[Metabolic changes in a 3-week treatment with a low calorie protein-carbohydrate diet in massively obese adolescents]

8 massively obese adolescents (2 girls, 6 boys, mean age 12.6 +/- 2.1 years, mean overweight 74 +/- 14%) were treated for 3 weeks with a very low calory diet (VLCD), containing 240 kcal, 33 g protein, 25.5 g carbohydrates and 0.7 g fat. Mean weight loss after 3 weeks was 9.47 +/- 2.8 kg. The mean loss of total nitrogen was 232.4 +/- 73.2 g. Great individual variations in regard to the amounts of nitrogen loss occurred. The mean nitrogen loss over the period of 21 days was 113.3 +/- 71.2 g. Three patients reached positive nitrogen balance in the third week. No pathological changes could be shown for serum electrolytes and enzymes as well as for glucose, urea and creatinine. At the end of the first week serum uric acid values were elevated, but reached normal values at the end of the diet period. 3 patients were treated with Allopurinol 200 mg for 7 to 14 days. Serum protein concentrations fell significantly from 7.64 +/- 0.3 to 7.0 +/- 0.2 g/dl, whereas serum albumin concentrations remained constant. Cholesterol and LDL-cholesterol fell significantly (p less than 0.001) to "supranormal" values, HDL-cholesterol and triglycerides remained almost constant. 24-h-ECG investigations before, during and after the diet did not reveal any pathological findings.