Effectiveness of weight reduction program in adolescents under sanatorium conditions in Poland including the role of diet and energy balance.

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. Investigations were conducted during 12 stays at a sanatorium, lasting for 24 days, with the program of body weight reduction. The study included 174 obese adolescents aged 12 - 16 years. The nutritive value of 288 daily rations was established on the basis of daily menus. Total daily energy expenditure (TDEE) during therapy was assessed by 24-hour heart rate 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. Weight reduction program consisted of low energy diet (5.47MJ/24h) 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 body composition 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. These 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.