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PubMed1988

Quantitative therapeutic plan for the treatment of obesity and a simple method for estimating appropriate caloric intake by using previous rate of weight loss.

We have formulated an equation for the calculation of the caloric intake in a reducing diet that is suited to individual obese patients. We have designed a system in which the weight loss achieved after the intake of a fixed number of calories over a given period is used as a basis for the next weight-reducing plan for a given patient. We devised the formula Y = X - 1000 (b2/a2-b1/a1) for calculating the daily caloric intake (Y). X is the previous caloric intake; b1 is achieved weight loss (kg) in the previous period (a1 weeks); and b2 is the planned reduction in weight in the subsequent target period (a2 weeks).

Energy Intake↗

PubMed1985

Influence of caloric intake on the respiratory mode during mandatory minute volume ventilation.

Mandatory minute volume ventilation has been proposed as a method for weaning patients from ventilators. The purpose of this study was to delineate the influence of caloric intake on spontaneous ventilation in patients receiving mandatory minute volume ventilation. While the value of such ventilation remained unchanged, eight patients were studied at the following three different levels of daily caloric intake: (1) level A, mean of 223 kcal/sq m; (2) level B, mean of 1,380 kcal/sq m; and (3) level C, mean of 2,100 kcal/sq m. We performed gas exchange measurements and a 24-hour recording of ventilation with a monitoring system providing distinction between spontaneous and mechanical cycles. We found that the ventilatory mode was markedly dependent upon the nutritional intake; the percentage of spontaneous ventilation over 24 hours increased from 11 +/- 7 percent (+/- SE) during diet A to 50 +/- 9 percent during diet B and 79 +/- 8 percent during diet C. This increment paralleled the increase in production of carbon dioxide with caloric intake. We suggest therefore that the patient's ability to breathe spontaneously when receiving mandatory minute volume ventilation should be interpreted according to caloric intake.

Aged↗

PubMed1991

Maternal weight and sire group, not caloric intake, influence adipocyte volume in infant female baboons.

We tested the hypothesis that overfeeding with a high caloric (concentrated) formula increases growth without influencing adipocyte volume in preweaning infant baboons. Female infant baboons from three sires and 25 dams were fed either 67.5 kcal (normal formula) or 94.5 kcal (concentrated formula)/100 g Similac formula. Immediately before weaning (19 wk), adipocyte volume was measured in biopsied adipose tissue from omentum, flank, and popliteal depots. From birth until weaning, infants fed the concentrated formula consumed 20% more total calories, averaged 15% more calories/kg/wk, and gained 14% more weight than normally fed infants. Adipocyte volume differed significantly among different sites (omentum greater than popliteal greater than flank) and among different sire groups. Increased caloric intake alone did not increase adipocyte volume. There was a small but significant sire by infant formula interaction on adipocyte volume. When fed the concentrated formula, progeny from one sire had larger adipocytes than normally fed infants, whereas progeny from the other two sires had smaller adipocytes or adipocytes that were comparable to infants fed normal formula. Variability in adipocyte volume at 19 wk of age was best accounted for by maternal weight and sire group (omentum R2 = 0.334, p = 0.026; flank R2 = 0.532, p = 0.01; popliteal R2 = 0.482, p = 0.01) and not by caloric intake. These results suggest that the level of triglyceride deposition into adipocytes attained during preweaning growth is determined to a greater extent by genetic and other factors rather than caloric intake.

Adipose Tissue↗

PubMed2005

The effect of the presence of others on caloric intake in homebound older adults.

BACKGROUND: Undernutrition in homebound older adults is a significant problem. The purpose of this study was to investigate the effect of the presence of others, both within the household and during meals, on caloric intake in homebound older adults. METHODS: In-depth interviews and three 24-hour dietary recalls were obtained from 50 older adults who were receiving home health services. Descriptive statistics were used to characterize participants, and hierarchical linear modeling was performed to evaluate predictors of caloric intake per meal. RESULTS: Participants' mean age was 77. Females composed 65% and African Americans composed 42% of the sample. Analyses are based on 553 meal observations. The majority (84%) of participants consumed all meals for each of the 3 days of data collection; however, they consumed an average of only 1305 calories per day. Hierarchical linear modeling analysis indicated that persons who had others present during meals consumed an average of 114.0 calories more per meal than those who ate alone (p =.009) and that women consumed 76.7 fewer calories per meal than did men (p =.045). The presence of others within the household had no effect on caloric intake. CONCLUSION: This research suggests that a simple and inexpensive way to increase caloric intake in homebound older adults is to make arrangements for family members or caregivers to eat with them.

Aged↗

PubMed1991

Relationships between weight and caloric intake of men who stop smoking: the Multiple Risk Factor Intervention Trial.

Data from 6,569 middle-aged men in the Multiple Risk Factor Intervention Trial were analyzed to determine whether the weight change associated with smoking cessation resulted primarily from appetite or metabolic alterations. The appetite hypothesis attributes weight gain to an enhanced appetite and subsequent increase in caloric intake. The metabolic change hypothesis attributes weight gain to a metabolic alteration and subsequent decrease in basic caloric needs. Caloric intake and weight changes were tabulated for men who quit smoking and were compared to similar changes in men who continued smoking over 12 months. The difference between caloric intake changes in men quitting smoking versus men continuing smoking, controlled for weight change, was attributed to the metabolic change hypothesis. Men who quit smoking consumed 103 calories per day less (95% confidence interval = 29 to 177) than men who continued smoking with similar body weight changes. The decrease in caloric intake attributed to smoking cessation was proportional to the number of cigarettes smoked prior to cessation [corrected].

Adult↗

PubMed1977

Postnatal growth of infants of less than 1.3 kg birth weight: effects of metabolic acidosis, of caloric intake, and of calcium, sodium, and phosphate supplementation.

Weekly increments of length, weight, head circumference, and skinfold thickness in response to a series of dietary changes were measured in 108 healthy infants who weighed less than 1.3 kg at birth. The serial manipulations included prevention of late metabolic acidosis, increased caloric intake, and calcium, sodium, and phosphorus supplementation. The study comprised four phases; the infants were divided into ten groups according to dietary regimen. AGA and SGA infants were studied separately. Growth in length was primarily influenced by a change to a formula providing a higher caloric intake and a 60:40 whey protein/casein ratio. Correction of late metabolic acidosis, sodium, and phosphorus supplementation had minor additive effects on growth in length. Increased caloric intake also influenced growth of head circumference, but only in AGA infants. Only the sodium intake was shown to influence body weight increments significantly with the range of caloric intake used in the study (132 to 160 calories/kg/day).

Acidosis↗

PubMedDate not supplied

Altered testosterone feedback in pubertal male rats raised on reduced caloric intake.

A study was conducted to explore the hypothesis that reduced caloric intake increases the negative feedback efficacy of testosterone on gonadotropin secretion. Daily subcutaneous injections of testosterone propionate in oil were administered to either age-matched (37-day-old) or weight-matched (mean = 178 g) ad libitum-fed (control) or underfed rats that received 60% of normal daily food intake from the age of 20 days. Daily doses of testosterone propionate ranged from 25 to 400 micrograms/100 g body weight. Results indicate that reduced caloric intake increases the suppression of serum LH by testosterone propionate in both age-matched and weight-matched underfed rats. On the other hand, the response of serum FSH concentrations to testosterone propionate was affected by reduced diet only in the weight-matched animals. Results suggest that the increased negative feedback of testosterone on LH secretion is a specific diet-induced effect and not merely the result of reduced growth. The altered response in FSH secretion, however, may represent age-associated changes in sensitivity to testosterone rather than diet-induced effects.

Animals↗

PubMed1995

Caloric intake stimulates growth hormone secretion in food-deprived rats with anterolateral deafferentation of the medial basal hypothalamus or administered antiserum to somatostatin.

In rats, food deprivation inhibits episodic growth hormone (GH) secretion. On the basis of previous studies, we hypothesized that during a recovery from prolonged fasting, caloric intake stimulates the release of GH-releasing factor (GRF) and this process does not depend on the specific macronutrients in the meal, while protein in the meal acts to restore characteristic ultradian rhythmicity of GH secretion. To test this hypothesis, the effect of caloric intake on GH secretion was examined in fasted adult male Wistar rats devoid of somatostatin (SS) influence on GH secretion either by anterolateral deafferentation (ALC) of the medial basal hypothalamus (MBH) or administration of anti-SS goat serum (ASS). Rats were provided with an indwelling right atrial cannula and were deprived of food for 72 h. ALC was performed 2 weeks prior to the study. ASS was given i.v. 8 h and 7 h prior to refeeding, respectively. Serial blood specimens were collected every 10 min. In rats with ALC (ALC rats) or rats given ASS (ASS rats), the blood GH level revealed irregularly occurring small fluctuations, instead of the usual high bursts and low trough level. The baseline GH level and the mean GH level of fasted ALC rats or fasted ASS rats were significantly lower than those of fed ALC rats or fed ASS rats. Feeding the isocaloric mixed meal, the protein meal or the protein-deficient meal increased the GH pulse frequency, the pulse amplitude, the baseline GH level and the mean GH level in 72-h fasted ALC rats. These changes in GH secretory pattern persisted during the period of observation and were independent of the type of meal ingested. Following feeding the mixed meal, similar changes in the GH secretory pattern demonstrated in 72-h fasted ALC rats were also observed in 72-h fasted ASS rats, suggesting that the stimulation of GH secretion following caloric intake is not limited to ALC rats. Since the influence of SS on GH secretion has been largely eliminated in ALC or ASS rats, it is highly unlikely that the augmentation of GH secretion following feeding after prolonged food deprivation was the consequence of inhibition of SS secretion. Although GRF measurement was not performed, it is conceivable that the signal of caloric intake is conveyed to the MBH and acts to stimulate GRF release.

Animals↗

PubMedDate not supplied

Comparison of resting energy expenditures and caloric intake in children with severe burns.

Nutritional support is provided to children after severe burn injuries in amounts derived from empirical formulas or measurements of resting energy expenditure. To scrutinize these methods, indirect calorimetry measurements were performed on 74 survivors of burns (greater than or equal to 40% total body surface area) and compared to their actual caloric intake, percent weight change, and optimal caloric requirements formulated from the Curreri and Shriners' equations. These parameters showed that in spite of an initial deficit in actual caloric intake as compared to formulated goals, weight was maintained, whereas resting energy expenditures ranged from 30% to 40% below the actual caloric intake. Furthermore, a subgroup of patients (n = 42) who met +/- 20% of their formulated needs were stratified by extent of burn; this illustrated a significant weight gain in the more severely burned children. In conclusion, nutritional formulas in popular use overestimate caloric requirements in severe burns, whereas resting energy expenditure measurements require an additional factor of 30% to maintain body weight.

Body Weight↗

PubMed1990

A proxy approach to the determination of total caloric intake for use in cancer epidemiology.

In the absence of complete dietary information on a cohort of 472 early-stage breast cancer patients a caloric prediction technique was developed. Deriving an accurate caloric denominator would enable examination of individual nutrient effects by controlling for potential confounding by calories. Surrogate measures of mean daily caloric intake were generated from estimates of basal metabolic rate (BMR) predicted from age, height, weight, and physical activity. A validation study was undertaken to test the relationship between the BMR proxy terms and mean daily energy intake obtained from four-day food diaries for 51 subjects. Pearson correlation coefficients between the diary-derived and predicted values of caloric intake were computed (r = 0.43, p = 0.001). The results are in the range of what many researchers found when comparing self-reports of total caloric intake in validation and reliability studies of various dietary assessment tools. Because of the large heterogeneity of results across the ages represented in this study (25-77 yrs), it is recommended that small validation studies of this type be carried out in the subpopulations of interest.

Adult↗

PubMed1975

Caloric intake and unconjugated hyperbilirubinemia.

Reduction in caloric intake was associated with a greater absolute rise in the serum bilirubin concentration in patients with Gilbert's syndrome and partial hepatic bilirubin uridine diphosphate glucuronyltransferase (UDPG-T) dysfunction compared to patients with hemolytic unconjugated hyperbilirubinemia and normal subjects. Two patients with overt hemolysis but an exaggerated response to caloric deprivation had reduced UDPG-T activities comparable to Gilbert's syndrome. The UDPG-T activities in the other patients with hemolytic jaundice were normal. The combination of fasting and novobiocin in 2 normal subjects produced a greater increase in bilirubin level than either fasting or novobiocin alone. These data suggest that theunderlying UDPG-T dysfunction, rather than the prefasting level of unconjugated hyperbilirubinemia, is responsible for the diet-induced hyperbilirubinemia in Gilbert's syndrome. The diet test appears to differentiate Gilbert's syndrome from hemolytic jaundice as well as from normal subjects, irrespective of the initial serum bilirubin concentration.

Anemia, Hemolytic↗

PubMed2005

Relationship between caloric intake and pregnancy outcome in diet-treated gestational diabetes mellitus.

A prospective observational study was performed to examine the relationship between estimated caloric intake with maternal blood glucose profile and infant outcome in a group of Chinese women with gestational diabetes mellitus (GDM) treated by diet alone. Following the diagnosis of GDM according to the World Health Organization (WHO) criteria, and using a 75 g oral glucose tolerance test (OGTT), 62 non-obese Chinese women who had completed a 5-day dietary survey were recruited into the study. They were categorized by their mean caloric intake over 5 days into tertiles for comparison of gestational weight gain, glycemic control and pregnancy outcome. Subjects in the highest tertile had a mean intake close to the prescribed intake. No differences were seen in maternal characteristics, gestational weight gain, OGTT, other postprandial glucose concentrations, or infant outcome among the tertiles. Our findings indicated that as long as the caloric intake did not exceed that prescribed, the infant outcome remained satisfactory.

Adult↗

PubMed2002

Thermal and respiratory control in young rats with altered caloric intake during postnatal development.

We asked to what extent differences in caloric intake during the first postnatal weeks may modify thermal and respiratory control of 1-month old rats. Large-size (Large) and small-size (Small) rats were obtained by raising rats in, respectively, small (6 pups) and large (16 pups) litters. In Small, the rate of oxygen consumption (V(O(2))/kg) was less than in Large during the first 2-3 weeks, and higher thereafter, when the thermogenic needs to maintain body temperature (Tb) increased. At day 31, when body weight in Small was approximately 80% of Large, Small maintained Tb in the cold with higher V(O(2))/kg than Large. The total uncoupling protein of the brown adipose tissue was unchanged. Also pulmonary ventilation (VE/kg) was higher in Small, maintaining the proportionality with V(O(2)). Lung weight in Small was reduced in proportion to body weight, with higher protein-DNA ratio. The compliances of the respiratory system and lungs, normalized by body weight, and the hyperventilatory responses to hypoxia or hypercapnia, expressed as % increase in VE/V(O(2)), were similar in Small and Large. Differences between Small and Large were reduced or no longer present in a group of Small rats raised until their body weight was as in Large. We conclude that rather important developmental differences in caloric intake and metabolic level, in otherwise healthy rats, had no long-term carry over effects in the developmental processes of respiratory and thermal control, other than the effects strictly attributable to the alterations in body size.

Adipose Tissue↗

PubMed1993

Weight Loss and Caloric Intake after Regular and Extended Gastric Bypass.

The morbidly obese and especially the super-morbidly obese (> 225% ideal body weight) often require gastric bypass surgery as treatment for long-term remission of their obesity. The extended gastric bypass Roux-en-Y (X-GBP) procedure evolved as a result of a perceived need to increase weight loss in morbidly obese subjects beyond the limitations of the regular gastric bypass Roux-en-Y (R-GBP). We compared weight loss, caloric intake, and percentage of total caloric intake from carbohydrate, protein, and fat in eight R-GBP and eight X-GBP patients at 3, 6, 9, and 12 months following surgery. We found that R-GBP and X-GBP groups were similar in age and height, adjusting for baseline weight differences (p = 0.122). Both groups demonstrated significant weight loss overtime (p < 0.0001), with similar patterns of weight loss at each interval of nonsignificant interaction (p = 0.585). Weight loss for the two groups did not differ statistically. The X-GBP group lost 5% more weight than the R-GBP group by 12 months following surgery. The adjusted average weight loss over 12 months was 56.82 kg for X-GBP and 46.82 kg for R-GBP patients. Furthermore, the X-GBP group ingested fewer calories than the R-GBP group at 3, 6, 9, and 12 months following surgery. The X-GBP group ingested a lower percentage of calories from fat than the R-GBP group at 3, 9, and 12 months following surgery. This study depicts clinical trends in weight loss following X-GBP and R-GBP surgeries. The greater weight loss of the X-GBP group may be due to differences in total caloric intake or the lower percentage of calories ingested from fat. Other possibilities for the greater weight loss shown by the X-GBP group may include changes in malabsorption or resting energy expenditure over time following surgery.

Journal Article↗

PubMed1997

Cyproheptadine produced modest increases in total caloric intake by humans.

Four male and three female normal-weight research volunteers, participating in an 18-day residential study, received oral cyproheptadine (4 mg) or placebo at 0930, 1245, and 1730 hours daily. Food intake, performance, and subjective ratings were measured throughout the day. The interaction between cyproheptadine and carbohydrate consumption was examined by providing subjects diets that engendered varied levels of carbohydrate intake. Three diet conditions were tested for 6 days each: a regular diet, a low-carbohydrate (high-fat) diet, and a high-carbohydrate diet. Placebo was given on days 1, 2, 3, and 6, while cyproheptadine was given on days 4 and 5 of each diet condition. When subjects received placebo and had access to a regular diet, they consumed 2500 kcal/day (59% carbohydrate 28% fat, 13% protein). Total caloric intake decreased (p < 0.007) when subjects received placebo and had access to the low-carbohydrate diet (40% carbohydrate, 43% fat, 17% protein) and increased (p < 0.056) when subjects received placebo and had access to a high-carbohydrate diet (70% carbohydrate, 19% fat, 11% protein). Cyproheptadine significantly increased total daily caloric intake by 20%, to 3000 kcal, only under the regular diet condition. The increase in caloric intake was due to an increase in the number of eating occasions without a change in eating occasion size. Although subjects consumed more food under the regular diet and cyproheptadine condition, cyproheptadine had no effect on the relative contribution of macronutrients to total daily caloric intake. There was no evidence for a modulation of the food-intake increasing effects of cyproheptadine by the macronutrient mix of the available diet. Cyproheptadine also significantly altered self-reported mood: compared to placebo, cyproheptadine produced significant increases in ratings of "Tired", "Sleepy", "Headache", "Can't Concentrate", and "Bad Drug Effect" and decreases in "Alert". Furthermore, cyproheptadine produced small decrements in psychomotor task performance.

Adult↗

PubMed1975

Effects of obesity and caloric intake on biliary lipid metabolism in man.

The effects of obesity and caloric intake on biliary lipid metabolism were investigated in a series of related studies. The degree of saturation of gallbladder bile with cholesterol was found to be significantly higher in a group of 23 obese healthy subjects than in a group of 23 nonobese controls matched for age, sex, and race. Bile was also significantly more saturated in 11 obese subjects before than after weight reduction. To determine whether supersaturated bile in obesity is due to excessive secretion of cholesterol or to deficient secretion of bile acids and phospholipids, the hepatic outputs of these three lipids were measured during constant duodenal infusion of formula in the same 11 subjects before and after weight reduction. Weight reduction resulted in significant reduction of cholesterol output but not of bile acid or phospholipid output. Moreover, very obese subjects were found to have cholesterol secretion rates markedly higher than less obese subjects previously studied by the same method. In obese subjects, bile was supersaturated with cholesterol despite increased bile acid pool sizes and increased secretion rates of bile acids and phospholipids. Supersaturated bile in the obese could therefore be attributed to a single defect in lipid secretion, namely, an excessive output of cholesterol. To determine whether the rate of caloric intake can account for the effects of obesity on biliary lipid composition and secretion, nine obese white men were studied on a weight maintenance diet and then during weight reduction on a 1,000 cal diet. As compared to weight maintenance, chronic caloric restriction resulted in reduced outputs of cholesterol, bile acids, and phospholipids, reduced bile acid pool size, and reduced synthesis and fecal excretion of cholesterol. Saturation of bile with cholesterol did not decrease during weight reduction, evidently because of the mobilization of cholesterol from adipose stores and the marked reduction in bile acid and phospholipid output observed during chronic caloric restriction. Acute alterations in caloric infusion rates did not fully reproduce the effects of chronic administration of high and low calorie diets. Likewise, chronic intake of hypercaloric diets by nonobese subjects did not reproduce the cholesterol hypersecretion characteristic of the obese. Thus, increased cholesterol secretion in obese subjects could not be fully explained by the amount of calories they ingested to maintain stable weight. It is concluded that obesity is characterized by excessive hepatic secretion of cholesterol which results in supersaturated bile.

Adipose Tissue↗

PubMed1982

Serum bile acids in Gilbert's syndrome before and after reduced caloric intake.

Fasting and postprandial serum bile acids were determined before and after reduced caloric intake in patients with Gilbert's syndrome. Cholic and chenodeoxycholic acid were determined by radioimmunoassay. In all patients there was a pronounced increase in serum bilirubin (mean increase, 140%) after caloric restriction. However, both fasting and postprandial levels of serum bile acids were within the normal range before and after reduced caloric intake. The results indicate that different mechanisms are involved in the hepatic uptake and secretion of bile acids and bilirubin. Moreover, the results show that determinations of serum bile acids can be used to assess liver function in patients with Gilbert's syndrome irrespective of the degree of hyperbilirubinemia.

Adolescent↗

PubMed1998

Effect of dietary carbohydrate on the glucose and insulin response to mixed caloric intake and exercise in both nonpregnant and pregnant women.

The objective of this study was to test the hypothesis that a woman's dietary carbohydrate mix modifies the glucose and insulin response to both mixed caloric intake and exercise. Either a prospective randomized or a prospective randomized crossover design was used to examine the effects of two isocaloric, high-carbohydrate diets on the whole-blood glucose and insulin responses to mixed caloric intake and exercise in healthy nonpregnant (n = 14) and pregnant (n = 12) women. The diets differed only in the type of carbohydrate ingested. Those in one had low glycemic indexes and those in the other had high glycemic indexes. In nonpregnant women, the blood glucose response to a meal containing low-glycemic carbohydrate was half that seen with high-glycemic carbohydrate, and the effect of exercise on blood glucose was more pronounced while eating the high-glycemic carbohydrate diet. During pregnancy, women on the low-glycemic carbohydrate diet experienced no significant change in their glycemic response to mixed caloric intake, whereas those who switched to the high-glycemic carbohydrate diet experienced a 190% increase in their response. In conclusion, the type of dietary carbohydrate in a healthy, physically active woman's diet influences both her postprandial blood glucose profile and her blood sugar response to exercise.

Adult↗