Comparative Effects of Different Energy and Nutrient Contents in a Conventional Very Low Calorie Diet Obesity Treatment Eiichi Akiyama *1, Yuko Mieno

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1 Comparative Effects of Different Energy and Nutrient Contents in a Conventional Very Low Calorie Diet Obesity Treatment Eiichi Akiyama *1, Yuko Mieno * 2, Hiroshi Eto * 3, Sukenobu Ito * 3 and Hiroshi Kuwahara * 3 *l Department of Nutrition * 2 Department of Nutrition, Kyushu Kosei-Nenkin Hospital ;, Yufuin Kosei-Nenkin Hospital ; * 3 Department of Internal Medicine, Yufuin Kosei-Nenkin Hospital We modified the usual nutrient composition of a conventional very low calorie diet (VLCD) for treating moderate to severe obesity from 380kcal (40 g of protein) to 460kca1 (55 g of protein) and examined the effects of the difference on the obesity treatment. All the subjects were inpatients of Yufuin Kosei-Nenkin Hospital : 44 had an average age of 46.1 }2.5 years (12 males and 32 females) who took 380kca1/day of VLCD ; and 39 had an average age of 45.1 }2.3 years (12 males and 27 females) who took 460kcal/day of VLCD. After administering 380kcal or 460kcal of VLCD in accordance with our treatment program, the body weight of all subjects significantly decreased after four weeks in both groups the body mass index (BMI) being significantly decreased aftetwo weeks in the 380kcal group and after three weeks in the460kcal group. Total cholesterol, LDL-cholesterol and triglyceride were significantly decreased in both groups after four weeks, while HDL-cholesterol was significantly decreased in the 380kcal group, but only slightly decreased in the 460kcal group. The atherogenic index (T-chol. -HDL-chol. /HDL-chol.) showed an apparent improvement in the 460kcal group. The nitrogen balance was significantly improved in the 460kcal group compared with that of the 380kcal group. Serum iron was lowered significantly after four weeks in both groups, but recovered to the normal range when both groups returned to a l, 200kcal diet. The decrease in weight after four weeks was not significantly different between the two groups ; however, the 460kcal group had more favorable results for serum lipid, atherogenic Key words : very low calorie diet, nutrient composition, body mass index, atherogenic index, nitrogen balance

2 index, and nitrogen balance. In conclusion, 460kcal a day seems to have been more suitable than 380kcal a day for the VLCD therapy. Jpn. J. Nutr., 56 (4) 199 `209 (1998)

3 Vol. 56 No. 4 Table 1 The comparison of the subjects

4 Table 3 3 days' menu examples of 380kca1 and <Menu examples of 380kcal VLCD)

5 Vol. 56 No kca1 very low calorie conventional diet (VLCD) Menu examples of 460kcal VLCD> <

6 Table 4 The comparison of the nutrient composition between 380kcal and 460kcal of VLCD Table 5 The changes of body weight and BMI by the difference of nutrient composition * p<0.05 (vs at admission) * p<0.05, ** p<0.01 (vs at admission) Table 6 The effects of the difference of energ intakes four weeks after the onset of dietary treatment upon body weight, the percentage of weight loss and BMI

7 Vol. 56 No. 4 Table 7 The changes of serum lipid and atherogenic index by the difference of nutrient composition Fig.2 The effects upon the nitrogen balance on the seventh day after the introduction of VLCD whose nutrient components differ between 380kcal and 460kcal Table 8 The effects of the difference of nutrient composition upon serum total protein, prealbumin, and iron (17)

9 Vol. 56 No. 4 3) Bloom, W. L.: Fasting as an introduction to the treatment of obesity, Metabolism, 8, 214 `220 (1959)

10 4) Evans, F. A. and Strang, J. M.: A departure from the usual methods of treating obesity, Am. J. Med. Sci., 177, (1929) 5) Blackburn, G. L., Flatt, J. P., Cloves, G. H. A., O'Donell, T. F. and Hensle, T.: Protein sparing therapy during periods of starvation with sepsis or trauma, Ann. Surg., 177, 588 `593 (1973) 6) McLean Baird, I., Parsons, R. L, and Howard,A. N.: Clinical and metabolic studies of chemically defined diets in the study of obesity, Metabolism, 23, 645 `657 (1974) 8) Wadden, T. A., Stunkard, A. T., Day, S. C., Gould, R. A. and Rubin, C. J.: Less food, less hunger : Reports of appetite and symptoms in a controlled study of a ptotein-sparing modified fast, Int. J. Obesity, 11, 238 `249 (1987) 9) Howard, A. N., Grant, A., Edwards, O., Littlewood, E. R. and McLean Baird, I.: The treatment of obesity with a very-low-calorie liquid-formula diet : an impatient/outpatient comparison using skimmed-milk protein as the chief protein source, Int. J. besity, 2, 321 `332 (1978) O 13) Brown, M., Tache, Y. and Fisher, D.: Central nervous system action of bombesin : Mechanism to induce hyperglycemia, Endocrinology, 105, 660 `665 (1979) 14) Gibbs, J. R., Young, R. C. and Smith, G. P.: Cholecystokinin decreases food intake in rats, J. Comp. Physiol. Psychol., 84, 488 `495 (1973) 15) Oomura, Y. and Inokuchi, A.: Effect of Glucagon on feeding behavior, Biomed. Res., 4, 209 `216 (1984) 16) Schmidinger, H., Weber, H., Zwiauer, K. Weidinger, F. and Widhalm, K.: Potential life-threatening cardiac arrhythmias associated with a conventional hypocaloric diet, Int. J. Cardiol., 14, 55 `63 (1987)

11 Vol. 56 No. 4 20) Sakata, T., Oomura, Y., Tsutsui, K., Arase, K., Fukushima, M., Fujimoto, K., Matsumoto, I. and Kuhara, T.: Hunger and satiety related activity induced by certain metabolites in rats, In The Neural Basis of Feeding and Reward/Hoebel, B. G. and Novin, D., eds., pp.339 `354 (1982) Hear institute for electrophysiological research, Maine 21) Sakata, T., Oomura, Y., Fukushima, M., Tsutsui, K., Hashimoto, K., Kuhara, T. and Matsumoto, I.: Circadian and long term variation of certain metabolites in fasted rats, implications, Brain Res. Bull., 5 (Suppl. 4), 23 `28 (1980) 22) Van Gaal, L. F., Vansant, G. A. and De Leeuw, I. H.: Upper body adiposity and the risk for atherosclerosis, J. Am. Coll. Nutr., 8, 504 `514 (1989) 23) Piatti, P. M., Pontirol, A. E., Saibene, A., Santambrogio, G., Paroni, R., Magni, F., Gallikionle, M., Misrali, S., Monti, L. D. and Pozza, G.: Insulin sensitivity and lipid levels in obese subjects after slimming diets complex and simple carbohydrate content, Int. J. Obesity, 17, 375 `381 (1993) 24) Ohno, M., Miura, J., Arai, K., Tsukahara, S. and Ikeda, Y.: The efficacy and metabolic effects of two different regiments of very low calorie diet, Int. J. Obesity, 13, 79 `85 (1989)

Table 1 Components of corn dietary fibers

Table 1 Components of corn dietary fibers Effects of Purified Corn Dietary Fiber on Blood Glucose, and Serum and Liver Lipids in Normal Rats and Mice Sachie Ikegami *1, Saeko Ohsawa *1, Shouko Machida *2 and Akiko Hada *2 The National Institute