American Dietetic Association Pediatric Weight Management Evidence Analysis Project

Altered Protein Diets: Theoretically at least, high protein, low carbohydrate, very low calorie diets (sometimes called "protein sparing modified fast" diets) could have the following benefits over balanced macronutrient very low calorie diets:

• Increased thermogenesis associated with higher protein diets.
• Increased satiety with higher protein diets.
• Preservation of fat free mass--especially in situations of very low energy intake (i.e., eliminate fat but preserve lean body mass)

Based on this, we might expect the use of protein sparing modified fast diets for weight loss in children to:

• result in greater overall weight loss
• provide a higher level of diet compliance (i.e., children are less hungry and so less likely to "cheat" on their diets)
• preserve fat free body mass relative to balanced macronutrient diets with the same energy intake

We analyzed the research on a series of questions (below) that address each of these issues.

It should be pointed out that all of the studies on the use of a PSMF diet were from the same pediatric weight management program, and that this program is a multi-component program. While the use of multi-component interventions is more effective in treating pediatric obesity, it does limit our ability to determine the contribution which any particular intervention makes to the treatment of pediatric obesity.