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PubMedDate not supplied

[Major abdominal surgery and the clearance of lipid emulsions].

The use of lipid emulsions for TPN remains controversial. Although experimental studies show that medium chain triglycerides (MCT) are beneficial over long chain triglycerides (LCT) clinical studies are contradictory. With the aim to study the clearance of two lipid emulsions a prospective study was designed. 21 patients, submitted to resective surgery because of upper gastrointestinal tract malignancy were randomized in three groups. In group I (without lipids): all caloric intake was supplied by hypertonic glucose solution. In group II (LCT group) 55% of caloric intake was supplied by glucose and 45% by a LCT 20% emulsion (Intralip[id 20%, Kabi-Pharmacia). In group III (MCT group) 55% of caloric intake was supplied by hypertonic glucose solution and 45% by a physical mixture of LCT and MCT at 20% concentration (Lipofundina MCT, B. Braun). Our results show that in postoperative period of major abdominal surgery both lipid emulsions are cleared of in a similar way. When these emulsions are administered during 12 hours per day plasmatic triglycerides are completely cleared before to start the next-day infusion of lipid emulsion. Differences in total cholesterol were not found between groups. Nevertheless LDL-cholesterol rose significatively between first and tenth postoperative day in LCT group.

Abdomen↗
PubMed2004

Adaptive thermogenesis is intact in B6 and A/J mice studied at thermoneutrality.

To investigate mechanisms of resistance to obesity, the physiologic responses to short-term moderate fat feeding were studied at ambient temperature (T(a)) = 23 degrees C and thermonuetrality (T(a) = 30 degrees C) in mice susceptible (B6) or resistant (A/J) to obesity. We hypothesized that A/J mice would exhibit greater adaptive thermogenic responses to consumption of moderate-fat diets, and that this response would be attenuated in thermoneutral conditions due to reduced activity of brown adipose tissue (BAT). B6 and A/J mice were adapted to either T(a) = 23 degrees C or T(a) = 30 degrees C, implanted with telemetry devices, housed in metabolic chambers for measurement of food intake, oxygen consumption (Vo(2)), and heart rate (HR), and studied before and during 1 week of consuming a diet containing 32% of calories from fat. Access to 32% fat diet resulted in increased caloric intake in both strains, but caloric intake for A/J mice returned to baseline levels within 72 hours, while B6 mice remained hyperphagic. Both strains exhibited increased light-phase Vo(2) indicative of adaptive thermogenesis; however, there was no strain difference in light-phase Vo(2) during the 1-week feeding trial. Surprisingly, T(a) had no effect on diet-induced thermogenesis in either mouse strain. Moderate high-fat feeding produced mild tachycardia that was similar in B6 and A/J mice and more clearly evident at thermonuetrality. We conclude that adaptive thermogenic responses are intact in both mouse strains studied at thermoneutrality, suggesting a minimal role for BAT in the initial metabolic response to hyperphagia. Furthermore, the results suggest that differences in control of caloric intake, rather than capacity for adaptive thermogenesis, may contribute to the relative susceptibility to obesity in A/J and B6 mice.

Adipose Tissue, Brown↗
PubMed2005

Short-term effect of oil supplementation of complementary food on total ad libitum consumption in 6- to 10-month-old breastfed Indian infants.

OBJECTIVES: To evaluate the short term effect of oil supplementation of complementary food on total ad libitum consumption in breastfed infants. METHODS: Twenty infants between 6 to 10 months of age were studied in a tertiary hospital in New Delhi for 48 hours. They were given three semi-solid complementary feeds per day and ad libitum breastfeeding. No other food or fluid was allowed during the study period. A traditional gruel made of rice and pulses with high energy density (oil added; caloric density = 35 kcal/100 g) or low energy density (without oil; caloric density = 20 kcal/100 g) was offered in a randomized manner on consecutive days to all infants. Total caloric intake from breast milk and semi-solids was computed for each day. RESULTS: Infants consumed an equivalent amount of semi-solid (mean difference, 10.75 g/day; 95% confidence interval, 10.56 to 32.06; P = 0.304) and a lower amount of breast milk (mean difference, 121.1 g/day; 95% confidence interval, 35.13 to 207.16; P = 0.008) when high energy density feeds were offered. Although the caloric intake from semi-solids increased significantly (18.9 kcal/day; 95% confidence interval, 12.9 to 24.8; P < 0.001) with the high density diet, the total caloric intake (breast milk and study feeds) decreased (mean difference = 59.6 kcal/day; 95% confidence interval, 5.95 to 113.34; P = 0.031). An inverse relationship was found between caloric density of semi-solids and breast milk intake (r = 0.34, r = 0.12, P = 0.032). CONCLUSION: In the short term, oil supplementation of complementary food in breastfed infants does not translate into enhanced total caloric intake, primarily as a result of breast milk displacement.

Breast Feeding↗
PubMed1996

Significance of physical activity for prevention and control of hypertension.

The beneficial effect of habitual physical exercise, and physical fitness, on blood pressure has been reported in the past. However, the reported fall in blood pressure, associated with physical exercise, could be related to at least one confounding factor. That is, the independent effect of weight loss caused by physical exercise, on blood pressure. Exercise results in loss of body fat, a redistribution of fat stores, and weight loss. All of these are associated with a concomitant reduction in blood pressure. It is not clear whether the reduction in blood pressure is caused independently by a decrease in caloric intake alone, or an increase in physical activity, or the combination of the two. This is particularly true in the case of primary prevention of hypertension in the community where an effective and acceptable strategy for life-style modification has to be developed; a strategy which must be based on valid scientific evidence. The Trial of Hypertension Prevention (TOHP), a large scale randomized clinical trial, was designed to test the hypothesis on the efficacy of weight loss (induced by a combination of reductions in caloric intake and increased physical exercise) on primary prevention of hypertension. Eligible participants were randomized into either the weight loss group, or the control group. The exercise component of the weight loss program included mild exercise, 3-4 days a week for 35-40 minutes at an intensity of 40-45% of heart rate reserve. The dietary component included a reduction in caloric intake to less than 1200 KCal per day. After 18 months, the difference in weight loss between the two groups was 3.9 Kg in favor of the dietary modification and exercise (P < 0.01). This was accompanied with a significant reduction in blood pressure (P < 0.01). Weight loss was a significant predictor for blood pressure change over time (P < 0.001). These findings confirm the efficacy of maintaining an ideal body weight, by a program which combines physical exercise and reduction in caloric intake, on primary prevention of hypertension in the community.

Clinical Trials as Topic↗
PubMed1993

Indices of thyroid function and weight loss in human immunodeficiency virus infection and the acquired immunodeficiency syndrome.

Abnormalities of thyroid hormone levels have been reported in the acquired immunodeficiency syndrome (AIDS), but there has been debate as to whether they are appropriate for the clinical status of the patients. Inappropriate maintenance of circulating 3,3',5-triiodothyronine (T3) levels could contribute to weight loss. Although many patients with AIDS have a history of wasting, recent data indicate that prolonged periods of stable weight occur in AIDS and that short-term weight loss is present in a subset of patients with anorexia, many of whom have active secondary infection (AIDS-SI). Therefore we analyzed thyroid hormone levels in a cohort of subjects that have been characterized in terms of recent weight loss and caloric intake. Asymptomatic patients with human immunodeficiency virus infection (HIV+) had short-term stable weights, normal caloric intake, and normal serum T3 levels. In AIDS, average short-term weight was stable, caloric intake was normal, and T3 levels were decreased by 19%. In AIDS-SI, both short-term weight loss and anorexia were significant, and this group showed a 45% decrease in T3 levels. The free T3 (FT3) index was decreased by 30% in AIDS and by 50% in AIDS-SI. Free thyroxine (FT4) levels were decreased while thyroxine-binding globulin (TBG) capacity was increased in HIV+ and AIDS; TBG sialylation was unchanged. Thyrotropin (TSH) levels were slightly increased in AIDS, although levels remained within the normal range. 3,3',5'-triiodothyronine (rT3) levels were decreased in HIV+, AIDS, and AIDS-SI. Thus asymptomatic patients with HIV infection whose weight is stable maintain normal T3 levels.(ABSTRACT TRUNCATED AT 250 WORDS)

Acquired Immunodeficiency Syndrome↗
PubMed1992

Resistance to insulin-induced hyperphagia in fat-preferring rats.

Outbred male Sprague-Dawley rats were screened for their macronutrient (fat, carbohydrate and protein) preference profile and divided into two groups, the low- and high fat-preferring groups each deriving 23% and 72% of its total caloric intake from fat respectively. Subcutaneous administration of bovine insulin (6U/kg) resulted in an increase in total caloric intake in the low, but not the high fat-preferring group. Furthermore, the increased caloric intake in the low fat-preferring group was entirely due to increased carbohydrate consumption. These data suggest a defect in the action of insulin in fat-preferring rats.

Animals↗
PubMedDate not supplied

Influence of liver failure, ascites, and energy expenditure on the response to oral nutrition in alcoholic liver cirrhosis.

The influence of liver failure, ascites, and energy expenditure on the response to oral nutrition was assessed in a group of 55 alcoholic cirrhotic patients. Caloric intake, nutritional status, resting energy expenditure (REE), and Child-Pugh score were evaluated before and after 1 mo of oral nutrition. Patients were severely malnourished, 73% had muscular midarm circumference (MMAC) below the 5th percentile of a reference population, 51% had triceps skinfold thickness below the 25th percentile. Eleven patients were in class A of Child, 19 in class B, and 25 in class C. Twenty-six patients were nonascitic, whereas ascites was resolved in 10 ascitic patients by the end of the study and 19 patients had refractory ascites. Liver damage was more pronounced and did not improve during the study in patients with refractory ascites. Caloric intake was approximately 40 kcal/kg of body weight and was in the same range in the three groups according to Child classification. Fat mass (FM) increased, respectively, from 17.4% +/- 1.7% to 19.5% +/- 1.4%, P < 0.01, in Child A patients; from 17.1% +/- 1.4% to 19.3% +/- 1.4%, P < 0.001, in Child B patients; and from 17.6% +/- 1.5% to 18.8% +/- 1.5%, P < 0.05, in Child C patients. The increase in FM was comparable in the three groups, whereas MMAC and the creatinine/height ratio did not change significantly. FM was lower and did not increase in patients with refractory ascites. Child C patients were characterized by an increase in the rate of glucose oxidation (P < 0.02) and a decrease in the rate of lipid oxidation (P < 0.05). High-density lipoprotein cholesterol and apolipoprotein (Apo) A1 were reliable indices of improvement of liver function in patients with severe liver failure, ApoA1 was also a marker of improvement of metabolic impairment. With respect to the measured REE/predicted REE ratio calculated according to Harris-Benedict equation (r), 19 patients were considered hypermetabolic (r < 1.1), 30 normometabolic (0.9 < r < 1.1), and 6 hypometabolic (r < 0.9). An increase in FM correlated with r (P < 0.01) and was more marked in hypermetabolic patients. In contrast to the other two groups, Child-Pugh score and nutritional status remained unchanged in the hypometabolic patients. These results show that severe liver failure did not preclude improvement of nutritional status provided caloric intake was high. In Child C patients, improvement of nutritional status paralleled improvement of liver function and normalization of oxidative metabolism. Refractory ascites had negative effects on changes in nutritional status and liver function. Despite adequate caloric intake to energy requirements, hypometabolism has a poor prognosis regarding both nutritional status and liver function.

3-Hydroxybutyric Acid↗
PubMed2005

Disodium Ascorbyl Phytostanyl Phosphates (FM-VP4) reduces plasma cholesterol concentration, body weight and abdominal fat gain within a dietary-induced obese mouse model.

PURPOSE: The purpose of this study was to determine if Disodium Ascorbyl Phytostanol Phosphates (FM-VP4) alters animal body weight and plasma lipid levels in a dietary-induced obese mouse model. METHODS: Twenty-four C57BL6 mice (28 days old) were housed individually and fed a standard mouse diet for 2 weeks upon arrival. After 2 weeks the animals were weighed and divided in 4 groups of similar average weight, and the groups received a low fat (10% kcal from fat) and high fat (45% kcal from fat) diet with or without FM-VP4 (2% w/w) for 12 continuous weeks. Food, water and caloric intake and body weight were recorded on a daily basis throughout the duration of the study. Following the 12th week of the study all animals were humanely sacrificed and blood and abdominal fat pads were harvested for further analysis. Plasma cholesterol, triglyceride, AST/ALT and creatinine levels were measured using enzymatic kits. RESULTS: There is a significant difference in weight gain between the low-fat diet and the low-fat diet + 2% w/w FM-VP4 treatment groups (P<0.05), as well as between the high-fat diet and the high-fat diet + 2% w/w FM-VP4 treatment groups (P<0.05). However, the reduction of weight gain of the high-fat diet + 2% FM-VP4 treatment group compared to the high-fat group was 51%, while the reduction in weight gain between the low-fat diet + 2% w/w FM-VP4 treatment group and the low-fat diet group was 17% over the duration of the study. No significant differences in food and water intakes, serum creatinine and AST/ALT levels were observed between the four groups. No significant differences in caloric intake between the low-fat diet and the low-fat diet + 2% w/w FM-VP4. However, a significant difference in caloric intake between high-fat diet and the high-fat diet + 2% w/w FM-VP4 treatment groups was observed. In addition, significant reductions in plasma cholesterol levels and abdominal fat pad weight between diet alone and diet + FM-VP4 treatment groups were observed. CONCLUSIONS: These findings suggest that FM-VP4 may have potential weight-loss and cholesterol lowering activity in both High Fat and Low Fat Diets treated groups.

Abdominal Fat↗
PubMed1983

Preoperative and postoperative assessment of nutrient intakes in patients who have undergone gastric bypass surgery.

The study of 25 morbidly obese patients who had undergone gastric bypass surgery was undertaken to determine the fat, carbohydrate (CHO), protein, and total caloric intake before and at 1, 3, 6, and 12 months postoperatively. No postoperative complications occurred, and all patients lost weight appropriately. The nutrient intakes were estimated from dietary recall. Dramatic decreases occurred in average total caloric intake from a preoperative value of 3979.4 to 351.6 kcal at 1 month, 471.3 kcal at 3 months, 932.7 kcal at 6 months, and 1091 kcal at 12 months. Fat, CHO, and protein intake decreased equally until 12 months when fat intake had reached a plateau while CHO and protein intake continued to rise. Weight reduction after gastric bypass surgery is related to decreased caloric intake, predominantly in the fat component.

Adult↗
PubMed1996

Effect of fluoxetine on food intake of humans living in a residential laboratory.

Ten male and one female normal-weight research volunteers, participating in a 16-day residential study, received oral fluoxetine (40 mg) or placebo at 0930 daily. Food intake, performance and subjective ratings were measured throughout the day. The interaction between fluoxetine and carbohydrate consumption was examined by providing subjects diets that engendered varied levels of carbohydrate intake. When subjects received placebo and had access to a regular diet, they consumed 3400 kcal day-1 (53% carbohydrate, 34% fat, 13% protein); and fluoxetine decreased caloric intake to 2770 Kcal, without affecting macronutrient contribution. Caloric intake (2730 Kcal; 67% carbohydrate) under the high-carbohydrate condition when subjects received fluoxetine was not different from intake under the regular-diet fluoxetine conditions. Subjects reported that the high-fat (low-carbohydrate) diet was less palatable and consumed 2975 Kcal under placebo conditions (35% carbohydrate); fluoxetine decreased caloric intake by an additional 400 Kcal without affecting macronutrient contribution. There was no evidence that carbohydrate intake modulated the effects of fluoxetine. Fluoxetine decreased food intake by decreasing the number of eating occasions. Performance and subjective measures were not significantly altered by fluoxetine compared to placebo. Thus, there was no evidence of a specific effect of fluoxetine on macronutrient consumption, nor were the effects of fluoxetine altered by the macronutrient composition of the available diet.

Adult↗
PubMed2004

Eating, drinking and being depressed: the social, cultural and psychological context of alcohol consumption and nutrition in a Brazilian community.

Much has been written about the socioeconomic distribution of nutritional status, both in more economically developed, and in developing nations. In general, persons of lower socioeconomic status suffer adverse consequences of poor nutritional status, although these consequences can vary depending on the level of development, i.e. in more developed countries the problem tends to be one of over-nutrition and obesity, while in developing countries the problem tends to be one of under-nutrition and nutritional deficiencies. In this paper, we explore the socioeconomic distribution of dietary intake in a Brazilian city, in an area that in some ways is neither prototypically developed or underdeveloped. The analysis presented here was stimulated by the surprising observation of no socioeconomic differences in total caloric intake in the context of extreme differences in income distribution. Further examination showed that socioeconomic differences in total caloric intake appeared after controlling for alcohol intake. A complete analysis of the data suggests that lower income leads to lower cultural consonance, which in turn leads to higher depression, higher alcohol intake, and higher total caloric intake. In this model, alcohol ingestion can be seen as both a psychological and nutritional adaptive strategy to economic, social and cultural marginality in a highly stratified society.

Adult↗
PubMedDate not supplied

Nutritional assessment with body composition measurements.

The measurement of body composition by multiple isotope dilution provides an accurate and precise measure of both the nutritional state and the response to nutritional support. A multiple isotope dilution technique has been developed that permits measurement of the three major components of body composition: body fat, extracellular mass (ECM), and body cell mass (BCM). Normal body composition was defined by data obtained in 25 healthy volunteers. Malnutrition is characterized by a loss of BCM and an expansion of the ECM, and as a result the lean body mass is not significantly different from normal. The loss of body weight with malnutrition therefore often reflects the loss of body fat. The utility of body composition measurements was demonstrated by determining the effect of total parenteral nutrition on body composition to determine the relationship between caloric intake and the change in the BCM. A statistically significant relationship was developed which demonstrated that a caloric intake in the range of 30-40 cal/kg/day is required for maintenance. To restore a depleted or malnourished BCM requires a caloric intake in excess of that required for maintenance. The measurement of body composition by multiple isotope dilution is complex and time consuming, and requires specialized laboratory facilities and specially trained personnel. As a result, these measurements are not suited for routine patient management, but should rather be reserved for research purposes.

Adipose Tissue↗
PubMedDate not supplied

Increased responsiveness to exogenous insulin administration in the hyperglycemic obese person with type II diabetes.

This study was undertaken to investigate whether obese persons with type II diabetes mellitus showed less of a response to the hypoglycemic effect of insulin treatment than did lean type II diabetic patients. Forty-three patients (lean, n = 17; obese, n = 22; obese on hypercaloric diets, n = 4) were treated with insulin and placed on a diet calculated to maintain ideal body weight. A rapid decrease in the mean serum glucose concentration was seen in both the lean and obese groups following the initiation of insulin therapy. The glucose concentration of the lean patients plateaued after the second day of insulin treatment, whereas the obese patients' levels continued to fall after the third and fourth days. A difference was noted in the caloric intake of the two groups. Lean patients ingested 28 kCal/kg/day; obese patients ingested 17 kCal/kg/day. An additional group of four obese diabetic patients who ingested 28 kCal/kg/day was studied to determine if the hypocaloric intake of the first group of obese patients had altered their responsiveness to insulin. Despite the higher caloric intake, the mean serum glucose concentration of this group of patients fell more rapidly than did that of the lean patients. Caloric intake during the initiation of insulin therapy does not seem to influence the increase in insulin responsiveness of obese insulin-requiring type II diabetic patients.

C-Peptide↗
PubMed2004

Interaction between corticosterone and insulin in obesity: regulation of lard intake and fat stores.

Passive elevations in glucocorticoids result in increased insulin and abdominal obesity with peripheral wasting, as observed in Cushing's syndrome, with little effect on chow intake. In the absence of insulin (streptozotocin-induced diabetes) diabetic rats markedly increase their chow intake in proportion to glucocorticoids. Given a choice of lard or chow, diabetic rats first eat lard, then reduce caloric intake to normal for 48 h before returning to hyperphagia on chow alone. We performed three experiments to determine the relationship of corticosterone and insulin to lard intake, chow intake, body weight, hormones, and fat depots. The results of these studies clarify the actions of both circulating glucocorticoids and insulin on caloric intake in adult male rats. Our experiments show that glucocorticoids provoke dose-related increases in total caloric intake that persist for days and weeks; the results also suggest that increasing insulin concentrations stimulated by glucocorticoids determine the amount of fat intake. Furthermore, we show that lard intake is associated with increasing insulin concentrations. Additionally, the results in adrenalectomized and adrenalectomized, streptozotocin-induced diabetic rats strongly suggest that it is a combination of corticosterone and insulin that increases abdominal fat depot weight. Independently of the hormonally manipulated rats, the results also show that intact rats voluntarily eat a considerable and stable proportion of their daily calories as lard when given a choice between lard and chow. These results suggest that some human obesities may result from elevated glucocorticoids and insulin increasing the proportional intake of high density calories.

Adipose Tissue↗
PubMed1983

Validation of a dietary questionnaire with plasma carotenoid and alpha-tocopherol levels.

We assessed the validity of a self-administered semiquantitative food frequency questionnaire by comparing carotene and vitamin E intake scores derived from form with plasma carotenoid and alpha-tocopherol levels among a group of 59 men and women. The simple correlation between carotene intake and plasma carotenoid was 0.29 (p = 0.02) and the partial correlation was 0.35 (p = 0.005) after adjustment for age, sex, total caloric intake, and plasma cholesterol and triglycerides. The simple correlation between vitamin E intake and plasma alpha-tocopherol was 0.12 (p = 0.19). However, adjustment for total caloric intake and plasma lipids each substantially increased this association so that the partial correlation adjusting simultaneously for caloric intake, plasma lipids, age, and sex was 0.34 (p = 0.006). As expected on the basis of previous randomized trials, the correlation between preformed vitamin A intake and plasma retinol was weak and not statistically significant. These data support the utility of self-administered food frequency questionnaires for use in epidemiological studies. In addition, they illustrate the importance of adjusting blood alpha-tocopherol levels for lipid concentrations when the former are used as surrogates for vitamin E intake.

Adult↗
PubMed1980

[Concentrated Totamin. Use in pediatric intensive care (author's transl)].

Concentrated Totamin was administered by venous infusion in 32 pediatric patients, aged 2 days to 13 years. In 17 cases (group "A"), patients received Totamin by separated and isolated infusion, which was followed by serum glucose and electrolytes infusion. N intake was 0.17-0.32 g/kg/day (m = 0.23), caloric intake was 5-50 cal/kg/day (m = 25), duration of treatment was 5,17 days. In 15 cases (group "B") patients received Totamin, serum glucose and electrolytes simultaneously. N intake was 0.07-0.26 g/kg/day (m = 0.17), caloric intake was 20-72 cal/kg/day (m = 47), duration of treatment was 5 days. The N positive or equilibrate total positive balance ratio is identical in both the groups = 12/17 (70.6%) in group "A" and 10/15 (66.7%) in group "B". But in 11 patients (5 of group "A" and 6 of group "B") which received an identical N intake (0.20 g/kg/day) N balance was negative in 5 (A) and positive in 6 (B). Thus its appears that for an identical N intake, serum glucose infusion simultaneously with concentrated Totamin, is a more efficacious treatment than alternate infusion. Simultaneous infusion produces and better utilisation of Totamin and a N positive balance.

Adolescent↗
PubMed2001

Oral supplementation of branched-chain amino acid improves nutritional status in elderly patients on chronic haemodialysis.

BACKGROUND: Anorexia may be associated with decreased plasma levels of branched-chain amino acids (BCAA). In malnourished elderly haemodialysis (HD) patients, oral BCAA supplementation may improve anorexia, resulting in improved nutritional status. METHODS: Among 44 elderly (age >70 years) patients on chronic HD, 28 patients with low plasma albumin concentration (<3.5 g/dl) were classified as the malnourished group; they also suffered from anorexia. The other 16 patients did not complain of anorexia and were classified as the well-nourished group. We performed a 12-month, placebo-controlled, double-blind study on the malnourished group. Fourteen patients each received daily oral BCAA supplementation (12 g/day) or a placebo in random order in a crossover trial for 6 months. Body fat percentage, lean body mass, plasma albumin concentration, dietary protein and caloric intakes, and plasma amino acid profiles were monitored. RESULTS: Lower plasma levels of BCAA and lower protein and caloric intakes were found in the malnourished group as compared to the well-nourished group. In BCAA-treated malnourished patients, anorexia and poor oral protein and caloric intakes improved within a month concomitant with the improvement in plasma BCAA levels over the values in well-nourished patients. After 6 months of BCAA supplementation, anthropometric indices showed a statistically significant increase and mean plasma albumin concentration increased from 3.31 g/dl to 3.93 g/dl. After exchanging BCAA for a placebo, spontaneous oral food intake decreased, but the favourable nutritional status persisted for the next 6 months. In 14 patients initially treated with a placebo, no significant changes in nutritional parameters were observed during the first 6 months. However, positive results were obtained by BCAA supplementation during the subsequent 6 months, and mean plasma albumin concentration increased from 3.27 g/dl to 3.81 g/dl. CONCLUSIONS: Normalization of low plasma levels of BCAA by oral supplementation can reduce anorexia and significantly improve overall nutritional status in elderly malnourished HD patients.

Administration, Oral↗
PubMed1986

Ventilatory and treadmill endurance during acute semistarvation.

Little is known about respiratory muscle function in acute undernutrition, although an inadequate caloric intake is common in numerous disease states. Twelve young-adult, healthy female volunteers performed two familiarization experiments and were then studied after 7 days of consuming 40% of normal daily caloric intake as well as after 1 wk of normal caloric intake. In each experiment subjects performed tests of resting pulmonary function, inspiratory muscle strength, and ventilatory endurance, the last of which involved two 60-s and two 6-min isocapnic maximum voluntary ventilation maneuvers. Subjects then walked to exhaustion in 8-20 min on a treadmill. The caloric restriction did not affect performance of any breathing test but did lower endurance time in severe treadmill exercise (P less than 0.05). Basal metabolic rate was lowered, resting blood levels of free fatty acids and beta-hydroxybutyrate elevated, and glucose lowered following the caloric restriction (P less than 0.05). Blood lactate levels were lower during and after exercise following caloric restriction (P less than 0.05). We conclude that ventilatory muscle strength and endurance are fully preserved in caloric restriction severe enough to cause mild ketoacidosis and hypoglycemia, lowered basal metabolic rate, and decreased endurance in severe treadmill exercise.

Acute Disease↗