Advances in Perioperative Nutritional Management in Metabolic and Bariatric Surgery

Ying Li, Ting Zhang Department of Gastrointestinal Surgery, Suzhou Municipal Hospital, The Affiliated Suzhou Hospital of Nanjing Medical University, Gusu School of Nanjing Medical University, Suzhou, Jiangsu, 215000, People’s Republic of ChinaCorrespondence: Ting Zhang, Department of Gastrointestina...

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Main Authors: Li Y, Zhang T
Format: Article
Language:English
Published: Dove Medical Press 2025-07-01
Series:Diabetes, Metabolic Syndrome and Obesity
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Online Access:https://www.dovepress.com/advances-in-perioperative-nutritional-management-in-metabolic-and-bari-peer-reviewed-fulltext-article-DMSO
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author Li Y
Zhang T
author_facet Li Y
Zhang T
author_sort Li Y
collection DOAJ
description Ying Li, Ting Zhang Department of Gastrointestinal Surgery, Suzhou Municipal Hospital, The Affiliated Suzhou Hospital of Nanjing Medical University, Gusu School of Nanjing Medical University, Suzhou, Jiangsu, 215000, People’s Republic of ChinaCorrespondence: Ting Zhang, Department of Gastrointestinal Surgery, Suzhou Municipal Hospital, The Affiliated Suzhou Hospital of Nanjing Medical University, Gusu School of Nanjing Medical University, No. 26 Daoqian Street, Gusu District, Suzhou, Jiangsu, 215000, People’s Republic of China, Tel +8618862120859, Email zhangting_ztg@163.comAbstract: Metabolic and Bariatric Surgery (MBS) is an effective treatment for severe obesity and its related complications. However, perioperative nutritional management is essential for the patient’s surgical outcome and postoperative recovery. This article reviews the research progress in perioperative nutritional management of MBS. Preoperative nutritional assessment and optimization are essential, including monitoring and correction of micronutrient deficiencies, such as vitamin D, iron, folic acid, to reduce the risk of postoperative complications. In terms of preoperative dietary management, the use of a low-carbohydrate ketogenic diet (LCKD) and ready-to-eat low-carbohydrate ketogenic product (RLCKP) showed the potential to promote weight loss and liver volume reduction, creating favorable conditions for surgery. Strategies for preoperative weight loss (WL) need to be cautious, and moderate preoperative WL may help to reduce surgical difficulty and postoperative complications. In addition, the application of preoperative carbohydrate load can reduce postoperative insulin resistance and protein loss and promote postoperative recovery of patients. In terms of postoperative nutritional management, the risk of postoperative micronutrient deficiency is significantly increased. At the same time, the adjustment of postoperative dietary structure and rational use of nutritional supplements are important to maintain the nutritional status of patients and promote weight management. In conclusion, perioperative nutritional management of MBS is a multifaceted and multi-level comprehensive process that requires a multidisciplinary approach involving medical staff, dietitians, and patients. A tailor-made approach based on the patient’s unique characteristics, such as nutritional status, surgical type, and personal preferences, is essential to achieve the best surgical results and improvement of patients’ quality of life. Major challenges remain in perioperative nutritional management, such as the high prevalence of preoperative malnutrition and the complexity of postoperative nutritional deficiencies. In the future, more accurate preoperative nutritional assessment tools and personalized postoperative nutritional supplementation strategies should be developed.Keywords: obesity, bariatric surgery, perioperative, nutritional management
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spelling doaj-art-48816062db574d9a809b99927eacbeb72025-08-20T03:31:48ZengDove Medical PressDiabetes, Metabolic Syndrome and Obesity1178-70072025-07-01Volume 18Issue 121912202104527Advances in Perioperative Nutritional Management in Metabolic and Bariatric SurgeryLi Y0Zhang T1Gastrointestinal SurgeryGastrointestinal SurgeryYing Li, Ting Zhang Department of Gastrointestinal Surgery, Suzhou Municipal Hospital, The Affiliated Suzhou Hospital of Nanjing Medical University, Gusu School of Nanjing Medical University, Suzhou, Jiangsu, 215000, People’s Republic of ChinaCorrespondence: Ting Zhang, Department of Gastrointestinal Surgery, Suzhou Municipal Hospital, The Affiliated Suzhou Hospital of Nanjing Medical University, Gusu School of Nanjing Medical University, No. 26 Daoqian Street, Gusu District, Suzhou, Jiangsu, 215000, People’s Republic of China, Tel +8618862120859, Email zhangting_ztg@163.comAbstract: Metabolic and Bariatric Surgery (MBS) is an effective treatment for severe obesity and its related complications. However, perioperative nutritional management is essential for the patient’s surgical outcome and postoperative recovery. This article reviews the research progress in perioperative nutritional management of MBS. Preoperative nutritional assessment and optimization are essential, including monitoring and correction of micronutrient deficiencies, such as vitamin D, iron, folic acid, to reduce the risk of postoperative complications. In terms of preoperative dietary management, the use of a low-carbohydrate ketogenic diet (LCKD) and ready-to-eat low-carbohydrate ketogenic product (RLCKP) showed the potential to promote weight loss and liver volume reduction, creating favorable conditions for surgery. Strategies for preoperative weight loss (WL) need to be cautious, and moderate preoperative WL may help to reduce surgical difficulty and postoperative complications. In addition, the application of preoperative carbohydrate load can reduce postoperative insulin resistance and protein loss and promote postoperative recovery of patients. In terms of postoperative nutritional management, the risk of postoperative micronutrient deficiency is significantly increased. At the same time, the adjustment of postoperative dietary structure and rational use of nutritional supplements are important to maintain the nutritional status of patients and promote weight management. In conclusion, perioperative nutritional management of MBS is a multifaceted and multi-level comprehensive process that requires a multidisciplinary approach involving medical staff, dietitians, and patients. A tailor-made approach based on the patient’s unique characteristics, such as nutritional status, surgical type, and personal preferences, is essential to achieve the best surgical results and improvement of patients’ quality of life. Major challenges remain in perioperative nutritional management, such as the high prevalence of preoperative malnutrition and the complexity of postoperative nutritional deficiencies. In the future, more accurate preoperative nutritional assessment tools and personalized postoperative nutritional supplementation strategies should be developed.Keywords: obesity, bariatric surgery, perioperative, nutritional managementhttps://www.dovepress.com/advances-in-perioperative-nutritional-management-in-metabolic-and-bari-peer-reviewed-fulltext-article-DMSOObesitybariatric surgeryperioperativenutritional management
spellingShingle Li Y
Zhang T
Advances in Perioperative Nutritional Management in Metabolic and Bariatric Surgery
Diabetes, Metabolic Syndrome and Obesity
Obesity
bariatric surgery
perioperative
nutritional management
title Advances in Perioperative Nutritional Management in Metabolic and Bariatric Surgery
title_full Advances in Perioperative Nutritional Management in Metabolic and Bariatric Surgery
title_fullStr Advances in Perioperative Nutritional Management in Metabolic and Bariatric Surgery
title_full_unstemmed Advances in Perioperative Nutritional Management in Metabolic and Bariatric Surgery
title_short Advances in Perioperative Nutritional Management in Metabolic and Bariatric Surgery
title_sort advances in perioperative nutritional management in metabolic and bariatric surgery
topic Obesity
bariatric surgery
perioperative
nutritional management
url https://www.dovepress.com/advances-in-perioperative-nutritional-management-in-metabolic-and-bari-peer-reviewed-fulltext-article-DMSO
work_keys_str_mv AT liy advancesinperioperativenutritionalmanagementinmetabolicandbariatricsurgery
AT zhangt advancesinperioperativenutritionalmanagementinmetabolicandbariatricsurgery