SAT161 The Impact Of A Very Low-calorie Diet On Reversal Of Metabolic Disorders Among Indian Subjects: A Real World Clinic-based Study

Abstract

Abstract Disclosure: N. Deshpande: None. N. Kapoor: None. Introduction: Reversal/remission of diabetes has been tested and well proven in the Caucasians. However, the Asian Indian phenotype is genetically and clinically distinct and there is a lack of robust data on this subject. Also, hitherto, the benefits of such an intervention have been reported only in a tightly monitored trial-based environment, but its efficacy from real-world data in busy clinical practices is lacking from the Indian subcontinent. In this study we aimed to study the impact of marked reduction of calorie intake on obesity indicators and diabetes related comorbidities in subjects of Indian ethnicity in a clinic-based cohort. Material and Methods: A 3-month structured Reversal Diet of 800-830 calories/day, comprising an inhouse packed commercially available meal replacement liquid formula, along with non-starchy veggies/soups/ diluted buttermilk, and fat replaced all 3 major meals. Clinical and biochemical metabolic parameters were assessed at baseline and at 3 months. Only those subjects who completed the 3-month assessment were included. Body composition was analyzed using bioimpedance with the INBODY 230 Analyser. Statistical analysis was undertaken using the SPSS 16·0 software package. This study was approved by the Institutional Review Board. Results: 374 subjects were included of which 117(31.2%) had type 2 Diabetes (T2DM). At baseline the mean (SD) age of the participants was 40.1(12.4) years and 333/374(89.1%) participants were women. There was significant improvement in body weight (85.4 Vs 77.7 Kg), BMI (32.6 Vs 29.8 kg/m2), Waist circumference (103.6 Vs 98.3 cm) and hip circumference (109.2 Vs 103.8 cm) at 3 months, compared to baseline. Body fat % changed from 41.9 to 37.6 and other anthropometric indicators (neck circumference, thigh circumference and arm circumference) were also significantly better after the intervention (P< .001). Among subjects with T2DM (31.2%), 40% had remission in diabetes, 28% of insulin users stopped insulin and about 30% stopped oral anti diabetic agents. Even among those who did not go into diabetes remission, Insulin was stopped in 29% and reduced in 38%, Oral Anti Diabetic agents reduced in 22%, blood pressure was normalized without medicines in 14% and NAFLD remission was attained in 41% of patients. Conclusion: A significant impact towards reversal of metabolic disorders was observed following a structured very low-calorie diet intervention, in this clinic-based cohort. Further follow-up studies are currently needed to provide long term evidence on the sustainability and long-term efficacy of such an intervention in the metabolically unique Indian population. Presentation: Saturday, June 17, 2023