同: very low calorie diet

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2014/06/29 16:37:32」(JST)

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Very low calorie diet (VLCD) is a diet with very or extremely low daily food energy consumption. It is defined as a diet of 800 kilocalories (3,300 kJ) per day or less. VLCDs are formulated, nutritionally complete, liquid meals containing 800 kilocalories or less per day. VLCDs also contain the recommended daily requirements for vitamins, minerals, trace elements, fatty acids and protein. Carbohydrate may be entirely absent, or substituted for a portion of the protein; this choice has important metabolic effects.^[1] The VLCD products are usually a powder which is mixed with water or another low-food-energy liquid. The VLCD is prescribed on a case to case basis for rapid weight loss (about 1.5 to 2.5 kilograms or 3 to 5 pounds per week) in patients with Body Mass Index of 30 and above. The health care provider can recommend the diet to a patient with a BMI between 27 and 30 if the medical complications the patient has due to being overweight present serious health risks.^[2]

Health effects

Health benefits

A 1997 study concludes that the short-term use of a VLCD is very effective in rapidly improving glycaemic control and promoting substantial weight loss in obese patients with Type 2 diabetes.^[3] Moreover, a VLCD increases insulin sensitivity and reduces the substrate for gluconeogenesis. Thus VLCD treatment may improve glycaemic control more than calorie restriction alone. A VLCD is typically undertaken by an obese patient who wishes to lose a lot of weight quickly, as the risk to health that obesity presents is considered much greater than any risks of the diet itself, so long as it is undertaken with medical supervision.^[4]

Adverse effects

Studies have shown that in about one in four individuals following a VLCD for a few months, gallstones develop. However, these gallstones may be small enough to not cause discomfort, and often disappear when a normal eating pattern is resumed.^[5]^[6]^[7] Gallstone formation is facilitated by the more concentrated bile fluid and reduced flow as a result of a VLCD. Another potential side effect is constipation (depending on the fiber content of the diet).^[8]^[9]^[10] Unmonitored VLCDs with insufficient macronutrient and mineral intake have the potential to cause sudden death via ventricular tachycardia. ^[11]^[12]

References

^ Howard AN (1981). "The historical development, efficacy and safety of very-low-calorie diets". Int J Obes 5 (3): 195–208. PMID 7024153.
^ "Very Low Calorie Diet for Rapid Weight Loss". Calorie Counter. Retrieved 2010-10-19.
^ Capstick F, Brooks BA, Burns CM, Zilkens RR, Steinbeck KS, Yue DK (May 1997). "Very low calorie diet (VLCD): a useful alternative in the treatment of the obese NIDDM patient". Diabetes Res. Clin. Pract. 36 (2): 105–11. doi:10.1016/s0168-8227(97)00038-7. PMID 9229194.
^ Diabetes for Professionals – VLCD in the treatment of obese patients with Type 2 diabetes: does it make sense?
^ Andersen T (July 1992). "Liver and gallbladder disease before and after very-low-calorie diets". Am. J. Clin. Nutr. 56 (1 Suppl): 235S–239S. PMID 1615889.
^ Broomfield PH, Chopra R, Sheinbaum RC, Bonorris GG, Silverman A, Schoenfield LJ, Marks JW (December 1988). "Effects of ursodeoxycholic acid and aspirin on the formation of lithogenic bile and gallstones during loss of weight". N. Engl. J. Med. 319 (24): 1567–72. doi:10.1056/NEJM198812153192403. PMID 3200265.
^ Liddle RA, Goldstein RB, Saxton J (August 1989). "Gallstone formation during weight-reduction dieting". Arch. Intern. Med. 149 (8): 1750–3. doi:10.1001/archinte.1989.00390080036009. PMID 2669662.
^ Astrup A, Vrist E, Quaade F (February 1990). "Dietary fibre added to very low calorie diet reduces hunger and alleviates constipation". Int J Obes 14 (2): 105–12. PMID 2160441.
^ Astrup A, Quaade F (1989). "VLCD compliance and lean body mass". Int J Obes. 13 Suppl 2: 27–31. PMID 2559044.
^ Nutra-Smart – VLCD's & Meal Replacements - A critical look
^ http://circ.ahajournals.org/content/60/6/1401.full.pdf
^ http://ajcn.nutrition.org/content/34/4/453.full.pdf

External links

Diet & VLCD - summary of studies

UpToDate Contents

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1. 成人における肥満：食事療法 obesity in adults dietary therapy
2. 成人における気晴らし食い-摂食障害：治療の概要 binge eating disorder in adults overview of treatment
3. 肥満手術手技：30日合併症発生率および死亡率 bariatric operative procedures thirty day morbidity and mortality
4. 胆石の疫学および危険因子 epidemiology of and risk factors for gallstones
5. 成人における肥満：薬物療法 obesity in adults drug therapy

English Journal

Effects of a caloric restriction weight loss diet on tryptophan metabolism and inflammatory biomarkers in overweight adults.

Strasser B1, Berger K, Fuchs D.
European journal of nutrition.Eur J Nutr.2015 Feb;54(1):101-7. doi: 10.1007/s00394-014-0690-3. Epub 2014 Apr 1.
PURPOSE: Recent data suggest that chronic low-grade inflammation, a characteristic of obesity, is associated with altered tryptophan (Trp) and tyrosine (Tyr) metabolism and plays a role in neuropsychiatric symptoms. The present study assessed the effect of an extreme short-term diet on Trp breakdown
PMID 24687684

Enhanced fatty acid uptake in visceral adipose tissue is not reversed by weight loss in obese individuals with the metabolic syndrome.

Bucci M1, Karmi AC, Iozzo P, Fielding BA, Viljanen A, Badeau RM, Borra R, Saunavaara V, Pham T, Hannukainen JC, Kalliokoski K, Haaparanta-Solin M, Viljanen T, Parkkola R, Frayn KN, Nuutila P.
Diabetologia.Diabetologia.2015 Jan;58(1):158-64. doi: 10.1007/s00125-014-3402-x. Epub 2014 Oct 21.
AIMS/HYPOTHESIS: Obesity causes an imbalance in fat mass distribution between visceral and subcutaneous adipose tissue (AT) depots. We tested the hypothesis that this relates to increased NEFA uptake between these depots in obese compared with healthy participants. Second, we hypothesised that a die
PMID 25331375

Middle-aged overweight South Asian men exhibit a different metabolic adaptation to short-term energy restriction compared with Europeans.

Bakker LE1, Guigas B, van Schinkel LD, van der Zon GC, Streefland TC, van Klinken JB, Jonker JT, Lamb HJ, Smit JW, Pijl H, Meinders AE, Jazet IM.
Diabetologia.Diabetologia.2015 Jan;58(1):165-77. doi: 10.1007/s00125-014-3408-4. Epub 2014 Oct 15.
AIMS/HYPOTHESIS: South Asians have a higher risk of developing type 2 diabetes than Europeans. The underlying cause of this excess risk is still poorly understood but might be related to differences in the regulation of energy/nutrient-sensing pathways in metabolic tissues and subsequent changes in
PMID 25316433

Japanese Journal

フォーミュラ食の適正使用 (肥満症(第2版)--基礎・臨床研究の進歩) -- (肥満症の予防・治療学の進歩食事療法)

井上郁夫
日本臨床 68(-) (972), 600-608, 2010-02
NAID 40016964544

Successful Lifestyle Modification--実践的なライフスタイル改善のノウハウ(No.2)肥満症治療におけるフォーミュラ食導入

川名秀俊,白井厚治
Life style medicine 3(2), 168-175, 2009-04
NAID 40016609008

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