Current Perspectives on the Role of Very-Low-Energy Diets in the Treatment of Obesity and Type 2 Diabetes in Youth

Megan L Gow,1 Anna Pham-Short,2 Hiba Jebeile,1 Benjamin J Varley,1 Maria E Craig3 1The University of Sydney Children’s Hospital Westmead Clinical School, Sydney, NSW, Australia; 2Institute of Endocrinology and Diabetes, The Children’s Hospital at Westmead, Sydney, NSW, Australia;...

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Autores principales:	Gow ML, Pham-Short A, Jebeile H, Varley BJ, Craig ME
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	pediatrics obesity type 2 diabetes very-low-energy diet youth Specialties of internal medicine RC581-951
Acceso en línea:	https://doaj.org/article/ac7e99e983f9401eb13ae683987b77d2
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spelling	oai:doaj.org-article:ac7e99e983f9401eb13ae683987b77d22021-12-02T15:20:56ZCurrent Perspectives on the Role of Very-Low-Energy Diets in the Treatment of Obesity and Type 2 Diabetes in Youth1178-7007https://doaj.org/article/ac7e99e983f9401eb13ae683987b77d22021-01-01T00:00:00Zhttps://www.dovepress.com/current-perspectives-on-the-role-of-very-low-energy-diets-in-the-treat-peer-reviewed-article-DMSOhttps://doaj.org/toc/1178-7007Megan L Gow,1 Anna Pham-Short,2 Hiba Jebeile,1 Benjamin J Varley,1 Maria E Craig3 1The University of Sydney Children’s Hospital Westmead Clinical School, Sydney, NSW, Australia; 2Institute of Endocrinology and Diabetes, The Children’s Hospital at Westmead, Sydney, NSW, Australia; 3School of Women’s and Children’s Health, University of New South Wales, Sydney, NSW, AustraliaCorrespondence: Megan L GowThe University of Sydney Children’s Hospital Westmead Clinical School, Sydney, NSW, AustraliaTel +61 2 9845 0000Fax +61 2 9845 3170Email megan.gow@health.nsw.gov.auAbstract: In both developed and developing countries, pediatric obesity and type 2 diabetes are an increasing public health concern: globally 5.6% of girls and 7.8% of boys aged ≥ 5 years have obesity. The incidence of type 2 diabetes has increased in youth in recent decades and disproportionately affects those from ethnic/racial minority groups and disadvantaged backgrounds. For the treatment of both conditions, conventional lifestyle intervention is frequently ineffective, access to bariatric surgery is very limited and many young people are unsuitable or unwilling to undergo surgery. A very-low-energy diet (VLED) provides a viable alternative and may be effective for weight reduction and improved glycemic control in youth, based on one systematic review. In particular, in the treatment of type 2 diabetes, a chart review and a pilot study both demonstrated that a VLED can reduce the requirement for medications, including insulin, and lead to the remission of diabetes. However, long-term follow-up and safety data remain limited and therefore a VLED is inconsistently recommended by clinical practice guidelines for the treatment of pediatric obesity and type 2 diabetes. In clinical practice, VLED use in children and adolescents is uniquely challenging due to intolerance of expected side effects, difficulty adhering to the highly restrictive diet and difficulty with behaviour change within the current social context and environment. Ultimately, more research, including larger, longer-term trials with comprehensive safety monitoring are required to strengthen the evidence base. This would inform clinical practice guidelines, which may facilitate more widespread utilization of VLED programs in the management of obesity and type 2 diabetes in youth.Keywords: pediatrics, obesity, type 2 diabetes, very-low-energy diet, youthGow MLPham-Short AJebeile HVarley BJCraig MEDove Medical Pressarticlepediatricsobesitytype 2 diabetesvery-low-energy dietyouthSpecialties of internal medicineRC581-951ENDiabetes, Metabolic Syndrome and Obesity: Targets and Therapy, Vol Volume 14, Pp 215-225 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	pediatrics obesity type 2 diabetes very-low-energy diet youth Specialties of internal medicine RC581-951
spellingShingle	pediatrics obesity type 2 diabetes very-low-energy diet youth Specialties of internal medicine RC581-951 Gow ML Pham-Short A Jebeile H Varley BJ Craig ME Current Perspectives on the Role of Very-Low-Energy Diets in the Treatment of Obesity and Type 2 Diabetes in Youth
description	Megan L Gow,1 Anna Pham-Short,2 Hiba Jebeile,1 Benjamin J Varley,1 Maria E Craig3 1The University of Sydney Children’s Hospital Westmead Clinical School, Sydney, NSW, Australia; 2Institute of Endocrinology and Diabetes, The Children’s Hospital at Westmead, Sydney, NSW, Australia; 3School of Women’s and Children’s Health, University of New South Wales, Sydney, NSW, AustraliaCorrespondence: Megan L GowThe University of Sydney Children’s Hospital Westmead Clinical School, Sydney, NSW, AustraliaTel +61 2 9845 0000Fax +61 2 9845 3170Email megan.gow@health.nsw.gov.auAbstract: In both developed and developing countries, pediatric obesity and type 2 diabetes are an increasing public health concern: globally 5.6% of girls and 7.8% of boys aged ≥ 5 years have obesity. The incidence of type 2 diabetes has increased in youth in recent decades and disproportionately affects those from ethnic/racial minority groups and disadvantaged backgrounds. For the treatment of both conditions, conventional lifestyle intervention is frequently ineffective, access to bariatric surgery is very limited and many young people are unsuitable or unwilling to undergo surgery. A very-low-energy diet (VLED) provides a viable alternative and may be effective for weight reduction and improved glycemic control in youth, based on one systematic review. In particular, in the treatment of type 2 diabetes, a chart review and a pilot study both demonstrated that a VLED can reduce the requirement for medications, including insulin, and lead to the remission of diabetes. However, long-term follow-up and safety data remain limited and therefore a VLED is inconsistently recommended by clinical practice guidelines for the treatment of pediatric obesity and type 2 diabetes. In clinical practice, VLED use in children and adolescents is uniquely challenging due to intolerance of expected side effects, difficulty adhering to the highly restrictive diet and difficulty with behaviour change within the current social context and environment. Ultimately, more research, including larger, longer-term trials with comprehensive safety monitoring are required to strengthen the evidence base. This would inform clinical practice guidelines, which may facilitate more widespread utilization of VLED programs in the management of obesity and type 2 diabetes in youth.Keywords: pediatrics, obesity, type 2 diabetes, very-low-energy diet, youth
format	article
author	Gow ML Pham-Short A Jebeile H Varley BJ Craig ME
author_facet	Gow ML Pham-Short A Jebeile H Varley BJ Craig ME
author_sort	Gow ML
title	Current Perspectives on the Role of Very-Low-Energy Diets in the Treatment of Obesity and Type 2 Diabetes in Youth
title_short	Current Perspectives on the Role of Very-Low-Energy Diets in the Treatment of Obesity and Type 2 Diabetes in Youth
title_full	Current Perspectives on the Role of Very-Low-Energy Diets in the Treatment of Obesity and Type 2 Diabetes in Youth
title_fullStr	Current Perspectives on the Role of Very-Low-Energy Diets in the Treatment of Obesity and Type 2 Diabetes in Youth
title_full_unstemmed	Current Perspectives on the Role of Very-Low-Energy Diets in the Treatment of Obesity and Type 2 Diabetes in Youth
title_sort	current perspectives on the role of very-low-energy diets in the treatment of obesity and type 2 diabetes in youth
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/ac7e99e983f9401eb13ae683987b77d2
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Current Perspectives on the Role of Very-Low-Energy Diets in the Treatment of Obesity and Type 2 Diabetes in Youth

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