Body composition of patients on a very low-protein diet: a two-year survey with DEXA

It has been reported that patients on a very-low-protein diet (VLPD) maintain a satisfactory nutritional status because of a conserved adaptive metabolic response. However, only few studies have examined the course of nutritional status and body composition in the long term (2 years). Thirteen stabl...

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Veröffentlicht in:Journal of renal nutrition Jg. 13; H. 4; S. 282
Hauptverfasser: Chauveau, Philippe, Vendrely, Benot, El Haggan, Wael, Barthe, Nicole, Rigalleau, Vincent, Combe, Christian, Aparicio, Michel
Format: Journal Article
Sprache:Englisch
Veröffentlicht: United States 01.10.2003
Schlagworte:
Absorptiometry, Photon
Adult
Aged
Amino Acids - administration & dosage
Amino Acids, Essential - administration & dosage
Body Composition
Bone Density
Creatinine - urine
Diet Records
Diet, Protein-Restricted - adverse effects
Diet, Protein-Restricted - standards
Dietary Supplements
Energy Intake
Female
Follow-Up Studies
Glomerular Filtration Rate
Humans
Kidney Failure, Chronic - complications
Kidney Failure, Chronic - diet therapy
Male
Middle Aged
Nutritional Status
Patient Compliance
Protein-Energy Malnutrition - etiology
Protein-Energy Malnutrition - prevention & control
Urea - urine
ISSN:1532-8503, 1532-8503
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Zusammenfassung:It has been reported that patients on a very-low-protein diet (VLPD) maintain a satisfactory nutritional status because of a conserved adaptive metabolic response. However, only few studies have examined the course of nutritional status and body composition in the long term (2 years). Thirteen stable patients (8 men; age, 55 +/- 12 years; glomerular filtration rate (GFR), 15 +/- 5 mL/min) receiving a VLPD (0.3 g/kg/day protein) supplemented with amino acids and ketoanalogues (SVLPD) were studied for 2 years. A joint visit with a physician and a dietitian and routine blood and urine analyses were performed every month. Dual-energy x-ray absorptiometry (DEXA), which was used to assess modification of body composition, and GFR (urinary 51Cr-EDTA) and urinary urea and creatinine excretion, which were used to assess nutritional status and compliance to the diet, were assessed every 3 months. GFR, albumin, and prealbumin levels remained stable. Urea urinary excretion decreased at 3 months and then slightly increased at 2 years, but the calculated protein intake remained low at 0.38 +/- 0.1 g/kg/day. Energy intake remained close to 30 kcal/kg/day. No significant change was observed for total fat mass or percent fat mass. After an initial decrease, lean body mass stabilized at 6 months and then increased significantly from 6 to 24 months (P =.02, paired t-test); the mean increase during this period was of 2 kg, that is, 4.6%. Urinary creatinine excretion showed the same profile. Total bone mass, lumbar or hip site bone mass, and Z-score significantly decreased from T0 to 1 and 2 years (P <.05). This study confirms that a supplemented VLPD is nutritionally safe for a long period, but attention must be paid to bone mass.
Bibliographie:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
ISSN:1532-8503
1532-8503
DOI:10.1016/S1051-2276(03)00117-1