scholarly journals Changes in Whole-Body Amino Acid Metabolism in Response to 2 Weeks of the Very-Low Calorie Diet Are Not Affected by Gender

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1700-1700
Author(s):  
Agata Wierzchowska-McNew ◽  
Mariëlle Engelen ◽  
Kristopher Knoop ◽  
Gabriella Ten Have ◽  
John Thaden

Abstract Objectives Very Low-Calorie Diet (VLCD) is an approved method to safely achieve substantial short-term weight loss in obese patients. We previously reported that two weeks of the VLCD maintains whole-body protein and amino acid turnover despite a large reduction in lean body mass. Since the observed effects on body weight (BW) and composition differed between men and women, we hypothesized that the changes in amino acid metabolism in a response to the calorie-restricted diet is gender-specific. Methods 34 morbidly obese adults (BMI: 42 ± 0.9 kg/m2, 10 males and 24 females) underwent a VLCD for 2 weeks consisting of 820 kcal/day and 105-grams protein/day. Before the start of the VLCD (baseline), the whole-body production (WBP) rates of multiple amino acids involved in protein metabolism (e.g., glycine (GLY), glutamine (GLN), phenylalanine (PHE), tyrosine (TYR), and arginine (ARG)) were measured after IV pulse administration of their stable isotopes. Weight loss and body composition by dual-energy X-ray absorptiometry were assessed after 2 weeks of the VLCD. Baseline plasma enrichments were measured by LC-MS/MS. Data are presented as mean ± SE. Statistics are performed by Pearson correlation tests. Results The magnitude of the BW loss after 2 weeks of the VLCD differed between males and females (7.0 ± 0.7 kg vs. 4.1 ± 0.2 kg, P < 0.0001, respectively) with a higher reduction in lean body mass observed in men than women (4.3 ± 0.8 kg vs. 2.7 ± 0.4 kg, P < 0.05). Although, females had significantly reduced baseline WBP of ARG (7.3% vs. 2%, P = 0.0027), GLY (22.8% vs. 3.6%, P < 0.001), and PHE (4.8% vs. 3.1%, P = 0.018) in comparison to men, two weeks of the VLCD had a comparable effect on multiple amino acid WBP in both genders. Suppressed contractile myofibrillar protein breakdown rate was observed in both groups (13% vs. baseline, P = 0.02) with no gender difference in net protein breakdown (PHE to TYR conversion rate). Hence, increased catabolism in men cannot be explained by a different response to the 2 weeks of a calorie-restricted diet. Conclusions Despite gender differences in body weight loss and changes in composition in response to a Very Low-Calorie Diet, changes in whole-body amino acid kinetics are not differently affected in men and women. Funding Sources CTRAL Internal Funds.

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Michael Garcia ◽  
Zhaoping Li ◽  
Vijaya Surampudi

Abstract Objectives The prevalence of adults with obesity in the United States continues to increase [1]. Obesity remains a relative contraindication to lung transplantation due to the potential for negative effects on post-transplant survival, including primary graft dysfunction [2]. We report a case of implementing a modified very low calorie diet for weight loss in an inpatient setting to improve candidacy for lung transplantation. Methods A 47 year-old male with morbid obesity, chronic hypercapneic respiratory failure status post tracheostomy seven years prior, and progressive pulmonary fibrosis was admitted to the intensive care unit for worsening hypoxia at home. On admission his weight was 108.9 kilograms with body mass index of 37 kg/m², making him ineligible for lung transplantation listing and evaluation. Due to persistently high oxygen requirements and nocturnal ventilator dependence, care for the patient could not safely be transitioned outside of an acute care setting. To achieve weight loss, we implemented a modified very low calorie diet to provide 800 kilocalories and 90–100 grams of protein per day. At the time of this report, the patient has achieved a 10.9 kilogram decrease in body weight over four weeks with stable clinical status and without new adverse events during the period on the calorie restricted diet. Results Median survival after lung transplantation is approximately five years. In transplant recipients, a BMI > 30 may be associated with increased short-term and long-term mortality and is a relative contraindication to transplantation [2,3]. Importantly, in patients with obesity, weight loss prior to lung transplantation may improve survival and decrease peri-operative morbidity [4]. While this is difficult in patients with limited exercise capacity and urgent indications for transplantation, utilizing a very low calorie diet for weight loss can be effective in the proper setting, especially a monitored inpatient unit [5]. This is important because it may allow for transplant eligibility and the possibility of transplantation for a patient that would otherwise have a limited survival period. Conclusions The use of a calorie restricted diet should be considered as a safe and effective method for rapid weight loss in an inpatient, monitored setting to allow for lung transplantation eligibility. Funding Sources None.


2018 ◽  
Vol 29 (1) ◽  
pp. 54-60 ◽  
Author(s):  
Kamthorn Yolsuriyanwong ◽  
Komdej Thanavachirasin ◽  
Kimberly Sasso ◽  
Lauren Zuro ◽  
Jessica Bartfield ◽  
...  

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e031431
Author(s):  
Simon Birk Kjær Jensen ◽  
Julie Rehné Lundgren ◽  
Charlotte Janus ◽  
Christian Rimer Juhl ◽  
Lisa Møller Olsen ◽  
...  

IntroductionThe success rate of weight loss maintenance is limited. Therefore, the purpose of this study is to investigate the maintenance of weight loss and immunometabolic health outcomes after diet-induced weight loss followed by 1-year treatment with a glucagon-like peptide-1 receptor agonist (liraglutide), physical exercise or the combination of both treatments as compared with placebo in individuals with obesity.Methods and analysisThis is an investigator-initiated, randomised, placebo-controlled, parallel group trial. We will enrol expectedly 200 women and men (age 18–65 years) with obesity (body mass index 32–43 kg/m2) to adhere to a very low-calorie diet (800 kcal/day) for 8 weeks in order to lose at least 5% of body weight. Subsequently, participants will be randomised in a 1:1:1:1 ratio to one of four study groups for 52 weeks: (1) placebo, (2) exercise 150 min/week+placebo, (3) liraglutide 3.0 mg/day and (4) exercise 150 min/week+liraglutide 3.0 mg/day. The primary endpoint is change in body weight from randomisation to end-of-treatment.Ethics and disseminationThe trial has been approved by the ethical committee of the Capital Region of Denmark and the Danish Medicines Agency. The trial will be conducted in agreement with the Declaration of Helsinki and monitored to follow the guidelines for good clinical practice. Results will be submitted for publication in international peer-reviewed scientific journals.Trial registration number2015-005585-32


Clinics ◽  
2019 ◽  
Vol 74 ◽  
Author(s):  
Marcela Pires Serafim ◽  
Marco Aurelio Santo ◽  
Alexandre Vieira Gadducci ◽  
Veruska Magalhães Scabim ◽  
Ivan Cecconello ◽  
...  

1999 ◽  
Vol 106 (2) ◽  
pp. 179-184 ◽  
Author(s):  
Marian Apfelbaum ◽  
Philippe Vague ◽  
Olivier Ziegler ◽  
Corinne Hanotin ◽  
Florence Thomas ◽  
...  

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