VERY LOW ENERGY DIET .. abrv. VLED. @ VERLY LOW CALORIE DIET
Got a chance to attend a talk by Dr Anthony R Leeds, at the Faculty of Medicine and Health Science, UPM.
VLED is a total diet replacement with an energy content between 450 kcal to 800 kcal, in the form of fortified liquid meals which provide vitamin, mineral, trace elements, essential fatty acieds requirement on a daily basis. This source of food usually administered over 12 - 16 weeks period, however recent guideline from UK National Institute for Clinical Excellence indicates this should be limited to 12 weeks.
This idea of VLED far back in 1920. It has faced an initial problem with the use of low quality and insufficient protein and inadequate vitamin & mineral supply. However has been corrected in early 1970s. The approach of VLED base on theory, where once body achieved a greater energy deficit than a low energy diet, this will result in greater rate of weight loss. Due to energy requirement is differ from each indivual rate of weight loss ~1.5 kg/week and ~2 kg/week for women and men respectively.
Follow up study for a minimum a year shown a significantly and dramatically drop in body weight after 6 month of VLED diet. However, this drop started to gain back another 10 kg and reach the same weight as those having other program (diet+exercise, drug therapy). The end point, VLED resulted the same as diet+exercise and drug therapy.
This regimen of diet is definately for short term as in
-preparation for bariatric and also other surgery
-where a clinical conditions limit control of energy intake pr energy utilisation such as in osteoarthritis.
-where best current therapeutic practice has failed to achieve desired outcomes such as in type 2 diabetes mellitus.
Personally, there is a doubt about this approach in T2DM management as this VLED kind of neglecting the actual cause of T2DM; physical inactivity and visceral obesity. Myself I'm still so much believe the best approach is lifestyle modification (diet and exercise). However, as the speaker also stated .. this VLED is for short term usage hence this regimen of diet might be able to give somehow an encouragement and motivation to those trying to reduce weight. Have to make sure, any patient undergoing this VLED is well informed about the weight gain after the significant loss.
Not to forget, the weight loss is due to very low energy intake hence body might switch its metabolic condition into hunger state, resulted in lower BMR., which is not so good. In any condition, exercise, need to be incorporated as muscle need to be activated. Weight loss due to VLED is a general weight loss meaning to say, body will loose both lean and fat mass. Loosing lean mass (muscular part) could lead to sarcopenia. Again, contradict to what shld be achieved in T2DM management.
Got a chance to attend a talk by Dr Anthony R Leeds, at the Faculty of Medicine and Health Science, UPM.
VLED is a total diet replacement with an energy content between 450 kcal to 800 kcal, in the form of fortified liquid meals which provide vitamin, mineral, trace elements, essential fatty acieds requirement on a daily basis. This source of food usually administered over 12 - 16 weeks period, however recent guideline from UK National Institute for Clinical Excellence indicates this should be limited to 12 weeks.
This idea of VLED far back in 1920. It has faced an initial problem with the use of low quality and insufficient protein and inadequate vitamin & mineral supply. However has been corrected in early 1970s. The approach of VLED base on theory, where once body achieved a greater energy deficit than a low energy diet, this will result in greater rate of weight loss. Due to energy requirement is differ from each indivual rate of weight loss ~1.5 kg/week and ~2 kg/week for women and men respectively.
Follow up study for a minimum a year shown a significantly and dramatically drop in body weight after 6 month of VLED diet. However, this drop started to gain back another 10 kg and reach the same weight as those having other program (diet+exercise, drug therapy). The end point, VLED resulted the same as diet+exercise and drug therapy.
This regimen of diet is definately for short term as in
-preparation for bariatric and also other surgery
-where a clinical conditions limit control of energy intake pr energy utilisation such as in osteoarthritis.
-where best current therapeutic practice has failed to achieve desired outcomes such as in type 2 diabetes mellitus.
Personally, there is a doubt about this approach in T2DM management as this VLED kind of neglecting the actual cause of T2DM; physical inactivity and visceral obesity. Myself I'm still so much believe the best approach is lifestyle modification (diet and exercise). However, as the speaker also stated .. this VLED is for short term usage hence this regimen of diet might be able to give somehow an encouragement and motivation to those trying to reduce weight. Have to make sure, any patient undergoing this VLED is well informed about the weight gain after the significant loss.
Not to forget, the weight loss is due to very low energy intake hence body might switch its metabolic condition into hunger state, resulted in lower BMR., which is not so good. In any condition, exercise, need to be incorporated as muscle need to be activated. Weight loss due to VLED is a general weight loss meaning to say, body will loose both lean and fat mass. Loosing lean mass (muscular part) could lead to sarcopenia. Again, contradict to what shld be achieved in T2DM management.
Dr Anthony R Leeds
