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Biomedical subjects

J C Peters

Publications and source records attributed to J C Peters.

At least 55 records · Page 3Linked to original sources

Assessment of the nutritional effects of olestra, a nonabsorbed fat replacement: summary.

Olestra is a zero-calorie fat replacement intended to replace 100% of the fat used in the preparation of savory snacks. Olestra can affect the absorption of other dietary components, especially highly lipophilic ones, when ingested at the same time. The potential effects of olestra on the absorption of essential fat-soluble and water-soluble dietary components have been investigated in pigs and in humans. In these studies, subjects were fed daily amounts of olestra up to 10 times the estimated mean intake from savory snacks and the olestra was eaten each day of the studies. In real life, snacks are eaten on average five times in a 14-d period. Olestra did not affect the availability of water-soluble micronutrients or the absorption and utilization of macronutrients. Olestra reduced the absorption of fat-soluble vitamins A, D, E and K; however, the effects can be offset by adding specified amounts of the vitamins to olestra foods. Olestra also reduced the absorption of carotenoids; analysis of dietary patterns showed that in real life the reduction will likely be <10%. Any effect on vitamin A stores caused by a reduction in carotenoid uptake is offset by the addition of vitamin A to olestra foods. Because of the olestra-to-nutrient ratios fed and the nutritional requirements of the test subjects, the effects of olestra on nutritional status of subgroups of the population are unlikely to be different than those measured in the studies. An analysis of lipophilicity showed that olestra is unlikely to significantly affect the uptake of potentially beneficial phytochemicals from fruits and vegetables. Some people eating large amounts of olestra snacks may experience common GI symptoms such as stomach discomfort or changes in stool consistency, similar to symptoms accompanying other dietary changes. These symptoms present no health risks.

Animals↗

Assessment of accuracy and applicability of a portable electronic diary card spirometer for asthma treatment.

A pocked-sized turbine flowmeter and spirometer device, integrated with an electronic diary card (EDC-spirometer, Micro Medical, U.K.), was tested with a mechanical calibrator, in an outpatient clinic and in the home situation. A screen pneumotachometer was used as flow and volume reference. Ten devices were tested; interdevice variability was small with a mean variation coefficient of 1.1% for both forced expiratory volume in 1 s (FEV1) and peak expiratory flow (PEF) (SD 0.5 and 0.4, respectively) for eight settings of the calibrator. Mean difference from reference was -0.13 l (SD 0.04) for FEV1 (range 0.38-3.16) and 0.09 l s-1 (SD 0.09) for PEF (range 4.2-11.7). No significant deviation from linearity was present. Results obtained in the outpatient clinic confirmed the accuracy of FEV1 and PEF data obtained with the calibrator. However, linear regression analysis showed a mean underestimation of 0.45 l (SD of estimate 0.29) for forced vital capacity over the whole measurement range, probably due to a restricted integration time. In 10 optimally-treated chronic obstructive pulmonary disease patients in a family practice, PEF measurements were done in the home situation, both with the EDC spirometer and a mini-Wright peak flow meter. No significant differences in the diurnal variation of PEF were found. The PEF data from the mini-Wright meter were corrected for earlier reported flow-dependent systematic deviations. In the home situation, patients preferred the EDC spirometer. It is concluded that this device is applicable in the follow-up and treatment of asthma at home.

Adolescent↗

Value of selective second-look sonography by radiologists.

PURPOSE: To assess the usefulness of sonography performed by radiologists after a review of the sonographer's findings. MATERIALS AND METHODS: A total of 398 sonograms were obtained in 392 patients. Sonographers presented preliminary images and impressions to radiologists, who performed additional imaging and recorded their conclusions. Radiologists also attempted to predict in which cases their scan was likely to show new findings or to refute the sonographer's findings. Follow-up data were obtained whenever the sonographer's and the radiologist's findings disagreed. RESULTS: In 28 cases, the radiologist made important new findings. Positive initial findings were refuted in 24 cases. Discrepant findings were seen in 22% of cases in which additional scanning was predicted to be beneficial, compared with only 6% of cases in which second-look sonography was predicted not to be of value. This difference was statistically significant (P<.0001). CONCLUSION: Second-look sonography by radiologists provides a valuable check of the sonographer's findings.

Diagnostic Errors↗

Fuzzy cluster analysis of positive stress tests, a new method of combining exercise test variables to predict extent of coronary artery disease.

Fuzzy set theory is useful in the analysis of data having a graded degree of abnormality. Previous studies using sharp cutoff points between normality and abnormality have resulted in general guidelines for the interpretation of positive stress tests, but do not enable the clinician to simultaneously combine several stress test variables, each having a range of abnormality. In this study, positive stress test results from 109 patients were reviewed. An angiogram recorded within 1 month of the stress tests showed that 100 patients had coronary artery disease (CAD) (15 had left main CAD, and 27 had 3-vessel, 30 had 2-vessel, and 28 had 1-vessel disease) and 9 were normal. Six variables were selected for fuzzy cluster analysis: ST-segment change, difference between resting systolic and peak exercise systolic blood pressure, total treadmill time, peak exercise heart rate as a percentage of 100% predicted maximum for age, time to onset of angina, and duration of repolarization abnormalities. The analysis used a similarity measure to compute how closely each stress test resembled a prototypical mildly, moderately, or severely abnormal stress test. Stress tests classified by this method showed better correlation with the extent of CAD than the degree of ST-segment depression alone. Unlike tests with mild degrees of ST depression (0.5 to 1.5 mm), tests classified as mild by the method virtually excluded high-grade CAD.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Fat and carbohydrate overfeeding in humans: different effects on energy storage.

Both the amount and composition of food eaten influence body-weight regulation. The purpose of this study was to determine whether and by what mechanism excess dietary fat leads to greater fat accumulation than does excess dietary carbohydrate. We overfed isoenergetic amounts (50% above energy requirements) of fat and carbohydrate (for 14 d each) to nine lean and seven obese men. A whole-room calorimeter was used to measure energy expenditure and nutrient oxidation on days 0, 1, 7, and 14 of each overfeeding period. From energy and nutrient balances (intake-expenditure) we estimated the amount and composition of energy stored. Carbohydrate overfeeding produced progressive increases in carbohydrate oxidation and total energy expenditure resulting in 75-85% of excess energy being stored. Alternatively, fat overfeeding had minimal effects on fat oxidation and total energy expenditure, leading to storage of 90-95% of excess energy. Excess dietary fat leads to greater fat accumulation than does excess dietary carbohydrate, and the difference was greatest early in the overfeeding period.

Adolescent↗

Physical activity and energy requirements.

Differences in physical activity represent the largest source of variability in energy requirements, both within and between individuals. Chronic changes in physical activity can produce chronic changes in energy requirements that, if not compensated for, can lead to changes in the level at which body weight and body composition are maintained over time. We present a model that can serve as a framework for understanding how energy and macronutrient balance are maintained in steady state conditions, and for illustrating the potential effect of a change in physical activity on these steady state conditions and on energy requirements. According to the model, a chronic change in physical activity forces changes in other aspects of energy and substrate utilization so that a steady state condition can be reestablished. The net effects of the change in physical activity on energy requirements will depend on how and over what period of time these new steady states are reached. Although we cannot at present predict, for any individual, the precise effect of changes in physical activity on energy requirements and on body weight and composition, our model provides a framework for further study of the factors that can influence energy requirements.

Body Weight↗

Obesity treatment: can diet composition play a role?

Diet composition can play a role in obesity treatment because it can influence energy intake and nutrient balance. The greatest potential effect of diet composition occurs not during weight reduction but during maintenance of a reduced body weight. During weight reduction, the extent of negative energy balance is the greatest determinant of the amount and rate of weight loss, and any effects of diet composition are likely to be very small. Conversely, during the maintenance period after weight reduction, maintenance energy requirements are reduced and the rate of fat oxidation may be low. Prevention of fat storage and regain of body weight can be achieved either by increasing fat oxidation (for example, by increasing exercise) or by reducing the fat content of the habitual diet. The treatment with the greatest chance for success combines a reduced-fat diet with aerobic exercise.

Diet, Reducing↗

Insulin action in rats is influenced by amount and composition of dietary fat.

The chronic influence of dietary fat composition on obesity and insulin action is not well understood. We examined the effect of amount (20% vs 60% of total calories) and type (saturated vs polyunsaturated) of fat on insulin action and body composition in mature male rats. Six months of feeding a high fat (HF) diet led to obesity and impaired insulin action (determined by a euglycemic-hyperinsulinemic clamp), neither of which were reversed by a subsequent 6 months of feeding a low fat (LF) diet. Within HF fed rats, type of fat did not affect body composition or insulin action. Six months of feeding a low fat diet led to only a slight decline in insulin action, with no difference due to type of dietary fat. From 6-9 months, insulin action became more impaired in LF rats fed the saturated diet than in LF rats fed the polyunsaturated diet. By 12 months, all groups were obese and had a similar impairment in insulin action. The amount and type of fat in the diet did not influence the overall degree of impairment in insulin action but did affect the time course. Both feeding a high fat diet and feeding a low fat saturated diet accelerated the impairment in insulin action relative to rats fed a low fat polyunsaturated fat diet.

Adipose Tissue↗

Effects of a nonenergy fat substitute on children's energy and macronutrient intake.

To determine whether children adjusted their energy intake in response to covert manipulations in the proportion of energy from dietary fat, 24-h food intake of 29 2- to 5-y-old children was measured over four 2-d blocks. In this within-subject crossover design, in the first three meals of the first day of each block, children consumed foods containing dietary fat or a nonenergy fat substitute, which provided 10% of total daily energy intake. Children compensated for the missing energy; cumulative energy intake differed by only 100 kJ over 2 d. Substitution for dietary fat reduced the percent of energy from fat from 38.7% to 36.4%. Children's intake at individual meals was highly variable (mean CV 24.7%) relative to the variability of total daily energy intake (CV = 8.6%). To produce this pattern, children adjusted energy intake across successive meals. Use of a fat substitute at 10% of energy from dietary fat did not significantly reduce 24-h energy intake.

Analysis of Variance↗

Lipid accumulation and body fat distribution is influenced by type of dietary fat fed to rats.

The amount of fat in the diet is known to influence body weight and body composition, but it is not clear whether dietary fat composition can affect body composition independently. We studied the effects of six months of feeding diets containing lard (L), corn oil (CO), fish oil (FO) or medium chain triglycerides (MCT) on body weight and body composition in adult male Wistar rats. Although FO fats ate slightly less total energy than the other groups, there were no differences among groups in body weight at any time during the study. However, body composition, the composition of depot triglyceride, body fat distribution and insulin resistance were all influenced by the type of fat in the diet. FO rats had less total body fat, less intra-abdominal fat, and less insulin resistance than all other groups. Although some of these metabolic effects may have been secondary to a slightly lower energy intake, we believe these data demonstrate the potential impact which dietary fat composition can have on metabolism and body weight regulation.

Adipose Tissue↗

Nutrient balance and energy expenditure during ad libitum feeding of high-fat and high-carbohydrate diets in humans.

To study the influence of diet composition on regulation of body weight, we fed 21 weight-stable subjects (11 lean, 10 obese) high-carbohydrate (HC) and high-fat (HF) diets for 1 wk each. Although diet composition was fixed, total energy intake was unrestricted. Subjects had a higher energy intake on the HF (11,039 +/- 2700 kJ/d) than on the HC (10,672 +/- 2617 kJ/d) diet (P less than 0.05), but energy expenditure was not different between diets. On day 7 of the HC diet, carbohydrate (CHO) oxidation was significantly related to CHO intake with the slope of the regression line 0.99, suggesting that overall CHO balance was near zero. However, the slope of the regression line was greater for obese than for lean subjects. On day 7 of the HF diet, fat oxidation was significantly related to fat intake but the slope of the line was 0.50, suggesting that overall fat balance was positive. However, this relationship was due entirely to lean subjects, with obese subjects showing no relationship between fat intake and oxidation.

Adult↗

Short-term effects of dietary-fat ingestion on energy expenditure and nutrient balance.

Joule for joule, dietary fat may promote obesity more than protein or carbohydrate. In this study we determined whether the addition of 50 g dietary fat to a standard breakfast would increase energy expenditure or fat oxidation during the immediate 6-h postprandial period or over the ensuing 18 h. We also determined whether subjects with a high level of aerobic physical fitness would show a greater increase in fat oxidation after the ingestion of the extra fat than would less fit subjects. Adding fat did not increase fat oxidation or energy expenditure either during the immediate 6-h postprandial period or over the following 18 h. This was true regardless of the subject's fitness level. Acutely, dietary fat ingested in excess of its usual rate of oxidation appears to be stored in the body. Being physically fit does not appear to provide an advantage in avoiding short-term storage of excess dietary fat.

Adult↗

Effects of olestra, a noncaloric fat substitute, on daily energy and fat intakes in lean men.

Nutrient and energy intakes, hunger, and fullness were examined after the replacement of 36, 20, or 0 g fat in breakfast with olestra, a noncaloric fat substitute. Twenty-four lean, nondieting men (aged 21-30 y) participated in a placebo-controlled, three-condition crossover design. Self-selected, ad libitum intakes at lunch and dinner were monitored in the laboratory. Evening snacks and breakfast the next day were assessed through food diaries. Visual-analog-scale ratings including hunger and fullness were collected throughout the test days. Single-meal olestra substitution produced a significant dose-related reduction in the amount and percentage of energy from fat consumed daily with a reciprocal increase in carbohydrate intake. Daily energy intakes were not significantly different nor did ratings of hunger and fullness vary systematically between conditions. Consumption of olestra can reduce fat intake and increase carbohydrate intake without affecting total daily energy intake or usual patterns of hunger and fullness.

Adult↗

Plasma lipids and lipoproteins during 6 d of maintenance feeding with long-chain, medium-chain, and mixed-chain triglycerides.

This study assessed fasting plasma lipids and lipoproteins and postprandial plasma lipids in healthy male subjects fed liquid-formula diets containing 40% of total energy as long-chain (LCT, primarily C18:1 and C18:2), medium-chain (MCT, C8:0-C10:0), or mixed-chain (structured lipid, STL, mostly C8:0, C10:0, and C22:0) triglycerides for 6 d. None of the diets altered plasma cholesterol concentrations. HDL cholesterol was decreased 14% by the STL diet (P < 0.044) and 15% by the MCT diet (P < 0.004) but was unchanged by the LCT diet. Plasma triglycerides were elevated 42% by the MCT diet (P < 0.006), but were unaltered by either the STL or LCT diets. Neither the STL nor the MCT diets produced changes in fasting lipoprotein lipid composition; however, during the LCT diet, VLDLs became enriched in triglyceride and LDLs became enriched in cholesterol. Postprandial triglyceridemia was significantly greater after subjects consumed the LCT diet than it was after they consumed either the STL or MCT diets, which were similar. Short-term feeding of MCT and STL diets produces significant changes in lipid metabolism. An understanding of the long-term effects of these diets awaits further study.

Adult↗

Skeletal muscle composition in dietary obesity-susceptible and dietary obesity-resistant rats.

The intent of this study was to determine whether a relationship exists between susceptibility to high-fat diet (HFD)-induced obesity and skeletal muscle fiber type. Forty-four adult male Wistar rats were given ad libitum access to a HFD (60% of calories from fat) for 4 wk. Rats were then grouped into quartiles for total weight gain, and the top-quartile [obesity prone (OP)] rats were compared with the bottom-quartile [obesity resistant (OR)] rats. OP rats gained 1.5 times as much weight as OR rats. OR rats had a significantly higher proportion of type I muscle fibers in the medial head of the gastrocnemius muscle than OP rats both before (determined from a muscle biopsy) and after the HFD feeding period. A greater proportion of type I fibers may be associated with a greater capacity for fat oxidation, which would favor resistance to body fat accumulation. Preexisting differences in muscle fiber composition may play a role in determining susceptibility to dietary obesity.

Animals↗

Development of dietary obesity in rats: influence of amount and composition of dietary fat.

This study was conducted to examine long-term effects of amount and type of dietary fat on body weight and body composition. Adult male Wistar rats were fed high fat (HF; 60% of calories) or low fat (LF; 20% of calories) diets for 28 weeks. Half of the rats in each condition received diets with saturated fat (lard) (S) and the remainder received diets with polyunsaturated fat (corn oil) (U). From 28-39 weeks, HF rats were switched to LF diets (fat type remained constant). From 40-50 weeks, previously HF fed rats were weight-matched to rats in the LF fed groups. HF rats became fatter than LF rats during weeks 1-28 and remained heavier and fatter from weeks 28-39. During weeks 1-28, type of dietary fat had no effect on total body fat in either HF or LF rats, but during period 2 (weeks 28-39), U rats were heavier and fatter than S rats. There was some indication that U diets were associated with greater accumulation of fat in subcutaneous adipose tissue depots than S diets. From 40-50 weeks, rats previously fed the HF diet required less food to maintain their body weight than did LF diet rats. In summary, these results suggest that although both amount and type of dietary fat can affect body weight and body composition, the effects of the type of fat are less than those of amount of dietary fat.

Adipose Tissue↗