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Low-calorie high-protein content diet

[Low-calorie high-protein content diet]

Low-calorie high-protein content diet

Contrary to most diets, the protein-diet is supposed to maintain the muscles while enabling significant weight-loss and rapid decrease of fat-tissues without experiencing hunger or fatigue.

Before all, one should be aware of the biochemical and physiological mechanisms involved, as well as the principles of diet (decrease of the supply in glucides and lipids, and coverage of the need for high-quality proteins). Its relative ineffectiveness in the long run is caused by the difficulty to maintain such an imbalance in food-intake, and to handle the change from this sort of diet to a 'normal diet'.

>> Contra-indications

- Severe kidney failure
- Severe liver failure
- Heart failure, heart-illness or recent strokes (proteins interact with sodium).
- During pregnancy or breast-feeding because the mother needs a balanced diet
- Depression, severe psychiatric troubles
- Hypokaliemia (decrease of the blood level potassium)

Some exams can be necessary (electrocardiogram, biological tests, thyroid-function tests). If the patient requires antibiotics, one should wait for the end of the treatment. Diuretics, anti-hypertension drugs, or colchicine are also contra-indicated.

>> Side-effects

- Orthostatic hypotension can be cured by sodium supply
- Diarrhoea is rare but should be stopped.
- Constipation is related to the diminution of food-intake. Vegetable fibres and the absorption of 1.5 l water per day should be enough to regulate the intestinal transit.
- Haletosis (bad breath) is caused by cetonic agents eliminated through the lungs. It can be helped with chlorophyll pills.
- Night cramps and muscular weakness can be prevented by prescription of calcium and potassium.
- Menstruation can be troubled by a decrease in estrogen level.
- A slight increase in uric acid level can be corrected by drinking abundantly.
- Hair-loss may be corrected by addition of zinc

>> Layout of the weight-loss program

Whatever weight is to be lost, there are always three stages involved:

- A stage of actual weight-loss aimed at reaching the desired weight. During this stage, proteins will be prescribed.
- A stage of transition is then set up, and consists in re-introducing normal food and suppression of protein-products.
- Eventually, a stage of maintenance which results in the establishment of rules to govern one's diet, in order not to regain weight.

Follow-up is a key-element for success. The onset of the weight-loss stage requires an assessment of the medical history (diseases, disorders linked with eating behaviour), eating-habits, life-habits, physical activity, period of onset of obesity, weight before and after pregnancies, availability of family support to maintain correct diet, etc.
A physical exam is mandatory : type of obesity (android or gynoid), search for contra-indications, weighing, measurement of waist and waist-hip ratio, etc.

>> The weight-loss stage

The period for weight-loss, characterized by cetose, has two stages according to the degree of excess weight.

- Strict protein diet
- Mitigated protein diet

>> Specifics of the strict protein diet
High-protein content products are prescribed, for example in bags (4 to 6 per day) combined with vegetables, uncooked, or cooked without fat. Vegetables provide fibres, minerals and vitamins.

>> Specifics of the mitigated protein diet
This is much less straightforward. The mitigated protein diet is different from the strict one in that it allows lean meat and fish to be introduced into the diet at lunch and dinner, as well as one milk-product per day. The number of protein bags is lower (3 to 4 per day).

>> Rules to enhance the diet efficiency and avoid undesired effects :

- There should be no deviation during the diet.
- Drink enough water, i.e.1.5 litres per day
- Add vitamins A, C and the B complex
- Add minerals : calcium, potassium, iron, sodium, magnesium
- Do not eat food or drink products containing sugar
- Eat vegetables freely during lunch and dinner
- Avoid animal fat (butter, fresh cream, lard) and vegetable fat (oil, except some olive or rape seed oil: 1 or 2 spoonfuls per day)
- Put salt in your food
- Do not drink alcohol

>> Results :
Provided simple diet rules are respected and the need in protein is covered, the results are rapid and maintained for some time. It is frequently observed that weight-loss is more rapid in men than in women. Also, water retention can occur at times, temporarily masking any weight-loss. Weight-loss is also irregular ; the common outcomes in terms of weight-loss are :

- Strict protein diet: 8 to 10 kg per month
- Mitigated protein diet : 5 to 8 kg per month

>> Stage of transition
During the stage of transition, normal eating can be re-introduced, in particular glucides and lipids can be reintroduced into the diet, but without overindulging. Readjustment of eating patterns should tailored to each patient.

The following programs are possible options: The number of daily protein bags can be reduced and the patient can again eat unauthorized food:

- First week : bread (prefer wholemeal bread or cereal bread, and eat this at breakfast).
- Second week : at lunch, have starchy food (pasta, rice, semolina…) or dried vegetables (chickpeas, lentils…) twice a week, 100 g cooked instead of bread.
- Third week : at breakfast and at 4 p.m., have a fruit.

>> Stage of maintenance
Eating as normal, with some simple diet rules that are easy to comply with.

- Vegetables : they can be eaten uncooked (in salads) or cooked, to be eaten freely during the meals.
- Drink 1.5 litres water per day, preferably outside mealtimes. Chose sugar-free beverages : mineral waters, herbal teas, tea, light coffee, vegetable stock and vegetable juices.
- Avoid fast-acting sugar such as : sugar, honey, jam, squash, pastry, caramels, lemonades, fizzy drinks…
- Chose glucides with a low glycaemia level : pasta, rice, semolina, dried vegetables, cereals, bread, potatoes, corn ; garden peas, fresh fruit … Eat slow-acting sugars such as wholemeal cereals, pasta or rice.
- Avoid lipids contained in pork meats, game, full-fat cheese, fatty meats (lamb, pork…) sauces, animal fat (butter, lard,…).
- Avoid food with a high fat content
- Avoid snacking in-between meals
- Do not skip a meal
- Favour steam cooking and fat-free cooking in order to preserve vitamins and minerals. Butter should not be eaten cooked.

>> The follow-up
During the maintenance stage, follow-up should be regular in terms of weight. In effect, a weight-regain is very likely to occur if there are frequent deviations.
Hence, one should be especially careful during the weight-maintenance stage and not tolerate a variation in weight of more than 2 kilograms. Follow-up should be done weekly, then monthly.

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