Sample structured abstract
Background: In Poland 10% population of teenagers aged 13-15 years are obese (1). An inappropriate slimming therapy may lead to growth inhibition, the occurrence of psychoneurological disorders or losses of lean body mass. Thus it is necessary to monitor thoroughly and systematically the course of the therapy in a way making it possible to monitor changes in the components of body composition (BC).
The aim of this study was to assess the effectiveness of weight reduction program and to develop recommendations for the therapeutic program conducted under sanatorium conditions, taking into consideration the composition of the diet and the share of macrocomponents in the negative energy balance.
Material and methods: Investigations were conducted for 6 years during 12 sanatorium stay periods of 24 days each. The study included 174 obese adolescents aged 12 - 16 years. The nutritive value of 288 diets prepared at the sanatorium was established on the basis of daily menus. Total daily energy expenditure (TDEE) during therapy was assessed by 24-hour HR monitoring. The body composition (fat mass - FM, fat free mass - FFM, body cell mass - BCM, total body water – TBW) were measured using bioelectrical impedance before and during therapy as well as six month later.
Results: Weight reduction program consisted of low energy diet (5.47 MJ/24h, 18% protein, 26% fat) and physical exercises. TDEE of individuals staying at the sanatorium considerably (P<0.001) exceeded energy intake from the diet, which was manifested in changes of body weight and BC of adolescents during the therapy. Six months after therapy at the sanatorium no statistically significant changes were recorded in the mean FFM, BCM and TBW contents.
Conclusions: The se results made it possible to establish optimum recommendations concerning low-energy diet and the degree of negative energy balance and their interrelations, determining the maximization of fat mass losses at the simultaneous minimization of lean body mass losses.