Moreno O, Meoro A, Martinez A, Rodriguez C, Pardo C, Aznar S, Lopez P, Serrano J, Boix E, Martin M D, Pico Alfonso A M
Endocrinology and Nutrition Section, Alicante General University Hospital, CP03010, Alicante, Spain.
J Endocrinol Invest. 2006 Jul-Aug;29(7):633-40. doi: 10.1007/BF03344163.
To evaluate the cost-effectiveness and safety of two distinct low calorie diets (LCD).
Prospective controlled study.
67 obese patients [body mass index (BMI) 40 kg/m2] were included in two study groups. Group A: 26 patients followed a 458 kcal diet given in three meals for 1 month. Group B: 41 patients followed a 800 kcal diet for 3 months and with outpatient control.
Anthropometric, cardiovascular risk and nutritional profile changes were evaluated, as well as total direct and indirect costs, and the incidence of complications.
No significant initial differences were observed between the two study groups. Eighty-six point two per cent of the patients completed the therapy correctly. After treatment a significant decrease was observed in the following variables for both groups, but no differences were detected between Groups A and B: mean weight loss (A= 9.28 kg, B= 8.7 kg), ponderal loss percentage (A/B= 7.2/6.8%), glycemia (A/B= 18.6/12.1 mg/dl), systolic blood pressure (SBP) (A/B= 11.8/6.5 mmHg), diastolic blood pressure (DBP) (A/B 5.9/6.8 mmHg), and final insulin-resistance (IR) index (A= 4.4, B= 4.3). Group A had the highest drop in total cholesterol (37.7 vs 8.1 mg/dl) and triglycerides (54.4 vs 2.5 mg/dl). No changes were observed in ureic acid, renal function and serum albumin. Thirty-six patients (55.3%) suffered trivial complications associated to the VLCD (16.9% gastrointestinal, 20% anxiety), with no differences between groups. Group A patients were on sick leave due to asthenia, and two patients in this group had serious complications (transient ischemic attack and atrial fibrillation). The total cost of Group A treatment was 3018.9 against 582.6 euros for Group B.
The 3-month 800 kcal/day VLCD was more cost-effective and safer than the 1-month 458 kcal/day diet.
评估两种不同低热量饮食（LCD）的成本效益和安全性。
前瞻性对照研究。
67例肥胖患者[体重指数（BMI）≥40kg/m²]被纳入两个研究组。A组：26例患者采用每日458千卡的饮食，分三餐食用，为期1个月。B组：41例患者采用每日800千卡的饮食，为期3个月，并接受门诊监控。
评估人体测量学、心血管风险和营养状况的变化，以及直接和间接总成本及并发症发生率。
两个研究组之间在初始时未观察到显著差异。86.2%的患者正确完成了治疗。治疗后，两组的以下变量均显著下降，但A组和B组之间未检测到差异：平均体重减轻（A组=9.28kg，B组=8.7kg）、体重减轻百分比（A组/ B组=7.2%/6.8%）、血糖（A组/ B组=18.6/12.1mg/dl）、收缩压（SBP）（A组/ B组=11.8/6.5mmHg）、舒张压（DBP）（A组/ B组=5.9/6.8mmHg）以及最终胰岛素抵抗（IR）指数（A组=4.4，B组=4.3）。A组的总胆固醇（37.7对8.1mg/dl）和甘油三酯（54.4对2.5mg/dl）下降幅度最大。尿酸、肾功能和血清白蛋白未观察到变化。36例患者（55.3%）出现与极低热量饮食（VLCD）相关的轻微并发症（16.9%为胃肠道并发症，20%为焦虑），两组之间无差异。A组患者因乏力而请病假，该组有2例患者出现严重并发症（短暂性脑缺血发作和心房颤动）。A组的治疗总成本为3018.9欧元，而B组为582.6欧元。
每日800千卡的极低热量饮食（VLCD）进行3个月，比每日458千卡的饮食进行1个月更具成本效益且更安全。
