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Lange, Undine Gabriele; Moulla, Yusef; Schütz, Tatjana; Blüher, Matthias; Peter, Veronika; Shang, Edward; Dietrich, Arne

Effectiveness and Tolerability of a Two-Week Hypocaloric Protein-Rich Diet Prior to Obesity Surgery with Two Different Diet Interventions: a Prospective Randomized Trial

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  • Media type: E-Article
  • Title: Effectiveness and Tolerability of a Two-Week Hypocaloric Protein-Rich Diet Prior to Obesity Surgery with Two Different Diet Interventions: a Prospective Randomized Trial
  • Contributor: Lange, Undine Gabriele; Moulla, Yusef; Schütz, Tatjana; Blüher, Matthias; Peter, Veronika; Shang, Edward; Dietrich, Arne
  • imprint: Springer Science and Business Media LLC, 2022
  • Published in: Obesity Surgery
  • Language: English
  • DOI: 10.1007/s11695-022-06180-z
  • ISSN: 0960-8923; 1708-0428
  • Keywords: Nutrition and Dietetics ; Endocrinology, Diabetes and Metabolism ; Surgery
  • Origination:
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  • Description: <jats:title>Abstract</jats:title><jats:sec> <jats:title>Purpose</jats:title> <jats:p>Preoperative very low-calorie diets (VLCDs) have been shown to reduce liver volume and improve bariatric surgery safety. Here, we compare two VLCD that differ in macronutrient composition.</jats:p> </jats:sec><jats:sec> <jats:title>Material/Methods</jats:title> <jats:p>Ninety patients awaiting obesity surgery were included in a prospective, open-label, randomized mono-centre trial comparing the effects of 2-week preoperative VLCDs: BCM Diät™ (diet 1) versus Optifast™ (diet 2).</jats:p> </jats:sec><jats:sec> <jats:title>Results</jats:title> <jats:p>Data from 33 patients in diet 1 and 36 in diet 2 could be analysed. There was no significant difference between the two diet intervention arms on outcome parameters. Overall, both VLCD strategies led to a mean weight reduction of 5.24 [4.72–5.76] kg (<jats:italic>p</jats:italic> &lt; 0.001), mean excess weight loss was 8.2 [7.4–9.1] % (<jats:italic>p</jats:italic> &lt; 0.001). BMI reduction was 1.81 [1.63–1.99] kg/m<jats:sup>2</jats:sup> (<jats:italic>p</jats:italic> &lt; 0.001). Over all patients, the liver volume was reduced by 397 [329–466] ml (<jats:italic>p</jats:italic> &lt; 0.001), which corresponds to 14.6 [12.4; 16.8] %. Liver fat content was significantly reduced by 18.35 [8.98–27.71] %. Reduction of body weight correlates with liver volume loss.</jats:p> <jats:p>In addition, hip/waist circumferences, body fat and fat-free mass decreased significantly. We found an increase of ALAT/ASAT and a significant decrease of triglycerides, LDL-cholesterol and HbA1c. Parameters of inflammatory were significantly reduced upon VLCD.</jats:p> </jats:sec><jats:sec> <jats:title>Conclusion</jats:title> <jats:p>Independently of the macronutrient composition, VLCD leads to a significant decrease of body weight, reduction of liver volume and improved parameters of inflammation, glucose and lipid metabolism. Preoperative diets are widely used in conditioning; however, VLCD should be considered as option for patients with obesity undergoing other abdominal surgeries.</jats:p> </jats:sec><jats:sec> <jats:title>Graphical abstract</jats:title> </jats:sec>