Study of the efficacy of hypocaloric diet with modified macronutrient composition in adolescent obesity
Authors:   Federal Research Centre of Nutrition, Biotechnology and Food Safety, Moscow, Russian Federation, Pavlovskaya E.V. ,   Russian Medical Academy of Continuous Professional Education, Moscow, Russian Federation, Bagaeva M.E. ,   Federal Research Centre of Nutrition, Biotechnology and Food Safety, Moscow, Russian Federation,   N.I.Pirogov Russian National Research Medical University, Moscow, Russian Federation, Zubovich A.I. ,   Federal Research Centre of Nutrition, Biotechnology and Food Safety, Moscow, Russian Federation, Taran N.N. ,   Federal Research Centre of Nutrition, Biotechnology and Food Safety, Moscow, Russian Federation,   N.I.Pirogov Russian National Research Medical University, Moscow, Russian Federation, Strokova T.V. ,   Federal Research Centre of Nutrition, Biotechnology and Food Safety, Moscow, Russian Federation,   N.I.Pirogov Russian National Research Medical University, Moscow, Russian Federation, Starodubova A.V. ,   Federal Research Centre of Nutrition, Biotechnology and Food Safety, Moscow, Russian Federation,   N.I.Pirogov Russian National Research Medical University, Moscow, Russian Federation
Published: February 2025

Objective. Comparative evaluation of the efficacy of hypocaloric diets with different macronutrient composition in therapy for obesity in adolescents.
Patients and methods. A single-center prospective controlled study included 40 obese adolescents aged 12 to 17 years who were undergoing inpatient treatment in a specialized department. Group 1 patients (n = 20) received a hypocaloric diet with the inclusion of an isocaloric polymer mixture, adolescents of group 2 (control) (n = 20) were on a standard hypocaloric diet. In the diet of adolescents of group 1 the amount of protein was 89.5 g/day, group 2 – 82.7 g/day with the norm of physiologic requirement up to 87 g/day. The duration of treatment was 10 days. The effectiveness of diet therapy was evaluated by the dynamics of anthropometric parameters (body weight, waist and hip circumference), component body composition by bioimpedanceometry, muscle strength by hand dynamometry, biochemical parameters of protein metabolism (total protein, albumin, globulins), lipid metabolism (total cholesterol, high and low density lipoprotein cholesterol, triglycerides), glucose, uric acid. The dynamics of quality of life indicators was determined against the background of the diet using PedsQL 4.0 Generic Core Scales questionnaire, the dynamics of the feeling of hunger using visual analog scale (VAS).
Results. On the background of diet therapy in patients of both groups the values of all studied anthropometric indices (body weight, waist and hip circumference) and lipid metabolism parameters decreased. Despite the higher energy value of the diet in group 1, the effectiveness of both diets with regard to the dynamics of anthropometric indices was comparable. Fat mass in group 1 adolescents decreased by 4.4 [1.8; 6.6]%, group 2 by 4.2 [2.9; 4.8]%, p > 0.05; muscle mass decreased by 3.8 [2.0; 5.8]% and 4.8 [1.9; 7.3]%, respectively (nonsignificant trend). Group 1 patients, in contrast to group 2, had decreased glycemia and increased serum albumin levels: 42.8 [42.0; 44.1] g/L and 43.8 [43.1; 45.2] g/L on days 1 and 10 of treatment, respectively (p = 0.047). Quality of life assessment showed a statistically significant increase in the PedsQL 4.0 Generic Core Scales physical functioning scale in group 1 (73.4 [62.5; 81.2] and 78.1 [67.2; 85.9] points on days 1 and 10, respectively), and in the total quality of life score in group 2 (71.9 [50.6; 73.6] and 75.1 [59.7; 79.8] points on days 1 and 10, respectively). Also, adolescents in Group 1 had a significant decrease in hunger as assessed by VAS during treatment (p = 0.001).
Conclusion. High efficacy of the diet with increased protein content (increase in serum albumin levels and physical functioning) and good tolerability (reduction in hunger) with comparable results on the dynamics of anthropometric parameters and lipid levels with the standard hypocaloric diet indicates the advisability of using specialized food products in adolescents with obesity during diet therapy.
Key words: obesity, adolescents, diet therapy, specialized food products, protein, quality of life