Energy and macronutrient intake regulation: independent or interrelated mechanisms?
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Animals↗
Biomedical subjects
G H Anderson
Publications and source records attributed to G H Anderson.
Soft drinks with aspartame: effect on subjective hunger, food selection, and food intake of young adult males.
Ingestion of aspartame-sweetened beverages has been reported to increase subjective measures of appetite. This study examined the effects of familiar carbonated soft drinks sweetened with aspartame on subjective hunger, energy intake and macronutrient selection at a lunch-time meal. Subjects were 20 normal weight young adult males, classified as either restrained or nonrestrained eaters. Four treatments of carbonated beverages included 280 ml of mineral water, one can of a soft drink (280 ml) consumed in either 2 or 10 minutes, or two cans of a soft drink (560 ml) consumed in 10 minutes, administered at 11:00 a.m. Subjective hunger and food appeal were measured from 9:30 a.m. to 12:30 p.m., and food intake data were obtained from a buffet lunch given at 12:00 noon. There were no treatment effects on energy intake, macronutrient selection or food choice at the lunch-time meal, or food appeal, though restrained eaters consumed more than nonrestrained eaters in all four treatment conditions. Consumption of two soft drinks (560 ml, 320 mg aspartame) significantly reduced subjective hunger from 11:05 a.m. to 11:30 a.m. compared to one soft drink (280 ml, 160 mg aspartame) or 280 ml of mineral water. Thus ingestion of soft drinks containing aspartame did not increase short-term subjective hunger or food intake.
Adult↗
Nutritional assessment of continuous ambulatory peritoneal dialysis patients: an international study.
We examined the nutritional status of 224 patients from six centers in Europe and North America to assess the incidence of protein-energy malnutrition. A "subjective nutritional assessment" was made, using 21 variables derived from history and clinical examination, or anthropometry and biochemistry. Eighteen patients (8%) were severely malnourished, 73 (32.6%) were mildly to moderately malnourished, and 133 (59.4%) did not show evidence for malnutrition. There was a higher incidence of mild to moderate malnutrition in diabetics than in nondiabetics. A statistical analysis identified 12 variables, seven objective and five subjective, that correlated with subjective nutritional assessment. Actual intercenter differences for the incidence of malnutrition were related to patient age, nutritional status at the commencement of continuous ambulatory peritoneal dialysis (CAPD), the length of time on CAPD, and residual renal function. Variables that were most frequently correlated with subjective nutritional assessment and with one another included plasma albumin, mid-arm muscle circumference (MAMC), weight loss, and the clinical judgement of muscle wasting and loss of subcutaneous fat. Loss of residual renal function correlated with muscle wasting and months on CAPD. Our data identified differences between the two sexes. In women there was a trend for more anorexia, greater weight loss from muscle wasting, and a larger decrease in albumin, whereas in men there was a more gradual decrease in nutritional status. Loss of residual renal function contributed to anorexia and symptoms of severe malnutrition.
Adolescent↗
Atrial natriuretic hormone. Predictive of the hypokalemic response to thiazide therapy in essential hypertension.
Thiazide diuretics cause hypokalemia in some, but not all patients. Adding a second diuretic with a different mechanism of action greatly increases the chance of inducing hypokalemia. Suggestive causative factors include hyperaldosteronism, acid-base status, and the degree of natriuresis. Atrial natriuretic hormone (ANH), a circulating peptide secreted primarily by the heart in response to changes in intravascular volume, induces a natriuresis by a mechanism distinct from the thiazides. It was previously shown that furosemide and thiazide diuretics can increase plasma ANH levels in some patients, but reduce ANH levels in others. This phenomenon was investigated in 26 patients with uncomplicated essential hypertension to observe the relationships between ANH and changes in serum potassium (K+) in response to chronic hydrochlorothiazide therapy (HCTZ, 50 mg/day for 1 month). Regression analysis demonstrated significant correlations between K+ level after HCTZ and initial ANH (r = 0.68, P less than .001), change in K+ level and initial ANH (r = 0.40, P less than .05), K+ level after HCTZ and change in ANH (r = -0.64, P less than .001), and change in K+ levels and change in ANH levels (r = -0.38, P less than .05). By multivariate analysis, initial ANH level, but not the plasma aldosterone level, was significantly (P less than .05) related to the change in K+ after HCTZ. These results suggest that initial plasma ANH levels are a marker predictive for diuretic-induced hypokalemia.
Adult↗
Facts and myths about sugar.
There is now considerable evidence that the concern about sugar consumption as reflected by the media in the 1970s was misplaced. Knowledge of sugar consumption has led to the conclusion that current consumption levels are consistent with the achievement of healthful diets. The myths surrounding sugar and health, including the myth that sugar causes hyperactivity, are slow to disappear. Because these myths are misleading and harmful, nutrition educators need to continue to place sugar in the diet in perspective.
Adolescent↗
A quality-control program for colposcopic practice.
Quality control is accepted as an integral part of the cytology laboratory's activities. However, provision of similar safeguards for colposcopic practice in assessing patients with abnormal cervical cytology has been an elusive problem. This report describes the quality-control program for colposcopy that is used province-wide in British Columbia for 21 hospital-based clinics staffed by 35 colposcopists. Copies of the results of all colposcopic examinations performed are sent to the Central Cytology Laboratory where the program is coordinated and the data are collated, analyzed, and evaluated. These data are used to set standards against which each colposcopist's performance and activity can be measured. One of the quality-control indicators used is a comparison between the colposcopic impression of the lesion and the corresponding direct biopsy diagnosis. Correlation within one histologic degree occurred in 86% of patients examined; this information was used to set a performance standard of 80% as the quality-control index for this particular indicator. Three colposcopists had scores below this standard. Comparisons were also made between presenting cytology, directed biopsy results, initial colposcopic impression, and final colposcopic evaluation (the clinical working diagnosis). The other major aspect of the quality-control program consists of an analysis of all cases of diagnosed invasive cervical cancer in the province in a given year to determine whether any colposcopically related errors occurred in the investigation and management of these cases. This system helps to identify individuals who may benefit from additional training.
Biopsy↗
Acute pulmonary oedema after tourniquet release.
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Acute Disease↗
Effect of age on response of secondary hypertension to specific treatment.
There is substantial evidence to show that correction of the causes of secondary forms of hypertension usually but certainly not always restores blood pressure to normal. We have analyzed the effect of age on the response of the blood pressure to the removal of the cause of hypertension in groups of patients with primary aldosteronism, renovascular hypertension, Cushing's syndrome and hypothyroid hypertension. In the patients studied, surgical or medical elimination of the mechanism responsible for the hypertension when the patients were below the age of 40 reduced diastolic blood pressure 1 to 2 years later to below 90 mm Hg in 24 of 25 patients. In the patients who were treated when they were over 40 years of age, blood pressure remained above 90 mm Hg after corrective treatment in 23 of 61 individuals (38%). In the 4 groups studied there was a significant correlation between age and post-treatment systolic and/or diastolic blood pressure. The findings indicate the importance of correcting secondary hypertension at an early age.
Adult↗
Effect of posture on plasma atrial natriuretic hormone and renal function during salt loading in patients with and without postural (idiopathic) edema.
The effect of posture on plasma atrial natriuretic hormone (ANH) and renal function was studied in subjects with idiopathic edema. Sixty-five subjects with edema but with no clinical evidence for cardiac, renal, or pulmonary diseases were studied after they had been off all medication for 1 week or more. They had nothing by mouth after midnight and were admitted to the Clinical Research Center at 0800 h. They voided, were weighed, and had their blood pressure and pulse measured in the recumbent and upright positions. A needle was inserted, and subjects were recumbent for 0.5 h, after which blood was drawn for measurement of plasma ANH, serum sodium, potassium, and (in 35 subjects) creatinine. They were then given 150 mL 0.14% sodium chloride solution to drink every 0.5 h for the next 6 h. Urine was collected every 0.5 h for measurement of sodium, potassium, and creatinine. After 4 h of recumbency repeat blood samples were drawn, subjects ambulated for 2 h, after which final repeat blood samples were drawn. Subjects were considered to have postural edema if their upright urinary sodium/previous 2-h urinary sodium was less than 33%, and to have a normal response if it was 33% or more. The clinical characteristics of the 34 patients with postural edema and 31 patients with a normal response were similar. Plasma ANH levels (initial, after oral saline, and after standing) were similar in the two groups, and there was no relationship between changes in ANH and urinary sodium with standing. In conclusion, under conditions of mild oral sodium chloride loading, changes in plasma ANH do not cause the abnormal sodium retention found in patients with postural edema.
Adult↗
Aspartame: effects on learning, behavior, and mood.
The effect of aspartame on the learning, behavior, and mood of children was evaluated in two experiments. After an overnight fast and a standard breakfast, 20 healthy 9- to 10-year-old children were given the treatments in a double-blind crossover design at 10:30 AM. Lunch was served at 12:00 noon. In experiment 1, the treatment consisted of an ice slurry of strawberry Kool-Aid containing 1.75 g/kg of carbohydrate (polycose) plus either aspartame (34 mg/kg) or the equivalent sweetness as sodium cyclamate and amino acids as alanine. In experiment 2, the treatment consisted of a drink of cold unsweetened strawberry Kool-Aid, containing either 1.75 g/kg of sucrose or 9.7 mg/kg of aspartame. Measures of associative learning, arithmetic calculation, activity level, social interaction, and mood were unaffected by treatment in experiment 1. In experiment 2, the only significant treatment effect was that on the frequency of minor and gross motor behaviors, which were less frequent after the consumption of sucrose than after aspartame. Thus, the effect of aspartame on the short-term behavior of healthy 9- to 10-year-old children appears to be related to its absence of metabolic consequences rather than to its amino acid composition and putative neurochemical impact.
Affect↗
Six-month overnight intraperitoneal amino-acid infusion in continuous ambulatory peritoneal dialysis (CAPD) patients--no effect on nutritional status.
The long-term effect of an AA solution based on Travasol, a solution for total parenteral nutrition, given intraperitoneally over a 6-month period was studied in 5 patients 22 to 75 years old, having been on continuous ambulatory peritoneal dialysis (CAPD) for 3 to 57 months. A low oral protein intake (less than 0.8 g/kg bw/day) and/or a low serum albumin (less than 35 g/L) were used as inclusion criteria. Two liters of 1% AA solution were infused overnight, while a glucose Dianeal was used for the other exchanges. During the study, BUN increased from 22.04 mM/L to 28.06 mM/L the first month and remained at these levels, indicating the increased protein intake. However, average oral total energy and protein intake, body weight (bw), serum creatinine, cholesterol, triglycerides, total proteins, albumin, transferrin, skinfold thickness, total body potassium, and plasma AA levels remained basically unchanged. The average total body nitrogen decreased from 1.746 to 1.554 Kg, but this decrease did not reach statistical significance (p greater than 0.05). We conclude that intraperitoneal overnight administration of 2 L of 1% AA based on Travasol over 6 months did not improve the nutritional status of CAPD patients. This ineffectiveness might be due to the AA composition of the solution, the timing of administration, or to a low caloric intake and/or that our patients were not severely malnourished.
Amino Acids↗
Enalaprilat-enhanced renography in a rat model of renovascular hypertension.
The effect of rapid converting enzyme inhibition (CEI) with intravenous enalaprilat on technetium-99m-(99mTc) diethylenetriaminepentaacetic acid (DTPA) and 99mTc-dimercaptosuccinic acid (DMSA) renograms was evaluated in rats with two-kidney, one-clip renovascular hypertension. Rapid sequential DTPA renograms, performed immediately before and five minutes after enalaprilat injection (30 micrograms/kg), demonstrated a selective decrease in clipped kidney DTPA plasma clearance following CEI and no significant effect on unclipped kidney function. Pre- and post-CEI data were obtained with a single injection of DMSA by administering enalaprilat five minutes after the radiopharmaceutical. Enalaprilat slowed the rate of DMSA accumulation in clipped relative to unclipped kidneys, and reduced the clipped/unclipped kidney ratio of absolute DMSA uptake at 10 and 30 min. DTPA and DMSA were equally effective in demonstrating the CEI effect. Enalaprilat was also compared with captopril (3 mg/kg, intraperitoneally), using sequential DTPA renograms. Clipped kidney DTPA plasma clearance was reduced to an identical degree (40%) by both converting enzyme inhibitors. Clinical renographic protocols can probably be devised to take advantage of the rapid, reliable CEI of enalaprilat, thereby shortening total procedure time.
Animals↗
Primary hyperepinephrinemia in patients without pheochromocytoma.
Clinical features of epinephrine release led to the finding of spontaneously elevated plasma epinephrine concentrations in five patients, in four of whom plasma norepinephrine concentrations were normal. Adrenal medullary hyperplasia was suspected in one patient, whose first cousin had multiple endocrine neoplasia type IIa, and in two others, all of whom have experienced relief from symptoms during propranolol or atenolol administration. The other two patients had unilateral adrenal cysts, with negative metaiodobenzylguanidine scans and no histological evidence of pheochromocytoma, but complete relief of symptoms by excision of the cysts. In one patient, Cushing's syndrome and associated hypertension, diabetes, and ischemic finger-tip ulceration all disappeared after surgery. It is concluded that spontaneous hyperepinephrinemic manifestations can be received by beta-blockers or, when an adrenal mass is present, by unilateral adrenalectomy even when the metalodobenzylguanidine test result is negative.
Adrenal Gland Diseases↗
Aspartame: effect on lunch-time food intake, appetite and hedonic response in children.
Two experiments were conducted, each with 20 healthy 9-10-year-old children. After an overnight fast, subjects were given a standardized breakfast at 0830 hrs, the treatments at 1030 hrs, and a lunch containing an excess of foods at 1200 hrs. Visual analog scales of hunger, fullness, and desire to eat were administered 5 min before and 20 and 85 min after treatment. Lunch-time food intake was measured. In experiment 1, either aspartame (34 mg/kg), or the equivalent sweetness of sodium cyclamate, was given in an ice slurry (300 ml) of unsweetened strawberry Kool-Aid with carbohydrate (1.75 g/kg polycose). In experiment 2, drinks (300 ml) contained either sucrose (1.75 g/kg) or aspartame (9.7 mg/kg). In both experiments, significant meal- and time-dependent effects were observed for subjective feelings of hunger, fullness and desire to eat. Treatments, however, did not affect either subjective feelings of appetite or lunch-time food intake. Thus, aspartame consumed without or with carbohydrate, did not affect either hunger or food intake of children when compared with the sweeteners sodium cyclamate and sucrose, respectively.
Appetite↗
Menstrual cycle effects on the metabolism of tryptophan loads.
The metabolism of tryptophan (Trp) was examined during the follicular and luteal phases of the human menstrual cycle. Eight healthy women were administered capsulated Trp (3 g) or placebo (3 g lactose) during two follicular and two luteal phases of their menstrual cycles. Trp loading resulted in increased plasma concentrations of Trp and kynurenine, in an increase in the ratio of Trp to neutral amino acids in plasma, and in an increase in urinary excretion of Trp and kynurenine at both phases of the menstrual cycle. However at 3 h after Trp ingestion, plasma kynurenine levels in the luteal phase (23.6 +/- 3.1 mumol/L) were 40% higher than in the follicular phase (16.7 +/- 1.1 mumol/L) (p less than 0.05). Urinary kynurenine excretion in the luteal phase (81.6 +/- 14.4 mumol/24 h) was 28% greater than in the follicular phase (63.9 +/- 13.0 mumol/24 h) (p less than 0.05). The results indicate that the catabolism of Trp via the kynurenine pathway is affected by the phase of the human menstrual cycle.
Adult↗
Route of delivery of phenylalanine influences its effect on short-term food intake in adult male rats.
The effect of phenylalanine (Phe) on plasma and brain Phe and tyrosine (Tyr) levels and on short-term food intake in male rats was measured after intragastric (i.g.), subcutaneous (s.c.) and intraperitoneal (i.p.) administration. Compared to equimolar alanine (Ala), which served as the control, Phe significantly suppressed feeding at a dose of 90 mg/kg body wt when given i.p., but doses up to 720 mg/kg body wt had no effect when given i.g. or s.c. The high doses of Phe given by the i.g. or s.c. route resulted in higher levels of Phe in both plasma and brain than those following i.p. injection (90 mg/kg body wt). Furthermore, brain Tyr levels after i.g. Phe (720 mg/kg body wt) were equal to or higher than after i.p. Phe (90 mg/kg body wt). We conclude that the route of administration is an important variable influencing the effects of Phe on feeding behavior, and that these effects are not readily explained by plasma or brain Phe and Tyr concentrations.
Alanine↗
Low glycemic index foods and reduced glucose, amino acid, and endocrine responses in cirrhosis.
Carbohydrate intolerance is common in patients with cirrhosis. The aim of the present study was to determine whether the beneficial metabolic effects of low glycemic index diets observed in noncirrhotic diabetics also occurred in patients with cirrhosis. Therefore, for one day, five patients with cirrhosis were fed diets in which low glycemic index foods were substituted, replacing those which produced higher blood glucose rises. Reduction in the estimated glycemic impact of the diet by approximately 30% reduced the mean incremental blood glucose level over the day by 40 +/- 5% (p less than 0.001). Measurement at breakfast of amino acid, insulin, and gastric inhibitory polypeptide profiles confirmed a reduction of similar magnitude. No change was seen in pancreatic glucagon, whereas enteroglucagon levels tended to be higher. In view of these findings and the possible long-term benefits of chronic reduction of hyperinsulinism and alteration in amino acid metabolism, this approach to dietary management of cirrhosis warrants further consideration.
Aged↗
Cervical intraepithelial neoplasia in female prisoners in British Columbia.
The annual incidence rates of cervical intraepithelial neoplasia (CIN), grades I to III, from 1975 to 1983 among 2440 prisoners in British Columbia for whom a history of screening by means of the Papanicolaou test was available were two to three times higher than the expected rates in the general female population of British Columbia. The rates among the prisoners from 1970 to 1984, although small, increased with a trend similar to that in the general population. Despite increases in the general population we conclude that prisoners are still at high risk for CIN.
Adult↗