[Effectiveness of a low-calorie diet in the postoperative period]

The characteristic feature of post-aggression metabolism is the hormone-induced metabolic changeover from anabolism to catabolism. Typically, a disturbance of glucose utilisation, enhanced lipolysis and protein catabolism are particularly prominent, all of which lead us to expect restricted utilisation of ingested food substrates. With regard to this special aspect the authors investigated in a clinical study in 10 patients with gastrectomy whether a low-calorie diet could meet energy requirements while at the same time reducing the increased glucogenesis, lipogenesis and protein catabolism. The results show that blood glucose homoeostasis is maintained without exogenous insulin supply by a daily ingestion of 1 g./kg. body weight amino acids and 4 g./kg. body weight carbohydrates, and that at the same time catabolism can be markedly reduced and that there is also no hypercatabolic increase of urea in the serum or excessive formation of triglycerides. Hence, it is considered meaningful to prescribe during the postoperative stress phase a low-calorie diet with a sufficient supply of amino acids even in case of severe trauma.