Aggressive nutritional strategy in morbid obesity in clinical practice: Safety, feasibility, and effects on metabolic and haemodynamic risk factors
| Autor: | Giuseppe Castaldo, Laura Castaldo, Vittorio Palmieri, Assunta Vitale, Luigi Monaco, Paola Molettieri, Giovanna Galdo |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Male medicine.medical_specialty Waist Diet Reducing Endocrinology Diabetes and Metabolism Hemodynamics Blood Pressure Intra-Abdominal Fat 030204 cardiovascular system & hematology Kidney Body Mass Index Diet Carbohydrate-Restricted Young Adult 03 medical and health sciences Enteral Nutrition 0302 clinical medicine Insulin resistance Heart Rate Internal medicine Weight Loss Heart rate medicine Humans 030212 general & internal medicine Nutrition and Dietetics business.industry Ketones Middle Aged medicine.disease Obesity Obesity Morbid Uric Acid Surgery Parenteral nutrition Blood pressure Female Insulin Resistance Waist Circumference Diet Ketogenic business Body mass index |
| Zdroj: | Obesity Research & Clinical Practice. 10:169-177 |
| ISSN: | 1871-403X |
| DOI: | 10.1016/j.orcp.2015.05.001 |
| Popis: | In morbid obesity, optimisation of nutritional strategies impacting cardiovascular and metabolic risk profile is a desirable target in clinical practice.To assess in morbid obesity the feasibility, safety and efficacy of a nutritional cycle comprising a short-term carbohydrates-free diet delivered by nasogastric tube followed by an almost equivalent oral diet.In our clinical practice, adults with body mass index (BMI)≥45kg/m(2), otherwise clinically healthy, signed informed consent for a 14-day stint of continuous and controlled carbohydrates-free nutritional regiment delivered via 8-Fr nasogastric tube (enteral nutrition, EN), followed by a 14-day stint of almost comparable oral nutrition (ON). Body metrics, insulin resistance, blood pressure (BP) and heart rate (HR), as well as parameters for safety were monitored.In 112 patients, EN significantly reduced BMI and waist circumference (WC), BP, insulin resistance while it increased urine ketones and uric acid increased (all p0.01 independent to confounders), but had no clinically significant impact on kidney and renal function, and coagulation parameters as well. With ON, findings were consistent. No major safety concerns were recorded during the nutritional treatment. In a subset of patients sharing clinical characteristics with the whole sample, the nutritional strategy reduced the mesenteric fat assessed by ultrasound.In morbid obesity, an aggressive nutritional cycle comprising a short-term ketogenic EN followed by an almost carbohydrates-free ON may be feasible, safe, and highly effective in reducing body weight, WC, BP and insulin resistance. |
| Databáze: | OpenAIRE |
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