A metabolic ward study of a high protein, very-low-energy diet.

Seven obese women were placed on a liquid formula diet providing 560 kcal (2.4 MJ) and 70 g protein daily and studied under metabolic ward conditions for four weeks. The diet was well tolerated and hunger sensations were minimal. Mean weight loss was 10.47 kg for the four weeks. A positive nitrogen balance was achieved within two weeks in most patients, but despite this serum prealbumin levels fell as did the excretion of 3-methylhistidine in the urine. Plasma beta-hydroxybutyrate and urate levels rose during the first two weeks but remained constant thereafter. The characteristic decrease in plasma triiodothyronine levels and increase in reverse triiodothyronine levels seen with fasting and other very-low-calorie diets were also observed with this diet. Potassium losses were minimal and no changes in electrocardiograms were seen. This diet would appear to be an acceptable, effective and safe means of achieving rapid weight loss in obesity.