Calculating protein requirements |HCP|OPTIFAST

Adequate protein intake during weight loss is important to help preserve fat-free mass and control appetite¹. Evidence suggests that loss of fat-free mass during weight loss can be attenuated by diets providing protein intakes of ≥0.8g/kg body weight/day¹.

Research has been mixed on the amount of protein level required for preventing loss of fat-free mass during severely energy-restricted diets¹. We propose that ≥ 0.8g/kg Adj IBW/day be used as a basis for calculating protein requirements; however, this is at the discretion of the treating healthcare professional.

Consumption of 3 standard OPTIFAST VLCD products per day meets the protein requirements for obesity/weight loss for most females providing between 54.6g and 60g of protein per day, depending upon what combination of OPTIFAST VLCD products are consumed. The below individuals may benefit from extra protein:

Individuals with a BMI >35kg/m²
Males
Individuals that participate in regular physical exercise

There are several ways to provide additional protein to meet increased requirements:

Replacing 1, 2 or 3 standard OPTIFAST VLCD products with OPTIFAST VLCD Protein Plus Shakes
Supplement with a pure protein, powdered supplement (e.g. BENEPROTEIN)
Increasing the number of OPTIFAST VLCD products used
Supplementing with lean protein-rich foods (e.g. meat, chicken, fish and eggs).

The method used to increase protein intake should be based on the best outcome for the individual. OPTIFAST VLCD Protein Plus Shakes can be used in place of the standard OPTIFAST VLCD products at any level of the OPTIFAST VLCD Program. OPTIFAST VLCD Protein Plus Shakes contains 40% more protein than the standard OPTIFAST VLCD Shakes, and also contains less lactose making it a suitable alternative for people with higher protein needs or lactose intolerance.

Research suggests to minimise additional energy and carbohydrate intake and avoid the temptation of food, the addition of a pure protein supplement such as BENEPROTEIN is a useful option. BENEPROTEIN dissolves readily and is relatively tasteless. In addition, BENEPROTEIN is rich in whey protein which may be important for reducing appetite¹.

Increasing the number of OPTIFAST VLCD products per day can be another option to increase protein intake. However, if extra OPTIFAST VLCD products are recommended/consumed (i.e. more than the recommended three products per day), carbohydrate and calorie intakes will also increase and therefore may affect ketosis on the Intensive Level.

If using a food source of protein, one serve of protein is equivalent to 65-100g meat, two eggs or 130g fish and can be added to the evening vegetables. This will provide approximately 25g protein and an additional 150kcal (630kJ) to the daily intake of approximately 800kcal.

Table 5: Protein, energy and carbohydrate content of OPTIFAST VLCD products, plus additional protein sources.

Meeting protein requirements with OPTIFAST products and protein foods

Regular medical monitoring of patients while following the OPTIFAST VLCD Program is important, so that adjustments can be made to the Program or medications. Read more in our Medical Monitoring section here.

References
1. Gibson, A.A., et al., Do ketogenic diets really suppress appetite? A systematic review and meta-analysis. Obes Rev, 2015. 16(1): p. 64-76.

Overview of Very Low Energy Diets

Very Low Energy Diets (VLED), also known as Very Low Calorie Diets (VLCD) have been shown to be very effective in the management of obesity, with weekly weight losses averaging approximately 1.0 -2.5kg per week, providing greater initial weight loss than other forms of calorie restriction.
Expected rate of weight loss on Intensive Level

During the Intensive Level of the OPTIFAST Program, weight loss averages 1.0 to 2.5kg/week with an average total loss of 20kg after 12 to 16 weeks.
Long term weight loss goals

It is often mentioned in the lay press and amongst healthcare professionals that "the faster you lose weight, the quicker you regain it", yet there is little evidence to support this assumption and in fact the opposite may be true.
Mechanics of a VLED

A VLED works by restricting total energy intake to approximately 800 calories (3300kJ) or less per day. Weight loss with a VLED is achieved by restriction of both carbohydrate and total energy intake. This enables the body to use its body fat stores for energy via a metabolic process called ketosis.
Patient suitability

For a patient to succeed with the OPTIFAST VLCD Program, it is important to assess their readiness to undertake the necessary behaviour changes required for effective weight management.
Calculating ideal body weight

Ideal body weight is calculated to help determine an appropriate weight for height or to determine a long term weight loss goal. We recommend that you use the ‘Adjusted Ideal Body Weight’ calculation.
Calculating protein requirements

OPTIFAST VLCD is formulated to contain adequate high quality protein in sufficient quantities for nitrogen sparing and to preserve lean body mass.
Medical monitoring

As a healthcare professional, you can tailor the program to suit your patient's specific needs.
Long-term weight management with the OPTIFAST VLCD Program

Research has shown that having the support and guidance of a healthcare professional will make the program more successful for your patients.
Bariatric surgery and the OPTIFAST VLCD Program

Surgical intervention by way of bariatric surgery can result in substantial weight loss that is sustained over the long term when combined with education, ongoing monitoring and patient support.
Diabetes and the OPTIFAST VLCD Program

Most overweight and obese patients with Type 1 or Type 2 diabetes are eligible to use OPTIFAST VLCD as part of an overall management program that emphasises the importance of ongoing weight maintenance.
References