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Short-Term Pre-Operative Protein Caloric Restriction in Elective Vascular Surgery Patients: A Randomized Clinical Trial

Authors :
Peter Kip
Thijs J. Sluiter
Jodene K. Moore
Abby Hart
Jack Ruske
James O’Leary
Jonathan Jung
Ming Tao
Michael R. MacArthur
Patrick Heindel
Alwin de Jong
Margreet R. de Vries
M. Furkan Burak
Sarah J. Mitchell
James R. Mitchell
C. Keith Ozaki
Source :
Nutrients, Vol 13, Iss 11, p 4024 (2021)
Publication Year :
2021
Publisher :
MDPI AG, 2021.

Abstract

(1) Background: Vascular surgery operations are hampered by high failure rates and frequent occurrence of peri-operative cardiovascular complications. In pre-clinical studies, pre-operative restriction of proteins and/or calories (PCR) has been shown to limit ischemia-reperfusion damage, slow intimal hyperplasia, and improve metabolic fitness. However, whether these dietary regimens are feasible and safe in the vascular surgery patient population remains unknown. (2) Methods: We performed a randomized controlled trial in patients scheduled for any elective open vascular procedure. Participants were randomized in a 3:2 ratio to either four days of outpatient pre-operative PCR (30% calorie, 70% protein restriction) or their regular ad-libitum diet. Blood was drawn at baseline, pre-operative, and post-operative day 1 timepoints. A leukocyte subset flow cytometry panel was performed at these timepoints. Subcutaneous/perivascular adipose tissue was sampled and analyzed. Follow-up was one year post-op. (3) Results: 19 patients were enrolled, of whom 11 completed the study. No diet-related reasons for non-completion were reported, and there was no intervention group crossover. The PCR diet induced weight loss and BMI decrease without malnutrition. Insulin sensitivity was improved after four days of PCR (p = 0.05). Between diet groups, there were similar rates of re-intervention, wound infection, and cardiovascular complications. Leukocyte populations were maintained after four days of PCR. (4) Conclusions: Pre-operative PCR is safe and feasible in elective vascular surgery patients.

Details

Language :
English
ISSN :
20726643
Volume :
13
Issue :
11
Database :
Directory of Open Access Journals
Journal :
Nutrients
Publication Type :
Academic Journal
Accession number :
edsdoj.952283acc3f44c2aa56ea5da0563726
Document Type :
article
Full Text :
https://doi.org/10.3390/nu13114024