{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T15:00:07Z","timestamp":1775142007374,"version":"3.50.1"},"reference-count":159,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T00:00:00Z","timestamp":1774915200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Micronutrient deficiencies are commonly observed in patients with obesity and may persist or worsen following bariatric and metabolic surgery. Emerging evidence suggests that micronutrients play a fundamental role in tissue repair, collagen synthesis, immune function, and inflammatory regulation processes that are critical in postoperative healing. Therefore, deficiencies in these nutrients could be pivotal in understanding and preventing postoperative complications. However, the potential link between preoperative micronutrient status and the development of postoperative complications, such as anastomotic or gastric fistula, remains underexplored. This narrative review aims to investigate the correlation between specific micronutrient deficiencies (e.g., vitamin C, zinc, selenium, vitamin A, and iron) and the incidence of fistula after bariatric surgery. We will discuss the underlying biological mechanisms, clinical evidence, and possible preventive strategies, including preoperative screening and targeted supplementation. Our aim is to highlight the often-overlooked micronutrient deficiency as a risk factor in patients undergoing bariatric surgery, both in the pre- and postoperative periods, and to propose a more comprehensive approach to patient assessment and management.<\/jats:p>","DOI":"10.3390\/nu18071131","type":"journal-article","created":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T16:34:08Z","timestamp":1774974848000},"page":"1131","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Micronutrient Deficiencies in Obese Patients and Risk of Postoperative Fistula: A Forgotten Link in Bariatric and Metabolic Surgery"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6116-6122","authenticated-orcid":false,"given":"Ludwig","family":"Alvarez-Cordova","sequence":"first","affiliation":[{"name":"Maestr\u00eda de Nutrici\u00f3n y Diet\u00e9tica, Facultad de Ciencias de la Salud, Universidad de las Am\u00e9ricas, Quito 170124, Ecuador"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1917-5869","authenticated-orcid":false,"given":"Victoria","family":"Gonzalez","sequence":"additional","affiliation":[{"name":"Unidad de Soporte Metab\u00f3lico y Nutricional, Sanatorio Allende, C\u00f3rdoba X5000BFB, Argentina"},{"name":"Facultad de Ciencias de la Salud, Universidad Cat\u00f3lica de C\u00f3rdoba, C\u00f3rdoba X5000IYG, Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-9265-7628","authenticated-orcid":false,"given":"Facundo","family":"Saettone","sequence":"additional","affiliation":[{"name":"Servicio de Alimentaci\u00f3n, Hospital Nacional \u201cProfesor Alejandro Posadas\u201d, Buenos Aires 1684, Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-3632-7755","authenticated-orcid":false,"given":"Mar\u00eda Sol","family":"Barry","sequence":"additional","affiliation":[{"name":"Servicio de Endocrinolog\u00eda, Metabolismo, Nutrici\u00f3n y Diabetes, Hospital Brit\u00e1nico de Buenos Aires, Buenos Aires 1280, Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-8864-7789","authenticated-orcid":false,"given":"Laura Ver\u00f3nica","family":"Godoy","sequence":"additional","affiliation":[{"name":"\u00c1rea de Nutrici\u00f3n Cl\u00ednica, Hospital Brit\u00e1nico de Buenos Aires, Buenos Aires 1280, Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-1474-3394","authenticated-orcid":false,"given":"Julieta","family":"Siman","sequence":"additional","affiliation":[{"name":"Servicio de Nutrici\u00f3n y Alimentaci\u00f3n, Hospital Central de Mendoza, Mendoza 5500, Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4777-0358","authenticated-orcid":false,"given":"Natalia","family":"Llobera","sequence":"additional","affiliation":[{"name":"Equipo de Soporte Nutricional, Hospital Brit\u00e1nico de Buenos Aires, Buenos Aires 1280, Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-6194-4047","authenticated-orcid":false,"given":"Melannie","family":"Toral-Noristz","sequence":"additional","affiliation":[{"name":"Escuela de Medicina, Universidad de Especialidades Esp\u00edritu Santo, Samborond\u00f3n 092301, Ecuador"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8083-1714","authenticated-orcid":false,"given":"Sebasti\u00e1n","family":"Chapela","sequence":"additional","affiliation":[{"name":"Equipo de Soporte Nutricional, Hospital Brit\u00e1nico de Buenos Aires, Buenos Aires 1280, Argentina"},{"name":"Departamento de Bioqu\u00edmica, Facultad de Ciencias M\u00e9dicas, Universidad de Buenos Aires, Buenos Aires C1428EGA, Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1016\/j.ajcnut.2022.10.012","article-title":"Incidence of obesity across adulthood in the United States, 2001\u20132017\u2014A national prospective analysis","volume":"117","author":"Nielsen","year":"2023","journal-title":"Am. 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