Protein sparing therapies in acute illness and obesity: a review of George Blackburn's contributions to nutrition science

Thomas, Dylan D.; Istfan, Nawfal W.; Bistrian, Bruce R.

doi:10.1016/j.metabol.2017.11.020

Cited by 15 publications

(13 citation statements)

References 134 publications

(127 reference statements)

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“…The problem is particularly acute in clinical nutrition and metabolism, a field that is largely ignored in undergraduate and postgraduate medical education and in which high‐enrollment clinical outcome RCTs are rare and frequently not fundable, not feasible, or not possible. The physiologic perspective explained in this review is not novel; it has been embedded in the clinical nutrition literature for >40 years and continues to be endorsed . Regrettably, the hypotheses and clinical suggestions that flow from this perspective tend to appear only in clinical nutrition journals that few physicians read.…”

Section: Barriersmentioning

confidence: 99%

High‐Protein Hypocaloric Nutrition for Non‐Obese Critically Ill Patients

Hoffer

2018

Nut in Clin Prac

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High-protein hypocaloric nutrition, tailored to each patient's muscle mass, protein-catabolic severity, and exogenous energy tolerance, is the most plausible nutrition therapy in protein-catabolic critical illness. Sufficient protein provision could mitigate the rapid muscle atrophy characteristic of this disease while providing urgently needed amino acids to the central protein compartment and sites of tissue injury. The protein dose may range from 1.5 to 2.5 g protein (1.8-3.0 g free amino acids)/kg dry body weight per day. Nutrition should be low in energy (≈70% of energy expenditure or ≈15 kcal/kg dry body weight per day) because efforts to match energy provision to energy expenditure are physiologically irrational, risk toxic energy overfeeding, and have repeatedly failed in large clinical trials to demonstrate clinical benefit. The American Society for Parenteral and Enteral Nutrition currently suggests high-protein hypocaloric nutrition for obese critically ill patients. Short-term high-protein hypocaloric nutrition is physiologically and clinically sensible for most protein-catabolic critically ill patients, whether obese or not.

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Section: Barriersmentioning

confidence: 99%

High‐Protein Hypocaloric Nutrition for Non‐Obese Critically Ill Patients

Hoffer

2018

Nut in Clin Prac

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“…The VLCD is an extreme (≤800 kcal), time-restricted, nutritional protocol that mimics the effects of fasting without the side effects of starvation, to treat severe obesity [17]. Given its carbohydrate content, it could, or not, induce metabolic ketosis [11]. Both diets were based on food replacements delivered to the patients’ home by the product supplier (Kalibra ® by S.D.M.…”

Section: Methodsmentioning

confidence: 99%

“…Although these diets can only be followed for limited periods because of their extreme caloric restriction, they can induce a high rate of weight-loss with long-term maintenance [9], especially if practiced along with an active follow-up treatment [10]. Furthermore, the protein sparing modified fast (PSMF), a modified variant of VLCD, was designed to exploit quasi-fasting induced ketosis to preserve lean body mass when following major weight loss programs, as widely studied and described by Dr. George Blackburn [11]. Because of their ability to induce ketosis by the mobilization of fatty acids from adipose tissue (physiological states of prolonged fasting), PSMF protocols are also called very low-calorie ketogenic diets (VLCKDs).…”

Section: Introductionmentioning

confidence: 99%

A Randomized Double-Blind, Cross-Over Trial of very Low-Calorie Diet in Overweight Migraine Patients: A Possible Role for Ketones?

et al. 2019

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Here we aimed at determining the therapeutic effect of a very low-calorie diet in overweight episodic migraine patients during a weight-loss intervention in which subjects alternated randomly between a very low-calorie ketogenic diet (VLCKD) and a very low-calorie non-ketogenic diet (VLCnKD) each for one month. In a nutritional program, 35 overweight obese migraine sufferers were allocated blindly to 1-month successive VLCKD or VLCnKD in random order (VLCKD-VLCnKD or VLCnKD-VLCD). The primary outcome measure was the reduction of migraine days each month compared to a 1-month pre-diet baseline. Secondary outcome measures were 50% responder rate for migraine days, reduction of monthly migraine attacks, abortive drug intake and body mass index (BMI) change. Only data from the intention-to-treat cohort (n = 35) will be presented. Patients who dropped out (n = 6) were considered as treatment failures. Regarding the primary outcome, during the VLCKD patients experienced −3.73 (95% CI: −5.31, −2.15) migraine days respect to VLCnKD (p < 0.0001). The 50% responder rate for migraine days was 74.28% (26/35 patients) during the VLCKD period, but only 8.57% (3/35 patients) during VLCnKD. Migraine attacks decreased by −3.02 (95% CI: −4.15, −1.88) during VLCKD respect to VLCnKD (p < 0.00001). There were no differences in the change of acute anti-migraine drug consumption (p = 0.112) and BMI (p = 0.354) between the 2 diets. A VLCKD has a preventive effect in overweight episodic migraine patients that appears within 1 month, suggesting that ketogenesis may be a useful therapeutic strategy for migraines.

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“…They are indispensable in the construction of connective, muscle, bone tissues, for tissue regeneration, for the transfer of oxygen and lipids with blood, as well as for maintaining immunity [1]. The lack or excess of these proteins negatively affects the nutritional balance and human health [2,3].…”

Section: Introductionmentioning

confidence: 99%

Development of functional product enriched with collagen hydrolysate from fish processing waste

Kuprina¹,

Yakkola²,

Kopylov³

et al. 2020

E3S Web Conf.

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Currently, there is an acute issue of environmental pollution and loss of vital substances for the human body and animals — fats, proteins and minerals. Scales, fins, skin, bones, and cartilage are a valuable source for these beneficial substances. The composition of fish protein contains almost all the essential amino acids, which characterizes its high biological value. A large share of the world’s catch is underutilized or simply lost, since the fish processing process usually comes down to primary cutting, resulting in a loss of 30 to 70% of the mass of raw materials in the form of biological waste. Therefore, at present, it is necessary to develop such technologies that will maximize the use of natural raw materials. It was found that the rational, to obtain the highest collagen content in the hydrolyzate, is the double extraction technology, which consists in using the electrochemically obtained hydrolyzate from fish bone waste as an extractant for the isolation of collagen from the skin. In the course of the work, the optimal treatment modes for the cartilage waste from cutting salmon fish by the electrochemical method were determined, as a result of which a protein hydrolyzate was obtained. The technological and physicochemical properties of the obtained protein hydrolyzate are studied, based on which the nutritional and biological value of the product is analyzed.

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Protein sparing therapies in acute illness and obesity: a review of George Blackburn's contributions to nutrition science

Cited by 15 publications

References 134 publications

High‐Protein Hypocaloric Nutrition for Non‐Obese Critically Ill Patients

High‐Protein Hypocaloric Nutrition for Non‐Obese Critically Ill Patients

A Randomized Double-Blind, Cross-Over Trial of very Low-Calorie Diet in Overweight Migraine Patients: A Possible Role for Ketones?

Development of functional product enriched with collagen hydrolysate from fish processing waste

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