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At first glance, one’s postoperative laboratory orders can seem excessive, however, each macronutrient(protein, fats and carbohydrates) and  micronutrient (vitamins and minerals) plays a vital role in postoperative success and health which needs to be monitored closely.

Today I will discuss with you the role of and the difference between prealbumin and albumin. Prealbumin is the precursor to albumin and has a much shorter half-life, making it a more sensitive indicator of protein status. The half-life of prealbumin is approximately 2-4 days, whereas the half-life of albumin is 20-22 days. Albumin levels are an indicator of long-standing nutritional deficiencies and rise slowly once nutritional therapy begins.

Certain conditions or comorbidities can cause misleadingly low or elevated albumin levels. Conditions which cause hemoconcentration (i.e. dehydration) will cause deceptively elevated albumin and conditions such as heart failure or kidney disease will cause falsely depleted albumin levels, making hydration status a factor to consider when assessing albumin. Liver disease can also impact albumin levels because albumin is formed within the liver.  Prealbumin gives us a slightly better understanding of each person’s short-term protein intake due to the short half-life and can be used to guide if the nutritional plan is effective or needs to be modified. Prealbumin levels are not impacted by comorbidities or hydration status but can be impacted by inflammatory processes within the body, corticosteroids, and Hodgkin’s disease.

Protein malnutrition (albumin <3.5 mg/dl) is a potential complication of bariatric surgery and is more commonly seen in patients who have malabsorptive surgeries done such as biliopancreatic diversion or duodenal switch. Protein malnutrition is a serious concern post operatively and can even require hospitalization and parenteral nutrition. Due to the restrictive and malabsorptive characteristics of bariatric surgery, the intolerance to protein rich foods, and the significantly reduced caloric intake after surgery, each bariatric patient at an increased risk for protein malnutrition and needs to be closely monitored by your provider. Signs and symptoms of protein malnutrition may be weakness, edema, a reduction in muscle mass, hair loss, poor wound healing. Guidelines recommend bariatric surgery patients consume 80-120 grams of protein daily to maintain lean body mass and avoid these complications.

Protein has several imperative functions within the body such growth and maintenance of tissues, protein serves as a chemical messenger between organs, cells, and tissues, make up hormones, provide structure such as keratin used for your hair, skin and nails, maintains proper pH, supports immune health, and provides energy.

In short, eat your protein! Eat it consistently, throughout your day, every day to achieve optimal success, weight loss and health!

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