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PubMed1992

[Growth rate of hepatocellular carcinoma and nutritional state].

To clarify the relationship between the growth rate of hepatocellular carcinoma (HCC) and nutritional state or liver function 32 HCC patients with a tumor volume less than 100 ml at the beginning of the study were investigated. These patients all had been treated by serial transcatheter arterial embolization (TAE). Tumor volume was measured by integrating the CT images of the liver before each TAE. The tumor at the TAE just before significant enlargement occurred was defined as the stage I tumor and it was designated stage II at the next TAE. The growth rate of the HCC was then calculated from the tumor volume at stage II minus that at stage I. Caloric intake, protein intake, liver function, and serum amino acid were determined in the patients at each stage. The results were as follows: 1) The tumor growth rate was greater in patients whose caloric intake and protein intake were more than 35 kcal/kg/day and 1.5 g/kg/day, respectively. 2) In patients with the greater tumor growth rate, the plasma BCAA/AAA ratio was the lower. However, after tumor growth, the ratio became higher, indicating that the growth of HCC decreased the requirement of BCAA. 3) The tumor growth rate correlated to the change of plasma arginine level (r = -0.76, p less than 0.05).

Amino Acids↗

PubMed1975

Nasoduodenal versus nasogastric feeding in the very low birthweight infant.

The practicality, effectiveness, and safety of feeding very low birthweight infants (less than 1,300 gm) by continuous nasoduodenal infusion was assessed by comparison with continuous nasogastric feeding. The nasoduodenal group appeared to have a clear advantage over the nasogastric group for the overall period in terms of caloric intake (131 cal/kg/day vs. 106 cal/kg/day), average weight gain (16 gm/day vs. 10 gm/day), and safety. This advantage was even more striking in the first two weeks of life. A caloric intake of 120 cal/kg/day could be reached within 48 to 72 hours after tube placement in the nasoduodenal group but only after a week in the nasogastric group. Nasoduodenal feeding resulted in faster weight gain than comparable published data on conventional feeding, peripheral intravenous alimentation, and parenteral alimentation. There were no cases of aspiration associated with tubes placed in the duodenum whereas two cases of aspiration pneumonia were associated with tubes placed in the stomach. With the tip of the catheter in the duodenum, none of the complications reported with nasojejunal tubes (intussusception, perforation, or necrotizing enterocolitis) were seen, either in the initial pilot study reported here or in 50 additional infants.

Birth Weight↗

PubMed2003

Physical inactivity, energy intake, obesity and the risk of rectal cancer in Canada.

We conducted a population-based case-control study of 1,447 incident rectal cancer cases and 3,106 population controls aged 20-76 years to assess the effect of recreational physical activity, energy intake and obesity on rectal cancer risk in 7 of 10 Canadian provinces in 1994-97. After adjustment for the effect of various potential confounding factors, total recreational physical activity in the highest quartile was associated with an odds ratio (OR) for rectal cancer risk of 0.88 (95% confidence interval [CI] = 0.64-1.20) in women and 1.15 (95% CI = 0.88-1.49) in men. Women and men in the highest quartile of caloric intake (> = 56,741 and > = 63,143 kJ/week) had ORs of 1.50 (95% CI = 1.00-2.25) and 1.61 (95% CI = 1.13-2.28), respectively. Total dietary fat intake was not associated with a risk of rectal cancer after adjustment for caloric intake. Obesity (BMI > = 30 kg/m(2)) was associated with an OR of 1.44 (95% CI = 1.06-1.95) for women and 1.78 (95% CI = 1.36-2.34) for men. Men and women with lifetime maximum body mass index (BMI) > = 30 kg/m(2) had respective ORs of 1.70 (95% CI = 1.30-2.23) and 1.26 (95% CI = 0.96-1.66). The greatest increase in rectal cancer risk was observed in men and women with simultaneous high energy intake, high BMI and low physical activity. Our study provides evidence that physical inactivity, high energy intake and obesity are associated with the risk of rectal cancer, and there is a probable synergic effect among the 3 risk factors.

Adult↗

PubMed1982

Smoking and its effects on body weight and the systems of caloric regulation.

Cigarette smoking and excess body weight, each of which contributes to poor health and risk of death, appear themselves to be inversely related. Data indicate that smokers weigh less than nonsmokers and that weight gain occurs after the cessation of smoking. The popular wisdom is that this is due to differences in caloric intake: smokers weigh less because they consume less and they gain weight upon stopping smoking as a consequence of consuming more. Cross-sectional data on this point are conflicting, however, with some studies of daily caloric intake suggesting that smokers may, in fact, consume more calories per day than nonsmokers. In addition to affecting ingestive behavior, however, cigarette smoking has a variety of physiological effects that may play a more important role than amount of calories consumed per se in accounting for lower body weights among smokers and weight gain after cessation. Evidence regarding the effects of cigarette smoking and nicotine upon the behavioral, sensory and metabolic components of the processes of caloric regulation and nutrition is reviewed in order to suggest mechanisms by which smoking may affect weight. Longitudinal within-subject designs investigating changes associated with the cessation and initiation of smoking are recommended.

Adolescent↗

PubMed2001

Evaluation of a psycho-educational nutritional program in diabetic patients.

In this study, we have retrospectively (2 years) assessed the efficacy of the nutritional education (NE) program provided to 83 diabetic patients during an in-hospital training week. Two years after NE, type 1 diabetic patients have decreased significantly their total caloric intake, protein (P<0.05) and fat consumption. Type 2a diabetic patients disclosed a significant increase in CHO consumption while type 2b diabetic patients decreased their fat consumption, SFA consumption and total caloric intake. The percentage of patients following the European Association Study for Diabetes (EASD) nutritional recommendations regarding fat intake has increased significantly in all three diabetic groups and in type 2a diabetic patients regarding CHO consumption. In conclusion, a psycho-educational nutritional education program of 1 week allows a significant improvement of the alimentary behavior 2 years thereafter with 45% of the diabetic patients following the current EASD dietary recommendations.

Adult↗

PubMed1992

Nutritional status and growth in children with chronic hepatitis B.

As reported for other chronic liver diseases, hepatitis B virus (HBV) chronic infection might result in malnutrition. In order to establish whether this disease could be responsible of malnutrition and hence influence growth, 75 children, chronically infected with HBV, have been followed up for 4 years. Thirty-one of them had chronic active hepatitis (CAH), 25 chronic persistent hepatitis (CPH), 14 chronic lobular hepatitis (CLH), and five cirrhosis (three active, two inactive). The nutritional status was evaluated every 12 months, with careful physical and laboratory examinations. General nutritional status was estimated according to Waterlow criteria (13, 14). At our first observation, 50 children were following a balanced diet with a caloric intake adequate for age and weight, whereas 25 were on a low-fat diet, begun in the belief of its therapeutic value. For seven patients of this second group, the caloric intake was below the daily requirement. The latter group showed a growth failure in weight when they were first seen at our center and gained weight when the dietary intake was normalized. However, no biochemical feature of malnutrition was observed in all the 75 children. At the end of the follow-up period, the nutritional status was satisfactory for all of them.

Alanine Transaminase↗

PubMed2006

Is there an association between sweetened beverages and adiposity?

Four mechanisms were reviewed to explain the possible association between sweetened beverages and increased overweight or obesity: excess caloric intake, glycemic index and glycemic load, lack of effect of liquid calories on satiety, and displacement of milk. The findings were inconsistent across studies. The strongest support was for the excess caloric intake hypothesis, but the findings were not conclusive. Assigning possible links between sweetened beverage consumption and adiposity requires research that compares and contrasts specific mechanisms, especially in populations at risk for obesity, while controlling for likely confounding variables.

Adiposity↗

PubMed1992

Clinical management of anorexia and cachexia in patients with advanced cancer.

Cachexia occurs in the majority of cancer patients before death. It is the result of major metabolic changes produced by tumor-released substances as well as by cytokines and some endogenous peptides. The most significant clinical manifestation is profound anorexia. Aggressive parenteral nutrition has not been able to increase patient survival or produce any significant symptomatic improvement. Recent research, therefore, has focused on drugs that might result in symptomatic improvement, even if no significant nutritional changes are detected. Corticosteroids have been shown to increase appetite for a brief period of time, but they do not appear to improve caloric intake or nutritional status. In addition to appetite stimulation, corticosteroids also improve a number of other symptoms transiently. Progestational drugs have been found in a number of studies to increase appetite, caloric intake, and nutritional status. The most effective type and dose of progestational drugs have not been clearly established. Cyproheptadine, hydrazine sulfate, and cannabinoids have all been suggested to have beneficial effects on appetite; their effectiveness, however, needs to be confirmed in prospective, controlled trials. Some of these trials are currently under way. Current data suggest that megestrol acetate or other progestational agents could be useful--because of effects on not only appetite but also overall nutritional status--in patients who have profound anorexia as the main manifestation of cachexia, provided expected survival can be measured in weeks or months. In patients with shorter expected survival or those who have problems tolerating progestational drugs, a brief course of corticosteroids may provide short-term symptomatic effects. Future studies should focus on (1) improving understanding of both the pathophysiology of cancer cachexia and the interaction of some of the major syndromes of terminal cancer--e.g., pain, cachexia, and cognitive failure--and (2) characterizing the symptomatic effects of different drugs more completely.

Anorexia↗

PubMed1979

Effect of sex and reproductive status on sucrose preference, food intake, and body weight of dogs.

In a study of preferences for diets containing 1% to 20% sucrose over a bland diet, both female and male dogs preferred the diets containing sucrose over a bland diet, but female dogs had a significantly (P less than 0.05) greater preference for 1% sucrose than did males. Differences between sexes were not observed at the higher concentrations. Mean daily caloric intake was calculated for 12 bitches fed ad libitum during metestrus, estrus, and anestrus, as determined from metachrome-stained vaginal smears. Mean daily caloric intake was lowest during estrus (149 +/- 17 kcal/kg of body weight), was higher during metestrus (159 +/- 8 kcal/kg of body weight), and was highest (175 +/- 9 kcal/kg of body weight) during anestrus. Ovariohysterectomized bitches gained significantly (P less than 0.01) more weight (1.3 +/- 0.3 kg) in the first 10 days after surgery than did sham operated controls (0.3 +/- 0.1 kg). Food intake also was significantly greater ( less than 0.01) in the ovariohysterectomized bitches (1,708 kcal/day) than in the sham operated controls (1,423 kcal/day). Depth of subcutaneous fat in shoulder, rib, and rump areas of ovariohysterectomized bitches was not significantly different from that of intact bitches.

Anestrus↗

PubMed2000

A moderate swimming exercise regularly performed throughout the life induces age and sex-related modifications in adaptive macronutrients choice.

The ability of laboratory rats to adapt food intake to needs is well-known. The present study investigates changes in this adaptive behavior when animals grow old. A cohort of male and female Lou/c/jall rats was regularly submitted to an exercise throughout their life (6 consecutive days of moderate intensity training (3x15 min/day)). Caloric intake and macronutrients selection during exercise and post-exercise periods were compared to the pre-training period. During swimming, a decrease in both caloric intake and fat selection was observed and an increase in protein intake was specifically seen in female groups. However, males were unable to modify the diet composition (macronutrient rate) from 16 months of age, whereas females were able to do it until 24 months of age. The present results suggest a sex-dependent loss of capacity of adjusting feeding behavior to metabolic needs when animals grow old, may be due to a deterioration of the central control of food intake.

Adaptation, Physiological↗

PubMed1993

The effects of continuous morphine infusion on diet selection and body weight.

The administration of morphine causes a short-term increase in food intake, and repeated administration of morphine has been shown to cause progressively larger increases in intake and/or the relative intake of dietary fat. In this experiment, we measured the effects of continuous morphine infusions on diet choice and total intake. Male rats were given ad lib access to two diets: a high-carbohydrate diet (80% carbohydrate, 20% protein) and a high-fat diet (80% fat, 20% protein). Diet intakes were measured daily for 21 days. Via the implantation of osmotic minipumps, one group received continuous infusions of morphine sulfate (approx. 2.8 mg/kg/h) for days 1-7 and of saline for days 8-14. A second group was infused with saline for days 1-7 and with morphine for days 8-14. A third group received sham surgery but no minipumps. Total caloric intake was significantly decreased on the final 6 days of morphine infusions. The percentage of total caloric intake consumed from the high-fat diet was significantly increased for the first 2-3 days of morphine treatment; this effect was due to an initial reduction in carbohydrate intake and an increase in fat intake. Over the course of the infusion period, fat intake gradually decreased and carbohydrate intake increased. The effects of morphine when infused on days 1-7 were similar to those observed when the drug was infused during days 8-14.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMed1982

Effect of diet and exercise on norepinephrine-induced thermogenesis in male and female rats.

Male and female rats were fed standard laboratory chow or a highly palatable diet (cafeteria diet) for 10 wk. The cafeteria diet caused an increase in caloric intake and in body weight, and it induced thermogenesis that was associated with elevated plasma triiodothyronine (T3) levels, increased brown adipose tissue size, and enhanced metabolic response to norepinephrine. For a comparable caloric intake, body-weight gain was significantly greater in female than in male rats possibly because of difference in thermogenesis as suggested by the response to norepinephrine. Exercise training (swimming 2 h/day for 10 wk) reduced food intake and body-weight gain and failed to increase norepinephrine-induced thermogenesis in rats fed laboratory chow. In animals fed the cafeteria diet, food intake and body-weight gain were also reduced by exercise training, which at the same time diminished the diet-induced thermogenesis as evidenced by the diminution of 1) brown fat hypertrophy, 2) the elevation of plasma T3, and 3) the hyperthermic response to injected norepinephrine. It is suggested that the thyroid hormone and catecholamines through their actions on the brown adipose tissue are the important regulatory of thermogenesis. Exercise training would reduce the diet-induced thermogenesis by preventing increased T3 production. Enhanced thermogenesis may be considered an adaptive reaction as it serves to reduce fat deposition in animals fed cafeteria diet and to promote nonshivering heat production in the cold. On the other hand, exercise training reduces thermogenesis and thus prevents energy wasting.

Adipose Tissue↗

PubMed1984

Longitudinal studies on metabolic rate, heat loss, and energy cost of growth in low birth weight infants.

Longitudinal studies on total and resting metabolic rate and total heat loss were made in 14 LBW infants, age 1-58 d. Metabolic rate was calculated from indirect calorimetry, heat loss was measured by direct calorimetry. Total metabolic rate and total heat loss were lowest during the first week of life, 178.9 +/- 18.0 and 171.8 +/- 15.5 kJ X kg-1 X 24 h-1, respectively. During the age period of 8-58 d both total metabolic rate and heat loss showed a very slight increase with age: mean total metabolic rate was 278.8 +/- 2.6 and mean total heat loss 257.0 +/- 3.4 kJ X kg-1. during the first week of life and 248.0 +/- 2.5 during d 8-58. The energy cost of components of new tissue was calculated from the energy balance equation. Ecomponents during the second week of life was 25.5 +/- 4.9 kJ/g weight gain and 11.9 +/- 0.4 kJ/g weight gain over subsequent weeks. The net energy cost of tissue synthesis, calculated from the difference between indirect and direct calorimetry was 3.2 +/- 1.1 kJ/g weight gain during the second week and 1.1 +/- 0.1 kJ/g weight gain in the following weeks. A neonate who receives a caloric intake of 535 kJ X kg-1 X 24 h-1 and is growing at a rate of 17 g X kg-1 X 24 h-1 will use 42% of the caloric intake for maintenance and thermoregulation, 6% for activity, 38% for the components of new tissue, 4% for tissue synthesis and 10% for loss in faeces and urine.

Body Temperature Regulation↗

PubMed1999

[Parenteral and enteral nutrition in palliative medicine].

Artificial nutritional support does not alter the natural course in patients with malignant disease. The outcome of these patients is mainly determined by the type and stage of the underlying tumor. Progress of the underlying disease is often paralleled by malnutrition which in turn facilitates complications and may reduce survival and quality of life. Nutritional support can be applied to maintain body weight, immune function and quality of life. Enteral nutrition can be applied with a functioning gastrointestinal tract and has been proven to be superior compared to parenteral nutrition. Maintenance of intestinal mucosal function due to enteral substrate application prevents disruption of intestinal barrier function as well as the overgrowth of intestinal microorganisms. Using a step-by-step approach dietetic counselling in combination with augmented oral caloric intake should be the first measure. The next step to take is nutritional support by enteral tube feeding using formula diets. Parenteral feeding should only be used if other options to support caloric intake have failed.

Enteral Nutrition↗

PubMed1983

[Effect of fat emulsion (intralipid) on essential fatty acid deficiency during total parenteral nutrition in pediatric patients. Part 1. Experimental study].

Experimental studies were performed to confirm the effect of TPN with and without fat emulsion, Intralipid, on fat metabolism in weanling rats and puppies. Long-term fat-free TPN induced essential fatty acid (EFA) deficiency in weanling rats and the intravenous fat emulsion which accounted for 10% of the total caloric intake could prevent EFA deficiency. In the long-term TPN in growing puppies, fatfree TPN and induced EFA deficiency within two weeks, and Intralipid which accounted for 4% of the total caloric intake (2% as linoleate) satisfied the EFA requirement.

Animals↗

PubMed1984

Effects of alcohol on plasma lipoproteins and cholesterol and triglyceride metabolism in man.

To define the effects of moderate alcohol intake on cholesterol and triglyceride metabolism in man, twelve patients were hospitalized on a metabolic ward and were fed defined diets for 10 weeks. Each patient underwent testing of plasma lipid and lipoprotein levels, of cholesterol metabolism (absorption, fecal excretion, bile saturation), and of triglyceride metabolism [turnover of triglycerides in chylomicrons and very low density lipoproteins (VLDL)]. This testing was done twice, first during a 4-week control period and then during a 4-week period in which 630 calories of alcohol were either added to or substituted for baseline calories. This increased the average baseline caloric intake by only 24% (range 20% to 30% depending on the initial caloric intake). Addition of alcohol to the baseline diet did not cause weight gain in lean individuals. Obese individuals' responses were more variable, and 3/6 definitely gained weight when the diet was supplemented with alcohol. In addition, obese subjects appeared to be more susceptible to the hyperlipidemic effects of alcohol; whereas 4/6 obese patients developed increased total triglyceride and VLDL-triglyceride concentrations when alcohol was administered, concentrations increased with alcohol administration in only 1/6 lean individuals. High density lipoprotein (HDL) cholesterol increased in all volunteers. Low density lipoprotein (LDL) levels did not change. Metabolic studies showed increased transport of VLDL-triglycerides in overweight patients but not in normal weight individuals; increased transport of VLDL-triglycerides in the former was associated with delayed clearance of chylomicron triglycerides. Alcohol consumption did not affect lipoprotein lipase or hepatic triglyceride lipase in six patients in whom these enzyme activities were measured. In the amounts of alcohol taken in this study, no changes were observed in absorption, synthesis, or excretion of bile acids, or percent saturation of gallbladder bile with cholesterol.

Absorption↗

PubMed1996

Weight gain by middle-aged mice: dietary modification does not result in loss.

Dietary induced obesity susceptibility and persistence was examined in middle aged female retired C57BL/6J breeder mice. One year old mice were fed control chow (C), chow with added corn oil (O), or chow with added sweetened condensed milk (SCM) for 18 weeks, during which time food consumption and weight change were monitored. Mice in both the O and SCM groups gained significantly more weight than the C group. Weight increase correlated with caloric intake for the O and SCM groups. All mice were then fed standard laboratory chow for 22 weeks. The increased weight of both supplemented groups was maintained during this time suggesting that caloric intake is not the sole variable controlling weight maintenance in adult female mice. We encourage the use of older mice as a model to explore means of manipulating adult weight in humans.

Adipose Tissue↗

PubMed1979

Nutrient intakes in an urbanized Micronesian population with a high diabetes prevalence.

Dietary data was obtained from 77 adult Micronesian (Nauruan) subjects during a diabetes epidemiological survey. The life-style of this isolated Pacific population is almost completely Westernized and they have been shown to have a very high diabetes prevalence rate. Nearly all food consumed by the islanders is imported from Australia. The main caloric intake of both males and females was at least twice those recommended for Western or developing Pacific populations. The diet meets or exceeds the Australian National Health and Medical Research Council recommended allowance for calories, protein, fat, and ascorbic acid, but thiamin intake was inadequate. The percentage of fat in the diet was lower than that consumer by Western populations. Obesity is a pronounced feature of this population and the high caloric intake coupled with reduced physical activity would appear to be a major factor in relation to this. This Micronesian group has a genetic susceptibility to diabetes which may have been unmasked by the change from traditional to Western life-style. This problem may not be unique to Nauru and, with progressive Westernization, many other Polynesian and Micronesian populations may be at risk.

Adolescent↗