Feasibility of protein-sparing modified fast by tube (ProMoFasT) in obesity treatment: a phase II pilot trial on clinical safety and efficacy (appetite control, body composition, muscular strength, metabolic pattern, pulmonary function test)

Sukkar, Samir Giuseppe; Signori, Alessio; Borrini, C.; Barisione, Giovanni; Ivaldi, C.; Romeo, C.; Gradaschi, Raffaella; Machello, N.; Nanetti, E.; Vaccaro, Alberto

doi:10.3233/s12349-013-0126-2

Cited by 7 publications

(15 citation statements)

References 28 publications

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“…In the other studies, consistent with the present study, whey protein could decrease the blood glucose, but these studies considered non-obese subjects (with BMI 26.2 to 28.2) [25,26]. In a study by Sukkar et al after 10 days of protein-sparing modified fast followed by 20 days of a low-calorie diet, in patients with morbid obesity, fasting glucose, insulin, and HOMA-IR were significantly reduced [27]. High BMI could also have a negative effect on the response of incretins to whey supplementation, and it is unclear how diabetes and obesity reduce the response of incretins to whey supplementation.…”

Section: Discussionsupporting

confidence: 87%

“…Hong et al also examined anti-obesity effects of whey in rats with high-fat diet and eventually observed lower levels of total cholesterol, triglyceride, and LDL-c in the whey-recipient group compared to other study groups [ 33 ]. Moreover, Sukkar et al after 10 days of whey protein-sparing modified fasting (Promofast) observed a significant improvement in lipid profile [ 27 ].…”

Section: Discussionmentioning

confidence: 99%

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Whey protein supplementation reducing fasting levels of anandamide and 2-AG without weight loss in pre-menopausal women with obesity on a weight-loss diet

Haidari

Aghamohammadi

Mohammadshahi

et al. 2020

Trials

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Background: Despite the importance of dairy proteins in modifying of metabolic abnormalities, no attention has been given to their effects on endocannabinoids. Methods: A total number of 60 obese women were recruited in a 2-month randomized clinical trial. Following random allocation, they were assigned to one of the two groups: control (n = 30) and intervention (n = 30). Then, all the subjects followed a hypocaloric diet of 800 kcal below estimated energy needs. The intervention group received isocaloric weight-loss diet and whey protein powders (30 g/day). Baseline and 2-month fasting anthropometric, blood glucose, serum insulin, insulin resistance, lipid profile, AEA, and 2-AG were measured. Results: The study groups were homogenous in terms of baseline characteristics (p > 0.05) except for MUFA intake (p = 0.021). There were no significant differences in energy and macronutrient intakes in the intervention group compared to the control group at the end of the study (p > 0.05). The results of the ANCOVA did not show significant reductions in body weight and BMI of the intervention group compared to the control group (p > 0.05); however, WC, body fat, FBS, AEA, 2-AG, total cholesterol, and triglyceride decreased and HDL-c significantly increased in the intervention group compared to the control group (p < 0.05). Conclusions: In this study, the effects of simultaneous weight-loss diet and whey protein supplementation on the reduction of endocannabinoids were determined. Trial registration: Iranian Registry of Clinical Trials IRCT2017021410181N8. Registered on March 2017.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Whey protein supplementation reducing fasting levels of anandamide and 2-AG without weight loss in pre-menopausal women with obesity on a weight-loss diet

Haidari

Aghamohammadi

Mohammadshahi

et al. 2020

Trials

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“…After eliminating duplicates, applying the inclusion and exclusion criteria, consulting the bibliographies of the selected articles and consulting with experts (Figure 1), 23 documents were selected [11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33] (Table 1). Two articles by Brown et al [15,34] were selected; although they presented different objectives of study, the population analyzed was the same, and adherence results were not different between them, and therefore, only one was accepted for review [15].…”

Section: Resultsmentioning

confidence: 99%

“…Study design included seven comparative studies [11,13,22,23,25,30,31] and 16 clinical trials [12,14,15,16,17,18,19,20,21,24,26,27,28,29,32,33], all written in English and developed in 10 different countries, with the United Kingdom [17,19,20,21,29,32,33] and Japan [11,23,26,28,30,31] contributing the most work.…”

Section: Resultsmentioning

confidence: 99%

Compliance and Adherence to Enteral Nutrition Treatment in Adults: A Systematic Review

et al. 2019

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Objective: To review the scientific literature that has verified and/or assessed compliance and adherence to enteral nutrition (EN) in adult patients. Method: This study involved a critical analysis of articles retrieved from MEDLINE (PubMed), The Cochrane Library, Embase, Scopus and Web of Science using the terms “Treatment Adherence and Compliance” and “Enteral Nutrition”, applying the filters “Comparative Study” or “Clinical Trial”, “Humans” and “Adults”. Date of the search: 25 October 2018. Results: A total of 512 references were retrieved, of which 23 documents were selected after applying the inclusion and exclusion criteria. The techniques measuring adherence to EN were determined by dietary intake, self-reporting, counts of leftover containers or presence of complications; however, in no case were validated questionnaires used. The time and periodicity of the assessment presented very heterogeneous results, with measurement predominantly being done at the beginning and at the end of the study. The best adherence rates were obtained in hospitalized patients (approximately 80%). Conclusions: Frequent and regular monitoring of the adherence of patients under prolonged treatment with EN is necessary, and the use of measurement techniques that allow obtaining information on the causes of non-adherence facilitates early interventions to optimize treatment outcomes. Patient and/or caregiver education in the management of EN and the intervention of the community pharmacy in monitoring patients can be key to improving the adherence to EN.

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“…KDs are associated with improvement in respiratory function in obese patients [ 35 , 36 ] After 10 d of a VLCKD, statistically significant improvements in the functional residual capacity and expiratory reserve volume were observed [35] . Additionally, a 20-d VLCKD shows a significant decrease in end-tidal carbon dioxide tension [36] .…”

Section: Evidence That Supports Hypothesismentioning

confidence: 99%

Induction of ketosis as a potential therapeutic option to limit hyperglycemia and prevent cytokine storm in COVID-19

Sukkar

Bassetti

2020

Nutrition

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The severe form of coronavirus disease 19 (COVID-19) is characterized by cytokine storm syndrome (CSS) and disseminated intravascular coagulation (DIC). Diabetes, obesity, and hypertension have, as minor common denominators, chronic low-grade inflammation and high plasma myeloperoxidase levels, which could be linked to pulmonary phagocytic hyperactivation and CSS. The hyperactivation of M1 macrophages with a proinflammatory phenotype, which is linked to aerobic glycolysis, leads to the recruitment of monocytes, neutrophils, and platelets from circulating blood and plays a crucial role in thrombo-inflammation (as recently demonstrated in COVID-19) through the formation of neutrophil extracellular traps and monocyte-platelet aggregates, which could be responsible for DIC. The modulation of glucose availability for activated M1 macrophages by means of a eucaloric ketogenic diet (EKD) could represent a possible metabolic tool for reducing adenosine triphosphate production from aerobic glycolysis in the M1 macrophage phenotype during the exudative phase. This approach could reduce the overproduction of cytokines and, consequently, the accumulation of neutrophils, monocytes, and platelets from the blood. Second, an EKD could be advantageous for the metabolism of anti-inflammatory M2 macrophages because these cells predominantly express oxidative phosphorylation enzymes and are best fed by the oxidation of fatty acids in the mitochondria. An EKD could guarantee the availability of free fatty acids, which are an optimal fuel supply for these cells. Third, an EKD, which could reduce high lactate formation by macrophages due to glycolysis, could favor the production of interferon type I, which are inhibited by excessive lactate production. From a practical point of view, the hypothesis, in addition to being proven in clinical studies, must obviously take into account the contraindications of an EKD, particularly type 1 or 2 diabetes treated with drugs that can cause hypoglycemia, to avoid the risk for side effects of the diet.

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Feasibility of protein-sparing modified fast by tube (ProMoFasT) in obesity treatment: a phase II pilot trial on clinical safety and efficacy (appetite control, body composition, muscular strength, metabolic pattern, pulmonary function test)

Cited by 7 publications

References 28 publications

Whey protein supplementation reducing fasting levels of anandamide and 2-AG without weight loss in pre-menopausal women with obesity on a weight-loss diet

Whey protein supplementation reducing fasting levels of anandamide and 2-AG without weight loss in pre-menopausal women with obesity on a weight-loss diet

Compliance and Adherence to Enteral Nutrition Treatment in Adults: A Systematic Review

Induction of ketosis as a potential therapeutic option to limit hyperglycemia and prevent cytokine storm in COVID-19

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