[Efficiency estimation of diet therapy with protein component modification in patients with obesity and purine...

The development of a personalized nutritional approach to diet therapy for patients with obesity and hyperuricemia, aimed at increasing the treatment effectiveness of these patients, is an urgent task. The aim: to assess the impact of nutritional approach with a modification of the protein component on body composition and biochemical parameters in patients with obesity and purine metabolism disorder. Material and methods. A randomized controlled trial was conducted, and included 50 patients (average age 46.9±2.5 years) with obesity and purine metabolism disorder. All patients were divided into two groups of 25 people. Within 2 weeks patients of group 1 received the main version of a standard low-calorie diet (1730 kcal, protein - 87.4 g, fat - 61.4 g, carbohydrates - 207 g). Group 2 received a personalized version of the diet (2125 kcal, protein - 100.2 g, fat - 75.9 g, carbohydrate - 260 g) with the modification of the protein component: protein content of at least 90 g per day, restriction of animal products containing a high purine load. Results and discussion. During diet therapy the decrease in fat mass in group 1 patients averaged 4.4%, visceral fat area - 8.6% (p<0.05) and in patients of group 2 - 6.9 and 9.1% respectively (p<0.05). During treatment a significant decrease in muscle mass was observed in group 1 at average 3.9% (p<0.05), and in group 2 on the basis of personal nutritional approach there was a slight decrease in muscle mass at average of 1.5%. After treatment patients of the two groups showed improvement in a number of indicators of lipid and carbohydrate metabolism: a significant decrease (p<0.05) of glucose, total cholesterol, LDL cholesterol and triglycerides in blood serum by 18.2-19.1, 23.2-23.6, 24.2-25.0 и 28.5-30.4%. However, patients in group 1 showed a slight decrease in uric acid in blood serum at average 7.6%, and patients in group 2 who received a personal nutritional approach with a modification of the protein component showed a significant decrease in uric acid at average of 12.5% (p<0.05). Conclusion. The obtained data indicate the need for a personal nutritional approach with a modification of the protein component in patients with obesity and purine metabolism disorder, which will prevent the development and progression of complications associated with obesity.