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Article

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

1
Department of Surgery and the Heart and Vascular Center, Brigham & Women’s Hospital and Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA
2
Department of Molecular Metabolism, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
3
Einthoven Laboratory for Experimental Vascular Medicine, Department of Surgery, Leiden University Medical Center, 2333 ZC Leiden, The Netherlands
4
Department of Systems Biology, Harvard Medical School, Boston, MA 02115, USA
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School of Medicine, University of Glasgow, Glasgow G12 8QF, UK
6
Department of Health Sciences and Technology, ETH Zurich, 8092 Zurich, Switzerland
*
Author to whom correspondence should be addressed.
Academic Editor: Maria Luz Fernandez
Nutrients 2021, 13(11), 4024; https://doi.org/10.3390/nu13114024
Received: 12 October 2021 / Revised: 3 November 2021 / Accepted: 4 November 2021 / Published: 11 November 2021
(This article belongs to the Special Issue Macronutrients in Frailty and Aging)
(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 (p = 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. View Full-Text
Keywords: dietary restriction; vascular surgery; metabolic fitness dietary restriction; vascular surgery; metabolic fitness
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MDPI and ACS Style

Kip, P.; Sluiter, T.J.; Moore, J.K.; Hart, A.; Ruske, J.; O’Leary, J.; Jung, J.; Tao, M.; MacArthur, M.R.; Heindel, P.; de Jong, A.; de Vries, M.R.; Burak, M.F.; Mitchell, S.J.; Mitchell, J.R.; Ozaki, C.K. Short-Term Pre-Operative Protein Caloric Restriction in Elective Vascular Surgery Patients: A Randomized Clinical Trial. Nutrients 2021, 13, 4024. https://doi.org/10.3390/nu13114024

AMA Style

Kip P, Sluiter TJ, Moore JK, Hart A, Ruske J, O’Leary J, Jung J, Tao M, MacArthur MR, Heindel P, de Jong A, de Vries MR, Burak MF, Mitchell SJ, Mitchell JR, Ozaki CK. Short-Term Pre-Operative Protein Caloric Restriction in Elective Vascular Surgery Patients: A Randomized Clinical Trial. Nutrients. 2021; 13(11):4024. https://doi.org/10.3390/nu13114024

Chicago/Turabian Style

Kip, Peter, 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, and C. Keith Ozaki. 2021. "Short-Term Pre-Operative Protein Caloric Restriction in Elective Vascular Surgery Patients: A Randomized Clinical Trial" Nutrients 13, no. 11: 4024. https://doi.org/10.3390/nu13114024

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