# A Comparison of the Health Benefits of Customized Multivitamins and Standard Supplementation Post-bariatric Surgery: A Systematic Review

## TL;DR

This study compares customized multivitamins to standard ones after bariatric surgery, finding that customized versions may better prevent nutrient deficiencies.

## Contribution

The paper introduces a systematic review comparing customized multivitamins to standard ones post-bariatric surgery, highlighting their potential for better micronutrient outcomes.

## Key findings

- Customized multivitamins (CMV) showed better results than standard multivitamins (SMV) in preventing micronutrient deficiencies.
- WLS Forte performed better than SMV, while chewable CMV and Opt. 1.0 were comparable to SMV.
- Opt. 2.0 showed slight improvement over Opt. 1.0, suggesting room for further CMV modifications.

## Abstract

Rates of obesity increase worldwide year after year. This review explored if customized multivitamins (CMV) resulted in less micronutrient deficiency and higher serum levels of vitamins and minerals when compared to standard multivitamins (SMV) post-bariatric surgery in adults. Vitamins investigated were vitamins B1, B6, B12, D, parathyroid hormone (PTH), calcium, iron, hemoglobin, ferritin, folic acid, zinc, and magnesium. In Roux-en-Y gastric bypass (RYGB) patients weight loss surgeries (WLS) Forte or chewable CMV were studied, while in sleeve gastrectomy (SG) patients, WLS Optimum 1.0 (Opt. 1.0) or WLS Optimum 2.0 (Opt. 2.0) multivitamins were studied. An electronic search was performed on three databases (PubMed (n=28), Embase (n=120), and Cochrane (n=106)) to identify clinical trials and cohort studies. The inclusion criteria focused on studies since 2011 for adults ≥18 years old post-GB and SG. The keywords included bypass, sleeve, WLS, and multivitamins. Four clinical trials and three cohort studies were included. Jadad Scale was used to assess the quality and the bias risk in the clinical trials and the Newcastle-Ottawa scale (NOS) was used for the cohort studies. The PICO model and PRISMA rules were followed, where the outcomes targeted certain vitamin serum levels and the levels of deficiencies. The results of WLS Forte were better than SMV. The chewable CMV and Opt. 1.0 results were comparable to SMV. Opt. 2.0 was slightly better than Opt. 1.0. Further modifications would enhance the CMV presented in this systemic review. SMV would still be recommended until CMV are modified and tested. Multi-center trials that monitor the effect of the modified CMV on the serum levels of vitamins and minerals in the longer term in different wider populations are needed.