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Biomedical subjects

B L Nichols

Publications and source records attributed to B L Nichols.

At least 55 records · Page 3Linked to original sources
PubMed1986

Sources of variance in milk and caloric intakes in breast-fed infants: implications for lactation study design and interpretation.

Between-individual variation (BIV) and day-to-day variation (DDV) of total caloric and human milk intakes were examined in 17 infants. Nine were studied at months 5 and 6; 8 at months 6 and 7. All 17 were exclusively breast-fed for 5 full mo after which solid foods were added to the diet. Each infant was studied for five consecutive 24-h periods during which serial measurements were made of milk intake (test weighing) and solid food intake (pre- and postfeeding jar weighing). Total daily caloric intakes (kcal/day) were (mean +/- SD) 492 +/- 57, 547 +/- 70, and 567 +/- 98 at months 5, 6, and 7, respectively. Estimates of caloric intakes (kcal/kg/day) adjusted for body weight were 65.9 +/- 6.7, 72.6 +/- 11.2, and 70.9 +/- 13.0 at months 5, 6, and 7, respectively. Milk intakes (g/day) were 735 +/- 85, 640 +/- 106, and 562 +/- 214 at months 5, 6, and 7, respectively. BIV of milk intake increased after the introduction of solid foods. DDV (expressed as coefficient of variation) of caloric intake was nearly constant at each monthly observation and BIV increased from 8.8 at month 5 to 14.6 at month 7. The numbers of 24-h periods and subjects required for estimates of known precision of caloric and milk intakes of older breast-fed infants can be determined from these estimates of variance.

Adult↗
PubMed1986

Absorption and oxidation of glucose polymers of different lengths in young infants.

Because mucosal glucoamylase is most active against glucose polymers less than 10 glucose units in length, longer chain polymers may not be completely absorbed by young infants. In order to investigate this possibility, the absorption and oxidation of 13C-rich glucose, short-chain (3 to 8 glucose units in length) and long-chain (average length 43 units) glucose polymers (GP) were compared in 12 healthy, 1-month-old infants. Recovery of the GP and glucose in stool was measured by determining the 13C enrichment of stool. The oxidation of the GP was measured by tracing the increase in breath 13CO2 after GP were fed. Carbohydrate malabsorbed in the small bowel was assessed by measurement of breath H2, a gas formed from the fermentation of carbohydrate in the colon. Analysis of the infants' stools revealed that one infant excreted 9.7% of the dose of glucose, another 6.7% of the dose of short-chain GP, and five infants excreted 2.6 to 18.5% (mean 8.4%) of the dose of long-chain GP. The percent of the administered dose recovered in breath was similar among substrates (mean = 28.7% of the dose fed). A rise in breath H2 greater than 20 ppm was found in four of the 12 infants after the feeding of glucose, in five of 12 after the short-chain GP, and in six of 12 after the long-chain GP. None of the infants developed diarrhea. The results suggest that healthy young infants do not absorb long-chain GP as completely as they absorb short-chain GP.(ABSTRACT TRUNCATED AT 250 WORDS)

Glucans↗
PubMed1986

Polyethylene glycol polymers of low molecular weight as probes of intestinal permeability. II. Application to infants and children with intestinal disease.

We used a mixture of low molecular weight polymers of polyethylene glycol (PEG) to study intestinal permeability in children with chronic diarrhea. After an oral load, urinary recovery of the longer chain, higher molecular weight polymers was significantly decreased compared with that in healthy adults and infants without disease of the gastrointestinal mucosa. A correlation was observed between clinical severity of disease, histopathologic condition of the small bowel mucosa, and PEG scores. These results indicate that intestinal permeability in children can be studied by noninvasive means and that an assessment of mucosal integrity can be obtained.

Adolescent↗
PubMed1986

Polyethylene glycol polymers of low molecular weight as probes of intestinal permeability. I. Innovations in analysis and quantitation.

The differential passive permeation of polymers of different lengths across the intestinal mucosa has been proposed as a probe to test mucosal integrity under a variety of physiologic and pathologic conditions. Polyethylene glycol (PEG) 400 contains a series of polymers whose pattern of urinary recovery after oral administration has been used to characterize intestinal mucosal function. To extend this method to the low levels of PEG polymers found in the urine of children with diarrhea, we have introduced three methodologic innovations. These alterations involve (1) formulation of a balanced PEG polymer mixture, (2) improved isolation, derivatization, and gas chromatography techniques, and (3) a new quantification of the pattern of PEG urinary recoveries. Urinary recovery of orally administered PEG was assessed in four normal adults, six hospitalized infants without gastrointestinal complains, two infants with prolonged diarrhea and carbohydrate malabsorption, and two children with cystic fibrosis. A parameter characterizing the urinary recovery of PEG, N1/2, which is the theoretical number of subunits in the polymer whose recovery is reduced to 50% of the value of the polymer whose recovery is maximal, gave stable, reproducible, and consistent results in normal adults and infants.

Adult↗
PubMed1985

Fortified mothers' milk for very low birth weight infants: results of growth and nutrient balance studies.

Mothers' milk, fortified daily with skim and cream components derived from mature donor human milk, was fed fresh during the first 2 postnatal months to 18 (group FMM) healthy, very low birth weight (VLBW) infants. Following the same feeding protocol, 16 additional VLBW infants were fed commercial formula that had a similar range of energy and nitrogen. Infants were evaluated for growth, metabolizable energy, balances of nitrogen and fat, and biochemical markers of nutritional status. Growth measurements from birth to 1800 gm were similar in the two groups. Nutritional balance was performed at approximately 2.5 (first study period) and 6 (second study period) weeks. Metabolizable energy (average 109 kcal/kg/day) was similar in both groups and met theoretical needs of the growing VLBW infant. Apparent nitrogen retention was similar and equivalent to estimates of intrauterine nitrogen accretion (approximately 325 mg/kg/day). Fat absorption increased from the first (70% of intake) to the second study (80% of intake) and was similar in both groups. Serum values for albumin, total protein, prealbumin, hemoglobin, and creatinine were also similar, and declined with increases in postnatal age. Significant differences were observed between feeding groups for serum phosphorus and calcium. These results indicate that healthy VLBW infants maintain adequate growth and macronutrient balance for the first 2 months postnatally when fed mothers' milk fortified with additional skim and cream components.

Anthropometry↗
PubMed1985

Free fatty acids in the development of breast milk jaundice.

The incubation of milk, at 4 degrees C, from mothers of infants with breast milk jaundice (BMJ) is reported to result in significantly higher levels of free fatty acids (FFA) compared with milk from controls. Single milk samples collected under standard conditions were obtained from four mothers of infants with BMJ and 14 control donors matched for stage of lactation. Milk samples were analyzed for the concentrations of FFA, using thin-layer gas chromatographic techniques. In addition, serum total fatty acids were measured in mothers and infants. The concentrations of FFA increased after storage of the milk from both the jaundiced and control groups. No differences were observed in the composition of milk FFA before or after incubation, when respective values were compared between these two groups. Similarly, no differences were detected in serum total fatty acids in either infants or mothers. The observation that increased levels of FFA in milk are associated with BMJ was not confirmed.

Adult↗
PubMed1985

[13C]Acetate oxidation in infants after oral versus rectal administration: a kinetic model.

To study the fate of volatile fatty acids (VFA) in the large bowel, we compared the rate of oxidation of 13C-labeled VFA administered rectally with that of the orally administered substrate. On two different days, 1-[13C]acetate was administered rectally or orally to five infants recovering from diarrhea. Breath samples were collected over 4 h and analyzed for 13C enrichment of breath CO2 by gas isotope ratio mass spectrometry. The percent dose recoveries of 13C in breath were fitted to multicompartmental models using the SAAM-27 program. Following model development procedures, the oral acetate breath test curves could be accounted for only by a compartmental model in which labeled acetate underwent absorption into and mixed with a systemic pool before oxidation took place. The rectal acetate breath test curves could be accounted for by a simpler model in which oxidation occurred directly in the compartment in which the rectal acetate was administered, and required no rate-limiting absorptive process. Our results indicate that the labeled acetate was oxidized more rapidly when the substrate was administered rectally than orally. This observation points to the direct utilization of volatile fatty acids within the colon.

Acetates↗
PubMed1985

Disaccharidase activities, jejunal morphology, and carbohydrate tolerance in children with chronic diarrhea.

Children with chronic diarrhea were examined for their carbohydrate tolerance, small bowel morphology, and specific disaccharidase activities to determine whether disaccharidase enzymatic activity is related to villus height and thus may be viewed as an independent variable that controls digestive capacity. Results indicated that 65-78% of all abnormal biopsy samples had specific disaccharidase activities that fell within the normal range. Clinical disaccharide tolerance studies indicated that specific enzyme activity did not correlate with disaccharide tolerance.

Adolescent↗
PubMed1985

Effect of infant age on aminopyrine breath test results.

UNLABELLED: The aminopyrine breath test has been used in adults as a measure of hepatic N-demethylase activity. In order to study maturational changes in enzyme function, 13C aminopyrine (2 mg/kg) was administered orally to infants (n = 16) between the ages of 1 and 38 wk. Breath samples were collected for 6 h after administration of the labeled aminopyrine for the measurement of 13CO2 enrichment. Using a number of different scoring methods to quantitate 13CO2 elimination of breath, demethylation of aminopyrine was found to be positively correlated to age. By 20 wk of age, some infants had rates of elimination similar to those measured in adults. Absorption was excluded as a limiting variable, because no improvement in oxidation rates was found when the aminopyrine was readministered as an intravenous bolus. Changes in nutritional status and route of feeding (enteral versus parenteral) did not prevent the effect of maturation on aminopyrine elimination. CONCLUSIONS: 1) maturational differences are seen in the metabolism of aminopyrine; 2) these differences may reflect immaturity of N-demethylase activity or diversion of the liberated formaldehyde into biosynthetic rather than oxidative pathways.

Age Factors↗
PubMed1985

Characterization of HCO3-/CO2 pool sizes and kinetics in infants.

The first bicarbonate pool sizes and kinetic data necessary for the interpretation of substrate oxidation studies have been determined in six fed, nonacidotic infants, ages 2.5 to 5 months. Following an intravenous bolus of NaH13CO3 (50 mumol/kg), breath samples were collected over 240 min for the analysis of breath 13CO2. Each breath 13CO2 disappearance curve was fitted to a multicompartmental bicarbonate model previously derived in adults. The mean sizes of the three bicarbonate pools were: 7.4 +/- 0.8 mmol/kg (central pool), 15.1 +/- 4.8 mmol/kg (rapidly exchanging peripheral pool), and 8.8 +/- 3.5 mmol/kg (slowly exchanging peripheral pool). The mean percentage dose recovery was 57 +/- 10%. The pool sizes suggested that extensive metabolic exchange of carbon between HCO3- and organic metabolites occurred in the infant.

Bicarbonates↗
PubMed1984

Longitudinal changes in milk composition of mothers delivering preterm and term infants.

The concentrations of protein nitrogen (PN), non-protein nitrogen (NPN), energy, fat, sodium (Na), calcium (Ca), phosphorus (P), magnesium (Mg), and zinc (Zn) were determined in human milk from mothers giving birth to full-term (n = 13) and preterm infants (n = 8). Milk samples were collected under controlled conditions at two-week intervals for 12 weeks postpartum. Statistically significant differences in PN, Ca, and P concentrations were detected between the milk from mothers of preterm and term infants. The mean PN concentration in the preterm milk was statistically higher than that of term milk (198 vs. 164 mg N/dl), in contrast to the lower mean Ca (220 vs. 261 mg/l) and P (125 vs. 153 mg/l) concentrations detected in the preterm milk. No other differences in mean nutrient concentration were observed between the two groups. Concentrations of PN, NPN, Na, P, and Zn decreased over time. The concentration of Mg increased slightly. The content of fat, energy, and Ca did not change.

Adult↗
PubMed1984

Human milk intake and growth in exclusively breast-fed infants.

Milk intake and growth in 45 exclusively breast-fed infants were documented during the first 4 months of life. Energy and protein intakes were substantially less than current nutrient allowances. Energy intake declined significantly from 110 +/- 24 kcal/kg/day at 1 month to 71 +/- 17 kcal/kg/day at 4 months. Protein intake decreased from 1.6 +/- 0.3 gm/kg/day at 1 month to 0.9 +/- 0.2 gm/kg/day at 4 months. Infant growth progressed satisfactorily, compared with National Center for Health Statistics standards. A reevaluation of energy and protein intakes and allowances during infancy is merited.

Adolescent↗
PubMed1984

Studies of human milk relevant to milk banking.

Issues regarding the efficacy of feeding human milk to premature infants include the development of optimal protocols for collecting, storing, and processing human milk. Studies of the nutritional and immunologic composition of milk produced by women who delivered term or premature infants and who weaned their infants gradually from human milk have been studied to identify optimal donors. The effects of specific collection, storage, and processing conditions on the composition of mature human milk also have been evaluated. Collection, storage, and processing conditions have distinct effects on specific functional components. The caloric content of milk, the content of nutrients carried in the lipid portion of milk, and selected enzymatic activities depend on the completeness with which the breast is emptied. Storing milk in polyethylene, polypropylene, and pyrex containers influences key immunologic components in human milk as do storage temperatures. None of the nutrient compositions of milks studied matched current estimates of the nutritional needs of premature infants. Importantly, both the concentrations and the pattern of change in nutrient and immunologic contents are distinct in milks of women delivering infants at term or prematurely. Further changes are seen during the process of gradual weaning.

Female↗
PubMed1984

Effect of maternal diet and body composition on lactational performance.

Milk production, dietary intake, and body composition of 45 lactating women were monitored for 4 months postpartum to examine the interrelationships of these maternal variables. A 3-day dietary record, 24-h test-weighing for determination of milk production, 24-h milk collection, anthropometric measurements, and water displacement for estimation of body fat were performed monthly. The overall mean (SD) energy intake was 2186 (463) kcal/day. Milk production (g/day) averaged 751 (130), 725 (131), 723 (114), and 740 (128) during the 4 sequential months. Weight postpartum was 64.6 (9.1) kg and was 59.3 (10.5) kg at 4 months. Body fat determined by water displacement averaged 28 (7)% at 1 month and 26 (8)% at 4 months. Estimations of body fat from skinfold thickness ranged from 28 (5)% postpartum to 27 (5)% at 4 months. Energy balance calculations based on the energy available from the diet plus the energy derived from tissue mobilization, minus the caloric equivalent of the milk, indicated sufficient energy available for maintenance and activity needs. Thus, it appears that successful lactation is compatible with gradual weight reduction and attainable with energy intakes less than current recommendations.

Adolescent↗
PubMed1984

Calorimetric validation of the doubly-labelled water method for determination of energy expenditure in man.

The turnover rates of water and carbon dioxide have been estimated at frequent intervals after a single dose of 2H2 18O had been given to an adult monitored continuously in a whole body calorimeter for 5 d. The integrated CO2 production rate for 5 d, estimated from the differential rates of 2H and 18O excretion in urine, was within 2 per cent of the actual CO2 output, based on an improved method of calculation. Changes occurred in the abundance of 2H and 18O in response to activity, so that the timing of samples was important. It was found better to compute the production rate of CO2 from multiple samples rather than from measurements at only two points of time. The proportion of total water lost by evaporation proved to be less than previously assumed. Direct validation of the technique requires calorimetric studies of 2 to 3 weeks duration, in either animals or human subjects. The potential value of this method for measurement of energy expenditure in man is such that exacting tests of its accuracy and precision are needed before it is adopted for general use in metabolic and epidemiological studies.

Adult↗
PubMed1983

Carbohydrate malabsorption in infants with diarrhea studied with the breath hydrogen test.

Fermentation of malabsorbed carbohydrate (CHO) reaching the colon was studied by measuring peak breath hydrogen (H2) production between feedings in 28 H2-producing hospitalized infants with diarrhea. Patients who required fewer than six days of hospitalization had lower breath H2 values when tested soon after admission than those who required longer stays. Patients hospitalized for more than five days had lower H2 amounts at discharge than on admission. Peak breath H2 values decreased when glucose was substituted for glucose polymers in formulas, or when the formula was fed by continuous drip via a nasogastric tube instead of by orally administered bolus. Glucose-positive and acidic stools were encountered occasionally and were associated with decreased H2 levels. The responses of H2 levels, stool pH, and glucose excretion after changes in patient management or intestinal metabolism of CHO reflect alterations in the balance between proximal intestinal absorption and distal colonic fermentation. Malabsorbed CHO that reaches a competent colon is utilized via microbial conversion, as indicated by high H2 levels, in the absence of glucose-positive and acidic stools. The presence of glucose in the feces or acidic stools indicates an inability of the colon to completely metabolize and absorb CHO or its products of fermentation.

Breath Tests↗
PubMed1983

Utilization of dietary cereal by young infants.

The direct demonstration of cereal utilization by 16 healthy 1-month-old infants was achieved by tracing the appearance in breath CO2 of carbon derived from the fed cereal. These oxidation rates were compared with rates obtained from the feeding of glucose and glucose polymers. Fermentation of unabsorbed carbohydrate by the colonic flora was assessed by measurement of breath H2. Stools from four infants were analyzed for the quantity of carbon that originated from the cereal. Oxidation rates were not significantly different (mean = 31.2% of the dose fed). Mean peak hydrogen production was 39.8, 29.1, and 18.6 ppm for cereal, glucose polymers, and glucose, respectively. Cereal carbon was detected in the stools of two infants (3.7% and 13.1% of the ingested load). We conclude that young infants can utilize cereal, although absorption is not always complete. Hydrogen production increases with carbohydrate complexity; participation of colonic bacterial fermentation increases the net absorption of cereal.

Breath Tests↗