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

(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 intima...

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Autores principales:	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
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	dietary restriction vascular surgery metabolic fitness Nutrition. Foods and food supply TX341-641
Acceso en línea:	https://doaj.org/article/d952283acc3f44c2aa56ea5da0563726
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spelling	oai:doaj.org-article:d952283acc3f44c2aa56ea5da05637262021-11-25T18:36:12ZShort-Term Pre-Operative Protein Caloric Restriction in Elective Vascular Surgery Patients: A Randomized Clinical Trial10.3390/nu131140242072-6643https://doaj.org/article/d952283acc3f44c2aa56ea5da05637262021-11-01T00:00:00Zhttps://www.mdpi.com/2072-6643/13/11/4024https://doaj.org/toc/2072-6643(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 (<i>p</i> = 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.Peter KipThijs J. SluiterJodene K. MooreAbby HartJack RuskeJames O’LearyJonathan JungMing TaoMichael R. MacArthurPatrick HeindelAlwin de JongMargreet R. de VriesM. Furkan BurakSarah J. MitchellJames R. MitchellC. Keith OzakiMDPI AGarticledietary restrictionvascular surgerymetabolic fitnessNutrition. Foods and food supplyTX341-641ENNutrients, Vol 13, Iss 4024, p 4024 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	dietary restriction vascular surgery metabolic fitness Nutrition. Foods and food supply TX341-641
spellingShingle	dietary restriction vascular surgery metabolic fitness Nutrition. Foods and food supply TX341-641 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 Short-Term Pre-Operative Protein Caloric Restriction in Elective Vascular Surgery Patients: A Randomized Clinical Trial
description	(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 (<i>p</i> = 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.
format	article
author	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
author_facet	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
author_sort	Peter Kip
title	Short-Term Pre-Operative Protein Caloric Restriction in Elective Vascular Surgery Patients: A Randomized Clinical Trial
title_short	Short-Term Pre-Operative Protein Caloric Restriction in Elective Vascular Surgery Patients: A Randomized Clinical Trial
title_full	Short-Term Pre-Operative Protein Caloric Restriction in Elective Vascular Surgery Patients: A Randomized Clinical Trial
title_fullStr	Short-Term Pre-Operative Protein Caloric Restriction in Elective Vascular Surgery Patients: A Randomized Clinical Trial
title_full_unstemmed	Short-Term Pre-Operative Protein Caloric Restriction in Elective Vascular Surgery Patients: A Randomized Clinical Trial
title_sort	short-term pre-operative protein caloric restriction in elective vascular surgery patients: a randomized clinical trial
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/d952283acc3f44c2aa56ea5da0563726
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Short-Term Pre-Operative Protein Caloric Restriction in Elective Vascular Surgery Patients: A Randomized Clinical Trial

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