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February 28, 2026Biomedicines0 citationsOpen Access

Effects of Recommended Supplementation and Mediterranean Diet Adherence on Post-Metabolic Bariatric Surgery Outcomes

JDJ DebskiASAnna SabućASAntonina Spalińska

Key Points

  • To evaluate the effects of Mediterranean diet adherence on laboratory parameters and weight loss after metabolic bariatric surgery.
  • Evaluated 80 adults with obesity before and 6 months after surgery
  • Classified patients based on Mediterranean diet adherence using dietary questionnaires
  • Assessed laboratory parameters including vitamin D, iron, and protein levels pre- and postoperatively
  • Calculated excess weight loss percentage (EWL%) using standard methodology.
  • Vitamin D and total protein levels increased in both groups after surgery
  • Iron concentration significantly increased in Mediterranean diet adherents but decreased in non-adherents
  • Iron deficiency occurred only in the non-Mediterranean diet group (10.4% vs. 0%)
  • Median EWL% was higher in Mediterranean diet adherents (44% vs. 31%), though not statistically significant.

Abstract

Background/Objectives: Metabolic bariatric surgery is an effective treatment for severe obesity but is associated with an increased risk of postoperative nutritional deficiencies. This study aimed to assess the impact of adherence to the Mediterranean diet on selected laboratory parameters and excess weight loss after bariatric surgery. Methods: Eighty adults with obesity were evaluated before and 6 months after surgery. Based on dietary questionnaires, patients were classified as adhering to the Mediterranean diet (n = 32) or not adhering (n = 48). Laboratory parameters, including vitamin D, vitamin B12, folic acid, iron, ferritin, calcium, hemoglobin, and total protein, were assessed pre- and postoperatively. Excess weight loss percentage (EWL%) was calculated using standard methodology. Results: Postoperatively, vitamin D and total protein levels increased in both groups, with median increases of 9.45 ng/mL and 1.1 g/dL, respectively. A significant increase in iron concentration was observed only in Mediterranean diet adherents (median +24 µg/dL), while a decrease was noted in non-adherent patients (−4 µg/dL). Iron deficiency and iron-deficiency anemia occurred exclusively in the non-Mediterranean diet group (10.4% vs. 0%). Median EWL% was higher in Mediterranean diet adherents (44% vs. 31%), although the difference was not statistically significant. Conclusions: Adherence to the Mediterranean diet may reduce the risk of iron deficiency after bariatric surgery, whereas total protein concentration alone appears insufficient for assessing nutritional status or weight loss effectiveness.

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Cite This Study

Debski et al. (2026) studied this question.

synapsesocial.com/papers/69a286370a974eb0d3c01001https://doi.org/10.3390/biomedicines14030513
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