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Biomedical subjects

R Uauy

Publications and source records attributed to R Uauy.

At least 127 records · Page 7Linked to original sources

Long-term validation of 1 g of protein per kilogram body weight from a predominantly vegetable mixed diet to meet the requirements of young adult males.

Eight healthy young men participated in a 90-d metabolic balance study designed to assess the adequacy of 1 g of protein (N X 6.25) per kilogram body weight per day provided by a predominantly vegetable diet. The mean gross energy intake of the subjects was 49 kcal/(kg X d). The individuals received the experimental diet for eleven 8-d experimental periods. Three isoenergetic, isonitrogenous meals were served at 0800, 1200 and 1900. Anthropometric measurements and biochemical determinations in blood were made at the beginning of the study and afterwards at regular 15-d intervals. Body weight was measured daily. The mean overall weight change for the group was -0.8 kg. The mean daily urinary nitrogen output decreased from an initial value of 134.6 mg/(kg X d) to a final figure of 115.1 mg/(kg X d) (P less than 0.01), while the daily fecal N decreased from 31.5 to 26.3 mg/(kg X d) (P less than 0.05). Mean cumulative nitrogen balances were slightly positive for seven out of the eight individuals with an overall mean nitrogen balance value of +6.7 mg N/(kg X d). Biochemical and hematological values showed no significant changes throughout the study, except for a decrease in serum cholesterol. It is concluded that the "Chilean" mixed diet fed at the level of 1 g of protein per kilogram body weight per day with sufficient energy meets the long-term protein-energy needs of healthy young men, thus supporting the 1984 FAO/WHO/UNU safe recommended daily protein allowance of 0.75 g of reference protein, with a correction for the lower digestibility of vegetable sources.

Adult↗

Red cell superoxide dismutase activity as an index of human copper nutrition.

Red cell superoxide dismutase (SOD) activity was evaluated as a biochemical index of copper nutrition in a double-blind study of 17 infants recovering from malnutrition and receiving marginal copper intakes. Children were paired on admission by sex, birth weight, nutritional status and antecedents of diarrhea and breast feeding. Nine served as controls receiving a copper sulfate supplement (80 micrograms/kg daily for 120 d; eight received a placebo and were supplemented only if plasma copper levels dropped below 90 micrograms/dl or on d 90 for at least 30 d. After copper supplementation there was a significant rise (paired t-test; P less than 0.05) in plasma copper (96 vs. 165 micrograms/dl); ceruloplasmin (33 vs. 50 mg/dl) and SOD (1073 vs. 1371 U/g Hb). After supplementation these values were similar to those of the controls. SOD was correlated with plasma copper (r = 0.78; P less than 0.001) and not with weight-for-age or weight-for-length. Addition of copper in vitro did not modify the SOD activity. Red cell SOD is a good marker of copper nutrition in humans and correlates well with plasma copper.

Clinical Enzyme Tests↗

Controlled trial of copper supplementation during the recovery from marasmus.

To evaluate copper nutritional status and the effect of a Cu supplement during recuperation, 27 marasmic infants were selected on admission to the nutrition recovery center at the Instituto de Nutrición y Tecnología de los Alimentos. Thirteen infants received 80 micrograms/kg/day of copper supplement as sulphate and the remaining a placebo. They were paired by birth weight, age, and sex. Anthropometric indices, complete blood count, ceruloplasmin, and Cu were measured on admission and at monthly intervals. Superoxide dismutase activity was measured in hypocupremic infants and was found to be low. The mean +/- SE Cu levels on admission were 127 +/- 10 micrograms/dl for the supplemented group and 137 +/- 10 micrograms/dl for the control. We found an increase in plasma Cu to 159 and 162 micrograms/dl on days 30 and 60 in the supplement group, and a significant decrease after day 30 in the placebo group. The ceruloplasmin levels followed this trend. Hypocupremia was found in 30% of the placebo group and none in the supplement group. The placebo group had a significantly higher prevalence of severe lower respiratory infections. It is concluded that a significant proportion of marasmic infants fed a milk-based diet present, during recovery, biochemical evidence of Cu deficiency. Supplementation with Cu is suggested.

Clinical Trials as Topic↗

Capacity of the Chilean mixed diet to meet the protein and energy requirements of young adult males.

1. The capacity of the Chilean mixed diet to meet the daily protein and energy needs was tested in eight subjects aged from 20 to 31 years using the nitrogen balance method. This diet was tested at the protein levels of 0.40, 0.55 and 0.70 g/kg body-weight per d. 2. An egg reference diet providing 0.30, 0.45 and 0.60 g protein/kg per d was also assayed. 3. The mean daily energy intake was 207 kJ/kg per d according to subjects' previous intake and activity pattern. 4. The N balance response to each dietary protein level was taken as a measure of adequacy of protein intake, and regression analyses of N balance (Y) v. N intake (X) were calculated to estimate protein needs. The equations found were Y = 0.70X - 68.7 for the egg diet, and Y = 0.74X - 92 for the mixed diet. 5. From these equations the mean protein requirements for equilibrium were estimated to be 0.61 g/kg for egg and 0.78 g/kg for the mixed diet. 6. If the coefficient of variation is 15, the protein requirement for N equilibrium of 97.5% of the population would be 0.8 g/kg per d for egg and 1.0 g/kg per d for the mixed diet.

Adult↗

Obligatory urinary and faecal nitrogen losses in young Chilean men given two levels of dietary energy intake.

1. The obligatory nitrogen losses were measured in young adult males of the low socio-economic group, consuming an N-free diet at 192 kJ (46 kcal)/kg per d from day 1 to 10 and 243 kJ (58 kcal)/kg per d from day 11 to 18. 2. All subjects, except one, lost weight compatible with N loss. 3. A kinetic evaluation of the results showed that the asymptotically derived urinary N loss after stability had been reached was 35.8 mg N/kg per d. The mean time to stability was 6.5 d. The subjects showed a trend toward decline in N loss while consuming the high-energy N-free diet. 4. The obligatory faecal N loss for days 1-10 was 16.1 mg N/kg per d and 8 mg N/kg per d for days 11-18. 5. Based on the factorial approach the total obligatory N loss of our subjects, for the initial 10 d, was 57.5 mg N/kg per d.

Adult↗

Musle protein breakdown rates in humans based on Ntau-methylhistidine (3-methylhistidine) content of mixed proteins in skeletal muscle and urinary output of Ntau-methylhistidine.

Samples of psoas muscle from nine infants (aged 1 day to 14 mo) and of several skeletal muscles from seven adult males (age 19-74 yr) were analyzed for content of protein-bound Ntau-methylhistidine (3-methylhistidine; 3-Mehis). The mean content of 3-Mehis (expressed as mumoles/g mixed protein) was 3.2 (range 2.4-3.7) in infants and 4.2 (range 3.7-4.6) in adults. The daily urinary excretion of 3-Mehis was measured in four young adult males receiving an egg-protein, flesh-free diet. Mean excretion of 3-Mehis was 211 (range 167-252) mumoles/day. From these two sets of data the mean rate of muscle protein breakdown in adult males was estimated to be 50 g/day, or 0.7 +/- 0.1 g/kg body weight/day. These results are compared with reported values for the 3-Mehis content of mixed proteins in muscle of various species, and with published estimates, computed by other techniques, of the rate of muscle protein breakdown in human subjects.

Adult↗

The changing pattern of whole body protein metabolism in aging humans.

Dynamic aspects of whole body protein (nitrogen) metabolism were explored in healthy young adults and elderly men and women. Measurements were made of the rate of whole body protein breakdown, with the aid of 15N-glycine, and the rate of muscle protein breakdown, as estimated from urinary N tau-methylhistidine excretion. The results also were evaluated in relation to obligatory (endogenous) urinary nitrogen losses, previously determined in this laboratory for the two age groups. Rates of whole body and muscle protein breakdown, per unit body weight, were lower in elderly subjects than in young adults. Muscle accounted for a mean of 27% of whole body protein breakdown in young adults and 20% or less (p less than 0.01) in elderly subjects. Daily obligatory N loss was positively correlated (p less than 0.01) with whole body protein breakdown. It was calculated that muscle contributed less to the obligatory N output in elderly subjects than in young adults. These results indicate a change in the distribution of whole body protein metabolism during aging in human subjects, with muscle making a lower contribution to total body protein metabolism in elderly subjects compared with young adults.

Adolescent↗

Determination of optimal continuous positive airway pressure for the treatment of IRDS by measurement of esophageal pressure.

We describe a simple and reliable method to determine optimal airway pressure in infants with idiopathic respiratory distress syndrome who require continuous positive airway pressure treatment. Esophageal pressure was monitored in ten infants with IRDS during initial application of CPAP. As the level of CPAP was increased in 2 cm H2O increments, changes in Pes were compared with changes in PaO2. Below optimal airway pressure, Pes as well as PaO2 increased insignificantly. When optimal airway pressure (8.1 +/- 0.8 cm H2O) was applied, there was a marked increase in Pes (3.6 +/- 0.8 cm H2O. p less than 0.001) and PaO2 (39.0 +/- 10.0 mm Hg, p less than 0.01). Further increase in CPAP did not result in any subsequent appreciable increase in Pes while PaO2 decreased slightly and PaCO2 increased. Less than optimal CPAP increases F102 requirements and may increase the associated risk of bronchopulmonary dysplasia, while excessive levels of CPAP may increase the risk of pneumothorax. We suggest that esophageal pressure be monitored routinely to determine the optimal level of CPAP for each infant during the initial application of therapy.

Carbon Dioxide↗

The radiographic features of early onset Group B streptococcal neonatal sepsis.

The clinical and radiographic features of 27 newborn infants with early onset Group B streptococcal infection as documented by blood culture have been reviewed. Initial chest radiographs revealed a wide spectrum of patterns. These included changes usually associated with the respiratory distress syndrome, extensive pneumonia, and small infiltrates as well as a normal appearance. Premature birth and a fatal outcome were associated with extensive radiographic changes. At autopsy some of the infants with a radiographic appearance of respiratory distress syndrome had pathologic features of Group B streptococcal infection with no apparent evidence of coexisting respiratory distress syndrome.

Humans↗

A comparison of early-onset group B streptococcal neonatal infection and the respiratory-distress syndrome of the newborn.

In attempting to differentiate early-onset Group B streptococcal infection from hyaline-membrane disease we found features of severe Group B infection to be rupture of the membranes for more than 12 hours before delivery (four or eight versus one of nine), gram-positive cocci in the gastric aspirate (four or four versus none of one), apnea and shock in the first 24 hours of life (seven of eight versus none of nine), and the generation of lower peak inspiratory pressures on avolume-cycled respirator (mean of 36.5 +/- 2.8 versus 63.9 +/- 6.2 cm of water; P = 0.005). In eight fatal cases of Group B infection, four patients had radiographic features indistinguishable from hyaline-membrane disease whereas the other cases were consistent with neonatal pneumonia. Seven of the eight infected infants had no histologic evidence of coexisting hyaline-membrane disease. Microscopical features of Group B infection included cocci in unevenly distributed hyaline membranes and minimal atelectasis. Group B streptococcal infection differs clinically and pathologically from hyaline-membrane disease. Differentiating clinical features include early apnea and shock and lower inspiratory pressures on mechanical ventilation.

Diagnosis, Differential↗