Protein-sparing diet for severely obese adolescents: design and use of an equivalency system for menu planning

When severe, obesity in adolescence demands effective treatment, thus justifying use of a protein-sparing, low-energy diet for periods of 3 to 4 months. When properly planned and supervised, this diet is safe and effective, even if only to maintain a functional body weight. The regimen used at the Hospital for Sick Children, Toronto, provides 2.0 to 2.5 gm protein per kilogram ideal body weight, plus adequate fluid and nutrient supplements. The amounts of meat, poultry, and fish that supply this allocation of protein are determined using a protein equivalency system developed for the diet. The system allows both dietitians and patients to plan meals that minimize energy intake while maintaining protein adequacy and dietary variety. With prolonged use of the diet, limited carbohydrate may be added in the form of selected vegetables measured using a similar carbohydrate equivalency system. Recent use of the diet for 21 patients, 8 to 20 1/2 years old and averaging 211% ideal body weight, resulted in acceptable weight control.