Very low calorie diets--history, safety and recent developments

Area of Science:

• Obesity treatment
• Nutritional science
• Dietary interventions

Background:

• Orthodox diets show poor results for obesity, necessitating alternatives like very low calorie diets (VLCDs).
• VLCDs have evolved from total fasting to formula diets with varying protein and carbohydrate content.
• Concerns exist regarding weight loss maintenance and the safety of VLCD programs.

Purpose of the Study:

• To review the advantages and pitfalls of very low calorie diets (VLCDs).
• To identify key factors for safe and effective VLCD programs.
• To address safety concerns associated with VLCDs, particularly regarding protein sources.

Main Methods:

• Review of clinical experience with over 4000 patients on VLCDs.
• Analysis of historical VLCD approaches, including total fasting and formula diets.
• Examination of safety data related to different protein sources in VLCDs.

Main Results:

• Sustained weight loss requires follow-up support, including behavior modification and increased physical activity.
• Liquid protein supplements sold over-the-counter were linked to deaths, but high-quality protein supplements mitigate risks like arrhythmias.
• Maximal safety and efficiency in VLCD programs depend on proper patient selection, high-quality supplements, and diligent monitoring.

Conclusions:

• Very low calorie diets (VLCDs) can be effective for obesity when implemented with specific safety measures.
• High-quality protein supplements are crucial for VLCD safety, preventing adverse cardiac events.
• A comprehensive approach involving patient selection, quality supplements, and monitoring is essential for successful VLCD outcomes.