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PubMed1987

Correlates of blood pressure in elementary schoolchildren.

This cross-sectional study determined which anthropometric, dietary, and physical fitness variables were best predictors of blood pressure (BP) in 323 white elementary schoolchildren. Height, weight, triceps, and subscapular skinfold thickness were measured, followed by two resting BP measurements. Cardiorespiratory fitness was assessed by time in a one mile run. A food frequency questionnaire measured habitual dietary intake. Correlational analysis revealed height, weight, body mass index (wt/ht2), and skinfold thicknesses were anthropometric variables associated significantly with both systolic and diastolic blood pressure. Physical fitness was not correlated with BP and, among dietary variables, only estimated daily caloric intake, dietary cholesterol, and nondiscretionary sodium were related to blood pressure. A multiple regression analysis selected weight, body mass index (BMI), and total caloric intake as factors explaining the greatest amount of BP variability. For some individuals, hypertension may originate in childhood, thus, these results could have implications for primary prevention of high blood pressure.

Blood Pressure↗
PubMed2007

Effect of cereal-thickened formula and upright positioning on regurgitation, gastric emptying, and weight gain in infants with regurgitation.

OBJECTIVE: We compared the effect of cereal-thickened formula or postural therapy on regurgitation and gastroesophageal reflux, weight gain, and gastric emptying in infants. METHODS: We performed a prospective trial in exclusively formula-fed infants 2 to 6 mo of age presenting with regurgitation or vomiting at least three times a day. Infants were randomized into two groups; group A received cereal-thickened formula versus group B who were placed in a postprandial upright position for 90 min and evaluated over an 8-wk period. A 90-min technetium 99m milk scintigraphy was performed before and at the end of the intervention period. RESULTS: Thirty-one infants were included in group A and 32 in group B; at inclusion, there were no anthropometric differences between groups (P = 0.813-0.955). After 4 and 8 wk, the difference in regurgitation frequency per day between groups A and B had become significant (at 4 wk, 2.39 +/- 0.86 for group A versus 2.84 +/- 0.81 for group B, P = 0.039; at 8 wk, 1.61 +/- 0.76 for group A versus 2.38 +/- 0.83 for group B, P < 0.001). The volume ingested per meal was not different between groups after 4 wk, although this parameter showed a larger intake in group A after 8 wk (156.8 +/- 23.5 mL for group A versus 143.4 +/- 25.1 mL for group B, P = 0.035), resulting in a significant difference in mean caloric intake. Gastric emptying after 8 wk showed no significant difference between groups A and B. Group A infants had significantly greater weight gain than did group B infants after 4 wk (636.2 +/- 103.4 g for group A versus 577.4 +/- 102.7 g for group B, P = 0.03) and 8 wk (1261.3 +/- 131.4 g for group A versus 1121.4 +/- 137.2 g for group B, P < 0.001). After 8 wk of intervention, the increase in length was significantly greater in group A than in group B (5.2 +/- 0.6 cm for group A versus 4.7 +/- 0.6 cm for group B, P = 0.032). CONCLUSION: Cereal-thickened formula is significantly more efficacious than postural therapy in decreasing the frequency of regurgitation in regurgitating infants. Treatment of regurgitation with cereal-thickened formula results in an increased caloric intake ( approximately 25%), related to increased gain in weight and length, in comparison with regular formula and positioning therapy.

Edible Grain↗
PubMedDate not supplied

Current treatment reduces calories required to maintain weight in pediatric patients with burns.

A previous study indicated that formulas for determining caloric requirements of severely burned children overestimated their needs. This study was undertaken to determine the caloric intake required to maintain weight in patients under 12 years of age with burns over more than 30% total body surface area. The 102 patients studied were divided into two groups according to weight changes. A comparison of the actual caloric intakes of these groups was conducted. Multivariate regression analysis indicated that body surface area in square meters and burn surface were significant predictors of caloric requirements to maintain weight in these patients. It was determined that 1800 kcal was a plausible value for the calories per body surface area. Therefore the regression was formed with 1800 kcal as the multiplier of body surface area, and the multiplier of burn surface area was estimated. The resulting formula provides 1300 kcal/m2 burned, which is 900 kcal/m2 burned less than our previously suggested formula.

Body Surface Area↗
PubMed1999

Diet and cancer prevention: the fiber first diet.

Diet can play a major role in cancer prevention. The international differences in cancer incidence are largely accounted for by lifestyle practices that include nutrition, exercise, and alcohol and tobacco use. About 50% of cancer incidence and 35% of cancer mortality in the U.S., represented by cancers of the breast, prostate, pancreas, ovary, endometrium, and colon, are associated with Western dietary habits. Cancer of the stomach, currently a major disease in the Far East, relates to distinct, specific nutritional elements such as excessive salt intake. For these cancers, information is available on possible initiating genotoxic factors, promoting elements, and prophylactic agents. In general, the typical diet in the United States contains low levels of the potent carcinogenic agents, heterocyclic amines, formed during the cooking of meats. It provides only about half the potent appropriate fiber intake and is high in calories. About twice as many calories as would be desirable come from fat, certain kinds of which enhance the development of cancers. Other foods with functional properties, such as soy products and tea, can be beneficial. To achieve reduction in risk of certain cancers, diet must be optimized, primarily to reduce caloric intake and the fat component. The latter should be 20% or less of total caloric intake and fiber should be increased to 25-35 g per day for adults. One approach to achieving these goals is the Fiber First Diet, a diet designed around adequate fiber intake from grains, especially cereals, vegetables, legumes, and fruits, which thereby reduces both calorie and fat intake. Such dietary improvements will not only reduce cancer and other chronic disease risks, but will contribute to a healthy life to an advanced age. A corollary benefit is a lower cost of medical care.

Adult↗
PubMed1996

Relationship between blood lead and nutritional factors in preschool children: a cross-sectional study.

OBJECTIVE: The purpose of this study was to assess the relationships between selected nutritional factors and blood lead levels of preschool children. METHODOLOGY: Data on 296 children, aged 9 to 72 months, who were cared for at the University of Maryland at Baltimore Pediatric Ambulatory Center were examined in this cross-sectional study. Nutritional status, socioeconomic aspects, medical history, and potential sources of lead exposure were assessed. Blood samples were evaluated for levels of blood lead, serum iron (ferritin), free erythrocyte photoporphyrin, calcium, and hematocrit. RESULTS: The average blood lead level was 11.4 micrograms/dL. Multicollinearity of nutritional factors was addressed using regression techniques. After adjusting for confounders, significant positive associations with blood lead were found for total caloric intake (P = .01) and dietary fat (P = .05). CONCLUSIONS: The findings of this study suggest that even when behavioral and environmental exposures to lead were statistically controlled, total caloric intake and dietary fat each had an independent and significant association with the level of blood lead.

Child, Preschool↗
PubMed1997

Stress injury to bone in the female athlete.

Stress injury to bone exists on a continuum, involving mechanical as well as hormonal and nutritional factors. Risk factors for stress injury include genetics, female gender, white ethnicity, low body weight, lack of weightbearing exercise, intrinsic and extrinsic mechanical factors, amenorrhea, oligoamenorrhea, inadequate calcium and caloric intake, and disordered eating. Prevention of stress injury to bone involves maximizing peak bone mass in the pediatric, adolescent, and young adult age groups. Maintaining adequate calcium nutrition and caloric intake, exercise and hormonal balance are important preventive measures in the adult years for optimizing skeletal integrity and preventing fractures. There are no prospective longitudinal studies to date that demonstrate a treatment that will increase bone density in female athletes with hypothalamic hypoestrogenic amenorrhea or disordered eating that have low bone density. Advances in genetic research show promise for future preventive and treatment strategies. More research is needed in this area to determine other factors that may be contributing to bone loss in these individuals, as well as to assess other treatment options leading to improvements in bone density and integrity.

Adult↗
PubMed1976

Marihuana use. Biologic and behavioral aspects.

More than 70 male chronic marihuana users were studied under research ward conditions for a 31-day period consisting of 5 days of baseline assessment, 21 days of marihuana availability, and 5 days of postsmoking assessment. Biological findings were for the most part within normal limits. Blood chemistry studies showed no abnormalities. Plasma testosterone levels for all subjects at all times during the study were well within normal limits, suggesting that previous reports of testosterone suppression by marihuana may have statistical but not biologic singificance. A significant reduction in baseline vital capacity was observed in six subjects, a compromise in pulmonary function similar to that characteristically produced by chronic inhalation of substances, such as tobacco smoke, which are irritants to the lung. Increased caloric intake and weight gain occurred in virtually all subjects and were causally related to marihuana smoking. The weight gain may be attributable to water retention as well as increased caloric intake. Behavioral findings indicated that no uniform alteration in mood is produced by marihuana smoking--all subjects reported becoming "high", but experienced no consistent degree of euphoria. Mood changes which occurred were relatively mild and were largely dependent on group determinants rather than individual experience. No relationship could be established between marihuana use and motivation to work or engage in socially desirable activities. Evidence that pulmonary function may be compromised as a function of marihuana smoking suggests the need for alerting individuals to this potential health hazard. As was true of cigarette smoking, the eventual public health consequences of marihuana use may become apparent only after large numbers of individuals have smoked marihuana for two or three decades.

Adult↗
PubMed1975

Dietary therapy and insulin secretory response to glucose in adult-onset non-obese diabetic subjects.

The effect of a 4-week diet regulation on non-obese, adul-onset diabetics was studied. The diet, which was prescribed for them, was composed of 60% carbohydrate, 15-20% protein and 20-25% fat. The total caloric intake was restricted to 30, 35 and 40 Cal/kg ideal body weight depending on their physical activity. In the group whose calculated diet showed over 10% reduction in total caloric intake and carbohydrate intake, fasting glucose was decreased and glucose tolerance was improved significantly after the 4-week dietary therapy. Insulin response to oral glucose loading was improved, particularly in the later stage of oral glucose tolerance test. As a result, insulin area, i. e. the total area under the insulin curve was increased to almost two times. The sensitivity to insulin did not show any significant changes after diet regulation. The present data indicate that the therapeutic effect of the diet restriction should be at least in part ascribed to the increased secretion of insulin. In the treatment of diabetics, a restricted diet is essential and beneficial from the point of view that it could improve the pancreatic beta-cell function.

Adult↗
PubMed1987

Relationships between dietary protein, dietary energy, rearing environment, and nutrient utilization by broiler breeder pullets.

The relationship between dietary energy and protein and their interaction with method of restriction and environment were studied. In Experiment 1, two isocaloric diets (2750 kcal/kg) formulated to contain either 13.5% or 15.5% protein were fed to broiler breeder pullets from hatching through 21 weeks of age. There were no significant differences in body weight due to dietary protein but chicks fed the 13.5% protein ration did require a significantly greater quantity of feed to produce an equivalent body weight. Sexual maturity, peak egg production, and egg size were not affected by the level of dietary protein but total egg production was significantly decreased in pullets fed the 13.5% protein diet. In Experiment 2, 2970 kcal/kg ration containing 15.5% protein was fed to pullets that were reared under two different lighting environments, natural daylength or 24 hr light for the first 7 days and 8 hr light per day thereafter. Pullets housed in the controlled environment and reared on an every-other-day restriction program had significantly improved feed utilization compared with similarly restricted birds kept under natural light. Environmental effects on feed utilization were not as great in the every day restriction treatment. Chicks exposed to natural daylight and fed 15.5% protein diets had similar caloric efficiencies (kcal/g) at 15 weeks of age in both experiments despite dietary density differences of 220 kcal/kg. This supports a hypothesis that above some minimal level of protein intake, caloric intake has the greatest control over body weight gain in restricted pullets, particularly where every-other-day feeding is used during part of the growing period.

Animal Feed↗
PubMed1989

[Evaluation of central parenteral alimentation in critically ill newborn infants at a provincial pediatric hospital].

A revision was made on files of newborns whom received total parenteral nutrition (TPN) in the neonatal intensive care unit of the Hospital Infantil de Tamaulipas during a two and a half years period. We try to correlate dosage and caloric intake with weight gain, survival and complications. We reviewed the principal indications that motivated the use of total parenteral nutrition. The average period of administration was 15 days and caloric intake average 75 cal. There was significance in weight gain in newborns older than 35 weeks (14.6 g/kg/day) compared with younger than 34 weeks (9.2 g/kg/day) (p less than 0.001). There was no relation between days and dosage in both groups. Only one case showed cholestatic jaundice. Hyperglycemia was present statistically more frequent in the group lesser gestational age. There were no important electrolytic disturbances. Necrotizing enterocolitis was present more frequent in the older group. Some comments are made in relation to sepsis and a discussion of possible causes that do no permit a better assimilation of nutrients in these babies.

Energy Intake↗
PubMed1975

Feeding studies in weanling rats with dorsomedial hypothalamic lesions: maintenance of competence to compensate for additional calories.

Weanling rats received bilateral electrolytic lesions in the dorsomedial hypothalamus primarily destroying the dorsomedial hypothalamic nuclei (DMN). Sham-operated rats served as controls. After a 14 day postoperative period during which food intake (lab chow) and body weight were recorded, each of the above groups were subdivided into 2 groups. One DMN group and one sham-operated control group were continued on lab chow alone throughout the remainder of the study. The other DMN group and the second control group were given additional calories in the form of a liquid diet by stomach tube during 2 separate periods of 10 and 14 days, respectivly, to increase their caloric intake beyond that taken in spontaneously. Both tube-fed groups reduced their ad lib caloric intake from chow considerably and to the same extent. Body weight gains were similar in tube-fed versus non-tube-fed rats, whether with or without DMN lesions. After the second, 14-day-long tube feeding period, however, DMN rats regulated their body weight somewhat less precisely than the controls. This may be related to their reduced food intake during that time period. The data indicate that weanling rats with DMN lesions, despite their basic hypophagia, do not show a deficit in caloric metering and gross body weight regulation.

Animals↗
PubMed2002

Serum leptin concentrations in children with type 1 diabetes mellitus: relationship to body mass index, insulin dose, and glycemic control.

Although obesity is a frequent feature of type 2 diabetes mellitus (DM), many patients with type 1 DM are prone to high body mass index (BMI). We measured serum leptin concentrations in a cohort of children (n = 55) with type 1 diabetes mellitus (DM), as well as their anthropometric parameters including BMI, skin fold thickness at multiple sites, and midarm circumference. Glycemic control was assessed by blood glucose (BG) monitoring before meals, and measurement of glycated hemoglobin (HbA1c) and insulin dose/kg/d was recorded. Dietary evaluation and assessment of caloric intake (kg/d) was performed by an expert dietitian. In the newly diagnosed children (n = 10) before initiation of insulin therapy, circulating leptin concentration was significantly lower (1.1 +/- 0.8 ng/dL) versus 5 days after insulin therapy (1.45 +/- 0.7 ng/dL). The decreased leptin level appears to be related to insulinopenia in these patients. In 45 children with type 1 DM on conventional therapy (2 doses of insulin mixture (NPH and regular) subcutaneous (SC) before breakfast and dinner for more than 2 years), serum leptin concentration was significantly higher (2.15 +/- 1 ng/dL) compared with age-matched normal children (1.3 +/- 1 ng/dL). Diabetic children were further divided into 2 groups according to their HbA1c level: group 1 with HbA1C less than 7.5% (less than 2 SD above the mean for normal population) (n = 29) and group 2 with HbA1c greater than 7.5%. (greater than 2 SD above the mean for normal population) (n = 16). Patients with a higher HbA1c level (group 2) had a higher leptin concentration (2.3 +/- 0.8 ng/dL), higher BMI (17.8 +/- 1.7), and were receiving higher insulin dose/kg (0.92 +/- 0.2 U/kg/d) compared with group 1 (lower HbA1c) (1.78 +/- 0.8 ng/dL, 16.7 +/- 1.5, and 0.59 +/- 0.2 U/kg/d, respectively). Group 2 patients had a higher incidence of late morning hypoglycemia (9/29) versus group 1 patients (2/16). Analysis of dietary intake showed that patients with a higher HbA1c (group 2) consumed more calories (73.5 +/- 10.5 kcal/kg/d) versus patients with lower HbA1c (64.2 +/- 8.7 kcal/kg/d). These findings pointed to the unphysiologic nature of injecting a mixture of insulin twice daily. To cover the relatively big lunch meal (40% to 50% of the total caloric intake in the Arab countries) and prevent afternoon hyperglycemia, there is a great tendency to increase NPH dose before breakfast. This, in turn, induces late-morning hypoglycemia and increases appetite and food intake at that time. Multiple regression analysis showed that circulating leptin concentrations (the dependent variable) were best correlated with the mean skinfold thickness (SFT), BMI, and caloric intake/kg/d (together they explained 65% of the variability in leptin concentrations). It appears that oversubstitution by insulin and increased food intake stimulate fat synthesis and subsequently BMI. Increased appetite and BMI contribute to increased leptin secretion and explains the higher leptin levels in undercontrolled diabetic children (higher circulating HbA1c concentrations) who were oversubstituted by insulin.

Blood Glucose↗
PubMed1994

Food intake patterns of marathon runners.

A group of marathon runners (290 males, 54 females, mean age 39.7 +/- 0.7 years) who participated in the Los Angeles Marathon recorded their food and fluid intake throughout a 3-day period, with the time of day denoted for each entry. Investigators coded each subject's food intake according to six time periods: 5:00-8:59 a.m., 9:00-10:59 a.m., 11:00 a.m.-1:59 p.m., 2:00-3:59 p.m., 4:00-7:59 p.m., and 8:00 p.m.-4:59 a.m. The average intake of the runners consisted of 314 +/- 6 g (52.3%) carbohydrates, 83.2 +/- 2.0 g (30.7%) fat, and 99.7 +/- 2.3 g (16.5%) protein. Time periods for breakfast (13.7%), lunch (23.8%), and supper (34.0%) accounted for 71.5% of total caloric intake, with snack time periods contributing 28.5%. Breakfast calories were 68.9 +/- 0.9% carbohydrate and 20.4 +/- 0.7% fat in contrast to supper calories, which were 47.7 +/- 0.8% and 31.8 +/- 0.6%, respectively. A sizable proportion of the daily caloric intake of recreational marathon runners is contributed by snacks and food intake after 4:00 p.m.

Adult↗
PubMed1992

Caloric restriction in pregnant diabetic women: a review of maternal obesity, glucose and insulin relationships as investigated at the University of California, San Diego.

Caloric restriction during pregnancy is contraindicated for women with a normal body mass index (BMI) of 19.8-26 kg/m2. Reduction of caloric intake in obese pregnant normal and diabetic women has been a controversial topic for many years. This paper reviews several clinical studies initiated in 1978 at the University of California, San Diego. One focus of this review concerns modest caloric reduction in obese women with gestational diabetes mellitus (GDM). Metabolic observations of diabetes during pregnancy in the past decade include extensive use of a 400 kcal isocaloric breakfast meal tolerance test to assess maternal glucose:insulin relationships and the degree of insulin resistance in obese pregnant subjects. We have previously reported that maternal hyperinsulinemia with or without maternal hyperglycemia is an important factor in fetal macrosomia. We suggest for obese pregnant diabetic women implementation of nutritional recommendations of the 1990 Committee on Nutritional Status During Pregnancy and Lactation, Food and Nutrition Board, Institute of Medicine, National Academy of Sciences that advise a lower caloric intake for obese normal pregnant women with BMIs greater than 26. In obese noninsulin-dependent diabetic women and those with GDM, we urge that a large prospective epidemiologic study be undertaken to assess the respective roles of modest maternal caloric restriction and maternal glucose:insulin relationships on neonatal and long-term longitudinal measurements of growth and development of children of diabetic mothers.

Adult↗
PubMed1985

Alcohol and obesity: a new look at high blood pressure and stroke. An epidemiological study in preventive neurology.

An investigation of the staff of a car assembly plant (3,351 persons) revealed a similarity between the change in relative body weight and diastolic blood pressure with age. There is a good temporal correlation between the course of alcohol consumption during life and the change of the relative body weight. German women had significantly less blood pressure for the same relative body weight than German men, and foreign employees had lower blood pressure than Germans. In both cases the main cause is the difference in alcohol consumption. Besides obesity and hereditary factors, alcohol is the main cause of "essential" hypertension today. Epidemiological and experimental data indicate that there are two ways from alcohol to high blood pressure, a more direct one and an indirect one via obesity. Alcohol causes obesity via a change in metabolism (hyperinsulinism) rather than by higher caloric intake. In both ways alcohol is an important cause of stroke. To reduce body weight and blood pressure, a reduction of alcohol consumption should be recommended in addition to reduced caloric intake and increased physical activity as means of preventive neurology.

Adult↗
PubMed1996

Short-term caloric restriction augments age-related decreases in gastrin content and release.

Aging is associated with significant structural and functional changes in the gastrointestinal tract. Gastrin, a hormone produced by G cells in the antrum of the stomach, stimulates proliferation of gastric mucosa; its synthesis appears to decrease with age. Life-long restriction of caloric intake is the only experimental manipulation that has been shown to retard aging processes in rats. The purpose of this study was to examine the effect of short-term caloric restriction (CR) on the production and release of the hormone gastrin with aging. Aging causes a fall in both fasting plasma levels of gastrin and antral content of gastrin in Fischer 344 rats; short-term CR appears to augment this age-related decrease. Steady state levels of antral gastrin mRNA were decreased with aging, and short-term CR resulted in an augmented decrease in aged, but not in young rats. Our findings indicate that gastrin release, synthesis and gene expression decrease with age. Restriction of the caloric intake for a short period (i.e. 8 weeks) augments this age-related decrease in antral gastrin and fasting plasma levels. Short-term CR appears to decrease the production of gastrin at the level of gene expression.

Aging↗
PubMed2000

[Diabetic diet 2000].

Diabetes diet in the year 2000 consists essentially of carbohydrates. 50% to 60% of the total caloric intake has to be taken in form of carbohydrate. Slowly metabolised forms of carbohydrate should be preferred. Fat and proteins should not exceed more than 20% of the respective total caloric intake. Vegetable fats should be preferred compared to animal fats. Patients with type 2 diabetes who should loose weight have to be extremely careful regarding the fat intake. Insulin-dependent diabetics can correct mistakes in the carbohydrate intake by injecting fast insulins provided that they have in-depth knowledge of the mode of action of insulin and dietary experience.

Diabetes Mellitus↗
PubMed1987

Behavioral and metabolic effects of sucrose-supplemented feeding in hyperactive rats.

Two hyperactive rat strains [spontaneously hypertensive rats (SHR) and SHR-Wistar-Kyoto cross (WK-HA)] and their nonhyperactive genetic control strain (Wistar-Kyoto) were fed ad libitum sucrose-supplemented rat chow, or chow alone in controls, to determine the effects of dietary sugar on behavior. The diets were given either overnight (acute sugar) or for 14-18 days (chronic sugar), and testing was carried out on the morning after each of the dietary schedules. The metabolic studies revealed significant strain, sex, and age differences in appetite for sucrose, caloric intake, postprandial plasma levels of glucose and insulin, and weight gain after sucrose feeding. The findings indicate that sugar feeding led to increased plasma glucose and insulin levels; however, total caloric intake was decreased, and less weight gain was observed than in chow-fed controls, particularly among the hyperactive strains. In behavioral tests, sugar feeding did not alter spontaneous activity levels in any of the strains after either acute or chronic diets. There were also no significant effects of sucrose consumption on spatial learning and memory in a plus-shaped maze as determined by use of a shock-avoidance paradigm. The only significant behavioral effects of sucrose observed were an impairment in habituation and distractibility among the WK-HA females, the most hyperactive group among these strains.

Age Factors↗