Reduced Body Weight and Adiposity With a High-Protein Diet Improves Functional Status, Lipid Profiles, Glycemic Control, and Quality of Life in Patients With Heart Failure A Feasibility Study

被引:67
作者
Evangelista, Lorraine S. [1 ]
Heber, David [2 ]
Li, Zhaoping [2 ]
Bowerman, Susan [2 ]
Hamilton, Michele A. [3 ]
Fonarow, Gregg C. [3 ]
机构
[1] Univ Calif Los Angeles, Sch Nursing, Los Angeles, CA 90095 USA
[2] Univ Calif Los Angeles, Ctr Human Nutr, Los Angeles, CA 90095 USA
[3] Univ Calif Los Angeles, Ahmanson UCLA Cardiomyopathy Ctr, Los Angeles, CA 90095 USA
关键词
heart failure; high-protein diet; quality of life; weight reduction; CARBOHYDRATE DIET; OBESITY PARADOX; MASS INDEX; OVERWEIGHT; PROGNOSIS; MORTALITY; PROGRAM; RISK;
D O I
10.1097/JCN.0b013e31819846b9
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: The effectiveness of high-protein (HP) diets in reducing body weight and adiposity and potentially improving clinical outcomes in heart failure (HF) is not known. Objective: This feasibility study was conducted to evaluate the impact of 3 dietary interventions on body weight and adiposity, functional status, lipid profiles, glycemic control, and quality of life (QOL) in overweight and obese patients with HF and type 2 diabetes mellitus. Design: Fourteen patients with HF with a body mass index greater than 27 kg/m(2) were randomized to an HP diet, a standard protein diet, or a conventional diet. Data were obtained at baseline and 12 weeks. Results: There were no significant differences in age (59 +/- 10 years), sex (78% male), New York Heart Association class (43% class II, 57% class III), and HF etiology or left ventricular ejection fraction (26 7) between the groups at baseline. Patients on the HP diet demonstrated significantly greater reductions in weight (P = .005), percent body fat (P = .036), total cholesterol (P = .016), triglyceride concentrations (P = .034), and low-density lipoprotein cholesterol (P = .041) and greater improvements in functional status (6-minute walk [P = .010] and Vo(2) peak [P = .003]), high-density lipoprotein cholesterol (P = .006), and physical QOL scores (P = .022) compared with those on standard protein and conventional diets. Conclusion: A 12-week HP diet resulted in moderate weight loss and reduced adiposity in a small sample of overweight and obese patients with HF that were associated with improvements in functional status, lipid profiles, glycemic control, and QOL. However, these preliminary findings must be confirmed in studies with more participants and long-term follow-up.
引用
收藏
页码:207 / 215
页数:9
相关论文
共 30 条
[1]   Cardiac morphology and left ventricular function in normotensive morbidly obese patients with and without congestive heart failure, and effect of weight loss [J].
Alpert, MA ;
Terry, BE ;
Mulekar, M ;
Cohen, MV ;
Massey, CV ;
Fan, TM ;
Panayiotou, H ;
Mukerji, V .
AMERICAN JOURNAL OF CARDIOLOGY, 1997, 80 (06) :736-740
[2]  
*AM HEART ASS, 2007, HEART DIS STROK STAT
[3]  
[Anonymous], 2008, NAT DIAB STAT 2007 F
[4]  
Aronne L J, 2001, Prog Cardiovasc Nurs, V16, P98, DOI 10.1111/j.0889-7204.2001.00589.x
[5]  
Beck-da-Silva Luis, 2005, Congest Heart Fail, V11, P118, DOI 10.1111/j.1527-5299.2005.03827.x
[6]   Long-term effects of a high-protein, low-carbohydrate diet on weight control and cardiovascular risk markers in obese hyperinsulinemic subjects [J].
Brinkworth, GD ;
Noakes, M ;
Keogh, JB ;
Luscombe, ND ;
Wittert, GA ;
Clifton, PM .
INTERNATIONAL JOURNAL OF OBESITY, 2004, 28 (05) :661-670
[7]   Reduced cardiac efficiency and altered substrate metabolism precedes the onset of hyperglycemia and contractile dysfunction in two mouse models of insulin resistance and obesity [J].
Buchanan, J ;
Mazumder, PK ;
Hu, P ;
Chakrabarti, G ;
Roberts, MW ;
Yun, UJ ;
Cooksey, RC ;
Litwin, SE ;
Abel, ED .
ENDOCRINOLOGY, 2005, 146 (12) :5341-5349
[8]   The obesity paradox - Body mass index and outcomes in patients with heart failure [J].
Curtis, JP ;
Selter, JG ;
Wang, YF ;
Rathore, SS ;
Jovin, IS ;
Jadbabaie, F ;
Kosiborod, M ;
Portnay, EL ;
Sokol, SI ;
Bader, F ;
Krumholz, HM .
ARCHIVES OF INTERNAL MEDICINE, 2005, 165 (01) :55-61
[9]   Usefulness of a home-based exercise program for overweight and obese patients with advanced heart failure [J].
Evangelista, LS ;
Doering, LV ;
Lennie, T ;
Moser, DK ;
Hamilton, MA ;
Fonarow, GC ;
Dracup, K .
AMERICAN JOURNAL OF CARDIOLOGY, 2006, 97 (06) :886-890
[10]   Effect of a high-protein, energy-restricted diet on body composition, glycemic control, and lipid concentrations in overweight and obese hyperinsulinemic men and women [J].
Farnsworth, E ;
Luscombe, ND ;
Noakes, M ;
Wittert, G ;
Argyiou, E ;
Clifton, PM .
AMERICAN JOURNAL OF CLINICAL NUTRITION, 2003, 78 (01) :31-39