The Effect of Restriction of Protein and Total Calories on Pancreatic Function in Obese Patients

Pancreatic dysfunction has been associated with experimental dietary manipulations l -4 as well as with clinical states of malnutrition and dietary metabolic disorders such as kwashiorkor,s-7 malabsorption syndrome,s regional enteritis,9.10 ulcerative colitis,1° alcoholism,11 Bantu salivary gland disease,12 hyperlipemia,13, 14 pregnancy, 15 and prolonged fast followed by surfeit. 16In the syndrome of kwashiorkor, in which pancreatic fibrosis and atrophy have ~een demonstrated, it is clear that the sahent dietary defect is prot.eindeficiency,r particularly in the face of maintenance of a relatively greater than normal intake of nonprotein calories.Grossman, Greengard, and Ivyl demonstrated in experiments with rats that a diet high in fat and low in protein resulted in a depression of all pancreatic enzymes in pancreatic tissue.They also demonstrated a parallelism between the enzyme concentration of pancreatic tissue and the enzyme content of pancreatic juice.This report is of studies of pancreatic function in 5 obese patients who participated in a long term program of weig~t reduction under rigidly controlled condItions on a metabolic ward.The findings indicate that the obese state in man is associated with a reversible pancreatic hypofunction probably due to fatty infiltration of the pancreas.In addition, it was noted that a prolonged low protein, low calorie diet did not have a deleterious influence on pancreatic function in these patients.