Optimizing muscle preservation during weight loss in patients with cirrhosis: A pilot study comparing continuous energy restriction to alternate-day modified fasting for weight loss in patients with obesity and non-alcoholic cirrhosis of the liver.

Autor: Dunn W; Division of Gastroenterology, Hepatology and Motility, Diabetes, and Clinical Pharmacology Department of Internal Medicine University of Kansas Medical Center Kansas City Kansas USA., Herrmann SD; Division of Physical Activity and Weight Management Department of Internal Medicine University of Kansas Medical Center Kansas City Kansas USA., Montgomery RN; Department of Biostatistics and Data Science, Department of Internal Medicine University of Kansas Medical Center Kansas City Kansas USA., Hastert M; Division of Physical Activity and Weight Management Department of Internal Medicine University of Kansas Medical Center Kansas City Kansas USA., Honas JJ; Division of Physical Activity and Weight Management Department of Internal Medicine University of Kansas Medical Center Kansas City Kansas USA., Rachman J; Division of Gastroenterology, Hepatology and Motility, Diabetes, and Clinical Pharmacology Department of Internal Medicine University of Kansas Medical Center Kansas City Kansas USA., Donnelly JE; Division of Physical Activity and Weight Management Department of Internal Medicine University of Kansas Medical Center Kansas City Kansas USA., Steger FL; Division of Endocrinology, Diabetes, and Clinical Pharmacology, Department of Internal Medicine Department of Dietetics and Nutrition University of Kansas Medical Center Kansas City Kansas USA.
Jazyk: angličtina
Zdroj: Obesity science & practice [Obes Sci Pract] 2024 Oct 24; Vol. 10 (5), pp. e70016. Date of Electronic Publication: 2024 Oct 24 (Print Publication: 2024).
DOI: 10.1002/osp4.70016
Abstrakt: Introduction: Obesity is associated with increased morbidity in patients with advanced liver disease, but it is particularly challenging for these patients to preserve skeletal muscle mass during weight loss and accelerating sarcopenia is a concern. Alternate-day modified fasting (ADMF) may be particularly effective for weight loss in patients with concomitant cirrhosis and obesity due to preservation of fat-free mass (FFM).
Methods: A weight loss program featuring either ADMF or a continuous low-calorie diet (LCD) was evaluated in a 24-week randomized clinical trial in 20 adult patients with Child-Pugh Class A cirrhosis and obesity. Participants were randomized to either ADMF ( n  = 11) or LCD ( n  = 9). Both groups received a remotely delivered exercise program. Body composition, sarcopenia measures, and functional outcomes were assessed pre-post.
Results: Thirteen participants completed the intervention (Age = 57 ± 10; BMI = 37.7 ± 5.8 kg/m 2 ). The median body weight lost in ADMF was 13.7 ± 4.8 kg (13.9% of initial body weight), while LCD lost 9.9 ± 6.9 kg (10.7% of initial body weight). Total body fat percentage decreased in both groups (ADMF: -4.1 ± 4.0%; LCD = -2.8 ± 1.4%). Fat-free mass accounted for 34 ± 20% of total weight loss in ADMF and 38 ± 10% in LCD. Functional measures, such as timed chair stands, improved in both groups.
Conclusion: This pilot study demonstrates the feasibility of the ADMF and LCD interventions to produce significant weight loss while improving body composition in patients with cirrhosis and obesity. Further research is needed to validate these findings in larger cohorts and to assess changes in muscle quality and visceral fat.
Trial Registration: ClinicalTrials.gov Identifier: NCT05367596.
Competing Interests: The authors declare no conflicts of interest.
(© 2024 The Author(s). Obesity Science & Practice published by World Obesity and The Obesity Society and John Wiley & Sons Ltd.)
Databáze: MEDLINE
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