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PubMedDate not supplied

The effect of the route of nutrient delivery on gut structure and diamine oxidase levels.

Diamine oxidase (DAO) is an intestinal mucosal enzyme which serves as a marker of cellular maturity and integrity in ontogeny and after mucosal injury in the gastrointestinal tract. Since total parenteral nutrition is known to result in intestinal hypoplasia, this study was done to determine the effect of enteral and parenteral delivery of nutrients on gut structure and DAO levels. Central venous catheters were placed in 27 Sprague-Dawley rats (180-260 g), which received nutrients for 12 days via parenteral nutrition (GpI n = 10), oral intake of the parenteral solution (GpII n = 8), or standard rat chow (GpIII n = 9). Gross and microscopic measurements were made at sacrifice. Mucosal DAO levels were determined by metabolism of [3H] putrescine. Group III animals had a greater caloric intake than groups I and II, and were the only group with a significant increase in body weight. Gut weight, mucosal weight, and villous height were significantly less in group I vs groups II and III; group II values were less than group III (p less than 0.05). Both DAO specific activity and total gut DAO were significantly less in group I and group II. Mucosal DAO content correlated with total gut and mucosal weight. DAO mucosal levels decrease with parenteral nutrition, reflecting the intestinal hypoplasia that occurs. Mucosal DAO content may be dependent on both caloric intake and diet composition. Since serum DAO levels are known to correlate with mucosal DAO content, DAO activity may prove useful as a circulating marker of the effect of nutritional therapy on the intestinal mucosa.

Amine Oxidase (Copper-Containing)↗
PubMedDate not supplied

Use of positioning to reduce the severity of neonatal narcotic withdrawal syndrome.

OBJECTIVE: This study tested the hypothesis that highly fretful, narcotic-withdrawing neonates experience less distress in a prone-lying position than comparable, supine-lying neonates. STUDY DESIGN: Equivalent numbers of randomly assigned, narcotic-withdrawing newborns were assigned to prone-lying (n = 25) or supine-lying (n = 23) conditions. Subjects in the two groups were similar with regard to gestational age, birth weight, and clinical presentation. Peak and mean withdrawal severity, as measured by Neonatal Abstinence Scoring System (NASS) scores and daily caloric intake, were compared between supine and prone groups by Wilcoxon's two-sample test. RESULTS: The prone-lying neonates had lower peak NASS scores (p < 0.0001), lower mean NASS scores (p < 0.0001), and lower caloric intake (p < 0.001) than supine-lying, narcotic-withdrawing newborns. CONCLUSION: The fretfulness associated with neonatal withdrawal and other stressful conditions can be moderated by laying the affected infant prone. The pronate quieting response is a significant, endogenous source of neonatal pacification.

Energy Intake↗
PubMed1996

[Food and nutrient consumption in Spain in the period 1940-1988. Analysis of its consistency with the Mediterranean diet].

BACKGROUND: Not enough information is available regarding Spanish alimentation from the Civil War up to the present. Furthermore, there are some evidence that the Spaniards are leaving behind their traditional, healthy Mediterranean diet. The aim of this study was therefore to describe the food and nutrient intake trends of the Spanish population from 1940-1988 and establish to what extent the pattern of the Mediterranean diet has been maintained. METHODS: New food balance sheets for the Spanish population have been elaborated using all the information available and consistently applying the methodology of the European Union over the period from 1940-1988. RESULTS: Total caloric intake and that of all the macronutrients increased over the study period although this increase was greater after 1960. The contribution of lipids to total caloric intake has increased (30% in 1960-1968 and 42% from 1980-1988), protein contribution has remained the same (13% 1960-1968 and 13% 1980-1988) and carbohydrate intake has decreased (58% from 1960-1968 to 45% from 1980-1988). These changes are the result of an important increase in the consumption of meat, eggs, milk and derivatives. Nonetheless the high intake of fruit and vegetables, fish and olive and seed oils has been maintained. Thus, from 1980-1988 the ingestion of monounsaturated/saturated fatty acids and polyunsaturated/saturated fatty acids was 1.3 and 0.5, respectively. CONCLUSIONS: The first systematic reconstruction of the alimentary and nutritional history of the Spanish population over the last fifty years has been carried out. The Spanish diet has undergone typical changes associated with economic development but continues to be consistent with the pattern of the Mediterranean diet. These changes in diet are, however, of worry because of their deviation from optimum nutritional patterns.

Diet↗
PubMed1990

Effects of a multidisciplinary management program on neurologically impaired patients with dysphagia.

Dysphagia is a major problem in patients with neurologic disorders. Aspiration pneumonia and impaired nutritional status are consequences of dysphagia that result in high morbidity and mortality rates. Assessment and treatment of the dysphagic patient by a multidisciplinary team have been advocated but to date the effects of such an approach have not been demonstrated quantitatively. This prospective study was conducted to determine if a dysphagia program would improve patients' caloric intake and body weight, decrease the instances of aspiration pneumonia, or improve patients' feeding ability. Patients were referred from a 26 bed neurology/neurosurgery unit. A time series design was utilized. The control group consisted of 15 patients (mean age = 46.1 years), managed according to the existing ward routine. Subsequently, nursing staff attended a dysphagia training program. Following this, the treated group of 16 patients, (mean age = 49.3 years) was assessed by the dysphagia team, using bedside and videofluoroscopic examinations to determine the specific swallowing disorder. An individualized treatment program was designed for each patient. The groups were compared on the basis of deviation from their baseline weight, deviation from ideal energy intake, and the incidence of aspiration pneumonia. Statistical analysis revealed that the groups were comparable in age, number of days on the study, and Glasgow Coma Scale score; and that a significant weight gain and increase in caloric intake occurred in the treated group. No incidence of aspiration pneumonia was reported in either group. We speculate that this may have been influenced by the meticulousness of the care delivered in an acute unit as well as greater attention to prevention given in both groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

Effect of a low-fat diet on the incidence of actinic keratosis.

BACKGROUND: Actinic keratoses are premalignant lesions and are a sensitive and important manifestation of sun-induced skin damage. Studies in animals have shown that dietary fat influences the incidence of sun-induced skin cancer, but the effect of diet on the incidence of actinic keratosis in humans is not known. METHODS: We randomly assigned 76 patients with nonmelanoma skin cancer either to continue their usual diet (control group) or to eat a diet with 20 percent of total caloric intake as fat (dietary-intervention group). For 24 months, the patients were examined for the presence of new actinic keratoses by physicians unaware of their assigned diets. RESULTS: At base line, the mean (+/- SD) percentage of caloric intake as fat was 40 +/- 4 percent in the control group and 39 +/- 3 percent in the dietary-intervention group. After 4 months of dietary therapy the percentage of calories as fat had decreased to 21 percent in the dietary-intervention group, and it remained below this level throughout the 24-month study period. The percentage of calories as fat in the control group did not fall below 36 percent at any time. The cumulative number of new actinic keratoses per patient from months 4 through 24 was 10 +/- 13 in the control group and 3 +/- 7 in the dietary-intervention group (P = 0.001). CONCLUSIONS: In patients with a history of nonmelanoma skin cancer, a low-fat diet reduces the incidence of actinic keratosis.

Basal Cell Carcinoma↗
PubMed1995

Determinants of high-fat diet hyperphagia: experimental dissection of orosensory and postingestive effects.

High-fat diets often promote greater caloric intake and/or weight gain than high-carbohydrate diets in both laboratory animals and humans. Because altering the fat content of a diet simultaneously changes both its sensory properties and postingestive effects, it is unclear whether high-fat hyperphagia is due to the diet's palatability, its postingestive effects, or both. The present studies isolated the independent capacity of the orosensory and postingestive effects of a liquid high-fat diet (High-Fat) to produce overeating relative to an isocaloric liquid high-carbohydrate (High-CHO) diet. Rats fed High-Fat orally ate more calories and gained more weight over 16 days than rats fed High-CHO orally. One-bottle sham-feeding intake of High-Fat and High-CHO did not differ, but in two-bottle sham-feeding tests High-Fat was clearly preferred. When orosensory influences on intake were equated via chronic self-regulated intragastric feeding, High-Fat still promoted greater intake than High-CHO, although absolute intake across both diets was lower during intragastric feeding relative to oral feeding. An analysis of short-term intake revealed that rats accustomed to infusion of High-CHO increased meal size immediately when switched to High-Fat. The present results, coupled with previous findings, suggest that the postingestive effects of fat enhance daily caloric intake in two ways: 1) during a meal, fat produces less suppression of intake per calorie than carbohydrate; and 2) after a meal, fat produces less suppression of intake per calorie during the intermeal interval than carbohydrate.

Animals↗
PubMed1989

[Nutritional assessment of patients on chronic hemodialysis: what is our reality?].

We evaluated 22 patients with chronic renal failure on hemodialysis. Nutritional status was evaluated by anthropometric indices, levels of serum albumin, lymphocytes, transferrin, complement and creatinine generation. Protein intake was estimated from 6 surveys performed over a period of 6 months and socioeconomic status gauged by social survey. Mean weight was 106% of expected being definitely low in 5 patients. Sixteen patients had at least one abnormal test, with a low transferrin level being the most common (15 patients). Mean caloric intake was 27.8 cal/kg/day and protein intake 0.96 g/kg/day. Good correlation between protein intake estimated by diet survey and urea nitrogen balance was observed. No correlation of nutritional status and socioeconomic status was observed. We conclude that patients on chronic hemodialysis commonly have malnutrition and low caloric intake.

Adult↗
PubMed1995

Evidence that a low-fat diet reduces the occurrence of non-melanoma skin cancer.

The effect of a low-fat diet on occurrence of non-melanoma skin cancer was examined in a 2-year dietary intervention trial. A total of 101 skin-cancer patients were randomized either to a control group that consumed, on average, 38% of caloric intake as fat, and in which no changes in dietary habits were introduced, or to a low-fat dietary-intervention group, in which patients were instructed to limit their calories from fat to 20% of total caloric intake. Patients were examined at 4-month intervals by dermatologists blinded to their dietary assignments. Nutrient analyses, conducted at each of the 4-month follow-up visits, indicated that the % calories of fat consumed in the intervention group had been reduced to 21% at 4 months and remained below this level throughout the 2-year period. There were no significant differences in total calories consumed, or in mean body weights, between the control and the intervention groups. Nor were there significant group differences in P/S ratios until month 24. Numbers of new skin cancers treated at each examination were analyzed in 8-month periods of the 2-year study. Comparisons of skin-cancer occurrences revealed no significant changes in the control group from baseline values. However, cancer occurrence in the low-fat intervention group declined after the first 8-month period and reached statistical significance by the last 8-month period. Patients in this group had significantly fewer cancers in the last 8-month period than did patients in the control group. In addition, there was a significant reduction in the number of patients developing skin cancer in the last 8-month period, as compared with the first 8-month period, within the low-fat intervention group. There were no significant changes in the control group. These data indicate that a low-fat diet can significantly reduce occurrence of a highly prevalent form of cancer.

Carcinoma↗
PubMedDate not supplied

[Multicenter study on incidence of total parenteral nutrition complications in the critically-ill patient. ICOMEP study. Part II].

OBJECTIVE: To assess enteral nutrition complications in a prospective cohort of patients admitted to the ICU. MATERIAL AND METHODS: Prospective, multicenter study of patients admitted to the ICU and that received enteral nutrition (EN). Demographical data, main diagnosis, and nutritional and severity indexes were included. Complications were previously defined and were categorized as gastrointestinal or infectious. An independent group managed the databases and performed the statistical analysis. Data were expressed in absolute values or by their median and percentile (25-75). The rate and incidence density of complications and the odds ratio for complications were determined. RESULTS: 544 out of 3409 patients received enteral nutrition. Three hundred and three patients were admitted for medical causes, 149 for surgical causes and 92 for trauma. Ninety nine patients were underfed, and the nutritional risk index was 69.7. The incidence of gastrointestinal complications was 6 episodes per 100 days of nutrition, and in 89 patient they resulted in enteral nutrition withdrawal. Early enteral nutrition did not yield more complications than late EN. Vomiting was more frequent in late EN (OR 0.4; 95%CI: 0.2-0.7). Temporary withdrawal of diet in 140 patients was the most used procedure, which resulted in a lower caloric intake (median of 2 kcal/kg/d) than programmed. Nosocomial infection rates were 7.47% for catheter-induced sepsis and 51% for other nosocomial infections, and 35% developed pneumonia. CONCLUSIONS: Gastrointestinal complications with enteral nutrition are frequent, result in insufficient caloric intake and definitive withdrawal of diet in a significant number of cases. Early enteral nutrition is not associated with an increased number of complications. Episodes of increase of the gastric residue do not increase the incidence of pneumonia. Other infectious complications are within the range of what has been published and seem to be little modified by the use of enteral nutrition.

Aged↗
PubMed1983

The effect of dietary sodium and protein on urine volume and water intake.

To test the notion that water intake and urine volume are related to dietary sodium or protein intake in free-living persons, we studied normal men at three levels of sodium intake and two levels of protein intake. Twenty-four men received 10, 200, and 400 mEq/day sodium intake for 7 days while protein and caloric intake were maintained constant. Eight men received 80 or 180 gm/day protein intake for 7 days while caloric and sodium intake were maintained constant. Although sodium, solute, and urea nitrogen excretion changed appropriately according to the regimens, there was no demonstrable influence of sodium or protein intake on water intake and urine volume. We conclude that in normal free-living American man, water consumption is independent of either sodium or protein intake.

Adult↗
PubMed1988

Nutrient intake, lipids, and lipoprotein cholesterols in black and white children: the Lipid Research Clinics Prevalence Study.

Our specific aim was to assess differences in nutrient intake and in lipids and lipoprotein cholesterols between blacks and whites in 259 black children (129 boys, 130 girls) and in 811 white children (424 boys, 387 girls) ages 5-19. The nutrient intake data were obtained by 24-hr recall from the Houston and Cincinnati Lipid Research Clinics. The fundamental nutrient differences between blacks and whites were in total calories and in calories per kilogram of body weight, both of which were uniformly and significantly lower among black than white boys and generally, but less consistently and significantly, lower among black than white girls. No racial differences in total cholesterol or cholesterol intake per kilogram body weight were observed. After statistically controlling for education of the head of household, there were no consistent significant racial differences in Quetelet index. There was no significant independent effect of education of head of household on the children's caloric intake and racial differences in socioeconomic status did not appear to systematically account for differences in total energy intake. In aggregate, black children had lower triglyceride and very-low-density lipoprotein cholesterol levels, and higher levels of high-density lipoprotein cholesterol than whites; there were no significant differences by race in low-density lipoprotein cholesterol levels. Race was a significant independent explanatory variable for high-density lipoprotein cholesterol levels (higher in blacks) and for very-low-density lipoprotein and triglyceride levels (higher in whites) (P less than 0.005), after covariance adjusting for education of head of household, sex, age, Quetelet index, calories, saturated fat (g/day/kg body wt), and clinic. Lower caloric intake among blacks compared with whites, the major nutrient difference in the current study, did not account for differences in lipoprotein cholesterol levels between the two groups.

Adolescent↗
PubMedDate not supplied

Body fat distribution's impact on physiologic outcomes during cardiac rehabilitation.

BACKGROUND: High waist-to-hip ratios (WHRs) predispose individuals to metabolic syndromes that may affect outcome responses to cardiac rehabilitation programs. METHODS: A total of 101 male patients who had undergone coronary artery revascularization surgery and completed 12 weeks of cardiac rehabilitation were divided into lower (LOWHR, n = 51) and higher (HIWHR, n = 50) waist-to-hip groups. Outcomes were measured at week 1 and week 12 of cardiac rehabilitation. RESULTS: Waist-to-hip ratio and body weight were greatest for HIWHR (P < 0.001) with no between-group differences in the amount of change from week 1 to 12. Triceps and subscapular skin-folds were greater for HIWHR (P < 0.001) with no difference in the amount of change between groups. Caloric expenditure during exercise class was higher for LOWHR (P = 0.022). Daily caloric expenditure was greater for LOWHR (P = 0.034) as was daily caloric intake (P < 0.001). There were no group differences for VO2peak and ventilatory anaerobic threshold (VAT) with nonsignificant trends for greater increases in LOWHR. CONCLUSIONS: Cardiac rehabilitation patients with greater WHRs expend less calories during exercise classes. To enhance overall caloric expenditure and obtain positive outcomes, cardiac rehabilitation professionals must emphasize greater activity with less sedentary time throughout the patients normal daily routine. The validity of using self-reported caloric intake and expenditure values in the cardiac rehabilitation population is questionable.

Adipose Tissue↗
PubMed2001

[D-LEU-4]-OB3, a synthetic leptin agonist, improves hyperglycemic control in C57BL/6J ob/ob mice.

We have recently shown that the activity of a synthetic peptide corresponding to amino acid residues 116-130 of secreted mouse leptin is contained in a restricted sequence at the amino terminus of the peptide, between residues 116-122 (Ser-Cys-Ser-Leu-Pro-Gln-Thr, OB3). Substitution of the Leu residue at position 4 of OB3 with its D-isomer ([D-Leu-4]-OB3) enhanced the ability of OB3 (1 mg/day, ip, 7 days) to reduce body weight gain, food and water intake, and serum glucose in female C57BL/6J ob/ob mice. In the present study, we have utilized a pair-feeding approach to demonstrate that the antihyperglycemic action of [D-Leu-4]-OB3 is not solely due to its effects on caloric intake. One group of female C57BL/6J ob/ob mice (n=6) was fed ad libitum, and two additional groups (n=6 per group) were allowed 3.0 g food/mouse daily, an amount previously determined to satisfy [D-Leu-4]-OB3-treated mice. At the end of the 7-day test period, vehicle-injected mice fed ad libitum were approximately 10% heavier than their initial body weights, while pair-fed mice injected with vehicle and [D-Leu-4]-OB3-treated mice lost 5% of their initial body weights. After 1 day of treatment, blood glucose was reduced by 20% in pair-fed vehicle-injected mice, and by 40% in mice given [D-Leu-4]-OB3. Food restriction reduced blood glucose throughout the 7-day study, but not to levels seen in wild-type nonobese C57BL/6J mice of the same sex and age. After 2 days of treatment with [D-Leu-4]-OB3, however, blood glucose was reduced to levels comparable to those seen in wild-type nonobese mice. [D-Leu-4]-OB3 also lowered serum insulin levels by 53% when compared to mice fed ad libitum. Neither pair-feeding nor [D-Leu-4]-OB3 treatment had any apparent effect on thermogenesis. These results suggest that [D-Leu-4]-OB3 exerts its effects on serum glucose not only by suppressing caloric intake, but also through a separate effect on glucose metabolism which may involve increased tissue sensitivity to insulin.

Animals↗
PubMed1986

The diabetic response of weanling sand rats (Psammomys obesus) to diets containing different concentrations of salt bush (Atriplex halimus).

Understanding the sand rat's metabolic responses is necessary in order to employ the animal gainfully in the study of diabetes. Weanlings are most susceptible to the effect of diabetogenic diets. In the present experiment, weanling sand rats were fed diets at 3 levels of energy intake. The diets were based on pellets composed of different ratios of salt bush (Atriplex halimus) and a standard laboratory animal chow pellet. The results showed a significant correlation between the level of energy intake, percent body fat and signs of Type 2 diabetes. Animals with 28-30.6% body fat had blood glucose levels of 260 +/- 66 mg% and plasma insulin concentrations of greater than 558 mu u/ml, and those with 17.9-24.0% body fat had a blood glucose level of 107 +/- 19.8 mg% and a plasma insulin level of 222 +/- 35 mu u/ml. Animals with approximately 10% body fat, had a blood glucose level of 60 +/- 1.9 mg% and a plasma insulin concentration of 35 +/- 10 mu u/ml. The fattest animals had the highest percentage of glycosylated hemoglobin. The animals with the highest quantity of fat receiving high caloric intake had a lower lean body mass than those of similar weight exposed to a lower caloric intake. This result could be accounted for by assuming that the extreme hyperinsulinemia promoted fat production at the expense of lean body mass.

Adipose Tissue↗
PubMed2005

Methylphenidate increases cigarette smoking.

RATIONALE: Methylphenidate (Ritalin) and d-amphetamine (Dexedrine), stimulants commonly prescribed for behavioral problems associated with attention deficit hyperactivity disorder (ADHD), produce a similar constellation of behavioral effects. The results of previous studies suggest that d-amphetamine increases rates of smoking and the reinforcing effects of smoking. The effects of methylphenidate on smoking have not been assessed although it is the most commonly prescribed pharmacotherapy for ADHD and individuals with ADHD are at increased risk for smoking. OBJECTIVE: In this experiment the acute effects of a range of doses of methylphenidate (5, 10, 20, and 40 mg) and placebo were assessed in ten cigarette smokers who were not attempting to quit and were without ADHD or other Axis I psychiatric disorders. METHODS: Each dose of methylphenidate was tested once, whereas placebo was tested twice. One hour after ingesting drug, participants were allowed to smoke ad libitum for 4 h. Measures of smoking included total cigarettes smoked, total puffs, latency to the first cigarette, and carbon monoxide levels. Snacks and decaffeinated drinks were available ad libitum, and caloric intake during the 4-h smoking session was calculated. RESULTS: Methylphenidate dose dependently increased the total number of cigarettes smoked, number of puffs, and carbon monoxide levels. As expected, methylphenidate dose dependently decreased the number of food items consumed and caloric intake. CONCLUSIONS: The results of this experiment suggest that methylphenidate, like d-amphetamine, increases rates of cigarette smoking.

Adolescent↗
PubMed1992

Dietary practices, physical activity, and body-mass index in a selected population of Down syndrome children and their siblings.

Thirty sibling pairs, each with one Down syndrome child between the ages of 2 and 14, were selected from families who had participated in an infant-stimulation program. The maternal and paternal educational levels were 14.9 and 16.9 years, respectively. The Down syndrome patients and their siblings were compared in terms of body-mass index, that is, weight/stature2 (w/s2); activity as measured on a questionnaire; and weekly caloric intake. There were no significant differences between the Down syndrome children and their siblings in terms of w/s2. The Down syndrome patients were less active than their siblings and spent significantly more time indoors, showing a preference for indoor activities. Caloric intake calculated as percentage of recommended allowance for height was somewhat less in the Down syndrome children--88.7%, compared with 95% in the siblings--but not significantly so. It is postulated that even though Down syndrome patients have been shown to be at risk for obesity, familial and other environmental factors, such as dietary control and involvement in physical activity, have an influence.

Adolescent↗
PubMed1980

Interrelationships between nutrient intake and plasma lipids and lipoproteins in schoolchildren aged 6 to 19: the Princeton School District Study.

Relationships between nutrient intakes and plasma lipids and lipoproteins were studied in 1,669 schoolchildren, aged 6 to 19 years; 948 were selected by random recall and 721 because of elevated plasma cholesterol or triglyceride (hyperlipidemic recall). Nutrient intake data was collected by using a 24-hour dietary recall. Median dietary cholesterol intakes for 6 to 9-year-old boys and girls in the random recall group were 222 and 230 mg/day, with polyunsaturated/saturated fat ratios of 0.34 and 0.33. For boys and girls, aged 10 to 12 years, median dietary cholesterol intakes were 296 and 235 mg/day, for 13 to 15 year olds, 343 and 237, and for 16 to 19 year olds, 418 and 221 mg/day. The dietary polyunsaturated/saturated fat ratios did not change appreciably with age. Partial correlation coefficients describing relationships between lipids, lipoproteins, and nutrients after adjustment for age, sex, race, and Quetelet index (W/H2) were calculated for all children (random and hyperlipidemic recall) after excluding children having plasma cholesterol, triglycerides, and calories less than or equal to the first or greater than or equal to the 99th percentiles for the random recall children. Plasma cholesterol was inversely and triglyceride positively correlated with dietary sucrose. Plasma low density lipoprotein cholesterol was inversely and triglyceride positively correlated with the dietary polyunsaturated/saturated fat ratio, total carbohydrate, and sugar. Potential relationships between nutrients and lipids-lipoproteins were also examined in children having low (first to tenth percentile), intermediate (45th to 55th percentile), and high (90th to 99th percentile) nutrient intake, after covariance adjustment for age, race, sex, and Quetelet index. Total plasma cholesterol fell as sucrose intake increased. Triglyceride rose along with caloric intake, total carbohydrate intake, and sucrose intake, while high density lipoprotein cholesterol levels fell with increasing caloric and sucrose intake. As dietary polyunsaturate ingestion rose from low to intermediate to high, plasma low density lipoprotein cholesterol increased. Nutrient intake may play a small but significant role relative to lipids and lipoproteins in children and, as such, may have importance relative to pediatric precursors of atherosclerosis.

Adolescent↗
PubMed1986

Total parenteral nutrition in familial hypercholesterolemia: importance of caloric control.

Effects of total parenteral nutrition (TPN) on serum cholesterol levels were examined in four patients with homozygous and three patients with heterozygous familial hypercholesterolemia and 13 patients without hypercholesterolemia. Fat-free TPN was administered in average doses of 26.5 cal/kg/day (43.6 cal/kg/day in a child) for 5 to 14 weeks. The serum cholesterol level decreased markedly by 47.5% and 58.6% in homozygous and heterozygous cases, respectively. Despite restriction in calories of TPN, protein nutrition was maintained in all patients. It became apparent that in familial hypercholesterolemia, whether the heterozygous or homozygous form, TPN performed at a well-adjusted caloric intake provided an adequate control of the serum cholesterol level as far as TPN was continued. In patients without hypercholesterolemia under TPN, serum cholesterol levels varied correlatively with the amount of calories to be administered. Compared with values before TPN, serum cholesterol level as far as TPN was continued. In patients without hypercholesterolemia under TPN, serum cholesterol levels varied correlatively with the amount of calories to be administered. Compared with values before TPN, serum cholesterol levels at the fourth week of TPN were elevated or maintained in patients receiving more than 40 cal/kg/day, while it was reduced in patients given less than 40 cal/kg/day. There was a statistically significant correlation between daily caloric intake per body weight and change of serum cholesterol level at the fourth week of TPN. This indicates that caloric control is of importance in TPN-induced change in serum cholesterol levels.

Adolescent↗