warrants further investigation.

Lesión ungueal en un escolar, ¿qué sospechar? / Nail injury in a seven-year-old girl, what to suspect?

Las alteraciones ungueales en los niños representan un motivo de consulta frecuente en Atención Primaria. El adecuado desarrollo de las uñas depende de varios procesos fisiológicos, tanto locales como sistémicos, por lo que un gran número de afecciones pueden generar alteraciones ungueales. Durante la infancia existen diferencias fisiológicas del aparato ungueal con los adultos. Conocer estas variaciones fisiológicas es imprescindible para un correcto manejo. Se presenta el caso clínico de una niña de siete años con lesiones ungueales con piqueteado ungueal y estriación (AU)

The nail changes in children are a common reason for consultation in primary care. The proper development of nails depends on various physiological processes, both local and systemic, so a large number of conditions can cause nail changes. During infancy, there are physiological differences on nails with adults. Knowing these physiological variations is essential for proper management. The case of a seven-year-old girl with nail lesions with nail pitting and striations is presented (AU)

Laparoscopic Sleeve Gastrectomy and Nutrient Deficiencies: A Prospective Study.

BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) is being increasingly established as a definitive procedure for weight loss. The mechanism for weight loss in LSG is gastric restriction and neurohormonal changes, but there is deficient information on its nutritional effect. The aim of this prospective study was to assess vitamin and micronutrient deficiencies following LSG (whats and when) in organized follow-up visits. PATIENTS AND METHODS: LSG was performed in 112 consecutive patients between June 2010 and December 2013. In all patients, the vitamin and micronutrient deficiencies were corrected before the LSG procedure. Patients were investigated for vitamin and micronutrient concentrations 2, 4, 6, 9, and 12 months after surgery. RESULTS: During the study time, 112 patients (65% female) underwent LSG. The mean age was 26 years (range: 20 to 37 y), and the mean preoperative body mass index was 41 (range: 35 to 52). Complications and nutrient deficiencies were observed and analyzed throughout the follow-up period. CONCLUSIONS: The appearance of vitamin and nutritional deficiencies after LSG is a common phenomenon. Correction of the deficiencies before surgery, sufficient supplementation immediately after the procedure, and routine long follow-up are important to avoid the serious consequences of the deficiencies.

[Vitamins and nutritional supplements in older persons: How to diagnose and when to substitute?]. / Vitamine und Nahrungsergänzung bei älteren Menschen : Welche Diagnostik und Substitution ist sinnvoll?

Despite an excellent food supply in Germany, a large percentage of older persons living at home or institutionalized older persons suffer from or are at risk for malnutrition. The purpose of this article is to highlight the association between nutrient deficiencies and age-related diseases and give rational recommendations for substitution. Both malnutrition and low levels of specific nutrients are associated with cognitive and functional impairment, dementia, and depression in older persons. Most prevalent are deficiencies in vitamin B1, vitamin B12, and vitamin D. Serum levels are often misleading and show false negative results in vitamin B1 and B12 deficiencies; therefore, determination of erythrocyte transketolase activity (ETKA) and the thiamine pyrophosphate (TPP) effect for vitamin B1 and of methylmalonic acid and holotranscobalamine for vitamin B12 is recommended. Prophylactic supplementation with vitamins is not supported by prospective trials; however, positive data from observational studies support a Mediterranean diet combined with intake of vitamins, antioxidants, and unsaturated fatty acids. Older persons should be regularly screened for malnutrition and the threshold for determination of vitamin B1, B12, and vitamin D should be low. Vitamin substitution should be reserved for proven deficits. There is now data regarding cognition from prospective trials on effects of a healthy diet combined with other life-style factors like physical and cognitive activity.

[Vitamin-mineral supplements in nutrition of adults].

The diet of population consisting of natural products is quite adequate and even excessive of energy consumption, but is not able to meet fully the need of organism in a number of micronutrients. Due to lack of sun exposure and long presence indoors endogenous synthesis of vitamin D in the skin by ultraviolet radiation does not provide the body's need for this vitamin. Intake of vitaminmineral supplements (VMS) is appropriate because combined deficiency of vitamins and minerals takes place in population. Prophylactic doses (equal to physiological needs) provide a diet completeness and reduce the risk of vitamin deficiency and its consequences. The high incidence of combined deficiency of vitamins among population and the existence of vitamin interactions are the basis for the application of the multivitamins. The simultaneous intake of vitamins is more physiological, their combination is more effective than a separate or isolated destination of each of them. Efficacy of the VMS has been shown in the treatment and prevention of some diseases. The main requirements for the VMS are full list of vitamins and minerals, the lack of which is detected most frequently, in doses covering the needs of organism. For the health of the pregnant woman and her unborn child preference should be given for complexes, containing DHA and/or probiotics along with vitamins. The principles of the selection of the composition and vitamin doses in the VMS for using patients suffering from various pathologies should be based on data on the patient's sufficiency with vitamins, the understanding of the role of vitamin deficiency in the pathogenesis of the disease, as well as on the composition of the diet and its modifications.

[Hematological indices of rats having complete and vitamin-deficient diets enriched with dietary fibers].

The hematological indices in 48 rats Wistar male with initial body weight 58.1+/- 0.5g has been studied. The rats were divided into 6 group and fed the complete semi-synthetic diet, containing 100% or 20% of vitamin mixture (Vit) with or without addition of dietary fiber (DF) in the form of wheat bran (5% of diet mass) during 4 weeks. The animals of the 1 group received 100% of vitamin mixture (100% Vit); of the 2 group--100% Vit+DF; 3 group--20% of vitamin mixture (20% Vit); 4 group--20% of vitamin mixture and DF (20% Vit+DF). The next 5 days rats from vitamin-deficient groups were fed with diets supplemented with 80% of Vit: (5 group--20% Vit+ 80% Vit; 6 group--20% Vit+DF+80% Vit). The animals fed vitamin-deficient diet lag significantly in growth from animals fed a complete diet. The growth curve of rats fed a diet with DF took an intermediate position. The studies were carried out at the Hematology analyzer "Coulter AC TTM 5 diff OV" (Beckman Coulter, USA) under the program, developed for the study of rat blood. Mean corpuscular volume (MCV) and mean corpuscular hemoglobin content (MCHC) were significantly decreased in rats with combined vitamin deficiency (20% Vit) in the diet compared with those of control group rats, while the compensatory increase in the number of red blood cells (RBC) and leukocytopenia took place. The enrichment of vitamin-deficient diet with DF (20% Vit+DF) prevented MCV and RBC changes, but MCHC left reduced in comparison with the indicator of the rats in control group. Indicators characterizing the state of platelets had no statistically significant differences between the groups. Compensation of vitamin deficiency in the diet of rats from group 5 (20% Vit+80% Vit) led only to the normalization of MCV. After vitamin restore in the diet of group 6 (20% Vit+DF+80% Vit) all investigated parameters were indistinguishable from the parameters of the control group. This indicates a positive effect of wheat bran DF consumption on the studied hematological indices.

[Correction of polyhypovitaminosis in rats, having standard and enriched with polyunsaturated fatty acids family omega-3 diets with different doses of vitamins].

The efficiency of the correction of combined alimentary vitamin deficit in male Wistar rats (body weight 90-121 g) fed standard diet or enriched with omega-3 polyunsaturated fatty acids diet (by replacing sunflower oil (4.5% of the diet) with linseed oil) with different doses (physiological and enhanced) of vitamins has been investigated. The control group of animals (n = 12) received a complete semisynthetic diet during all experimental period (42 d). The animals of the test groups (each of 20 rats) received vitamin-deficient diet containing sunflower or linseed oil and 20% per cent of vitamin mixture amount in control diet from which vitamin E had been excluded. After 28 days of such feeding each of test groups was divided into two subgroups (6-8 rats in each), and the next 14 days the animals of subgroups received the diet with different degree of vitamin compensation (50 or 180% percent of vitamin content in the diet of the control group). The addition of both low and high vitamin dose in deficient diet based on standard fat component did not compensate the reduced liver vitamin A content, which amounted to 47.4% of the level in the liver of the control group. The lack of vitamin E in animals was eliminated only after adding of the enhanced dose of vitamin E to the ration. Recovering of decreased plasma and liver B2 level, plasma 25(OH)D and liver vitamin B1 content have been occurred after addition of the low dose of these vitamins to rat diet. Increasing of omega-3 PUFA diet level improved vitamins A and D sufficiency to some extent, but was accompanied by the significant reduction of rat liver alfa-tocopherol content both under combined vitamin deficiency (by 14%) and increased vitamins consumption (by 43%). PUFA enrichment of the diet of rats with vitamin deficiency had no impact on vitamin B1 and B2 liver level. The use of high doses of vitamins for a long time to eliminate a combined deficiency of vitamins has been proved.

A question of balance: achieving appropriate nutrient levels in biofortified staple crops.

The biofortification of staple crops with vitamins is an attractive strategy to increase the nutritional quality of human food, particularly in areas where the population subsists on a cereal-based diet. Unlike other approaches, biofortification is sustainable and does not require anything more than a standard food-distribution infrastructure. The health-promoting effects of vitamins depend on overall intake and bioavailability, the latter influenced by food processing, absorption efficiency and the utilisation or retention of the vitamin in the body. The bioavailability of vitamins in nutritionally enriched foods should ideally be adjusted to achieve the dietary reference intake in a reasonable portion. Current vitamin biofortification programmes focus on the fat-soluble vitamins A and E, and the water-soluble vitamins C and B9 (folate), but the control of dosage and bioavailability has been largely overlooked. In the present review, we discuss the vitamin content of nutritionally enhanced foods developed by conventional breeding and genetic engineering, focusing on dosage and bioavailability. Although the biofortification of staple crops could potentially address micronutrient deficiency on a global scale, further research is required to develop effective strategies that match the bioavailability of vitamins to the requirements of the human diet.

The WHO evidence-informed guideline development process and implications for vitamin and mineral research priorities: symposium rationale and summary.

The WHO evidence-informed guidelines provide recommendations to Member States and their partners on interventions with vitamins and minerals. Evidence gathered and synthesized through systematic reviews contributes to the development of these guidelines, a process that is dependent on the availability and quality of evidence. Although the guideline development process is stringently governed and supervised to maintain clarity and transparency, the lack of adequacy and specificity of available evidence poses limitations to the formulation of recommendations that can be easily applied for policy and program decision making in diverse contexts. The symposium created a space for dialogue among scientists and public health practitioners to improve the understanding of how evidence fulfills the needs and reflect on mechanisms by which policy and program guidance and priorities for research could be better informed by policy and program needs. Ultimately, programmatic success depends not only on identifying efficacious agents but ensuring effective delivery to those with the potential to respond. To do this, we must understand the rationale for recommending interventions, the biological pathways by which interventions work, delivery systems required to make efficacious interventions work, and other contextual factors that might limit or facilitate successful implementation.

[The influence of dietary fibers on cell immunity under the adequate nutrition and in the presence of alimentary polyhypovitaminosis in rats].

The effect of wheat bran on cell immunity in rats adequately provided with vitamins or insufficiently supplied with vitamins has been investigated. 48 male Wistar rats (58.1 +/- 0.5 g) were divided into 6 group and fed with complete semi-synthetic diet, containing 100% or 20% of vitamin mixture (Vit) with or without supplement of insoluble dietary fiber (DF) in the dose corresponding to the upper allowable level of its consumption (5% wheat bran of diet mass) for 4 weeks. The animals of the 1 group received 100% of vitamin mixture (100% Vit); 2 group--100% Vit+DF; 3 group--20% of vitamin mixture (20% Vit); 4 group--20% of vitamin mixture and DF (20% Vit+DF). The next 5 days rats from vitamin-deficient groups were fed with diets supplemented with 80% of Vit: (5 group--20% Vit+80% Vit; 6 group--20% Vit+DF+80% Vit). The contents of lymphocytes, relative quantity of B-(CD45RA+) and T-lymphocytes (CD3+), subpopulations of T-lymphocytes: T-helper (CD3+CD4+) and cytotoxic T-lymphocytes (CD3+CD8+), NK-cells (CD161a+) in the peripheral blood of rats were determined by the method of flow cytometry using Beckman Coulter FC 500 (USA) cytometer. In rats fed complete semi-synthetic diet supplemented with DF (100% Vit+DF) the reduction of relative contents of T-lymphocytes and the increase of the fraction of cytotoxic T-lymphocytes in peripheral blood has been found. The analogous changes and more pronounced degree of immunosupression, that appeared in a lymphocytopenia, much smaller level of T-lymphocytes, T-helper and increase of cytotoxic T-lymphocytes content in rats fed a low vitamins diet (20% Vit) in comparison with these parameters of control group, have been detected. In rats received 20% Vit+DF the suppressed cell immunity was accompanied with decreased level of NK-cells. Normalization of vitamins content in the diets of rat deficient groups led to an almost complete recovery of cell immunity indicators to the level of the animals from the corresponding control groups. Inclusion in the diet of fiber requires its further enrichment with vitamins. Special studies of fiber diet influence on are needed to clarify the upper allowable level of insoluble dietary fiber in human nutrition.

Tetania neonatal por hipocalcemia secundaria a hipovitaminosis D. Forma extrema de una enfermedad que resurge / Neonatal hypocalcemic tetany due to vitamin D deficiency. Extreme form of a re-emerging disease

Desde el inicio de la era industrial, el raquitismo ha sido una enfermedad endémica. Con el descubrimiento de la vitamina D y el aporte de suplementos, sobre todo en las fórmulas lácteas infantiles, prácticamente había desaparecido, pero durante los últimos años parece haberse convertido de nuevo en un problema de salud pública. La carencia de vitamina D se asocia no sólo a problemas óseos, sino también a un importante incremento del riesgo de enfermedades cardiovasculares, autoinmunes, infecciosas y tumorales. Comunicamos un caso de tetania neonatal por hipocalcemia secundaria a hipovitaminosis D en un neonato de menos de 2 días de vida. La precocidad de la aparición y la gravedad clínica son excepcionales. Además, advierte del problema emergente que constituye el déficit de vitamina D y de la necesidad de instaurar la suplementación con ésta vitamina, siguiendo las últimas recomendaciones de la Asociación Española de Pediatría (AU)

Since industrial revolution, rickets has been an endemic disease. Since the discovery of vitamin D and its supplements, above all in milk formulates, practically it was disappear, but in the last few years it seems to be again a public health problem. Vitamin D deficiency contributes, not only to bone problems, but also to an important increase in the risk of cardiovascular, autoimmune, infectious diseases and cancer. We communicate a case of neonatal hypocalcemic tetany secondary to a vitamin D deficiency that appeared in a neonate before the second day of life. The precocity of its appearance and its clinical severity are exceptional. It also warn of the emergent problem that it suppose the vitamin D deficiency and the necessity of set up the supplementation with this vitamin, following the last recommendations of the Spanish Paediatrics Association (AU)

Nutritional treatment in inflammatory bowel disease. An update.

BACKGROUND AND AIMS: enteral (EN) and parenteral (TPN) nutrition exert variable therapeutic effects on the induction and maintenance of remission in inflammatory bowel disease (IBD). This review aims to provide an updated discussion on the complex relationship between diet and IBD. METHODS: medline, Cochrane and Scopus database searches were conducted. Sources cited in the articles obtained were also searched to identify other potential sources of information. RESULTS: nutritional status is significantly compromised in IBD patients, especially those with Crohn's disease (CD). Apart from restoring malnourishment, dietary components contribute to modulate intestinal immune responses. Nutritional treatment is divided into support therapy and primary therapy to induce and maintain remission through TPN and EN. EN is considered a first-line therapy in children with active CD whereas it is usually used in adult CD patients when corticosteroid therapy is not possible. TPN has limited effects on IBD.En formula composition, in terms of carbohydrates, nitrogen source and bioactive molecules supplementation, differentially influence on IBD treatment outcomes. Other dietary components, such as poorly absorbed short-chain carbohydrate, polyols, and exogenous microparticles, also participate in the etiopathogenesis of IBD. Finally, new approaches to understanding the complex relationship between IBD and diet are provided by nutrigenenomic. CONCLUSION: further long-term, well-powered studies are required to accurately assess the usefulness of nutrition in treating IBD. In future research, the potential role of nutrient-gene interaction in drug trials and specific dietary formula compositions should be investigated in order to incorporate new knowledge about the etiopathology of IBD into nutritional intervention.

Micronutrientes en cirugía bariátrica / Micronutrients in bariatric surgery

La obesidad mórbida es una enfermedad crónica con prevalencia creciente y que asocia una importante morbimortalidad. La cirugía bariátrica es el tratamiento más eficaz para conseguir una reducción ponderal mantenida en el tiempo y una disminución en las tasas de complicaciones asociadas a la obesidad. El sobrepeso y la obesidad son factores de riesgo para el déficit de varios micronutrientes como las vitaminas B1, B6, C, ácido fólico y D, minerales como el hierro y oligoelementos como el zinc, en general por déficit dietético. A pesar de ello, por el momento no existe un consenso acerca de la monitorización de micronutrientes en el preoperatorio, aunque parece razonable a la vista de su considerable prevalencia. La cirugía bariátrica puede provocar déficit de micronutrientes o intensificar deficiencias previas, tanto por limitación de la ingesta como por la maldigestión y malabsorción en las técnicas malabsortivas, siendo el riesgo paralelo a la pérdida ponderal. Es preciso monitorizar de por vida los diferentes micronutrientes, sobre todo tras las técnicas quirúrgicas malabsortivas. Se recomienda el uso de un complejo polivitamínico de forma sistemática y en los casos en los que sea insuficiente, será preciso emplear suplementación específica (AU)

The morbid obesity is a chronic disease with increasing prevalence and that associates an important morbility and mortality. The bariatric surgery is the most effective treatment to secure a weight reduction maintained in the time and a diminution in the rates of complications associated to the obesity. The overweight and the obesity are risk factors for the deficit of several micronutrients like vitamins B1, B6, C, folic acid and D, minerals like the iron and trace elements like zinc, generally by dietetic deficit. In spite of it, at the moment a consensus don't exist about the monitoring of micronutrients in the preoperative one, although it seems reasonable in view of his considerable prevalence. The bariatric surgery can bring about deficit of micronutrients or to intensify previous deficiencies, as much by limitation of the ingestion like by the maldigestión and malabsorption in the malabsortives techniques, being the parallel risk to the ponderal loss. It is precise to monitor of by life the different micronutrients, mainly after the malabsortives surgical techniques. The use of a polivitamínic complex of systematic form is recommended and in the cases in which he is insufficient, it will be precise to use specific suplementación (AU)

Pre- and postoperative nutritional deficiencies in obese patients undergoing laparoscopic sleeve gastrectomy.

BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) has been identified as an innovative surgical approach for the treatment of obesity and is increasingly applied worldwide. However, data on outcome of LSG regarding nutrient deficiencies, protein status, and body composition are scarce. METHODS: Obese subjects (54; f:m = 4:1) scheduled for LSG were included in this study. Micronutrient analysis, protein status assessment, and bioimpedance measures were performed before and 1, 3, 6, and 12 months after LSG. RESULTS: In 51% of the subjects, at least one micronutrient deficiency was found prior to surgery. Baseline concentrations were below normal for 25-OH vitamin D (27%), iron (29%), vitamin B6 (11%), vitamin B12 (9%), folate (6%), and potassium (7%). Frequencies of deficiencies for vitamin B12, folate, iron, and vitamin B6 tended to increase following LSG within the first year after intervention. Also, parameters of protein status (albumin, transferrin, cholinesterase, and total protein) decreased. After surgery, bioimpedance measures indicated a reduction of total body fat, but also of body cell mass. CONCLUSIONS: Preoperative micronutrient deficiencies were common in morbid obese individuals scheduled for LSG. LSG had a modest effect on micronutrient status by further reducing iron, vitamin B12, vitamin B6, and folate within the first year after intervention. Our data suggest that especially obese patients with preoperative deficits require control and supplementation of micronutrients and protein in the postoperative period.