title: Effect of a commercial hypocaloric diet in weight loss and post surgical morbidities in obese patients with chronic arthropathy, a randomized clinical trial.
abstract: BACKGROUND
  The aim of our study was to evaluate in patients with obesity and surgical indication of orthopaedic surgery for chronic osteoarthritis (hip or knee), the impact on weight loss, metabolic control and post surgical co morbidities of a hypocaloric commercial formula (Optisource®) versus conventional nutritional advice before orthopaedic surgery.
  
  
  METHODS
  40 patients were randomized in both branches: diet I with lunch and dinner substituted by two Optisource® (1109.3 kcal/day, 166.4 g of carbohydrates (60%), 63 g of proteins (23%), 21.3 g of lipids 17%) and intervention II with nutritional counselling that decreases 500 cal/day of the previous dietary intake. Previous and after 3 months of the treatment, a nutritional and biochemical study was realized. Postsurgical co-morbities have been recorded.
  
  
  RESULTS
  20 patients finished in each group. The improvement in weight (-7.56 ± 5.2 kg vs -5.18 ± 5.1 kg: p < 0.05), body mass index (-3.15 ± 2.2 vs -2.1 ± 1.9 kg/m2: p < 0.05), fat mass (-5.5 ± 5.9 kg vs -3.0 ± 2.6 kg: p < 0.05), insulin (-3.6 ± 3.8 mUI/L vs -3.0 ± 2.6) p < 0.05) and HOMA (-0.5 4 ± 1.2 vs -0.33 ± 1.14): p < 0.05) was higher in group I than in group II. All post surgical recorded parameters such as minutes of orthopaedic surgery, length of stay, vein thrombosis episodes, general infections complications, haemoglobin levels and days till independence of walking were similar in both groups.
  
  
  CONCLUSIONS
  Obese patients with chronic osteoarthritis subsidiary of surgery, lose more weight, fat mass and improve more resistance to insulin treated with a mixed diet with a commercial formula hypocaloric that patients treated only with dietary advice.
authors.affiliation: Unit of Investigation, Center of Investigation of Endocrinology and Clinical Nutrition, School of Medicine, Hospital Rio Hortega, University of Valladolid, Spain. dadluis@yahoo.es
authors.forename: D A
authors.initials: DA
authors.lastname: de Luis
authors.forename: O
authors.initials: O
authors.lastname: Izaola
authors.forename: M
authors.initials: M
authors.lastname: García Alonso
authors.forename: R
authors.initials: R
authors.lastname: Aller
authors.forename: G
authors.initials: G
authors.lastname: Cabezas
authors.forename: B
authors.initials: B
authors.lastname: de la Fuente
mesh_terms: D000368:Aged; D002908:Chronic Disease; D004038:Diet, Reducing; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D009765:Obesity / Q000503:physiopathology*; D010003:Osteoarthritis / Q000601:surgery*; D015431:Weight Loss
chemical_list: D008055:Lipids