Pediatric Weight Management

PWM: Protein Sparing Modified Fast Diets (2007)

Protein sparing modified fast diets to reduce pediatric overweight

• Intervention
  Are children on protein sparing modified fast diets less hungry than children on balanced macronutrient diets at the same level of energy intake?

  • Conclusion

    There is insufficient evidence to determine whether or not high-protein, low-carbohydrate, very-low-calorie diets provide a greater level of satiety for children in weight loss programs than balanced macronutrient diets at the same level of energy intake.

  • Grade: V
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: Are children on protein sparing modified fast diets less hungry than children on balanced macronutrient diets at the same level of energy intake?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Figueroa-Colon R, von Almen TK, Franklin FA, Schuftan C, Suskind RM. Comparison of two hypocaloric diets in obese children. Am J Dis Child. 1993 Feb;147(2):160-6.
  Do protein sparing modified fast diets bring about greater weight loss in children than macronutrient balanced diets of the same level of energy intake?

  • Conclusion

    There is insufficient evidence to suggest that high-protein, low-carbohydrate, very-low-calorie diets (protein-sparing modified fast) result in greater long-term weight loss in children, compared to balanced macronutrient diets at the same calorie intake level.

  • Grade: V
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: Protein Sparing Modified Fast Diets and Long Term Weight Loss
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Brown R, Sothern M, Suskind R, Udall J, Blecker U. Racial differences in the lipid profiles of obese children and adolescents before and after significant weight loss. Clinical Pediatrics 2000; 39: 427-431.
      • Figueroa-Colon R, von Almen TK, Franklin FA, Schuftan C, Suskind RM. Comparison of two hypocaloric diets in obese children. Am J Dis Child. 1993 Feb;147(2):160-6.
      • Sothern, M., Hunter, S., Suskind R., Brown, R., Udall, J. and Blecker, U. Motivating the obese child to move: the role of structured exercise in pediatric weight management. Southern Medical Journal 1999; 92: 577-584.
      • Sothern, M., Despinasse, B., Brown, R., Suskind, R., Udall, J. and Blecker, U. Lipid profiles of obese children and adolescents before and after significant weight loss: differences according to sex. Southern Medical Journal 2000; 93: 278-282.
      • Sothern, M., Loftin, M., Udall, J., Suskind R., Ewing, T., Tang, S., & Blecker, U. Safety, feasibility and efficacy of a resistance training program in preadolescent obese children. American Journal of the Medical Sciences, 2000; 319: 370-375. 
      • Sothern, M., Schumacher, H., von Almen, T., Carlisle, L., & Udall, J. Committed to Kids: an integrated, four level team approach to weight management in adolescents. Journal of the American Dietetic Association 2002;102:S81-S85.
      • Sothern, M., Udall, J. Suskind, R., Vargas, A., & Blecker, U. Weight loss and growth velocity in obese children after very low calorie diet, exercise and behavior modification. Acta Paediatrica, 2000; 89(9): 1036-43.
  • Search Plan and Results: Diet Therapy: Modified Protein 2005
     
  Do protein sparing modified fast diets preserve fat free body mass in children better than balanced macronutrient diets at the same level of energy intake?

  • Conclusion

    There is insufficient evidence to determine whether the short-term use of protein-sparing modified-fast diets preserve fat-free body mass in children any more or less effectively than balanced macronutrient diets at the same energy intake level.

  • Grade: V
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: Protein Sparing Modified Fast Diets and the Preservation of Fat Free Mass in Children
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Figueroa-Colon R, von Almen TK, Franklin FA, Schuftan C, Suskind RM. Comparison of two hypocaloric diets in obese children. Am J Dis Child. 1993 Feb;147(2):160-6.
      • Sothern, M., Loftin, M., Udall, J., Suskind R., Ewing, T., Tang, S., & Blecker, U. Safety, feasibility and efficacy of a resistance training program in preadolescent obese children. American Journal of the Medical Sciences, 2000; 319: 370-375. 
      • Sothern, M., Udall, J. Suskind, R., Vargas, A., & Blecker, U. Weight loss and growth velocity in obese children after very low calorie diet, exercise and behavior modification. Acta Paediatrica, 2000; 89(9): 1036-43.
  Does short term (no more than 20 weeks) use of protein sparing modified fast diets compromise fat free body mass in obese children?

  • Conclusion

    Several studies from a single program that measured body composition, using skin calipers, indicate that short-term use of PSMF for weight-loss in children, by and large, preserves fat-free body mass. 

  • Grade: III
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: Protein Sparing Modified Fast Diets and the Preservation of Fat Free Mass in Children
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Figueroa-Colon R, von Almen TK, Franklin FA, Schuftan C, Suskind RM. Comparison of two hypocaloric diets in obese children. Am J Dis Child. 1993 Feb;147(2):160-6.
      • Sothern, M., Loftin, M., Udall, J., Suskind R., Ewing, T., Tang, S., & Blecker, U. Safety, feasibility and efficacy of a resistance training program in preadolescent obese children. American Journal of the Medical Sciences, 2000; 319: 370-375. 
      • Sothern, M., Udall, J. Suskind, R., Vargas, A., & Blecker, U. Weight loss and growth velocity in obese children after very low calorie diet, exercise and behavior modification. Acta Paediatrica, 2000; 89(9): 1036-43.
• Basic Research
  What evidence is there that short-term use of protein sparing modified fast diets for childhood weight loss may compromise the growth velocity of children?

  • Conclusion

    The evidence is too limited to determine the long-term the effects of the short-term use (less than 20 weeks) of a protein-sparing modified fast on children's linear growth.

  • Grade: V
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: Protein Sparing Modified Fast Diets and Growth Velocity in Children
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Figueroa-Colon R, von Almen TK, Franklin FA, Schuftan C, Suskind RM. Comparison of two hypocaloric diets in obese children. Am J Dis Child. 1993 Feb;147(2):160-6.
      • Sothern, M., Despinasse, B., Brown, R., Suskind, R., Udall, J. and Blecker, U. Lipid profiles of obese children and adolescents before and after significant weight loss: differences according to sex. Southern Medical Journal 2000; 93: 278-282.
      • Sothern, M., Loftin, M., Udall, J., Suskind R., Ewing, T., Tang, S., & Blecker, U. Safety, feasibility and efficacy of a resistance training program in preadolescent obese children. American Journal of the Medical Sciences, 2000; 319: 370-375. 
      • Sothern, M., Udall, J. Suskind, R., Vargas, A., & Blecker, U. Weight loss and growth velocity in obese children after very low calorie diet, exercise and behavior modification. Acta Paediatrica, 2000; 89(9): 1036-43.