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Visceral protein levels in trauma patients are greater with peptide diet than with intact protein diet.

Early enteral nutrition may preserve gut function and prevent bacterial translocation after trauma. Standard enteral nutrition uses products which contain intact protein and require digestion for absorption. Peptide-based enteral nutritional products are better absorbed and stimulate the release of gut trophic hormones. This study was performed to determine whether a peptide-based (PEP) product (Reabilan HN) was better tolerated and/or produced better hepatic protein responses in patients after trauma when compared to an intact-protein (PRO) formula (Osmolite HN). Eighteen trauma patients were prospectively randomized to PEP (n = 9) or PRO (n = 9) enteral diets administered via nasoduodenal tubes (within 1-2 days of injury). Visceral protein synthesis was assessed by measuring baseline and 1 week pre-albumin and transferrin levels. Diarrhea was defined as greater than 300 gm/day of stool. Groups were similar in age, Injury Severity Score (ISS), caloric intake, and protein intake. Protein levels increased significantly faster in PEP patients despite similar urea nitrogen excretion. Diarrhea developed in four (44%) PRO patients and none of the PEP patients. Three of the PRO patients were switched to PEP after one week and diarrhea subsided in all three patients. Peptide-based enteral diets are associated with better hepatic protein responses and less diarrhea compared to intact-protein diets.

Adolescent↗

Diet induced ketosis in epilepsy and anaesthesia. Metabolic changes in three patients on a ketogenic diet.

Ketogenic diets have a high fat and low carbohydrate and low protein content to induce ketosis which is monitored by daily urine testing. Lapses in diet are frequently associated with loss of anticonvulsant control. There has, as yet, been no report of children maintained on a ketogenic diet subject to anaesthesia and surgery: this paper records the changes in metabolic variables observed in three patients undergoing simple inhalation anaesthetics for minor surgery.

Anesthesia, Inhalation↗

Influence of weight reduction on platelet volume: different effects of a hypocaloric diet and a very low calorie diet.

Since platelet volume reflects platelet activity, the mean platelet volume (MPV) is proposed to be a further independent risk factor for cardiovascular disease (CVD). Even if it is well established that weight reduction reduces some of the risk factors of CVD in obese patients, an increase of MPV occurs during periods of weight loss. We therefore prospectively investigated the effects of different weight reduction therapies on platelet mass, platelet volume, body weight and serum lipid profile in patients undergoing an 8 week weight reduction therapy either by a hypocaloric diet (HD) or a nutritionally completed very low calorie diet (VLCD) with a subsequent maintenance period of 40 weeks. In both groups, MPV transiently increased during the 8 week diet period. After 48 weeks the MPV was decreased to initial values. The change in MPV was significantly (P < 0.05) smaller in the VLCD group. We therefore suggest that fasting might alter the control of platelet size with a possible impact on platelet activity. This might result in an increased risk for thromboembolic ischaemic events in atherosclerotic patients. Thus, we conclude that the use of a VLCD is potentially superior for weight reduction in patients with pre-existing atherosclerosis.

Adult↗

Blood vitamin concentrations in privately owned dogs fed non-standardized commercial diets and after intake of diets with specified vitamin concentrations.

The objective was to investigate in a survey study the blood vitamin concentrations in healthy dogs fed non-specified commercial complete diets and in an intervention study to determine the effects of defined dietary vitamin intakes on blood vitamin levels and hair and skin condition. Sixty-four privately owned dogs, aged from 1 to 8 years, without history of skin or coat problems were included. All animals were fed commercial complete diets with uncertain vitamin concentrations before enrolment. The animals were assigned, according to weight and gender, to four groups with graded vitamin intakes. The blood vitamin levels and skin and coat quality of the dogs were investigated at days 0 and day 122. Coat and hair condition was not influenced by the experimental diets. The retinol concentrations were reduced at the end of the experiment compared with the baseline levels, retinyl esters were not influenced. 25-Hydroxycholecalciferol decreased in all groups, alpha-tocopherol was constant or tended to decrease. Ascorbic acid, thiamine pyrophosphate and riboflavin concentrations were not affected by treatment, flavin adenine dinucleotide and pyridoxal-5'-phosphate were partially reduced on day 122. Cobalamin, pantothenate and biotin concentrations increased with higher dietary intakes, folate levels in tendency. In conclusion, this study gives a survey of blood vitamin concentrations in healthy dogs and provides a data base for the evaluation of the vitamin status in health and disease.

Animal Feed↗

Benefits of the nonfasting ketogenic diet compared with the initial fasting ketogenic diet.

OBJECTIVE: The ketogenic diet (KD) is traditionally introduced with an initial period of fasting and fluid restriction that is difficult and sometimes complicated by moderate dehydration. This investigation compares the efficacy and tolerability of the nonfasting ketogenic diet (NFKD) and the conventional initial-fasting ketogenic diet (IFKD). METHODS: Forty-one children with intractable epilepsy were treated with the NFKD, beginning with a gradual increase in calories with no initial fasting or fluid restriction. This NFKD population was compared retrospectively with 83 recent historical control subjects who were treated with the IFKD. Efficacy, tolerability, time until strong ketosis, and occurrence of complications were compared. RESULTS: Fourteen (34.1%) patients became seizure-free for at least 3 months after the NFKD, compared with 29 (34.9%) after the IFKD. There was no significant difference in days until strong urinary ketosis between the 2 groups. The incidence of hypoglycemia was also not significantly different between the groups as most other laboratory findings, although the blood urea nitrogen was elevated in 24.1% of the IFKD group and in only 12.2% of the NFKD patients without statistical significance. Conversely, moderate dehydration was significantly less frequent in the NFKD group (12.2%) than in the IFKD group (62.7%). Finally, these results were reflected to the shortening of the hospitalization period in the NFKD group. CONCLUSIONS: These observations suggest that initial fasting and fluid restriction are not essential for the KD and that the tolerability of this treatment may be improved. These data support our intention to conduct a formal, prospective, randomized trial comparing 2 forms of the KD.

Child, Preschool↗

Gestational diabetes mellitus (GDM). Comparative evaluation of two treatment regimens, diet versus insulin and diet.

Two-hundred and two pregnant women with impaired glucose tolerance were randomized to treatment with diet or diet and insulin by stratified selection. Self-monitoring of blood glucose was performed six times a day, 3 days/wk. Dietary treatment was considered inappropriate if fasting and postprandial blood glucose values exceeded 7 and 9 mmol/L, respectively, in which case insulin therapy was instituted. Insulin doses were adjusted according to blood glucose values, aiming at fasting and postprandial values below 5 and 6.5 mmol/L, respectively. There were no perinatal deaths. The two treatment regimens disclosed no differences regarding achieved degree of maternal blood glucose control, hemoglobin A1c at delivery, obstetric or neonatal complications, infant's size at birth including skin-fold thickness, or C-peptide concentration in cord serum. Routine treatment of pregnant women with mild carbohydrate intolerance with insulin seems unnecessary. However, 15 patients (14%) in the diet group needed insulin to achieve acceptable blood glucose control, underlining the importance of monitoring blood glucose to detect those who are at risk of developing overt diabetes.

Adolescent↗

Effect of voluntary exercise on physiological function and feeding behavior of mice on a 20% casein diet or a 10% casein diet.

The effects of voluntary exercise on growth and food intake, body composition, organ weight, and fatty acid composition of adipose tissue of mice fed on a 20% casein diet or a 10% casein diet were examined. The weight gain was greater for the 20% casein nonexercise group (20% NE) than that for the 20% casein exercise group (20% E), 10% casein exercise group (10% E) and 10% casein nonexercise group (10% NE). There were no significant differences between the groups except the 20% NE. In 20% E and 10% E, body fats decreased markedly. On the other hand, a very high ratio of protein was present in the body composition of both groups. In the 20% and 10% casein diet groups, food intake was increased by voluntary exercise, but there was no significant difference between 10%E and 10% NE except occasional periods during these experiments. After 6 weeks of age, 10% E had a tendency to undertake more voluntary exercise than 20% E, though the difference was not statistically significant. Development of the heart and gastrocnemius muscles was accelerated by voluntary exercise and epididymal fat tissue was markedly decreased.

Adipose Tissue↗

Nutritional studies of the south eastern state peasant diet: studies of the effect of malarial infection (Plasmodium berghei) on electrolyte changes in rats fed the peasants' diet.

1. Plasmodium Berghei (malaria infection) is not specifically related to the nutritional status of the host though nutritional status may aid the advance or elimination of the parasite. 2. The effect of the infection is more severe in low protein diets than in diets whose protein content was adequate. 3. There was no evidence of excessive urinary excretion of electrolytes in the infected rats. 4. It is suggested that low plasma levels of electrolytes in the infected rats were due to skin losses and these losses were independent of the protein content of the diet thus severity of malarial infection is unaffected by protein nutrition.

Animals↗

[Unusual fatty acids in turkeys fed a diet containing "Toprina". I. Composition of the higher fatty acids in "Toprina", the diet, feces and blood].

Totals lipids (TL) phospholipids (PL) and fatty acid composition of TL and PL (the latter in blood only) were estimated in Candida lipolytica cultivated on n-alkanes by industrial method ("Toprina"), in 0%, 10% and 15% "Toprina" diets and in faeces and blood of turkeys, males and females, fed these diets. With increasing concentrations of dietary "Toprina" phospholipids and 15:0 and 17:0 fatty acids increased, 17:1 and 17:2, typical of the product, appeared and increased in diets and blood. Other lipid and fatty acids values were not affected by dietary yeast.

Alkanes↗

[Diet induced changes of Ca-regulation in rabbit papillary muscle. 1. Contraction and relaxation following a cholesterol diet].

To characterize consequences of cholesterol induced increases of the Na content on the Ca regulation in rabbit myocardium the influence of increasing extracellular Ca (Cae) on isometric contraction and relaxation of papillary muscles has been investigated after a 12 weeks lasting cholesterol-rich diet. After cholesterol-rich diet increasing Cae caused a higher augmentation in peak tension T, accompanied by a decreased index in contractility [Formula: see text], an insignificantly prolonged time to peak tension TPT, and a decrease in the refractory period, which was extended compared with the control group. A delay in relaxation is demonstrated by the maximum relaxation rate [Formula: see text], the half time of relaxation RT 1/2 and more pronounced by a prolonged relaxation time RT. The results correspond with changes in the Na content published earlier and are in agreement with the assumption that a Na-Ca exchange is involved in beat-to-beat regulation in rabbit myocardium; thereby the cholesterol component of atherogenic diet promotes Ca enhancement in rabbit cardiac cells.

Animals↗

[Diet-induced changes on Ca-regulation in rabbit papillary muscle. 2. Contraction, relaxation and rest potentialization following a rapeseed diet].

To characterize consequences of rape oil-induced changes on the Ca regulation in rabbit papillary muscle, the influence of increasing extracellular Ca (Cae) on contraction, relaxation and resting potentiation of tension has been investigated after a 12 weeks lasting rape oil-diet. After oil diet increasing Cae caused a similar augmentation in peak tension T accompanied by an increased index in contractility [Formula: see text], a significantly shortened time to peak tension and a decline in refractory period. A higher relaxation rate is demonstrated by the maximum relaxation rate [Formula: see text], the half time of relaxation RT 1/2 and relaxation time RT. The resting potentiation of the isometric contraction was enhanced. The results are in agreement with the assumption that the sarcoplasmic reticulum (SR) is more involved in Ca regulation after the oil diet than in the control group. This may be related to differences in the phospholipid content of SR membranes.

Animals↗

[The influence of diet habits and diet compose upon the heart and circulation system of elderly people (author's transl)].

The following conclusions can be drawn from examination results: 1. The degree to which the functional condition of the cardiovascular system varies depends on the caloric content of the diet. 2. In elderly patients functional changes of the cardiovascular system can be observed to take place in two stages (1st stage about 1 hour, 2nd stage from 3rd to 5th hour after meals). 3. A high-caloric diet can be expected to provoke an inadequate cardiovascular response in elderly hypertensives. 4. The impact of fat in the diet on cardiovascular function depends on the subject's age and the kind of fat consumed. Saturated fats have a more adverse effect that unsaturated ones. 5. That a high concentration of blood sugar influences metabolic processes in the myocardium (ATP metabolism, potassium balance, membrane effects) seems to be an established fact. 6. Insulin appears to have a considerable direct effect on the myocardium and on variations of the sympathico-adrenal and vago-insulinary systems. 7. The second postprandial stage of functional changes in the cardiovascular system, based on a relative hypoglycaemia, is probably induced by a sudden release of catecholamines.

Adult↗

Influence of the DASH diet and other low-fat, high-carbohydrate diets on blood pressure.

The Dietary Approaches to Stop Hypertension (DASH) and DASH-sodium trials were controlled feeding dietary trials that lowered blood pressure in the absence of weight loss. The beneficial aspect of DASH appears to be the low saturated fat content (< 7%). Sodium restriction added additional blood pressure lowering to the low saturated fat DASH diet. Sodium restriction was more effective with increasing age and more effective than increasing fruit and vegetable content. When achievement of sodium restriction, exercise, and weight loss goals were reached in the outpatient setting with subjects making their own food choices (as in the PREMIER study), adding the DASH diet with an average fruit and vegetable intake of 7.8 servings daily had no additional benefit in those younger than 50 years of age or in ethnic/gender subgroups, but did have a benefit for the total group older than age 50 years. Because many hypertensive subjects are overweight, hypocaloric versions of DASH geared toward weight loss are appropriate. Mechanisms for dietary beneficial effects are related to inflammation and insulin sensitivity.

Blood Pressure Determination↗

Diet and lung cancer risk: findings from the Western New York Diet Study.

This study compares the diets of 450 lung cancer cases (296 males, 154 females) with those of 902 controls (587 males, 315 females). Cases were lung cancer patients diagnosed between August 1980 and July 1984 in three western New York counties, while controls were selected from the general population of these same counties. Usual diet was estimated by detailed interviews using a modified food frequency method. Case-control comparisons were made for dietary fat, protein, fiber, calories, cholesterol, and vitamins A, C, and E according to quartiles of intake, adjusting for age and pack-years of cigarettes by multiple logistic regression. Risk was lower for males in the lowest quartile of total dietary fat intake compared with those in the highest quartile (relative risk = 0.5), although the overall trend in the association with dietary fat was not statistically significant (p = 0.12). Likewise, there was a weak, but not statistically significant, direct association between dietary cholesterol and lung cancer in men (p = 0.17). The intake of vitamin A from fruits and vegetables (carotene) was much more strongly associated with reduced cancer risk. For males, the relative risks by quartiles (lowest intake to highest intake) were 1.8, 1.8, 1.0, 1.0 (p for trend = 0.001). For females, this relation was considerably weaker, and was not statistically significant. These findings are generally in agreement with those of several previous studies. The risk reduction associated with vitamin A from fruits and vegetables (carotene) was most evident for males, for those with squamous cell cancers, for light or ex-smokers, and for those over 60 years of age.

Adult↗

Relationship between diet and smoking--is the diet of smokers different?

STUDY OBJECTIVE: The aim was to compare nutrient intakes of smokers, past smokers, and non-smokers. DESIGN: The study was cross sectional and compared nutrient intake by smoking status using data obtained from a concurrent study of diet. SETTING: The study took place in three towns in England: Ipswich, Wakefield, and Stoke on Trent. PARTICIPANTS: Food records were obtained from 1115 men and 1225 women aged 35 to 54 years, representing response rates of 84-86% in the three towns. MEASUREMENTS AND MAIN RESULTS: Diet was assessed using a 24h food record in household measures. For both men and women vitamin C, total fibre, beta carotene, and vitamin E intakes were lowest in the current smokers and highest in the non-smokers with past smokers having intermediate values. Polyunsaturated/saturated fat ratio was lowest in the current smokers. Men who smoked had higher energy intakes than those who did not. The lower fat intakes of beta carotene, vitamin C, fibre, and polyunsaturated fat in the smokers was due to fewer smokers eating a whole range of foods including fruit, wholemeal bread, cereals, and polyunsaturated margarine. Current smokers had a lower body mass index than non-smokers or past smokers despite their higher energy intakes. CONCLUSIONS: Smokers have different nutrient and food intakes compared with past smokers or non-smokers.

Body Mass Index↗

Fad diets and obesity--Part II: An introduction to the theory behind low-carbohydrate diets.

Low-carbohydrate diets are not only highly popular but also controversial. The theory or general concept behind the low-carbohydrate dietary approach needs to receive more attention to provide more objectivity to this discussion. The theory or concept that actually has some evidence currently lies in the values of the glycemic index (GI) and glycemic load (GL). Basically, the higher the GI, the greater the glucose response. However, the GI system that was originally proffered in 1981 comes with one apparent limitation in that some foods or beverages need to be obtained in enormous amounts in order to observe such a glucose change. Therefore, the newer concept of GL (derived from the GI) is based on a more moderate-portion size and the resultant glucose change with some of the higher GI foods or beverages actually demonstrating a low GL. These and other limitations and some advantages of low-carbohydrate diets with an emphasis of what an actual GI or GL means are discussed.

Diet Fads↗

Dietary chromium intake. Freely chosen diets, institutional diet, and individual foods.

Chromium content of 22 daily diets, designed by nutritionists to be well-balanced, ranged from 8.4 to 23.7 micrograms/1000 cal with a mean +/- SEM chromium content of 13.4 +/- 1.1 micrograms/1000 cal. Most diary products are low in chromium and provide less than 0.6 micrograms/serving. Meats, poultry, and fish are also low in chromium, providing 2 micrograms of chromium or less per serving. Chromium contents of grain products, fruits, and vegetables vary widely, with some foods providing greater than 20 micrograms/serving. In summary, chromium content of individual foods varies, and is dependent upon chromium introduced in the growing, transport, processing, and fortification of the food. Even well-balanced diets may contain suboptimal levels of dietary chromium.

Adult↗

Influence of high-fat diet on amine oxidase activity in white adipose tissue of mice prone or resistant to diet-induced obesity.

Decreased monoamine oxidase (MAO) activity has been observed in adipose tissue of obese patients. Since substrates of MAO and semicarbazide-sensitive amine oxidase (SSAO) can modify adipocyte metabolism, this work investigates whether changes in amine oxidase activity may occur during white adipose tissue (WAT) development. We evaluated MAO and SSAO activities in WAT of high-fat diet (HFD) and low-fat diet fed mice. To distinguish the effect of HFD on its own from the effect of fat mass enlargement, obesity-prone transgenic line of the FVBn strain lacking beta3-adrenergic receptors (AR) but expressing human beta3-AR and alpha2-AR (mbeta3-/-, hbeta3+/+, halpha2+/-) was compared to its obesity-resistant control (mbeta3-/-, hbeta3+/+). As already reported, the former mice became obese while the latter resisted to HFD. No significant change in SSAO or MAO activity was found in WAT of both strains after HFD when expressing oxidase activity per milligram of protein. However, when considering the overall capacity of the fat depots to oxidize tyramine or benzylamine, there was an increase in MAO and SSAO activity only in the enlarged WAT of HFD-induced obese mice. Therefore, the comparison of these models allowed to demonstrate that the higher amine oxidase capacity hold in enlarged fat stores of obese mice is more likely the consequence of increased fat cell number rather than the result of an increased expression of MAO or SSAO in the adipocyte.

Adipose Tissue↗