A very-low-calorie diet (VLCD) intervention for the management of prediabetes and early Type 2 diabetes mellitus in a multi-ethnic cohort in Aotearoa New Zealand: The PROGRESS NZ feasibility study.

IF 1.3 4区医学 Q4 NUTRITION & DIETETICS

Asia Pacific journal of clinical nutrition Pub Date : 2024-06-01 DOI:10.6133/apjcn.202406_33(2).0007

Patricia Louise Whitfield, Rosemary Megan Hall, Lorène Théaude, Ryan Phillip Sixtus, Rami Kanaan, Ana Simone Holley, A Margot Umpleby, Mark Weatherall, David Stephen Rowlands, Jeremy David Krebs

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引用次数: 0

Abstract

Background and objectives: Very-low calorie diets (VLCD) achieve weight loss and remission of Type 2 diabetes (T2DM), but efficacy and acceptability in non-European populations is less clear. This feasibility study examines the impact of 10% weight loss through VLCD on metabolic and body composition outcomes in a multi-ethnic cohort of Aotearoa New Zealand (AoNZ) men with prediabetes/early T2DM, and VLCD tolerability/cultural acceptability.

Methods and study design: Participants followed a VLCD intervention (mean energy 3033kJ/day) until achievement of 10% weight loss. An oral glucose tolerance test (OGTT), hyperinsulinaemic isoglycaemic clamp with stable isotopes, hood calorimetry and dual-energy Xray absorptiometry (DXA) were undertaken before and after intervention. Qualitative data on VLCD tolerability/cultural acceptability were collected.

Results: Fifteen participants were enrolled; nine achieved 10% weight loss. In this group, mean HbA1c reduced by 4.8mmol/mol (2.4-7.1) and reverted to normoglycaemia in n=5/9; mean body weight reduced by 12.0 kg (11.0-13.1) and whole-body glucose disposal improved by 1.5 mg kgFFM-1 min-1 (0.7-2.2). Blood pressure and fasting triglycerides improved significantly. No changes in hepatic glu-cose metabolism were found. In all participants who attended completion testing, HbA1c reduced by 3.4mmol/mol (SD 3.5) and total weight by 9.0kg (SD 5.7). The intervention was highly tolerable/culturally acceptable however challenges with fulfilment of cultural obligations were described.

Conclusions: Results support VLCD use in AoNZ however further work to investigate ethnic differences in physiological response to VLCDs and to optimise protocols for multi-ethnic populations are required.

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新西兰奥特亚罗瓦多民族队列中的极低热量饮食 (VLCD) 干预疗法，用于管理糖尿病前期和早期 2 型糖尿病：新西兰 PROGRESS 可行性研究。

背景和目的：极低热量饮食（VLCD）能减轻体重并缓解 2 型糖尿病（T2DM），但在非欧洲人群中的疗效和可接受性尚不明确。这项可行性研究考察了通过 VLCD 减肥 10%，对新西兰奥特亚罗瓦（AoNZ）多民族男性糖尿病前期/早期 T2DM 患者的代谢和身体成分结果的影响，以及 VLCD 的耐受性/文化接受度：参与者接受 VLCD 干预（平均能量为 3033kJ/天），直至体重减轻 10%。干预前后进行了口服葡萄糖耐量试验（OGTT）、使用稳定同位素的高胰岛素血症等甘油三酯血症钳夹、罩式热量计和双能 X 射线吸收测量（DXA）。此外，还收集了有关 VLCD 耐受性/文化可接受性的定性数据：15 名参与者参加了干预，其中 9 人的体重减轻了 10%。在这一组中，平均 HbA1c 降低了 4.8mmol/mol (2.4-7.1)，其中 5/9 人恢复到正常血糖水平；平均体重降低了 12.0 kg (11.0-13.1)，全身葡萄糖排出量提高了 1.5 mg kgFFM-1 min-1 (0.7-2.2)。血压和空腹甘油三酯显著改善。肝糖代谢没有发生变化。在所有参加完测试的参与者中，HbA1c 降低了 3.4mmol/mol（标准差 3.5），总重量降低了 9.0kg（标准差 5.7）。干预的可耐受性/文化可接受性很高，但在履行文化义务方面存在挑战：研究结果支持在澳新地区使用 VLCD，但还需要进一步研究不同种族对 VLCD 生理反应的差异，并为多种族人群优化方案。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Asia Pacific journal of clinical nutrition 医学-营养学

CiteScore

2.50

自引率

7.70%

发文量

审稿时长

6-12 weeks

期刊介绍： The aims of the Asia Pacific Journal of Clinical Nutrition (APJCN) are to publish high quality clinical nutrition relevant research findings which can build the capacity of clinical nutritionists in the region and enhance the practice of human nutrition and related disciplines for health promotion and disease prevention. APJCN will publish original research reports, reviews, short communications and case reports. News, book reviews and other items will also be included. The acceptance criteria for all papers are the quality and originality of the research and its significance to our readership. Except where otherwise stated, manuscripts are peer-reviewed by at least two anonymous reviewers and the Editor. The Editorial Board reserves the right to refuse any material for publication and advises that authors should retain copies of submitted manuscripts and correspondence as material cannot be returned. Final acceptance or rejection rests with the Editorial Board