{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T02:14:07Z","timestamp":1780625647964,"version":"3.54.1"},"reference-count":44,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2021,11,11]],"date-time":"2021-11-11T00:00:00Z","timestamp":1636588800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000968","name":"American Heart Association","doi-asserted-by":"publisher","award":["#19POST34400059"],"award-info":[{"award-number":["#19POST34400059"]}],"id":[{"id":"10.13039\/100000968","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000968","name":"American Heart Association","doi-asserted-by":"publisher","award":["16GRNT27090006"],"award-info":[{"award-number":["16GRNT27090006"]}],"id":[{"id":"10.13039\/100000968","id-type":"DOI","asserted-by":"publisher"}]},{"name":"De Drie Lichten Foundation","award":["n\/a"],"award-info":[{"award-number":["n\/a"]}]},{"name":"Prins Bernhard Cultural Foundation","award":["n\/a"],"award-info":[{"award-number":["n\/a"]}]},{"name":"Michael- van Vloten Foundation","award":["n\/a"],"award-info":[{"award-number":["n\/a"]}]},{"DOI":"10.13039\/100000009","name":"Foundation for the National Institutes of Health","doi-asserted-by":"publisher","award":["1R01HL133500"],"award-info":[{"award-number":["1R01HL133500"]}],"id":[{"id":"10.13039\/100000009","id-type":"DOI","asserted-by":"publisher"}]},{"name":"F31","award":["F31AG064863-01"],"award-info":[{"award-number":["F31AG064863-01"]}]},{"DOI":"10.13039\/100000049","name":"NIA","doi-asserted-by":"publisher","award":["P01AG034906"],"award-info":[{"award-number":["P01AG034906"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"name":"National Institute of Health","award":["AG036712, DK090629"],"award-info":[{"award-number":["AG036712, DK090629"]}]},{"name":"Charoen Pokphand Group","award":["n\/a"],"award-info":[{"award-number":["n\/a"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>(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.<\/jats:p>","DOI":"10.3390\/nu13114024","type":"journal-article","created":{"date-parts":[[2021,11,11]],"date-time":"2021-11-11T23:04:46Z","timestamp":1636671886000},"page":"4024","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Short-Term Pre-Operative Protein Caloric Restriction in Elective Vascular Surgery Patients: A Randomized Clinical Trial"],"prefix":"10.3390","volume":"13","author":[{"given":"Peter","family":"Kip","sequence":"first","affiliation":[{"name":"Department of Surgery and the Heart and Vascular Center, Brigham & Women\u2019s Hospital and Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA"},{"name":"Department of Molecular Metabolism, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA"},{"name":"Einthoven Laboratory for Experimental Vascular Medicine, Department of Surgery, Leiden University Medical Center, 2333 ZC Leiden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0199-2729","authenticated-orcid":false,"given":"Thijs J.","family":"Sluiter","sequence":"additional","affiliation":[{"name":"Department of Surgery and the Heart and Vascular Center, Brigham & Women\u2019s Hospital and Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA"},{"name":"Department of Molecular Metabolism, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA"},{"name":"Einthoven Laboratory for Experimental Vascular Medicine, Department of Surgery, Leiden University Medical Center, 2333 ZC Leiden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8281-1234","authenticated-orcid":false,"given":"Jodene K.","family":"Moore","sequence":"additional","affiliation":[{"name":"Department of Systems Biology, Harvard Medical School, Boston, MA 02115, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abby","family":"Hart","sequence":"additional","affiliation":[{"name":"Department of Surgery and the Heart and Vascular Center, Brigham & Women\u2019s Hospital and Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1005-1544","authenticated-orcid":false,"given":"Jack","family":"Ruske","sequence":"additional","affiliation":[{"name":"Department of Surgery and the Heart and Vascular Center, Brigham & Women\u2019s Hospital and Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"O\u2019Leary","sequence":"additional","affiliation":[{"name":"Department of Surgery and the Heart and Vascular Center, Brigham & Women\u2019s Hospital and Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0674-9066","authenticated-orcid":false,"given":"Jonathan","family":"Jung","sequence":"additional","affiliation":[{"name":"Department of Molecular Metabolism, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA"},{"name":"School of Medicine, University of Glasgow, Glasgow G12 8QF, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming","family":"Tao","sequence":"additional","affiliation":[{"name":"Department of Surgery and the Heart and Vascular Center, Brigham & Women\u2019s Hospital and Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3593-6995","authenticated-orcid":false,"given":"Michael R.","family":"MacArthur","sequence":"additional","affiliation":[{"name":"Department of Molecular Metabolism, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA"},{"name":"Department of Health Sciences and Technology, ETH Zurich, 8092 Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6030-6923","authenticated-orcid":false,"given":"Patrick","family":"Heindel","sequence":"additional","affiliation":[{"name":"Department of Surgery and the Heart and Vascular Center, Brigham & Women\u2019s Hospital and Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4556-5393","authenticated-orcid":false,"given":"Alwin","family":"de Jong","sequence":"additional","affiliation":[{"name":"Einthoven Laboratory for Experimental Vascular Medicine, Department of Surgery, Leiden University Medical Center, 2333 ZC Leiden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3648-9130","authenticated-orcid":false,"given":"Margreet R.","family":"de Vries","sequence":"additional","affiliation":[{"name":"Einthoven Laboratory for Experimental Vascular Medicine, Department of Surgery, Leiden University Medical Center, 2333 ZC Leiden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. Furkan","family":"Burak","sequence":"additional","affiliation":[{"name":"Department of Surgery and the Heart and Vascular Center, Brigham & Women\u2019s Hospital and Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA"},{"name":"Department of Molecular Metabolism, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah J.","family":"Mitchell","sequence":"additional","affiliation":[{"name":"Department of Molecular Metabolism, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA"},{"name":"Department of Health Sciences and Technology, ETH Zurich, 8092 Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James R.","family":"Mitchell","sequence":"additional","affiliation":[{"name":"Department of Molecular Metabolism, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA"},{"name":"Department of Health Sciences and Technology, ETH Zurich, 8092 Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. Keith","family":"Ozaki","sequence":"additional","affiliation":[{"name":"Department of Surgery and the Heart and Vascular Center, Brigham & Women\u2019s Hospital and Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,11,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1563","DOI":"10.1016\/j.jacc.2018.07.046","article-title":"Cardiovascular Outcomes after Lower Extremity Endovascular or Surgical Revascularization: The EUCLID Trial","volume":"72","author":"Baumgartner","year":"2018","journal-title":"J. Am. 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