VLCD - Very Low Calorie Diets
KicStart

What is a VLCD?

Very Low Calorie Diets (VLCDs) are nutritionally complete formulated liquid meals, such as KicStart™, that are available from doctors or pharmacies. They provide a total of around 1700kJ to 3300 kJ (approximately 400 cal to 800 cal) of energy per day. VLCDs should contain 0.8 to 1.0 grams per kilogram of ideal body weight per day of high quality protein, the recommended daily allowances (RDI) of minerals, vitamins and trace elements.

Note:- Standard meal replacement products can not be used in a VLCD program.

How do VLCDs work?

VLCDs provide a strictly limited amount of food energy for your body to use each day. As the amount of energy provided is less than your body needs, you will start to use your stored fat as a source of energy. The high quality protein provided by the VLCD helps preserve your muscle mass while your stored fat is burned for energy. As your body burns this stored fat, you will start to lose weight.

IMPORTANT NOTICE

VLCD programs, where all meals are replaced, should only be used under the direct supervision of a healthcare professional such as a doctor, pharmacist or dietitian. They should only be used for people who are classified as obese (BMI > 30) or overweight (BMI > 27) with medical complications associated with being overweight (e.g. high blood pressure, diabetes, high cholesterol).

KicStart™ VLCD may be unsuitable for use by pregnant, nursing or lactating (breast-feeding) women, or by infants, children, adolescents or the elderly.

Phased VLCD programs

Your supervising healthcare professional may design a specific VLCD program that is suitable for your individual circumstances. You should follow the instructions from your supervising healthcare professional carefully. VLCD programs may be structured with an intensive phase (phase 1) followed by a less rigorous healthy eating and activity weight management phase (phase 2).

Phase 1 may consist of:

1. Replacing all three meals per day for 8 to 16 weeks with KicStart™.
2. Eating 2 cups of low GI vegetables each day (in addition to the liquid meals).
3. Drinking an additional 2 litres of water each day.
4. Introducing a program of increased physical activity or light exercise into your daily routine.

Phase 2 may consist of:

1. Replacing 1 - 2 meals per day with a KicStart™ milkshake. (eg replacing 2 meals each day for 6 weeks, reducing to 1 meal replaced each day for the following 6 weeks)
2. Eating sensible portions of healthy foods for your remaining meals*.
3. Introducing a program of increased physical activity or light exercise into your daily routine.

VLCD Contraindications

People who have acute cerebrovascular or cardiovascular disease (including unstable angina), kidney disease, liver disease, Type 1 diabetes or severe psychological disturbances should not undergo total meal replacement with a VLCD (partial meal replacement may be appropriate if medically supervised and prescribed).

KicStart™ VLCD may also be unsuitable for use by pregnant, nursing or lactating (breast-feeding) women, or by infants, children, adolescents or the elderly.

VLCD – Precautions & Monitoring

VLCD programs should only be used under the direct supervision of a healthcare professional such as a doctor, pharmacist or dietitian. They should only be used for people who are classified as obese (BMI > 30) or overweight (BMI > 27) with medical complications associated with being overweight (e.g. high blood pressure, diabetes, high cholesterol).

During the course of a VLCD program an additional 2 litres of water (or low calorie soft drink) and 2 cups of low GI vegetables should be consumed each day.

Before a VLCD program is commenced, individuals should be assessed by a doctor for any evidence of pre-existing kidney disease, liver disease, diabetes, cardiovascular disease, gall bladder disease or gout and should be monitored carefully throughout a VLCD program.

A base line serum uric acid measurement should be taken. Individuals with a history of gout or a raised baseline uric acid level should have their serum uric acid monitored regularly during their VLCD program.

Before commencing a VLCD program please inform your supervising healthcare professional of any medical conditions that you have, as well as any medication or supplements that you may be taking. Your doctor may need to monitor your existing medical conditions and reduce the dose of some medications (or stop them entirely) as you lose weight. This is especially important in the early stages of weight loss. Do not stop taking medications without your doctor’s prior approval. If you are being treated for diabetes, high blood pressure or cholesterol, or if you are on lithium or warfarin therapy, it is particularly important that your doctor monitors your medication carefully whilst on a VLCD program.

VLCD – Adverse Reactions

Some people on VLCD programs report minor side effects such as fatigue, constipation, nausea and diarrhoea, but these conditions usually improve within a few weeks and rarely prevent patients from completing the program. A fibre supplement can be used if constipation becomes a problem.

Rapid weight loss on a VLCD program can lead to a significant rise in uric acid in some individuals, which can result in the development of acute gout. Please discontinue use until this resolves.

Another potentially serious side effect seen in all weight loss programs and especially with VLCDs is the formation of gallstones. Gallstones, which are a recognised co-morbidity of obesity, are even more common during rapid weight loss. Report any abdominal discomfort to your doctor.

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