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Copper and Bariatric Surgery

Copper is a trace mineral that our body uses to carry out several different important functions. These functions include creating energy; laying down new connective tissue and blood vessels, activating genes, and maintaining the immune system. Copper is also vital for brain development and helps carry out enzyme reactions, which aid the brain in controlling neurotransmitters such as dopamine. This allows the brain cells to communicate with one another. Because of this, adequate copper intake is crucial, especially during pregnancy. In fact, some research has shown that copper deprivation during pregnancy may lead to the underdevelopment of crucial areas in the brain that are responsible for memory and learning. While copper deficiency is not considered to be a public health concern, 8 to 16 percent of women were found to have inadequate copper intakes in a survey-based study.

Copper deficiency is rare, as the body does not need much copper. The recommended daily allowance (RDA) of copper is about 900 micrograms (mcg) a day for both adolescents and adults. Pregnant or breastfeeding women need a little more, roughly 1,200 mcg per day since copper is so important for fetal brain development. The upper limit for this mineral is about 10,000 mcg, and intake above this level could be toxic. Though deficiency is rare, certain factors and health conditions increase the risk of being deficient, including a genetic defect, high intake of other supplements (which can affect copper absorption), and central nervous system conditions. Most copper is stored in the liver and deficiency develops slowly over time. Another condition that can lead to deficiency is weight loss surgery, as this can reduce absorption into the small intestine. Low levels of copper can lead to anemia, bone fractures, osteoporosis, and thyroid problems.

Copper is found in many different foods. Some of the best sources include shellfish, whole grains, beans, potatoes, dark leafy greens, organ meats, and nuts. Though fruits and vegetables are naturally low in copper, this mineral is added to some breakfast cereals and other grain-based foods.

Listed below are the amounts of copper found naturally in a few different foods:

  • Beef liver, 3 oz: 12,400mcg
  • Oysters, 3 oz cooked: 1,318 mcg
  • Shiitake mushrooms, 1 cup cooked: 1,300 mcg
  • White beans, 1 cup cooked: 608 mcg
  • Almonds, 1 oz: 330mcg
  • Spinach, 1 cup cooked: 310mcg

Eating a well-balanced diet can ensure that you are getting plenty of copper every day. If a person is showing signs of copper deficiency (fatigue, memory problems, difficulty walking, pale skin, vision loss, etc), a doctor may order a blood test. However, this test isn’t always definitive, as other factors can falsely elevate a person’s blood copper levels. Instead, a doctor may recommend an increase in foods that are high in copper. A supplement is not always recommended, since they interact with several different medications (birth control, aspirin, ibuprofen, zinc supplements).

Though copper deficiency is rare, it can be serious. People who have undergone bariatric surgery, especially gastric bypass, are at higher risk of deficiency as they have reduced gastrointestinal absorption. Eating a well-balanced healthy diet can reduce the risk for most deficiencies, though a dietitian or other health care professional can help make sure you are meeting all of your nutritional needs following surgery.

Chloe Seddon is a registered dietitian nutritionist who holds a Master’s Degree in health promotion from the University of Connecticut. She specializes in nutritional counseling, with a focus on a non-dieting approach to maintain healthy weight and goal-oriented lifestyle changes for long term success. She teaches intuitive eating and easy meal preparation to help clients sort through the myriad of nutritional misinformation to focus on having a balanced and happy relationship with food. She counsels clients with a range of issues, including chronic disease management, sports nutrition, disordered eating and weight loss. Chloe currently works as a nutritional counselor and educator providing group and individual consulting. She believes that balancing food, eating and exercise should be enjoyable and healthful.

References:

  1. Institute of Medicine, Food and Nutrition Board. Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. Washington, DC: National Academies Press; 2001.
  2. Hellman NE, Gitlin JD. Ceruloplasmin metabolism and function. Annu Rev Nutr 2002;22:439-58. [PubMed abstract]
  3. Allen KG, Klevay LM. Copper: an antioxidant nutrient for cardiovascular health. Curr Opin Lipidol 1994;5:22-8. [PubMed abstract]
  4. Owen CAJ. Biochemical Aspects of Copper: Copper Proteins, Ceruloplasmin, and Copper Protein Binding. Park Ridge, NJ: Noyes Publications; 1982.
  5. Klevay LM. Is the Western diet adequate in copper? J Trace Elem Med Biol 2011;25:204-12. [PubMed abstract]
  6. U.S. Department of Agriculture, Agricultural Research Service. What We Eat in America, 2013-2014. 2017.
  7. Institute of Medicine. Food and Nutrition Board. Dietary Reference Intakes: Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline. Washington, DC: National Academy Press; 1998.

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