Using a Revised Protein-Sparing Modified Fast (rPSMF) for Children and Adolescents with Severe Obesity: A Pilot Study

Ihuoma Eneli, Jinyu Xu, Alexis Tindall, Rosanna Watowicz, Jennifer Worthington, Kelly Tanner, Keeley Pratt and Marnie Walston
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Ihuoma Eneli: Center for Healthy Weight and Nutrition, Nationwide Children’s Hospital, Columbus, OH 43205, USA
Jinyu Xu: Center for Healthy Weight and Nutrition, Nationwide Children’s Hospital, Columbus, OH 43205, USA
Alexis Tindall: Center for Healthy Weight and Nutrition, Nationwide Children’s Hospital, Columbus, OH 43205, USA
Rosanna Watowicz: Department of Nutrition, Case Western University, Cleveland, OH 44106, USA
Jennifer Worthington: Division of Clinical Therapies, Nationwide Children’s Hospital, Columbus, OH 43205, USA
Kelly Tanner: Division of Clinical Therapies, Nationwide Children’s Hospital, Columbus, OH 43205, USA
Keeley Pratt: Department of Human Sciences, The Ohio State University, Columbus, OH 43210, USA
Marnie Walston: Department of Pediatrics, Akron Children’s Hospital, Akron, OH 44308, USA

IJERPH, 2019, vol. 16, issue 17, 1-12

Abstract: Treatment options are limited for children and adolescents with severe obesity. One alternative treatment is the protein-sparing modified fast (PSMF), a low-carbohydrate, high-protein diet that can result in substantial weight loss. The aim of the study is to evaluate the adherence and efficacy of a revised PSMF (rPSMF) for severe obesity in a pediatric tertiary care weight-management program. The rPSMF with 1200–1800 calories, 40–60 g of carbohydrate/day and 1.2–1.5 g protein/kg of ideal bodyweight was implemented over 12 months. Twenty-one participants enrolled in the study. Mean age 16.2 ± 1.4 years, females (76.2%) and mean weight at baseline was 119 ± 19.9 kg. Regardless of adherence to the rPSMF, the mean weight change at 1 month was −3.7 ± 3.5 kg, (range −13.5 kg to 0.9 kg); at 3 months was −5.5 ± 5.1 kg, (range −19.3 kg to 1.8 kg) and at 6 months was −4.7 ± 6.6 kg, (range −18.3 kg to 8.6 kg). At 12 months, the mean weight change was −1.3 ± 10.6 kg (range −17.7 kg to 14.8 kg). Parent and child-reported physical and psychosocial quality of life (HRQOL) improved. Despite limited adherence, the rPSMF diet resulted in clinically significant weight loss and improved HRQOL for children and adolescents with severe obesity.

Keywords: severe obesity; protein-sparing modified Fast; children and adolescents; weight management (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2019
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