PROTEIN SPARING MODIFIED FAST DIET

This approach has to be reserved to patients with an severe obesity (overweight above 70 %) without metabolic disorders and for whom a fast and significant weight loss is advisable.

The aim is to achieve a fast weight loss in the shortest period of time. Protein sparing modified fast diet requires a close clinical and metabolic monitoring, in particular for the risk of cardiac arrhythmia and severe ketosis.

Protein sparing modified fast diet allows only meat, fish and vegetables. It provides a caloric intake equal to or less than 800 kcal/die; protein intake ranges from 1.5 to 2.5 g/kg/die (the percentage is from 50 to 65 %), remaining calories come from lipids (40%) and carbohydrates from vegetable sources (10%).

During the treatment, daily supplementations must be given: calcium (800 mg), KCl (25 mEq/l), vitamins and micronutrients, non-caloric drinks (2 litres).

Protein sparing modified fast diet produces considerable weight loss up to 1 kg per week and this can induce adolescent to associate weight loss to drastic diet and to continue an unbalanced diet for a long period of time.

There is not demonstration that in long-term management this diet gives better results than hypocaloric balanced diet.

ORIGINAL RESEARCH COMMUNICATIONS

A comparison of two very-low-calorie diets: protein sparing modified fast versus protein-formula-liquid diet

TA Wadden, AJ Stunkard, KD Brownell and SC Day

This study investigated the acceptability of two very-low-calorie diets in 16 moderately overweight persons participating in a weight reduction program. Subjects were prescribed a 1000-1200 kcal balanced diet the first month and asked to complete appetite and mood scales on a weekly basis. They were then randomly assigned to either a protein sparing modified fast or a protein-formula-liquid diet, each of which provided about 400 kcal daily. Analysis of the appetite data showed that protein sparing modified fast subjects reported significantly less hunger and preoccupation with eating than did liquid diet subjects during 2 of the 4 weeks on a very-low-calorie diet. Subjects in both conditions reported significant reductions in anxiety. Results are discussed in terms of possible advantages of protein sparing modified fast

American Journal of Clinical Nutrition, Vol 41, 533-539, Copyright � 1985

Protein-sparing modified fast in the treatment of severe obesity: weight loss and nitrogen balance data.

Contaldo F, Di Biase G, Scalfi L, Presta E, Mancini M.

Compared: total fasting with protein-sparing modified fast

• Group 1 - total fasting;
• Group 2 - protein-sparing modified fast (80 kcal, 17 g protein, traces of fat and carbohydrate);
• Group 3 - protein-sparing modified fast (180 kcal, 40 g protein, 2 g fat, traces carbohydrate)
• Group IV - protein-sparing modified fast (80 kcal during the 1st and 2nd week and 180 kcal during the 3rd and 4th week).

RESULTS

In in groups 1, 2 and 4 average weight loss was 11 kg. It was lower,average 8 kg, in group 3.

These observations suggest a new approach to the treatment of severe obesity by protein-sparing modified fast and show that is is possible to further reduce the early catabolic phase which commonly arises during this type of therapy.

International Journal of Obesity. 1980;4(3):189-96.