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By improving the flavour of an elementary diet rich in aminoacids it was possible to treat 33 patients with inflammatory bowel diseases over longer periods compared to the duration of treatment with Vivasorb elementary diet. This was accomplished by addition of certain fruit juices, several kinds of teas, soups and relishes. Difficulties by taste of BSD could largely be overcome.
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Biological evaluations using rats were carried out to determine the complementation effects on dietary protein of cooked mung bean/rice and cooked germinated mung bean/rice mixtures. On an isoproteic basis, mung bean protein was found to be of a lower quality than rice protein. Upon complementation with rice, however, the protein quality of the ungerminated and germinated mung bean/rice mixtures steadily increased when rice was incorporated to provide 25, 50 and 75% of the protein in the diet. A comparison study between germinated and ungerminated mung bean/rice mixtures indicated that the latter mixture was of a better protein quality. Nevertheless, replacement of 75% of the dietary protein of mung bean by rice showed no difference between the germinated and ungerminated mung bean.
Three mixtures containing varying proportions of threonine, tyrosine, and the ornithine, lysine, and histidine salts of branched-chain keto acids have been tested as dietary supplements to a 20- to 25-g mixed-quality protein diet in patients with severe chronic uremia. Two of the three supplements improved the abnormalities of plasma amino acid concentrations, and slowed or arrested progression of renal insufficiency. The second supplement, which contained less threonine and lysine, led to subnormal plasma concentrations of these two amino acids and aggravated hypophosphatemia. The third supplement, which also contained a small amount of the hydroxy analogue of methionine, was the most effective in slowing progression. The results emphasize the importance of optimizing the composition of such supplements.
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The nutritive value of a soya milk and soya protein isolate available in Brazil was tested in formulas fed to 30 malnourished children during a period of 25 days. The chemical composition of all formulas was similar, including their energy and protein content. The protein (1.5 g/100 ml) was supplied by either cow's milk, unfortified soy milk, unfortified soy protein isolate, and methionine-enriched soy milk or methionine-enriched soy isolate. Methionine was added at the level of 1.5 g/100 g of protein. The trials included clinical, biochemical and nitrogen balance studies, and results indicated that these soy products formulas did not have the same nutritive value of cow's milk. However, the nutritional quality of soy milk was improved by methionine supplementation, but the soy protein isolate was not affected by the addition of the same amino acid. Average nitrogen retention as percent of intake ranged from 31.8 to 34.7 in the children fed cow's milk. Those that received soy milk retained 10.5 to 15.3%, and when methionine was added the average retention increased from 17.2 to 24.8%. When the isolated soy protein was fed, the average retention values were 14.7 to 16.5% without methionine, and 11.0% when the methionine-supplemented formula was used. Factors that could influence the results and the importance of the subject are discussed.
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A low nitrogen, low phosphorus diet, supplemented with essential amino acids and keto-analogues, was administered to 48 chronic uraemics for a maximum of 36 months. In 10 cases renal function deteriorated and dialysis was started; eight patients changed to the dialytic therapy having difficulties in complying to the diet and three died for reasons not directly related to renal failure. The remaining twenty-seven patients are still on dietetic treatment and their renal function has not changed significantly. Their serum inorganic phosphorus and their circulating iPTH decreased significantly. Their subjective and objective conditions are satisfactory and no manifestation of protein malnutrition or other unwanted effects are detectable.
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Nutrition support in acute, chronic, or home care settings can be implemented successfully by the well-informed primary care physician, who often is the first to identify poor nutritional health in his or her patients. Using established protocols for the identification or of risk factors and indicators of malnutrition, specific alerts to the need for nutrition support are presented. The logical approach to nutrition support interventions through four stages representing the gradual increase in complexity and cost, paralleling the progressive inability to use regular foods and the gastrointestinal tract are discussed. Specific, practical measures that can be recommended and implemented by the primary care physician managing the older person are presented. The ethical, legal, and home health aspects of nutrition support in the care of the older American by the primary care physician are also reviewed.
A liquid chromatographic (LC) method has been developed to determine the percent of olestra in lipid samples. To achieve the highest degree of accuracy, this method requires the use of an olestra standard with the same molecular composition as the olestra in the lipid sample to be analyzed. Samples were analyzed by reversed-phase LC using an evaporative light-scattering detector. Chromatography was performed with a 5 microns octadecylsilane-Zorbax column that separates olestra from other lipophilic components. Three types of olestra standards (soybean-oil olestra, unheated cotton-seed-oil olestra, and heated cottonseed-oil olestra), each analyzed in soybean oil, showed linearity when the amount of olestra injected ranged from 20 to 160 micrograms (r = 0.9996). The area under the olestra peak (retention time 3.5 to 4.9 min) was used to quantify the amount of olestra in olestra-lipid samples, by comparing the olestra area for the sample with that of the standard using a curve derived by linear regression. The method was evaluated using 3 types of olestra blended with soybean oil and varying the percent of olestra in the olestra-lipid blend from 5 to 90%. Recovery of olestra from these olestra-lipid blends varied from 99.2 to 106.0%, demonstrating excellent accuracy, with method precision expressed as the coefficient of variation, 0.9%. Each error estimate was derived from 5 parallel determinations. With proper validation (e.g., running an olestra-free blank for each lipid matrix), this method provides a rapid, accurate, and precise technique for measuring the percent of olestra in lipids extracted from olestra-formulated foods and in olestra-lipid blends.
Eight laboratories participated in a collaborative study of AOAC Official Method 985.35, Minerals in Ready-to-Feed Milk-Based infant Formula and Pet Foods, Atomic Absorption Spectrophotometric Method; and 7 laboratories participated in a study of AOAC Official Method 986.24, Phosphorus in Milk-Based infant Formula, Spectrophotometric Method, to extend these methods to infant formulae (other than milk-based) and enteral products. Three ready-to-feed soy-based formulae and 2 soy-based powder formulae were chosen to represent the plant matrix. A whey-based formula and a casein-based enteral formula were also included in the study. Soy formulae containing nearly identical concentrations of particular elements were matched, and an application of the Youden "closely matched pair" approach was used to estimate repeatability parameters. Average reproducibility values were as follows: calcium, 9.3%; copper, 9.7%; Iron, 5.5%; potassium, 4.0%; magnesium, 5.2%; manganese, 10.6%; sodium, 4.7%; phosphorus, 10.5%; and zinc, 7.3%. At similar analyte concentrations, the between-laboratory variabilities compared well with those reported for the official methods. Most repeatability and reproducibility parameters compared well with the original collaborative study. AOAC Official Methods 985.35 and 966.24 have been modified to extend their applicability to infant formulae (other than milk-based) and enteral products.
This article focuses on the current experience with the use of fortified milk in feeding premature infants. The use of fortified human milk provides the premature infant adequate growth, nutrient retention, and biochemical indices of nutritional status when fed at approximately 180 mL/kg/d compared with unfortified human milk. When compared with preterm formula, the feeding of fortified human milk may provide significant protection from infection and necrotizing enterocolitis. Neonatal centers should encourage the feeding of fortified milk for premature infants. Skin-to-skin contact is a reasonable method to enhance milk production while potentially facilitating the development of an enteromammary response.