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DEKAs afterBariatric Surgery*Once Daily All-in-one Multivitamin and Mineral Chewable Tablets with Enhanced Absorption for Dietary Management after Bariatric Surgery
Roberto Jongejan, MD, PhDGus Papas, MD, MPH
* Food for Special Medical Purposes, use only under medical supervision
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DEKAs Product ConceptRegistered as Food for Special Medical Purposes Use under medical supervision
DEKAs comes with a clinically tested delivery technology• Experte agree that the DEKAs delivery technology enhances absorption of fat-soluble
vitamins and micronutrients.1
DEKAs Bariatric covers all relevant vitamins and minerals in one tablet 2• DEKAs supplies all micronutrients recommended in US Bariatric Surgery guidelines.2,3
DEKAs Bariatric offers scalable dosing to cover all forms of Bariatric Surgery • The most recent guidelines show that patients with gastric banding or a sleeve
gastrectomy may need lower doses for supplementation than patients operated with other techniques.3 Therefore the dosing of DEKAs allows a choice between 1 or 2 chewable tablets per day, depending on patient, procedure and healthcare professional preferences.
1. EASL Clinical Practice Guidelines: Management of cholestatic liver diseases European Association for the Study of the Liver, Journal of Hepatology , Volume 51 , Issue 2 , 237 – 267. DOI: http://dx.doi.org/10.1016/j.jhep.2009.04.009
2. DEKAs Bariatric does not supplement calcium as this should not be combined with the supplementation of iron.3. Parrot J, Frank L, Dilks R, et al. American Society for Metabolic and Bariatric Surgery Integrated Health Nutritional
Guidelines for the Surgical Weight Loss Patient 2016 Update: Micronutrients, In Surgery for Obesity and RelatedDiseases, Volume 13, Issue 5, 2017, Pages 727-741, ISSN 1550-7289, https://doi.org/10.1016/j.soard.2016.12.018.
http://dx.doi.org/10.1016/j.jhep.2009.04.009
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DEKAs Delivery TechnologyBased on micelle forming ingredients1,2
DEKAs delivery technology has been clinically proven to increase the absorption of fat-soluble vitamins and other lipophilic compounds in conditions of malabsorption such as in cholestatic liver disease and cystic fibrosis.1,2
1. Papas K, Kalbfleisch J, Mohon R, Bioavailability of a novel, water-soluble vitamin E formulation in malabsorbing patients. Dig Dis Sci. (2007) Feb;52( 2) :347-52. DOI 10.1007/s10620-006-9489-2
2. EASL Clinical Practice Guidelines: Management of cholestatic liver diseases European Association for the Study of the Liver, Journal of Hepatology , Volume 51 , Issue 2 , 237 – 267. DOI: http://dx.doi.org/10.1016/j.jhep.2009.04.009
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Gastric Roux-en-Y bypass (RYGB) surgery in detail
http://www.weightlosssurgery.ca/about-our-surgeries/laparoscopic-roux-en-y-gastric-bypass/
http://www.weightlosssurgery.ca/about-our-surgeries/laparoscopic-roux-en-y-gastric-bypass/
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Diagram of common surgical options in Bariatric Surgery1,2Different procedures require different post-operative supplementation regimes
AGB - Adjustable gastric banding | GS - gastric sleeve RYGB - Roux-en-Y gastric bypass | BPD - biliopancreatic diversion
1. Heber D, Greenway FL, Kaplan LM, et al. Endocrine and Nutritional Management of the Post-Bariatric Surgery Patient: An Endocrine Society Clinical Practice Guideline, The Journal of Clinical Endocrinology & Metabolism, Volume 95, Issue 11, 1 November 2010, Pages 4823–4843, https://doi.org/10.1210/jc.2009-2128
2. Diagram adapted with permission from W. J. Pories: J Clin Endocrinol Metab 2008 Nov; 93:S89–S96, doi: 10.1210/jc.2008-1641
https://doi.org/10.1210/jc.2009-2128
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Multiple High Rates of Micronutrient Deficiency1-3Both pre- and post Bariatric Surgery
0102030405060708090
100
Vit D Zinc Vit B12 Vit B1 Iron Folate
Patie
nts w
ith d
efic
ienc
y (%
)
Pre-operative (%) Post-operative (%)
1. Adapted from C.I. Story, Improving Nutritional Deficiencies After Metabolic & Bariatric Surgery, Webinar August 2017.2. Stein, J., Stier, C., Raab, H. et al. (2014), Review article: the nutritional and pharmacological consequences of obesity surgery. Aliment
Pharmacol Ther, 40: 582–609. doi:10.1111/apt.128723. Parrot J, Frank L, Dilks R, et al. American Society for Metabolic and Bariatric Surgery Integrated Health Nutritional Guidelines for the
Surgical Weight Loss Patient 2016 Update: Micronutrients, In Surgery for Obesity and Related Diseases, Volume 13, Issue 5, 2017, Pages 727-741, ISSN 1550-7289, https://doi.org/10.1016/j.soard.2016.12.018.
< 30 ng/ml
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Guidelines for supplementation after Bariatric SurgeryOnly ASMBS 2016 guideline specifies type and amount of micronutrients5
1. American Soc. for Metabolic & Bariatric Surgery - ASMBS (2008)Allied Health Nutritional Guidelines for the Surgical Weight Loss Patient
2. Endocrine Soc. Clinical Practice Guideline (2010)Endocrine and Nutritional Management of the Post-bariatric Surgery Patient
3. European Assoc. for the Study of Obesity - EASOInt. Fed. for the Surgery of Obesity and Metabolic Dis. - IFSO-EC (2013)Interdisciplinary European Guidelines on Metabolic and Bariatric Surgery
4. American College Endocrinologiy (ACE) / The Obesity Society (TOS) (2013 Update)Clinical practice guidelines for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient
5. ASMBS (2016 Update)Micronutrients
1. Aills L, Blankenship J, Buffington C, et al. ASMBS Allied Health Nutritional Guidelines for the Surgical Weight Loss Patient. SOARD. 4 (2008); S73-S108. DOI: 10.1016/j.soard.2008.03.002
2. Heber D, Greenway FL, Kaplan LM, et al. Endocrine and Nutritional Management of the Post-Bariatric Surgery Patient: An Endocrine Society Clinical Practice Guideline, The Journal of Clinical Endocrinology & Metabolism, Volume 95, Issue 11, 1 November 2010, Pages 4823–4843, https://doi.org/10.1210/jc.2009-2128
3. Fried M, Yumuk V, Oppert J, et al. Interdisciplinary European Guidelines on Metabolic and Bariatric Surgery. Obes Facts 2013;6:449-468. https://doi.org/10.1159/0003554804. Mechanick J.I., Youdim A., Jones D.B., et al. Clinical practice guidelines for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient -
2013 update: Cosponsored by American Association of Clinical Endocrinologists, the Obesity Society, and American Society for Metabolic & Bariatric Surgery (2013) Surgery for Obesity and Related Diseases, 9 (2) , pp. 159-191. DOI: http://dx.doi.org/10.1016/j.soard.2012.12.010
5. Parrot J, Frank L, Dilks R, et al. American Society for Metabolic and Bariatric Surgery Integrated Health Nutritional Guidelines for the Surgical Weight Loss Patient 2016 Update: Micronutrients, In Surgery for Obesity and Related Diseases, Volume 13, Issue 5, 2017, Pages 727-741, ISSN 1550-7289, https://doi.org/10.1016/j.soard.2016.12.018.
https://doi.org/10.1210/jc.2009-2128https://doi.org/10.1159/000355480http://dx.doi.org/10.1016/j.soard.2012.12.010https://doi.org/10.1016/j.soard.2016.12.018
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Nutrient Unit Prod. A1 tab
Prod. B1 tab
DEKAs1 tab
DEKAs2 tabs
Vitamin A µgIU
6002000
12004000
15005000
300010000
Vitamin B1 mg 3 4,2 12,5 25Vitamin B12 µg 350 500 500 1000Vitamin D µg
IU75
300050
200062,52500
Gastric Band RYGB125
5000
Vitamin E µgIU
2436
2436
4770
Sleeve BPD/DS95
141
Vitamin K µg 0 135 500 RYGB 1000Folate µg 400 400 400 800Iron mg 70 14 23 45Copper mg 3 1 1 2Zinc mg 22,5 22,5 10 20Nutrient intake at this dose is within guidelines
Daily Dose
Nutrient intake at this dose is below or above the level recommended in the guidelines
DEKAs Bariatric guideline-compliant dosingComparison to competitors in N-Europe
Roux-en-Y gastric bypass (RYGB), Biliopancreatic diversion (BPD), BPD/duodenal switch (BPD/DS)
Start with one per day. Increase to two if needed
DEKAs Guide Compet. Simpl
NutrientUnitProd. A1 tabProd. B1 tabDEKAs1 tabDaily DoseDEKAs2 tabs
Vitamin AµgIU60020001200400015005000300010000
Vitamin B1mg34.212.525
Vitamin B12µg3505005001000
Vitamin DµgIU75300050200062,52500Gastric BandRYGB1255000
Vitamin EµgIU243624364770SleeveBPD/DS95141
Vitamin Kµg0135500RYGB1000
Folateµg400400400800
Ironmg70142345
Coppermg3112
Zincmg22.522.51020
Nutrient intake at this dose is within guidelines
Nutrient intake at this dose is below or above the level recommended in the guidelines
DEKAs Guide Competitors
Nutrient intake at this dose is within guidelines
Nutrient intake at this dose is below or above the level recommended in the guidelines
NutrientUnitCompetitor A1 tabCompetitor B1 tabDEKAs1 tabDaily DoseDEKAs2 tabsUpper LimitGeneral Population
Vitamin Aµg6001200150030003000
Vitamin AIU2000400050001000010000
Vitamin B1mg34.212.5Gastric BandRYGB25None set
Vitamin B12µg350500500SleeveBPD/DS1000None set
Vitamin Dµg755062.5RYGB125100
Vitamin DIU30002000250050004000
Vitamin Emg242447951000
Vitamin EIU3636701411500
Vitamin Kµg01355001000None set
Folateµg4004004008001000
Ironmg7014234545
Coppermg3112None set
Zincmg2322.5102040
0123456ERROR:#REF!ERROR:#REF!
DEKAs Guide V3
NutrientUnit1 tabDaily Dose2 tabsUpper LimitGeneral Population
Vitamin Aµg50075010001250150030003000
Vitamin AIU166725003333416650001000010000
Vitamin B1mg12.53.54.512.5Gastric BandRYGB25None set
Vitamin B12µg300350400450500SleeveBPD/DS1000None set
Vitamin Dµg4550556062.5RYGB125100
Vitamin DIU1800200022002400250050004000
Vitamin Emg716.726.736.747951000
Vitamin EIU1024.925373134339.850746268754.776119403701411500
Vitamin Kµg01252503755001000None set
Folateµg01002003004008001000
Ironmg131517.520234545
Coppermg00.250.50.7512None set
Zincmg0246102040
Nutrient intake at this dose is within guidelines
Nutrient intake at this dose is below the level recommended in the guidelines
01234567ERROR:#REF!ERROR:#REF!
Chewables Compared
IngredientFormUnitBar. AdvUS 60#
Roberto Jongejan: Roberto Jongejan:Advanced Multi EABar. Adv. EU 90#DEKAs60#WLS Max NL caps 90#
Roberto Jongejan: Roberto Jongejan:For Duodenal SwitchBiliopancreatic Div.WLS Forte NL Chew 90#
Roberto Jongejan: Roberto Jongejan:For GastricBypassMini BypassWLS Optim NL Chew 90#
Roberto Jongejan: Roberto Jongejan:For SleeveStomach bandUS Guideline MinimumAGB & SG
Roberto Jongejan: Roberto Jongejan:Laparoscopic adjustable gastric banding (LAGB), Roux-en-Y gastric bypass(RYGB), laparoscopic sleeve gastrectomy (SG), biliopancreatic diversion (BPD), andBPD/duodenal switch (BPD/DS) are the primary procedures performedUS Guideline MaximumRYGB, BPD/DS
Roberto Jongejan: Roberto Jongejan:Laparoscopic adjustable gastric banding (LAGB), Roux-en-Y gastric bypass(RYGB), laparoscopic sleeve gastrectomy (SG), biliopancreatic diversion (BPD), andBPD/duodenal switch (BPD/DS) are the primary procedures performedUpperLimit
Vitamin ABetacaroteen en retinylpalmitaatµg15001200150012006001000150030003000
Vitamin B1Thiaminemononitraatmg6.254.212.532.75212None
Vitamin B2Riboflavinemg1.72.81.73.53.52
Vitamin B3Niacinamidemg103210323225
Vitamin B5Calciumpanthotenaatmg10121018189
Vitamin B6Pyridoxal-5-fosfaatmg22.821.412
Vitamin B12Methylcobalamineµg50050050050035010350500None
Vitamin CAscorbinezuurmg4516045120120100
Vitamin DCholecalciferolµg37.55062.525757.575100
Vitamin EGemengde tocoferolen en alfatocoferylacetaatmg502450502412151000
Vitamin KFytomenadionµg50013550030009090300None
Folate5-methyltetrahydrofolaatµg400400400600600300400800
Roberto Jongejan: Roberto Jongejan:800-1000 in childbearing age1000
Biotinµg300100300100100150
IronFumaraatmg22.51422.5917028184545
ChromiumPicolinaatµg60806016016040
CopperCitraatmg111331.912None
IodineKaliumjodideµg7522575225225150
ManganeseCitraatmg141333
MagnesiumBisglycinaatmg256025.00030
MolybdenumNatriummolybdaatµg2510025.011211250
SeleniumSelenomethionineµg351053510510555
ZincBisglycinaatmg822.51022.522.51582240
Boronmg11
Cholinebitartraatmg10510000
Sodium10
Calciummg25Do not co-administer calciumcitrate/antacids with iron1200 -15001800-24003000tablets of 1200 mg 1-2 per day
Inositolmg5000
Coenzyme Q10mg505000
Bar. Adv US 60#
Roberto Jongejan: Roberto Jongejan:Advanced Multi EA
Roberto Jongejan: Roberto Jongejan:Advanced Multi EABar. Adv. EU 90#DEKAs60#WLS Max NL caps 90#
Roberto Jongejan: Roberto Jongejan:For Duodenal SwitchBiliopancreatic Div.WLS Forte NL Chew 90#
Roberto Jongejan: Roberto Jongejan:For GastricBypassMini BypassWLS Optim NL Chew 90#
Roberto Jongejan: Roberto Jongejan:For SleeveStomach band
Roberto Jongejan: Roberto Jongejan:For Duodenal SwitchBiliopancreatic Div.
Roberto Jongejan: Roberto Jongejan:800-1000 in childbearing age
Roberto Jongejan: Roberto Jongejan:For GastricBypassMini Bypass
Roberto Jongejan: Roberto Jongejan:For SleeveStomach band
Roberto Jongejan: Roberto Jongejan:Laparoscopic adjustable gastric banding (LAGB), Roux-en-Y gastric bypass(RYGB), laparoscopic sleeve gastrectomy (SG), biliopancreatic diversion (BPD), andBPD/duodenal switch (BPD/DS) are the primary procedures performed
Roberto Jongejan: Roberto Jongejan:Laparoscopic adjustable gastric banding (LAGB), Roux-en-Y gastric bypass(RYGB), laparoscopic sleeve gastrectomy (SG), biliopancreatic diversion (BPD), andBPD/duodenal switch (BPD/DS) are the primary procedures performedBarinutrics Calciumcitr 90#Citracal Calciumcitr Maximum 90#Combi Bar AdvCombi DEKAs60#
List Price per unit$43.06€ 47.99€ 33.50€ 44.95€ 49.45€ 38.65€ 26.99€ 32.39€ 74.98€ 39.50
CU per unit609060909090903609060
Internetprice, gross USD$37.44$46.07$40.20$43.02$43.02$35.82$25.91$26.99$71.98$47.40
Internetprice, gross Euro€ 31.20€ 38.39€ 33.50€ 35.85€ 35.85€ 29.85€ 21.59€ 21.59€ 59.98€ 39.50
Internetprice, net€ 36.09€ 31.49€ 33.70€ 33.70€ 28.06€ 20.29€ 20.29€ 56.38€ 37.13
Sending€ 2.50€ 1.72€ 2.50€ 2.50€ 2.50€ 1.72€ 1.72€ 2.50€ 1.72
Total net€ 33.59€ 29.77€ 31.20€ 31.20€ 25.56€ 18.57€ 18.57€ 52.16€ 35.41
Transportation US to EU€ 0.83€ 0.00€ 0.83
Total net net€ 28.94€ 0.00€ 34.58
Total USD$40.30$34.73$37.44$37.44$30.67$22.29$22.29$62.59$41.50
Price per CU€ 0.52€ 0.37€ 0.48€ 0.35€ 0.35€ 0.28€ 0.21€ 0.05€ 0.58€ 0.58
List price per CU€ 0.56€ 0.56€ 0.53€ 0.58€ 0.46€ 0.32€ 0.09€ 0.88€ 0.66
-33%-34%-40%-38%-35%-46%-34%-12%
DEKAs Guide Basis
NutrientUnitDaily DoseUpper Limit
Vitamin Aµg500750100012501500175020002250250027503000325035003000
Vitamin AIU166725003333416650005833666675008333916610000108331166610000
Vitamin B1mg12.53.54.56789101112.515.518.5N/A
Vitamin B12µg300350400450500583666749832915100010831166N/A
Vitamin Dµg4550556065758595105115125130135100
Vitamin DIU18002000220024002600*2800*34003800420046005000520054004000
Vitamin Emg7172737475563717987951031111000
Vitamin EIU102540557082941061171291411531651500
Vitamin Kµg0125250375500580660740820900100011001200N/A
Folateµg010020030040046553059566072580090010001000
Ironmg1315182023263034384145495345
Coppermg00.250.50.751.0001.21.31.51.61.82.02.22.4N/A
Zincmg0246891112141516181940
Nutrient intake at this dose is within guidelines or is below the tolerable upper intake level
Nutrient intake at this dose is below the level recommended in the guidelines
Nutrient intake at this dose is either dangerously low or is above the tolerable upper intake level so needs to be justified by individual patient considerations
0123456789101112
Composition
60 chewable tablets per pack1 chewable tablet
IngredientUnitQuantity% RIRef Inname
Vitamin A75% Beta-carotene 25% palmitateμg (IU)1500 (5000)75%800μg6667 IU
Vitamin B1 (thiamine)mg12.51136%1.1mg
Vitamin B2 (riboflavin)mg1.7121%1.4mg
Niacin (B3)mg1063%16mg
Cholinemg10N/Amg
Pantothenic Acid (B5)mg10167%6mg
Vitamin B6 (pyridoxin)mg2143%1.4mg
Biotin (B7)μg300600%50μg
Folic acidμg400200%200μg
Vitamin B12 μg50020000%2.5μg
Vitamin Cmg4556%80mg
Vitamin D3 μg (IU)62,5 (2500)1250%5μg2500
Vitamin Emg (IU)50 (75)417%12mg
Vitamin K1μg500667%75μg
60 chewable tablets per pack1 chewable tablet
IngredientUnitQuantity% RIRef Inname
Ironmg22.5161%14mg
Chromiumμg60150%40μg
Coppermg1100%1mg
Zincmg10100%10mg
Seleniumμg3564%55μg
Iodineμg7550%150μg
Manganesemg150%2mg
Molybdenumμg2550%50μg
Magnesiummg257%375mg
Calciummg253%800mg
Boronmg1N/Amg
Sodiummg10N/Amg
Coenzyme Q10mg5N/Amg
Composition Brochure
1 chewable tablet
IngredientUnitQuantity% RI*Ref Inname
Vitamin A75% Beta-carotene 25% palmitateμg (IU)1500 (5000)75%800μg6667 IU
Vitamin B1 (thiamine)mg12.51136%1.1mg
Vitamin B2 (riboflavin)mg1.7121%1.4mg
Niacin (B3)mg1063%16mg
Cholinemg10N/Amg
Pantothenic Acid (B5)mg10167%6mg
Vitamin B6 (pyridoxin)mg2143%1.4mg
Biotin (B7)μg300600%50μg
Folic acidμg400200%200μg
Vitamin B12 μg50020000%2.5μg
Vitamin Cmg4556%80mg
Vitamin D3 μg (IU)62,5 (2500)1250%5μg2500
Vitamin Emg (IU)50 (75)417%12mg
Vitamin K1μg500667%75μg
Ironmg22.5161%14mg
Chromiumμg60150%40μg
Coppermg1100%1mg
Zincmg10100%10mg
Seleniumμg3564%55μg
Iodineμg7550%150μg
Manganesemg150%2mg
Molybdenumμg2550%50μg
Magnesiummg257%375mg
Calciummg253%800mg
Boronmg1N/Amg
Sodiummg9N/Amg
Coenzyme Q10mg5N/Amg
Composition Unsorted
Nutritional information / Nährwertinformationen / Information nutritionnelle / Información nutricional / informazione nutrizionale / Voedingswaarde-informatie Factor
contains 60 chewable tablets / 1 chewable tablet /100 g28.41
enthält 60 Kautabletten /1 Kautablette /
contient 60 comprimés à croquer /1 comprimé à croquer /
contiene 60 tabletas masticables / 1 tableta masticable /
bevat 60 kauwtabletten1 pastiglia da masticare
1 kauwtablet
Energy / Brennwert / Énergie / Energia / Energie kJ / kcal0 / 02 / 00.05481040.013120
Fat / Fett / Matières grasses / Grasas / Grassi / Vetten g0.26.4
of which / davon / dont / de las cuales / di cui / waarvan:
saturates / gesättigte Fettsäuren / acides gras saturés / ácidos grasos saturados / acidi grassi saturi / verzadigde vetzureng0.11.6
Carbohydrates / Kohlenhydrate / Glucides / Carbohidratos / Carboidrati / Koolhydrateng3.085
of which / davon / dont / de los cuales / di cui / waarvan:
Sugars/ Zucker / Sucres / Azúcares / Zuccheri / Suikersg2.159
Protein / Eiweiß / Protéines / Proteínas / Proteine / Eiwitteng0.154.2
Salt / Salz / Sel / Sal / Sale / Zoutg0.02
Roberto Jongejan: Roberto Jongejan:salt = sodium × 2.5.0.65
Vitamin/ Vitamine / Vitamina Aμg (IU)150 (1250)4261 (35511)426135511
Beta-carotene / Beta-carotin / Bêta-carotène/ Beta-caroteno / Bèta-caroteenμg RE* (IU)400 (3750)11364 (106534)11364106534
Vitamin/ Vitamine / Vitamina Cmg4512781278
Vitamin/ Vitamine / Vitamina D3 μg (IU)50 (2500)1420 (71023)142071023
Vitamin/ Vitamine / Vitamina Emg (IU)46 (75)1307 (2131)13072131
Vitamin/ Vitamine / Vitamina K1μg50014205
Vitamin/ Vitamine / Vitamina B1 - Thiamin(e), Tiaminamg12.5355
Vitamin/ Vitamine / Vitamina B2 - Riboflavin(e), Riboflavinamg1.748
Niacin(e), Niacinamg10284
Vitamin/ Vitamine / Vitamina B6 mg2.057
Folic acid / Folsäure / Acide folique / Ácido fólico / Foliumzuurμg40011364
Vitamin/ Vitamine / Vitamina B12 μg50014205
Biotin(e), Biotinaμg3008523
Pantothenic Acid / Pantothensäure / Acide pantothénique / Ácido pantoténico / Pantotheenzuur Mg10284
Calcium / mg25710
Iron / mg23639
Iodine / μg752131
Magnesium / mg25710
Zink / Zinc / Cincmg10284
Selen / Sélénium / Selenium / Selenio / Seleenμg35994
Coppermg1.0028
Boronmg1.028
Manganesemg1.028
Chromiumμg601705
Molybdenumμg25710
Sodiummg10284
Cholinemg10284
Co(-)enzym(e) Q10, coenzima Q10mg5.0142
Ingredients Guidelines
Nutrient recommended UnitMinimum starting dose AGB, SG, RYGB*Increased dose mostly in BPD or BPD/DS* Tolerable upper intake level for general population
Vitamin Aµg/IU1500 / 50003000 / 100003000 / 10000
Vitamin B1mg12None set
Vitamin B12µg350500None set
Vitamin Dµg/IU75 / 3000as needed for 30 ng/mL100 / 4000
Vitamin Emg/IU15 / 22,5 1000 / 1500
Vitamin Kµg90300None set
Folateµg4008001000
Ironmg1845-6045
Coppermg12None set
Zincmg82240
Calcium **mg120024002000-3000
DEKAs Bariatric is also a complete multivitamin and mineral supplement as is recommended in the guidelines.
* Adjustable Gastric Banding (AGB), Sleeve Gastrectomy (SG), Roux-en-Y gastric bypass (RYGB), Biliopancreatic diversion (BPD), BPD/duodenal switch (BPD/DS)** Calcium (or antacids) should be taken separately and not be co-adminstered with iron
Blad1
BariNutr Caps
per potaantalper dagper potper chewaantal
Prijs€ 19.0060€ 0.63Prijs€ 19.00€ 0.6330€ 38.00
€ 48.00€ 0.5390€ 32.00
BariNutrics Multi 60 caps Euro 15,20IngrediëntenBariNutrics Multi Kers 30 tabs Euro 15,99DEKAs
Ingrediënten per 2 capsulesRI*per kauwtablet
Vitamine A (betacaroteen en retinylpalmitaat)1200 mcg150%Vitamine ABetacaroteen en retinylpalmitaat1501200 µg600Vitamine A
Vitamine B1 (thiaminemononitraat)4,2 mg382%Vitamine B1Thiaminemononitraat3824,2 mg6.3Vitamine B1
Vitamine B2 (riboflavine)2,8 mg200%Vitamine B2Riboflavine2002,8 mg1.7Vitamine B2
Vitamine B3 (niacinamide)32 mg200%Vitamine B3Niacinamide20032 mg10Niacine (Vitamin B3)
Vitamine B5 (calciumpanthotenaat)12 mg200%Vitamine B5Calciumpanthotenaat20012 mg10Pantothenzuur (Vitamine B5)
Vitamine B6 (pyridoxal-5-fosfaat)2,8 mg200%Vitamine B6Pyridoxal-5-fosfaat2002,8 mg2Vitamine B6
Vitamine B12 (methylcobalamine)500 mcg20000%Vitamine B12Methylcobalamine20000500 µg500Vitamine B12
Vitamine C (ascorbinezuur)160 mg200%Vitamine CAscorbinezuur200160 mg45Vitamine C
Vitamine D (cholecalciferol)50 mcg1000%Vitamine DCholecalciferol100050 µg50Vitamine D3
Vitamine E (gemengde tocoferolen en alfatocoferylacetaat)24 mg200%Vitamine EGemengde tocoferolen en alfatocoferylacetaat20024 mg46Vitamine E
Vitamine K (fytomenadion)135 mcg180%Vitamine KFytomenadion180135 µg1000Vitamine K
Folaat (calcium-L-methylfolaat)400 mcg200%Folaat5-methyltetrahydrofolaat (5-MTHF), Metafolin®200400 µg400Foliumzuur
Biotine100 mcg200%Biotine200100 µg300Biotine
Ijzer (fumaraat)14 mg100%IjzerFumaraat10014 mg22.5IJzer
Chroom (picolinaat)80 mcg200%ChroomPicolinaat20080 µg60Chroom
Koper (citraat)1000 mcg100%KoperCitraat1001000 µg1Koper
Jodide (kaliumjodide)225 mcg150%JodideKaliumjodide150225 µg75Jodium
Mangaan (citraat)4 mg200%MangaanCitraat2004 mg1Mangaan
Molybdeen (natriummolybdaat)100 mcg200%MagnesiumBisglycinaat1660 mg25Magnesium
Selenium (methionine)105 mcg191%MolybdeenNatriummolybdaat200100 µg25Molybdeen
Zink (bisglycinaat)22,5 mg225%SeleniumSelenomethionine191105 µg35Selenium
Cholinebitartraat5 mgZinkBisglycinaat22522,5 mg7.5Zink
Inositol5 mgCholinebitartraat5 mg10Choline
Gemengd met: hydroxypropylmethylcellulose, siliciumdioxide, magnesiumstearaatInositol5 mg5.0Coenzyme Q10
*RI = Referentie Inname
*RI = referentie inname
Ingrediënten kers:
Zoetstoffen: xylitol en sorbitol, magnesiumbisglycinaat, draagstof: hydroxypropylcellulose, ascorbinezuur, antiklontermiddel: stearinezuur, smaakstoffen: kersenaroma en citroenzuur, zinkbisglycinaat, kleurstof: rodebietenpoeder, ijzerfumaraat, antiklontermiddelen: magnesiumstearaat en siliciumdioxide, niacinamide, alfatocoferylacetaat, mangaancitraat, calciumpantothenaat, natuurlijk gemengde tocoferolen, thiaminemononitraat, cholinebitartraat, inositol, bètacaroteen,zoetstof: sucralose, pyridoxal-5-fosfaat, ribo avine, kopercitraat, retinylpalmitaat, chromiumpicolinaat, methylcobalamine, calcium-L-methylfolaat, kaliumjodide, selenomethionine, natriummolybdaat, fytomenadion, biotine, cholecalciferol
Ingrediënten citrus:
Fructose, magnesiumbisglycinaat, draagstof: hydroxypropylcellulose, zoetstof: xylitol, antiklontermiddel: stearinezuur, ascorbinezuur, smaakstoffen: gesproeidroogd sinaasappelsappoeder, natuurlijk sinaasappelaroma en citrusaroma, zinkbisglycinaat, smaakstof: citroenzuur, ijzerfumaraat, niacinamide, antiklontermiddelen: magnesiumstearaat en silciumdioxide, alfatocoferylacetaat, mangaancitraat, calciumpantothenaat, natuurlijk gemengde tocoferolen, kurkumawortelextract (Curcuma longa), zoetstof: sucralose, thiamine mononitraat, cholinebitartraat, inositol, bètacaroteen, pyridoxal-5-fosfaat, ribo avine, kopercitraat, retinylpalmitaat, chromiumpicolinaat, methylcobalamine, calcium-L-methylfolaat, kaliumjodide, selenomethionine, natriummolybdaat, fytomenadion, biotine, cholecalciferol
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€ 19,99voor 30 kauwtabletten € 47,99voor 90 tabletten
Aanbevolen publieksprijs
FitforMe
FitforMe
€ 0.55
90
€ 49.45€ 32.97
StudymedicationWLS Optimum 1 capsWLS Forte 1 chewWLS Maximum 1 caps 1 DEKAs BarRef Quant
SleeveMaagbandGastricBypassMini BypassDuodenal SwitchBiliopancreatic Div.
Vitamine ARetinolpalmitaat100080060012001500188%800
Vitamine B1Thiamine HCL2.82.752.7536.25569%1.1
Vitamine B2Riboflavine3.523.53.51.7121%1.4
Niacine (Vitamin B3)Nicotimanide322532321063%16
Pantothenzuur (Vitamine B5)Calcium Pantothenaat189181810167%6
Vitamine B6Pyridoxin HCL2.82.01.01.42.0143%1.4
BiotineBiotine600150100100300600%50
FoliumzuurPteroylmonoglutaminezuur600500600600400200%200
Vitamine B12Cyanocobalamine35010035050050020000%2.5
Vitamine CAscorbinezuur1201001201204556%80
Vitamine D3Cholecalciferol12.57.52525631250%5
Vitamine ED-alfa-Tocopherol succinaat2412245050419%12
ChroomChroom III Chloride1604016016060150%40
JodiumKaliumjodaat1501502252257550%150
MangaanMangancitraat3333150%2
MolybdeenNatriummolybdaat112501121122550%50
SeleniumNatriumseleniet105551051053564%55
ZinkZinkcitraat22.52822.522.57.575%10
IJzerFerro Fumaraat7028709122.5161%14
KoperKopergluconaat31.9331100%1
Vitamin K1Vitamin K190300500667%75
CholineCholine10
MagnesiumMagnesium257%375
Coenzyme Q10Coenzyme Q105
Vitamin B12 1000μg
Vitamin D3 100 (5000)μg (IU)
Vitamin K11000μg
Biotin (B7)600μg
Vitamin B1 (thiamine)12.5mg
Vitamin E / TPGS92 (150)mg (IU)
Folic acid (B11)800μg
Pantothenic Acid (B5)20mg
Iron45mg
Chromium120μg
Vitamin B6 (pyridoxin)4mg
Vitamin B2 (riboflavin)3.4mg
Copper2mg
Zink15mg
Vitamin A75% Beta-carotene 25% palmitate10000(IU)
Selenium70μg
Niacin20mg
Vitamin C90mg
Iodine150μg
Manganese2mg
Molybdenum50μg
Magnesium50mg
Calcium50mg
Boron2mg
Sodium20mg
Choline20mg
Coenzyme Q1010mg
DEKAs Guide V2
NutrientUnitDaily Dose1 tab2 tabsUpper Limit
Vitamin Aµg5007501000125015003000325035003000
Vitamin AIU1667250033334166500010000108331166610000
Vitamin B1mg12.53.54.56SleeveRYGB121518N/A
Vitamin B12µg300350400450500Gastric BdBPD/DS100010831166N/A
Vitamin D*µg4550556062.58595105125130135100
Vitamin D*IU180020002200240025003400380042005000520054004000
Vitamin Emg717273747951031111000
Vitamin EIU10254055701411531651500
Vitamin Kµg0125250375500100011001200N/A
Folateµg010020030040080090010001000
Ironmg131518202345495345
Coppermg00.250.50.75122.22.4N/A
Zincmg0246816181940
Nutrient intake at this dose is within guidelines and/or within the tolerable upper intake level
Nutrient intake at this dose is below the level recommended in the guidelines
Nutrient intake at this dose is either dangerously low or is above the tolerable upper intake level so needs to be justified by individual patient considerations
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DEKAs prototype formulation clinically tested in RCTSignificantly better than the standard bariatric vitamin regime used at Johns Hopkins Center for Bariatric Surgery, Baltimore, USA 1
tart with one per day, increase to two if needed.
1. Steele K, Peterson L, Papas K, et al. Efficacy of a chewable multivitamin/mineral supplement in preventing vitamin deficiency in Roux en-Y gastric bypass patients: A randomized controlled clinical trial. ASMBS Poster A6208, November 4-6, 2014. Full publication will follow shortly.
Study outline• DEKAs prototype formulation + calcium (n=29) was RCT-tested against the
standard regimen (n=27, 2 multivitamins + 500 mcg B12 + iron + calcium) at Johns Hopkins, Baltimore, USA after Roux-en-Y Gastric Bypass Surgery.
• Mean BMI 47, mean age 42, 89% female patients.• Plasma levels of vitamins A, D, E, folate, thiamine, vitamin B12, ferritin & iron, were
measured preoperatively and 3 months postoperatively. Main results for the DEKAs prototype group• A greater percentage of optimal levels for the majority of vitamins and minerals.• PTH (p=0,02), vitamin D (p=0,02), thiamine (p=0,01), folate (p=0,03) and beta
carotene (p=0,04) improved significantly.• Better initial taste (p=0,01)• Better aftertaste (p=0,04)• Greater satisfaction and compliance
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What makes DEKAs Bariatric specialDEKAs Bariatric chewable tablets
DEKAs has a unique delivery technology• The delivery technology ensures enhanced absorption of fat-soluble vitamins and micronutrients.1
DEKAs is guideline compliant: one dose covers all minerals and vitamins2• The composition of DEKAs incorporates the latest consensus guidelines on bariatric surgery.3
DEKAs was clinically tested in RYGB patients and improved results in a meaningful way 4• In a clinical study a prototype formulation of DEKAs Bariatric showed significantly better results than the
standard bariatric vitamin used in the Johns Hopkins Center for Bariatric Surgery, Baltimore, USA 4
DEKAs is taste-optimized and contains no paraben, gluten, casein or lactose• DEKAs is based on natural flavors.
DEKAs eliminates the risk of hypervitaminosis A• Most of the vitamin A in DEKAs is given as ß-carotene, which is a precursor to vitamin A and is converted
by the body to vitamin A as needed. No risk of hypervitaminosis A.
1. EASL Clinical Practice Guidelines: Management of cholestatic liver diseases European Association for the Study of the Liver, Journal of Hepatology , Volume 51 , Issue 2 , 237 – 267. DOI: http://dx.doi.org/10.1016/j.jhep.2009.04.009
2. DEKAs Bariatric does not supplement calcium as this should not be combined with the supplementation of iron.3. Parrot J, Frank L, Dilks R, et al. American Society for Metabolic and Bariatric Surgery Integrated Health Nutritional Guidelines for the
Surgical Weight Loss Patient 2016 Update: Micronutrients, In Surgery for Obesity and Related Diseases, Volume 13, Issue 5, 2017, Pages 727-741, ISSN 1550-7289, https://doi.org/10.1016/j.soard.2016.12.018.
4. Steele K, Peterson L, Papas K, et al. Efficacy of a chewable multivitamin/mineral supplement in preventing vitamin deficiency in Roux en-Y gastric bypass patients: A randomized controlled clinical trial. ASMBS Poster A6208, November 4-6, 2014.
http://dx.doi.org/10.1016/j.jhep.2009.04.009https://doi.org/10.1016/j.soard.2016.12.018
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Nutritional Information DEKAs BariatricFood for Special Medical Purposes. Use only under medical supervision.
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Product Information DEKAs BariatricFood for Special Medical Purposes. Use only under medical supervision.
DEKAs after�Bariatric Surgery*��Once Daily All-in-one Multivitamin and Mineral Chewable Tablets with Enhanced Absorption for Dietary Management after Bariatric SurgeryDEKAs Product Concept�Registered as Food for Special Medical Purposes �Use under medical supervision�DEKAs Delivery Technology�Based on micelle forming ingredients1,2Gastric Roux-en-Y bypass (RYGB) surgery in detail�Diagram of common surgical options in Bariatric Surgery1,2�Different procedures require different post-operative supplementation regimes �Multiple High Rates of Micronutrient Deficiency1-3�Both pre- and post Bariatric SurgeryGuidelines for supplementation after Bariatric Surgery�Only ASMBS 2016 guideline specifies type and amount of micronutrients5 �DEKAs Bariatric guideline-compliant dosing�Comparison to competitors in N-Europe�DEKAs prototype formulation clinically tested in RCT�Significantly better than the standard bariatric vitamin regime used at Johns Hopkins Center for Bariatric Surgery, Baltimore, USA 1��tart with one per day, increase to two if needed.�What makes DEKAs Bariatric special�DEKAs Bariatric chewable tablets�Nutritional Information DEKAs Bariatric�Food for Special Medical Purposes. Use only under medical supervision.���Product Information DEKAs Bariatric�Food for Special Medical Purposes. Use only under medical supervision.���