Vitamins in Oil

by

Dr. Jacqueline Jacques
Chief Science Officer for Bariatric Advantage

Dear Barbara,
I have heard that weight loss surgery patients cannot absorb any vitamins in an oil form.  I have asked many doctors and nutritionist and they disagree.  I have learned so much from you and your website and newsletters, can you tell me if it is true and send me in a direction that would verify it.  I don't like telling my group something that I can't verify that it is true.

Judy Harris


Hi Judy,
To answer this, I went to a true expert, Dr. Jacqueline Jacques, the Chief Science Officer for Bariatric Advantage.  Here is her answer:


Barbara,
This is a great question, and the answer I am about to give is going to be long, but hopefully it will help somehow.

Fundamentally, no one has critically tested the difference in weight loss surgery
patients between the absorption of vitamins in oil and the absorption of dry forms.  So everything I am about to say is based on other conditions and on theory.

For fat-soluble vitamins (A, D, E and K), they are often delivered in the form of a soft-gel capsule.  These capsules are not filled purely with the nutrient.  Since in most cases the nutrient would take up very little space, much of what is in that soft gel is a carrier oil such as soybean or safflower oil and maybe things like vegetable glycerine and a preservative.

Normally, this fat is thought to be an advantage to absorption since the body absorbs fat soluble vitamins with fat.  The exception, for rather complicated reasons, is vitamin E where we have pretty well confirmed that the dry form is always better absorbed.

If someone has fat malabsorption, then when we put a globule of fat such as that soft gel into the gut, there is a significantly increased chance that they will malabsorb the fat AND the vitamin it is blended with.  This is where "dry" or water miscible (also called water dispersible) vitamins may have the advantage.  With the exception of vitamin E which has a different chemical structure in its dry form, dry fat soluble vitamins are typically made by spraying them in a very fine mist and then coating them with something to make a sort of powder composed of extremely small beadlets. They are usually stabilized with emulsifying agents like lecithin – allowing them to disperse and be stable in water.  Since there is less fat in the preparation and an emulsifying agent that helps to keep the nutrient dispersed, there is reason to believe it would be better absorbed in the case of fat malabsorption.

I guess the final questions is: when does this matter?  I think it would matter much more in DS patients than in RNY patients based on the evidence that we have today.

Hope this helps!

Sincerely,
Jacqueline Jacques, ND

Chief Science Officer
Bariatric Advantage
Catalina Lifesciences, LLC
18102 Sky Park Circle
Building 52, Suite J
Irvine, CA  92614
Tel: (800) 898-6888 x22
Fax: (949) 553-0844
www.bariatricadvantage.com