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Clinical Trial
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Using a Revised Protein-Sparing Modified Fast (rPSMF) for Children and Adolescents With Severe Obesity: A Pilot Study

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Clinical Trial

Using a Revised Protein-Sparing Modified Fast (rPSMF) for Children and Adolescents With Severe Obesity: A Pilot Study

Ihuoma Eneli et al. Int J Environ Res Public Health.

Abstract

Treatment options are limited for children and adolescents with severe obesity. One alternative treatment is the protein-sparing modified fast (PSMF), a low-carbohydrate, high-protein diet that can result in substantial weight loss. The aim of the study is to evaluate the adherence and efficacy of a revised PSMF (rPSMF) for severe obesity in a pediatric tertiary care weight-management program. The rPSMF with 1200-1800 calories, 40-60 g of carbohydrate/day and 1.2-1.5 g protein/kg of ideal bodyweight was implemented over 12 months. Twenty-one participants enrolled in the study. Mean age 16.2 ± 1.4 years, females (76.2%) and mean weight at baseline was 119 ± 19.9 kg. Regardless of adherence to the rPSMF, the mean weight change at 1 month was -3.7 ± 3.5 kg, (range -13.5 kg to 0.9 kg); at 3 months was -5.5 ± 5.1 kg, (range -19.3 kg to 1.8 kg) and at 6 months was -4.7 ± 6.6 kg, (range -18.3 kg to 8.6 kg). At 12 months, the mean weight change was -1.3 ± 10.6 kg (range -17.7 kg to 14.8 kg). Parent and child-reported physical and psychosocial quality of life (HRQOL) improved. Despite limited adherence, the rPSMF diet resulted in clinically significant weight loss and improved HRQOL for children and adolescents with severe obesity.

Keywords: children and adolescents; protein-sparing modified Fast; severe obesity; weight management.

Conflict of interest statement

We do not have any financial interest or conflicts of interest to disclose, and all authors have contributed to and reviewed the manuscript in its entirety for publication. Additionally, data from this manuscript has not been published in any form elsewhere.

Figures

Figure 1
Figure 1
Schematic representation of the rPSMF intervention and study protocol.
Figure 2
Figure 2
rPSMF adherence rate over 12 months.
Figure 3
Figure 3
Weight change by adherence to rPSMF.
Figure 4
Figure 4
Participant-reported physical (a) and psychosocial (b) HRQOL by adherence (Dotted lines: Mean score at baseline).

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