Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy.
IRCCS Santa Lucia Foundation, 00128 Rome, Italy.
Nutrients. 2022 Dec 15;14(24):5325. doi: 10.3390/nu14245325.
Effective nutrition therapy is a pressing issue in obesity and type 2 diabetes mellitus (T2DM) management. As such, this research aimed to determine the performance of a revised dietary strategy built on the protein-sparing diet in obesity and type 2 diabetes mellitus with regard to obtaining a rapid and stable improvement in glucometabolic control, body weight, body composition, and energy metabolism when applying the strategy in just twenty-one days. The revised protein-sparing diet differs from the traditional protein-sparing modified fast (PSMF) because it does not include foods. The daily calorie intake of this diet is exclusively derived from Isolate whey protein in addition to a formulation of Isolate whey protein enriched with essential amino acids in free form, with the addition of lipids such as extra virgin olive oil and coconut oil as a source of medium chain fatty acids, where the latter is taken for only the first four days of the diet, together with the use, for the same duration, of extended-release metformin, as the only antihyperglycemic allowed. Anthropometric measurements, bioimpedance analysis, indirect calorimetry, and blood chemistry assessments were conducted at the beginning of the study, time 0 (T0), and at the end, time 1 (T1), i.e., on the 21st day. The main outcomes of the revised protein-sparing diet after only twenty-one days were a reduction in body weight with the predominant loss of visceral atherogenic abdominal fat and, therefore, a possible contextual reduction in ectopic fat deposits together with a simultaneous reduction in insulin resistance and normalization of insulin levels, maintenance of free fat mass and basal metabolism, restoration of metabolic flexibility, and improvement of the glucometabolic and lipidic parameters. These results demonstrate the promising potential of the revised protein-sparing diet as an "etiologic tool" in the integrated nutritional treatment of metabolic diseases such as obesity and type 2 diabetes mellitus.
有效的营养治疗是肥胖和 2 型糖尿病（T2DM）管理中的一个紧迫问题。因此，本研究旨在确定一种基于蛋白质节约饮食的修订饮食策略在肥胖和 2 型糖尿病中的表现，该策略旨在在短短 21 天内实现葡萄糖代谢控制、体重、身体成分和能量代谢的快速和稳定改善。修订后的蛋白质节约饮食与传统的蛋白质节约改良快速饮食（PSMF）不同，因为它不包括食物。这种饮食的日卡路里摄入量仅来自分离乳清蛋白，此外还有一种分离乳清蛋白配方，其中含有游离形式的必需氨基酸，添加了橄榄油和椰子油等脂质作为中链脂肪酸的来源，其中后者仅在饮食的前四天使用，同时使用延长释放二甲双胍作为唯一允许的抗高血糖药物，持续同样的时间。在研究开始时（时间 0，T0）和结束时（时间 1，T1），即第 21 天，进行了人体测量学测量、生物阻抗分析、间接热量测定和血液化学评估。修订后的蛋白质节约饮食仅 21 天后的主要结果是体重减轻，主要是内脏致动脉粥样硬化腹部脂肪减少，因此可能会减少异位脂肪沉积，同时降低胰岛素抵抗并使胰岛素水平正常化，维持游离脂肪量和基础代谢，恢复代谢灵活性，并改善葡萄糖代谢和脂质参数。这些结果表明，修订后的蛋白质节约饮食作为肥胖和 2 型糖尿病等代谢性疾病综合营养治疗的“病因学工具”具有很大的潜力。
