Normal-fat versus fat-restricted diets in patients with acute pancreatitis: A randomized controlled study (NouRish-AP study).

IF 2.7 2区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Pancreatology Pub Date : 2025-08-14 DOI:10.1016/j.pan.2025.08.011

Nutchakorn Kittisuphat, Narisorn Lakananurak, Pradermchai Kongkam

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引用次数: 0

Abstract

Background/objectives: International guidelines recommend a low-fat diet (LFD) in patients with acute pancreatitis (AP); however, no randomized controlled trials have compared LFD with a normal fat diet (NFD). The necessity of LFD remains uncertain, with concerns about its palatability and lower energy density potentially leading to reduced intake and quality of life (QoL). This study evaluates the efficacy and safety of NFD versus LFD in patients with mild to moderately severe non-hypertriglyceridemic AP.

Methods: This randomized controlled study enrolled patients from July 2022 to April 2023. Participants were randomly assigned to either NFD (30 % of total calories from fat) or LFD (15 % of total calories from fat). The primary outcome was daily energy intake. Secondary outcomes included QoL, complications, length of stay (LOS), and 90-day readmission.

Results: Sixty-five patients were enrolled (33 NFD, 32 LFD). The NFD group had significantly higher energy intake during the first two intervention days (Day 1: 18.7 vs. 12 kcal/kg/day, p = 0.007; Day 2: 18.6 vs. 12.7 kcal/kg/day, p = 0.005) and in the malnourished subgroup (23.2 vs. 15.6 kcal/kg/day, p = 0.024). However, overall energy intake was not significantly different (18.9 vs. 16.5 kcal/kg/day, p = 0.087). NFD resulted in significantly higher QoL scores in the physical (53.9 vs. 39.4, p = 0.019) and mental domains (55.9 vs. 40.7, p = 0.004). No significant differences were found in abdominal pain, triglyceride increment, infections, LOS, or 90-day readmission.

Conclusions: NFD was associated with higher calorie intake during the first two days of oral feeding in patients with mild and moderately severe AP, along with better QoL and no increase in adverse events. Routine LFD prescription may not be necessary, making NFD a viable option for non-hypertriglyceridemic AP patients.

Clinical trial registration: The trial was registered, and the protocol is available online at Thaiclinicaltrials.org (Identifier: TCTR20230926008).

查看原文本刊更多论文

急性胰腺炎患者的正常脂肪与脂肪限制饮食：一项随机对照研究（营养- ap研究）。

背景/目的：国际指南推荐急性胰腺炎（AP）患者采用低脂饮食（LFD）；然而，没有随机对照试验将低脂饮食与正常脂肪饮食（NFD）进行比较。LFD的必要性仍然不确定，人们担心它的适口性和较低的能量密度可能导致摄入量和生活质量（QoL）的降低。该研究评估了NFD与LFD在轻度至中度非高甘油三酯血症ap患者中的疗效和安全性。方法：该随机对照研究于2022年7月至2023年4月招募患者。参与者被随机分配到NFD（总热量的30%来自脂肪）或LFD（总热量的15%来自脂肪）。主要指标是每日能量摄入。次要结局包括生活质量、并发症、住院时间（LOS）和90天再入院。结果：共纳入65例患者（NFD 33例，LFD 32例）。NFD组在干预前两天的能量摄入显著高于营养不良组（第1天：18.7 vs. 12 kcal/kg/ Day, p = 0.007；第2天：18.6 vs. 12.7 kcal/kg/ Day, p = 0.005）和营养不良组（23.2 vs. 15.6 kcal/kg/ Day, p = 0.024）。然而，总能量摄入没有显著差异（18.9 vs. 16.5 kcal/kg/day, p = 0.087）。NFD导致身体（53.9比39.4,p = 0.019）和精神领域（55.9比40.7,p = 0.004）的生活质量得分显著提高。在腹痛、甘油三酯增加、感染、LOS或90天再入院方面没有发现显著差异。结论：在轻度和中重度AP患者口服喂养的前两天，NFD与较高的卡路里摄入量相关，同时有更好的生活质量，且不良事件没有增加。常规LFD处方可能没有必要，使NFD成为非高甘油三酯血症AP患者的可行选择。临床试验注册：该试验已注册，方案可在泰国临床试验网站（编号：TCTR20230926008）上查询。

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

Pancreatology 医学-胃肠肝病学

CiteScore

7.20

自引率

5.60%

发文量

194

审稿时长

44 days

期刊介绍： Pancreatology is the official journal of the International Association of Pancreatology (IAP), the European Pancreatic Club (EPC) and several national societies and study groups around the world. Dedicated to the understanding and treatment of exocrine as well as endocrine pancreatic disease, this multidisciplinary periodical publishes original basic, translational and clinical pancreatic research from a range of fields including gastroenterology, oncology, surgery, pharmacology, cellular and molecular biology as well as endocrinology, immunology and epidemiology. Readers can expect to gain new insights into pancreatic physiology and into the pathogenesis, diagnosis, therapeutic approaches and prognosis of pancreatic diseases. The journal features original articles, case reports, consensus guidelines and topical, cutting edge reviews, thus representing a source of valuable, novel information for clinical and basic researchers alike.