Department of Internal Medicine, University of Genoa, 16132 Genoa, Italy.
Dietetics and Clinical Nutrition Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy.
Nutrients. 2023 Nov 17;15(22):4822. doi: 10.3390/nu15224822.
Protein-sparing modified fast (PSMF) diet is a very-low-carbohydrate ketogenic diet administered to patients with obesity, which preserves lean mass and suppresses appetite as well as continuous enteral feeding. Thus, we aim to evaluate the effect of the PSMF diet administered continuously by nasogastric tube (NGT) or orally.
Patients with a body mass index (BMI) > 34.9 kg/m were randomly assigned to receive a whey protein PSMF formula through NGT (ProMoFasT) or orally. Data were collected at baseline and after 150 days. The endpoints were assessed in the intention-to-treat population.
We enrolled 20 patients in the ProMoFasT group and 24 in the oral group. No differences in body weight, BMI or waist circumference between the two groups were found after 150 days. At follow-up, FFM (%) and MM (%) results were higher in the ProMoFasT group than the oral group (63.1% vs. 52.9%, = 0.012 and 45.0% vs. 36.1%, = 0.009, respectively) and FM (kg) and FM (%) were significantly lower in the ProMoFasT group (36.9 kg vs. 44.0 kg, = 0.033 and 37.4% vs. 44.9%, = 0.012, respectively). Insulin levels were lower in the ProMoFasT group than the oral group at follow-up (11.8 mU/L vs. 28.0 mU/L, = 0.001, respectively).
The ProMoFasT is more effective in improving body composition and glucometabolic markers than the same diet administered orally.
蛋白质节约型快速（PSMF）饮食是一种非常低碳水化合物的生酮饮食，适用于肥胖患者，可保留瘦肉量并抑制食欲，同时持续进行肠内喂养。因此，我们旨在评估通过鼻胃管（NGT）或口服连续给予 PSMF 饮食的效果。
将 BMI>34.9 kg/m2 的患者随机分配至通过 NGT（ProMoFasT）或口服接受乳清蛋白 PSMF 配方。在基线和 150 天后收集数据。意向治疗人群评估终点。
我们纳入了 20 名 ProMoFasT 组患者和 24 名口服组患者。150 天后两组间体重、BMI 或腰围无差异。随访时，ProMoFasT 组的去脂体重（FFM）（%）和肌肉量（MM）（%）高于口服组（63.1% vs. 52.9%， = 0.012 和 45.0% vs. 36.1%， = 0.009，分别），而 ProMoFasT 组的脂肪量（FM）（kg）和 FM（%）显著低于口服组（36.9 kg vs. 44.0 kg， = 0.033 和 37.4% vs. 44.9%， = 0.012，分别）。随访时，ProMoFasT 组的胰岛素水平低于口服组（11.8 mU/L vs. 28.0 mU/L， = 0.001，分别）。
与口服给予相同的饮食相比，ProMoFasT 更有效地改善身体成分和糖代谢标志物。
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