Abstract
Although a very-low-calorie diet (VLCD) is considered safe and has demonstrated benefits among other types of diets, data are scarce concerning its effects on improving health and weight loss in severely obese patients. As part of the personalized weight loss program developed at the Duga Resa Special Hospital for Extended Treatment, Croatia, we evaluated anthropometric, biochemical, and permanent DNA damage parameters (assessed with the cytochalasin B-blocked micronucleus cytome assay—CBMN) in severely obese patients (BMI ≥ 35 kg m−2) after 3-weeks on a 567 kcal, hospital-controlled VLCD. This is the first study on the permanent genomic (in)stability in such VLCD patients. VLCDs caused significant decreases in weight (loss), parameters of the lipid profile, urea, insulin resistance, and reduced glutathione (GSH). Genomic instability parameters were lowered by half, reaching reference values usually found in the healthy population. A correlation was found between GSH decrease and reduced DNA damage. VLCDs revealed susceptible individuals with remaining higher DNA damage for further monitoring. In a highly heterogeneous group (class II and III in obesity, differences in weight, BMI, and other categories) consisting of 26 obese patients, the approach demonstrated its usefulness and benefits in health improvement, enabling an individual approach to further monitoring, diagnosis, treatment, and risk assessment based on changing anthropometric/biochemical VLCD parameters, and CBMN results.
Highlights
Non-communicable diseases (NCDs), characterized as non-transmissible with a long duration and slow progression, account for 63% of total deaths worldwide (up to 36 million of the 57 million total deaths according to the World Health Organization’s (WHO) Global Action Plan for the Prevention and Control of NCDs 2013–2020) [1]
As part of the personalized weight loss program developed at the Duga Resa Special Hospital for Extended Treatment, Croatia, we evaluated anthropometric, biochemical, and permanent DNA damage parameters in severely obese patients (BMI ≥ 35 kg m−2) after 3-weeks on a 567 kcal, hospital-controlled very-low-calorie diet (VLCD)
That was the reason for not changing their regular therapy during the diet, and for those for whom it proved a necessity to change it, they were excluded from the study
Summary
Non-communicable diseases (NCDs), characterized as non-transmissible with a long duration and slow progression, account for 63% of total deaths worldwide (up to 36 million of the 57 million total deaths according to the World Health Organization’s (WHO) Global Action Plan for the Prevention and Control of NCDs 2013–2020) [1]. Diet, and nutritional status, including being overweight and obese, are associated with the elevated parameters of lipid profile and insulin action resistance [8,9] These conditions are risk factors for NCDs, but are themselves major contributors of illness. With the lack of serious systemic monitoring of overweight/obese people, there is a need to develop a special program for monitoring the health, diet, and lifestyle habits of the Croatian (obese) population that would generate a personalized motivation towards weight loss lifestyle changes. This need was recognized by the Duga Resa Special Hospital for Extended Treatment, Croatia, which developed a local program that is open to accepting obese persons from other parts of Croatia and other regions. The program has been in place for five years and has proven to be a highly successful and low-cost program that improves patient wellbeing and offers a good opportunity to reduce the burdens on the healthcare system associated with incidences of severe chronic disease and comorbidities in obese people since a healthy diet is considered both a primary and secondary factor in the prevention of NCD (further) development
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