Wechsler J G, Wenzel H, Swobodnik W, Ditschuneit H H, Ditschuneit H
Postgrad Med J. 1984;60 Suppl 3:66-73.
Protein or nitrogen depletion may be harmful and deleterious as reports of deaths in obese patients fed by liquid protein diets have shown. The aim of our studies was to determine the protein losses (by urinary nitrogen losses) during treatment of obesity with modified fasting over four weeks under inpatient conditions. Sixty-one patients were treated in our metabolic ward with modified fasting randomized into four groups. The daily diet consisted of 33-50 g protein/day, 1-10 g fat/day and 25-45 g carbohydrates/day thus providing 240 to 450 kcal/day or 1.0 to 1.9 MJ. The mean weight losses ranged between 11.0 +/- 0.7 kg and 13.9 +/- 0.9 kg in 28 days. The acceptability and compliance of the four applied diets were excellent and no severe side effects could be observed. The nitrogen balances could be equilibrated from the third week on. The composition of weight lost during modified fasting was as follows. The percentage of body protein ranged between 3% and 16% and the percentage of adipose tissue between 63% and 79% of the total weight loss. Therefore modified fasting represents a very effective and safe therapy of massive obesity.
正如有关采用流质蛋白质饮食喂养的肥胖患者死亡报告所示，蛋白质或氮耗竭可能是有害的。我们研究的目的是确定在住院条件下，通过四周改良禁食治疗肥胖症期间的蛋白质损失（通过尿氮损失来衡量）。61名患者在我们的代谢病房接受改良禁食治疗，并随机分为四组。每日饮食包括每天33 - 50克蛋白质、1 - 10克脂肪和25 - 45克碳水化合物，从而提供每天240至450千卡或1.0至1.9兆焦耳的能量。28天内平均体重减轻在11.0±0.7千克至13.9±0.9千克之间。所采用的四种饮食的可接受性和依从性都很好，未观察到严重副作用。从第三周开始氮平衡可以达到平衡。改良禁食期间体重减轻的组成如下。身体蛋白质占总体重减轻的百分比在3%至16%之间，脂肪组织占总体重减轻的百分比在63%至79%之间。因此，改良禁食是一种治疗重度肥胖非常有效且安全的疗法。
