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Biomedical subjects

R M Suskind

Publications and source records attributed to R M Suskind.

At least 37 records · Page 2Linked to original sources
PubMed1996

Feasibility of a clinic-based hypocaloric dietary intervention implemented in a school setting for obese children.

The objective of this study was to examine whether a protein-sparing modified fast diet and a hypocaloric balanced diet are effective in a clinic-based dietary intervention implemented in a school setting high-risk weight loss program for superobese (> or = 140% of their ideal body weight for height [IBW] children. A group of children from two suburban public schools in New Orleans, Louisiana were randomized to either dietary-intervention group and control group. Children were followed for 6 months. In the dietary-intervention-group, 12 of 44 superobese children [ages 8.8 to 13.4 years, weight 144% to 212% of IBW] volunteered to participate. In the control group, 7 of 19 superobese children [ages 9.4 to 12.9 years, weight 140% to 195% of IBW] volunteered to participate. During the first 9 weeks, 12 superobese children were placed on a 2520 to 3360 J (600 to 800 Cal) protein-sparing modified fast diet. Subsequently, the diets of all children were increased in a 3-month period 420 J (100 Cal) every 2 weeks until a 5040 J (1200 Cal) per day balanced diet was attained. In both groups, height and weight were obtained at baseline, 10 weeks, and 6 months; and biochemical measurements were performed at baseline and 6 months. At 6 months the 12 superobese children on protein-sparing modified fast diet had a significant weight loss from baseline (-5.6 +/- 7.1 kg, ANOVA p < 0.02); a significant decrease in percentage IBW (-24.3 +/- 20%, ANOVA p < 0.002); and had positive growth velocity Z-score (1.3 +/- 1.6, ANOVA p < 0.05). Six children were not superobese at 6 months. At 6 months eight of 12 children were active participants and 11 of 12 children were followed. Decrease in blood pressure, as well as, downward trends in serum lipids were observed at 6 months. No clinical complications were observed. At 6 months, the 7 control superobese children, when compared with baseline had gained weight (2.8 +/- 3.1 kg, ANOVA p < 0.008); but had no significant change in percentage IBW (-0.3 +/- 5.9%, ANOVA p = 0.61); and had no changes in growth velocity Z-score (0.1 +/- 1.3, ANOVA p = 0.83). These children did not have any change in blood pressure and an upward trend in serum lipids were observed at 6 months. Protein-sparing modified fast diet and a hypocaloric balanced diet appear to be effective in a group of superobese-school-age children in a medically supervised clinic-based program implemented in a school setting over a 6-month period. The efforts of committed clinic staffs, school officials, peers, and family involvement were crucial to the success of this intervention program in promoting and maintaining weight loss over a 6-month period. Further research with a specific comparison of the hypocaloric diets with longer follow-up periods in the school setting is necessary. In the meantime, these diets should be used only with close medical supervision.

Behavior Therapy↗
PubMed1996

Nutritional factors and thalassaemia major.

Abnormal growth is a common feature of thalassaemia major in children. In an attempt to determine whether it has a nutritional cause, 12 children aged 1 to 3 years with thalassaemia major were studied under metabolic ward conditions. Nutritional status was assessed by anthropometry and biochemistry before and after an intensive nutrition regimen. Five children had wasting or stunting on admission. As a result of the nutrition intervention, mean weight for height improved significantly. The mean height increase of 0.4 cm after one month was not significant. Plasma zinc, depressed in half the children on admission, improved, as did alpha tocopherol, while copper decreased. Plasma insulin-like growth factor-I also increased commensurate with improved growth. Fat absorption was normal in all children. Undernutrition is an important cause of associated growth disturbances in children with thalassaemia major. Malnutrition was primarily caused by inadequate nutrient intake, as indicated by the capacity to gain weight appropriately when provided with nutrition support, and by the absence of intestinal malabsorption. While long term studies are required to determine if nutritional support will prevent stunting, these results underscore its central role in preventing nutritional deficiencies and in promoting normal growth in thalassaemic children.

Anthropometry↗
PubMed1994

Relationship between vitamin A deficiency, malnutrition, and conjunctival impression cytology.

One hundred seventy-eight children from three villages were studied in a cross-sectional fashion to evaluate the efficacy of conjunctival impression cytology (CIC) to characterize vitamin A status of individual children and populations of children and to examine the relationship of vitamin A status to nutritional status. Although children with abnormal CIC results had lower retinol concentrations than those with normal CIC results (P < 0.02), CIC exhibited poor sensitivity and specificity. Results of a CIC prevalence criterion were concordant with plasma retinol criteria in characterizing the vitamin A status of each community. Plasma retinol measurements, but not CIC, were associated with height (P < 0.003) and severe stunting (P < 0.001). We conclude that although CIC was a poor indicator of an individual child's vitamin A status, it accurately characterized the risk of vitamin A deficiency of communities. Furthermore, vitamin A deficiency defined by circulating retinol measurements but not CIC is associated with poor linear growth.

Anthropometry↗
PubMed1994

Effect of dietary fat on cardiovascular risk factors in infancy.

OBJECTIVE: To determine the effects of feeding regimens of varying fat composition on dietary intake and serum lipid and lipoprotein concentrations in older infants. DESIGN, SETTING, AND PARTICIPANTS: One hundred four healthy infants aged 4 to 6 months were enrolled from private pediatric practices or public health clinics and were randomly assigned to one of four feeding groups until 12 months of age. INTERVENTIONS: Infants received whole cow milk or a standard infant formula (48% to 49% of energy as fat from butterfat or a soy-coconut oil blend, respectively) or one of two nearly identical investigational lower fat follow-up formulas (36% kcal from a fat blend of palm olein, corn, and safflower oils) as their primary food source in addition to table foods. MAIN OUTCOME MEASURES: Nutrient intakes during the study period were characterized qualitatively and quantitatively. Serum lipids, lipoprotein concentrations, and anthropometrics were determined at baseline and at 12 months of age (study completion). RESULTS: Total energy intake was equivalent among feeding groups. Infants fed cow milk had higher mean daily intakes of total fat, saturated fat, monounsaturated fat, and cholesterol. Linoleic acid intake by infants fed cow milk, including that from table foods, was insufficient to meet current recommendations. Mean serum total cholesterol was significantly higher in the infants fed cow milk at age 12 months, whereas mean low density lipoprotein and apolipoprotein B were lower in the infants fed the follow-up formulas. Infants consuming the infant formula or whole cow milk demonstrated greater increases in mean serum total cholesterol, low density lipoprotein, and apolipoprotein B by 12 months of age compared with infants ingesting follow-up formula. Ponderal, linear, and head circumference growth was equivalent among feeding groups. CONCLUSIONS: (1) Older infants fed lower fat formula have adequate total energy intake and normal growth. (2) The fat composition of the diets fed to the infants influenced serum lipid and lipoprotein profiles. (3) The fat composition of cow milk is inferior compared with commercial formulas. (4) The optimal fat blend for older infants including the consequences of the standard practice of adding high percentage of coconut oil to infant formulas should be defined further.

Animals↗
PubMed1993

Recent advances in the treatment of childhood obesity.

The multidisciplinary, four-phase approach, which includes PSMF, BEM, and MPE is successful in treating mild, moderate, and severe degrees of childhood and adolescent obesity. The MPE program is appropriate for use with PSMF and BEM due to its progressive nature, variety of options, and moderate intensity level. In addition, the MPE program is of sufficient intensity, duration, and frequency to promote a significant increase in estimated aerobic capacity (VO2max) and to promote the maintenance of lean body mass and resting energy expenditure. The short-term intervention of PSMF, BEM, and MPE also results in an improvement in body composition, lipid profiles, and IGF-1 and T3 levels. The 1200-calorie balanced diet, MPE, and BEM also provide a successful method of weight maintenance in children and adolescents, as indicated by further improvement in body composition at the 26-week measure. Additional studies are needed to assess the contribution of exercise to the maintenance of lean body mass and resting energy expenditure in obese children and adolescents. In addition, it will be important to assess long-term weight maintenance in obese adolescents who effectively lose weight in this multidisciplinary program.

Adolescent↗
PubMed1993

Comparison of two hypocaloric diets in obese children.

OBJECTIVE: To examine whether a protein-sparing modified fast diet and a hypocaloric balanced diet are safe and effective for children in an outpatient weight reduction program. DESIGN: Randomization of two groups to either diet, with follow-up at 14.5 months. SETTING: Physician or parent referral to outpatient program at Children's Hospital of New Orleans, La. PARTICIPANTS: Nineteen children, ranging in age from 7.5 to 16.9 years, weighing 45% to 131% more than the mean weight for age, sex, and height. INTERVENTION: During the first 10 weeks, 10 children were placed on a protein-sparing modified fast diet (2520 to 3360 J), and nine children and adolescents were placed on a hypocaloric balanced diet (3360 to 4200 J). Subsequently, all participants were placed on a hypocaloric diet; calories were increased from 4200 to 5040 J in a 3-month period and maintained for 1 year. SELECTION PROCEDURES: Children were assigned to one of two diets for the first 10 weeks according to their time of enrollment. MEASUREMENTS/MAIN RESULTS: Both diets produced significant weight loss during the first 6 months. However, the protein-sparing modified fast diet produced significantly greater changes in the percentage of overweight at 10 weeks (-30% vs -14%) and at 6 months (-32% vs -18%). At 10 weeks, a significant loss of adipose tissue with preservation of lean body mass occurred in the protein-sparing modified fast group. A transient slowing of growth velocity was noted at 6 months in both dietary groups compared with values at 14.5 months. Growth velocity approached normal levels at 14.5 months compared with standards for North American children. When dietary groups were combined, the initial mean blood pressure decreased significantly at all points in the study. The initial mean serum cholesterol value also decreased significantly at 10 weeks. No biochemical or clinical complications were observed. CONCLUSIONS: These hypocaloric diets appear to be safe and effective in the short-term management of pediatric obesity. However, these diets should not be used without close medical supervision.

Adolescent↗
PubMed1993

Iron status and intake of older infants fed formula vs cow milk with cereal.

One hundred four infants were randomly assigned to receive whole cow milk plus iron-fortified cereal (WCM + C) in accord with the previous recommendations of the Committee of Nutrition/American Academy of Pediatrics (CON/AAP); one of two iron-fortified, follow-up formulas; or an iron-fortified infant formula. Mean iron intakes and vitamin C exceeded the recommended dietary allowance in all groups. By 12 mo of age, mean ferritin and mean corpuscular volume were lower in the WCM + C group and significantly more infants had serum ferritin concentrations < 12 micrograms/L. We conclude that infants 6-12 mo of age fed whole cow milk and iron-containing table food are at risk of developing depleted iron stores but not anemia. The iron insufficiency in these infants is not due to inadequate intake of iron or vitamin C, but probably to relatively poor bioavailability of iron in infant cereal.

Animals↗
PubMed1989

Obesity.

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Child↗
PubMed1983

Impairment of blastogenic response of splenic lymphocytes from iron-deficient mice: in vivo repletion.

Iron-deficiency anemia impaired the blastogenic response of splenic lymphocytes and partially purified T cells to Concanavalin A and phytohemagglutinin. The response of splenic lymphocytes and partially B cells to bacterial lipopolysaccharide was also significantly impaired. Caloric restriction in pair-fed mice did not have any significant effect. Blastogenic response to the three mitogens was restored to normal after anemic mice were fed the regular diet containing 25 to 30 mg Fe/kg (FeSO4) for approximately 10 days. We also found that in the anemic mice the mean wet weights per 100 g of body of spleen, heart, brain, and kidney increased, while those of the thymus and liver decreased. In the pair-fed mice only the mean wet weight of the liver significantly decreased. There was a small but significant decrease in the white blood count and peripheral lymphocyte count in the anemic but not the pair-fed mice. The mechanism by which iron deficiency impairs the cell-mediated immune response is discussed.

Anemia, Hypochromic↗
PubMed1983

Impairment of blastogenic response of splenic lymphocytes from iron-deficient mice. In vitro repletion by hemin, transferrin, and ferric chloride.

Splenic lymphocytes from iron deficient C57BL/6 mice gave smaller proliferative responses to T and B cell mitogens than those from either the control of pair-fed mice. The addition of hemin to the culture medium partially restored the responses to Con A and phytohemagglutinin but not to bacterial lipopolysaccharide in unfractionated spleen cells and enriched T cell fractions. The responses of lymphocytes from the control and pair-fed mice were either unchanged or decreased. Hemin restored the blastogenic response to Con A more efficiently than to phytohemagglutinin. The blastogenic responses were increased linearly with increasing doses of hemin. Ferric chloride and iron saturated mouse transferrin did not restore the response to either Con A or lipopolysaccharide. However, both transferrin and ferric chloride partially restored the response to phytohemagglutinin. The possible mechanism of selective restoration of blastogenesis by hemin, transferrin, and ferric chloride in iron-deficient T lymphocytes is discussed.

Animals↗
PubMed1983

The effect of iron-deficiency anemia on cytolytic activity of mice spleen and peritoneal cells against allogenic tumor cells.

The capacity of spleen and peritoneal cells from iron deficient mice, ad libitum fed control mice, and pair-fed mice to kill allogenic tumor cells (mastocytoma tumor P815) has been investigated. In the first study, mice were sensitized in vivo with 10(7) viable tumor cells 51 and 56 days after weaning. The capacity of splenic cells and peritoneal cells from sensitized and nonsensitized mice to kill tumor cells was evaluated 5 days after the second dose of tumor cells. At ratios of 2.5:1 to 100:1 of attacker to target cells, the percentage 51Cr release after 4 h of incubation was significantly less in iron-deficient mice than control and/or pair-fed mice (p less than 0.05). Protein-energy undernutrition in pair-fed mice had no significant effect. In the second study, spleen cells and enriched T cell fractions were incubated in vitro for 5 days with uv irradiated Balb/C spleen cells in a 2:1 ratio. The cytotoxic capacity against the same allogenic tumor cells was again evaluated. The percentage chromium release at different attacker to target cells was less than 30% in the iron-deficient group compared to either control or pair-fed supporting the results of in vivo sensitized cells. The possible mode of impairment of the cytotoxic capacity is discussed.

Anemia, Hypochromic↗
PubMed1983

Depressed erythrocyte glutathione reductase activity in sickle cell disease.

In a group of 27 sickle cell disease patients ranging in age from 2 yr 3 months to 43 yr, 13 (48%) were found to have depressed erythrocyte glutathione reductase activity suggesting riboflavin deficiency. Glutathione reductase activity coefficients did not correlate with riboflavin intakes which were calculated from 3-day diet records returned by 16 patients. Other causes of riboflavin deficiency including decreased absorption, altered metabolism, or increased excretion of the vitamin must be considered. The potential effect of depressed erythrocyte glutathione reductase activity in the sickle cell disease process is discussed.

Adolescent↗
PubMed1982

A prospective randomized clinical trial of total parenteral nutrition in children with cancer.

A prospective randomized clinical trial was undertaken to test the efficacy of total parenteral nutrition (TPN) among previously untreated children receiving abdominal/pelvic irradiation with or without adjuvant chemotherapy who were at risk for weight loss, malnutrition, and complications from treatment. Children were evaluated by weight/height determinations, anthropomorphic measurements, and laboratory studies. TPN was associated with an improved nutritional status during therapy as compared with control patients on ad libitum intake. However, when TPN was discontinued, weight declined and there were no differences among treated and control patients detected at three-month follow-up. Likewise there was no obvious effect from TPN on tolerance to therapy in the adequately nourished child. TPN as initial supportive therapy should be reserved for those children who are malnourished or marginally malnourished at the time of presentation. Close nutritional assessment during treatment is essential since approximately 25% of children undergoing abdominal/pelvic radiotherapy with chemotherapy can be expected to become malnourished during an initial course of therapy.

Adolescent↗
PubMed1982

Nutritional status of vegetarian children.

Thirty-nine preschool children consuming different types of vegetarian diets were studied. Type and amount of carbohydrate, fat, protein, and amount of sodium and cholesterol provided by their diets were more like intakes suggested in the proposed Dietary Goals for the United States than to levels in usual diets of nonvegetarian children. Macrobiotic vegetarian children consumed less animal food than did other vegetarian children. The mean intake of vitamin D of macrobiotics was an eighth of the Recommended Dietary Allowance and mean serum alkaline phosphatase values were elevated. The mean intake of vitamin B12 levels were normal. Vegan macrobiotic children had the lowest intakes of vitamins B12 and D. Other vegetarians' mean intakes of these vitamins met the Recommended Dietary Allowance. Mean iron intakes of the vegetarians approximated the Recommended Dietary Allowance. Hematological indices were suggestive of mild iron deficiency anemia in a quarter of subjects. Serum cholesterol values were low for the group. Physical measurements were within normal limits and macrobiotic vegetarians were not smaller or leaner than other vegetarian children. The nutritional difficulties discovered could be corrected by careful planning of vegetarian children's diets while preserving the beneficial qualities of the diet in other respects.

Birth Weight↗