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PubMed1996

Nitrogen balance in hospitalized chronic hemodialysis patients.

Malnutrition is an important factor in the increased morbidity and mortality of chronic hemodialysis (CHD) patients. Dietary protein intake necessary to maintain neutral nitrogen balance appears to be higher in CHD patients due to various catabolic effects of the hemodialysis procedure, including nutrient losses and increased energy expenditure. Dietary intake may be further decreased in hospitalized CHD patients. We examined this issue in 18 CHD patients (9 male, 9 female) who were admitted to a regular ward. Daily protein intake (DPI) and daily caloric intake were measured for each patient. In addition, protein catabolic rate (PCR) calculated from interdialytic changes in BUN were calculated. Our results showed that mean (+/- SD) DPI was 0.79 +/- 0.41 g/kg/day, while PCR was 0.93 +/- 0.38 g/kg/day. Dietary protein and energy intake were 66% and 50% of suggested values, respectively, and DPI accounted for only 85% of PCR. Mean nitrogen balance was negative by -2.11 +/- 2.77 g of nitrogen/day (range -9.91 g of nitrogen/day to +3.89 g of nitrogen/day). Biochemical nutritional parameters such as serum albumin, cholesterol, prealbumin and transferrin obtained one week following admission were also indicative of undernutrition (3.16 +/- 0.39 g/dl, 132 +/- 30 mg/dl, 20 +/- 7.4 mg/dl, 154 +/- 49 mg/dl, respectively). We conclude that hospitalized CHD patients have inadequate protein and energy intake and this is evidenced by a significant deterioration in nutritional parameters during hospitalization. More aggressive nutritional interventions may be needed for this group of patients to prevent the adverse effects of hospitalization on nutritional status.

Adult↗
PubMed1984

Dietary fat versus caloric content in initiation and promotion of 7,12-dimethylbenz(a)anthracene-induced mammary tumorigenesis in rats.

Enhancement of mammary tumor formation by dietary fat may be mediated via increased caloric intake. Three experiments were performed to study this relationship in 7,12-dimethyl-benz(a)anthracene (DMBA)-treated female Sprague-Dawley rats: (a) high- or low-fat isocaloric diets were fed in a crossover design; (b) low-fat, high-calorie and high-fat, low-calorie diets were fed in a crossover design; (c) pair-fed rats were restricted to 60% of the calories of controls with ad libitum access to food beginning 10 days after DMBA administration. The pair-fed rats received daily 60% of calories, the same level of fiber, and 115% more fat than did rats fed ad libitum. Tumor yield but not tumor incidence was greater in rats fed high-fat rather than low-fat isocaloric diets prior to initiation of tumorigenesis. A low-fat, high-calorie diet led to more tumor incidence and yield than was associated with feeding of a high-fat, low-calorie diet. Caloric restriction (although with concomitant intake of more fat) led to complete inhibition of tumor formation. These results indicate that both high-fat and high-calorie diets exhibit cocarginogenic, not merely promotional, properties. Caloric intake may be a greater determinant than dietary fat of a tumor-enhancing regimen. Finally, restriction of caloric intake during promotion markedly suppresses tumor formation, despite the increased fat content of the restricted diet, suggesting a permissive role for calories in tumor formation. The possibility remains that alterations in levels of other dietary components could also have contributed to the observed effects.

9,10-Dimethyl-1,2-benzanthracene↗
PubMedDate not supplied

The role of protein and calorie restriction in outcome from Salmonella infection in mice.

We studied the separate effects of protein and calorie restriction in mice challenged with Salmonella typhimurium, an intracellular pathogen eliminated by cell-mediated immunity. Female A/J mice (n = 73) were placed on one of eight solid diets for 3 weeks. Animals were weighed at the beginning and the end of the feeding period. Diets were adjusted by two factors. The total amount of protein in the diet was 1%, 5%, 20%, or 40% by weight. The diets were fed to half the mice in quantities of 3 g and to the other half at 1.5 g per mouse per day. At the end of 3 weeks, mice were injected intraperitoneally with bacteria and mortality was observed for 2 weeks. Mortality was related to protein intake and was significantly higher in the 1% and 5% groups (chi 2: p = .0021). However, mortality was lower in the calorie-restricted groups (chi 2: p = .0242). Although caloric intake did not affect cell-mediated immunity, the response to 2,4-dinitrofluorobenzene was greater in the low protein groups. Lymphoproliferative responses in the mixed lymphocyte response were not affected by either caloric or protein intake. Lymphoproliferative responses to both lipopolysaccharide and phytohemagglutinin were affected by dietary protein but not by caloric intake; proliferative responses were higher in the low-protein groups. We conclude that protein restriction can increase mortality in this model. On the other hand, short-term calorie restriction can improve survival.

Animals↗
PubMed1993

Effects of caloric restriction and dietary fat on epithelial cell proliferation in rat colon.

Epidemiological studies indicate that caloric intake and dietary fat content influence colonic carcinogenesis. In rodents, caloric restriction reduces, and some fats increase, carcinogen-induced colon cancer incidence. The present study was designed to investigate the effects of caloric restriction on colonic cell proliferation (CCP) in carcinogen-treated or control rats fed low- or high-fat diets. F344 rats were treated with azoxymethane (15 mg/kg x2) and then fed an isocaloric AIN 76A diet containing either 5 or 23% corn oil, ad libitum or calorie-restricted to 70 or 80% of the kilocalories consumed by ad libitum rats. Biopsies of the distal colon were taken at 10 and 20 weeks, and rats were sacrificed at 21 or 34 weeks on the experimental diets. Distal CCP was determined by microautoradiography after [3H]thymidine labeling in vitro or presacrifice administration in vivo. The labeling index and number of labeled cells per crypt column were significantly reduced by caloric restriction at all time points (10, 20, 21, 34 weeks). Caloric restriction reduced CCP in high fat- and low fat-fed rats and in azoxymethane-treated and control rats. High fat resulted in decreased CCP in the distal colon compared to low fat at 34 weeks but not earlier. The findings indicate that: (a) caloric restriction is effective in favorably modulating CCP, an intermediate biomarker of colon cancer risk; (b) a high fat ad libitum diet, which increased tumor yield, does not increase distal colon proliferation; (c) dietary fat intake alters proliferation in a manner differing from that induced by changing dietary caloric intake.

Animals↗
PubMed1986

Caloric compensation and sensory specific satiety: evidence for self regulation of food intake by young children.

Twenty-one two and half- to five-year-old children and 26 25- to 35-year-old adults participated in an experiment designed to provide evidence for two behavioral mechanisms involved in self regulation of food intake: caloric compensation and sensory specific satiety. All participants were seen in two lunch sessions that differed in the caloric density of the preload presented. To obtain evidence on sensory specific satiety, preference data were obtained immediately before and after, and 20 min after preload consumption. Subjects then ate an ad libitum lunch and consumption was recorded. Both children's and adults' preferences for the food eaten declined relative to foods not eaten, providing the first evidence of sensory specific satiety in children. The patterns of preference did not differ with the caloric density of the food eaten. Children showed much clearer evidence for caloric compensation than did the adults.

Adult↗
PubMed1997

Veterans Administration Cooperative Dental Implant Study--comparisons between fixed partial dentures supported by blade-vent implants and removable partial dentures. Part V: Comparisons of pretreatment and posttreatment dietary intakes.

PROBLEM: Good scientific evidence is lacking on the impact of improvement in masticatory function after prosthodontic restoration of missing teeth. PURPOSE: This study compares 1-week dietary intakes of 218 healthy, male patients, 111 patients restored with mandibular unilateral or bilateral distal base extension removable partial dentures and 107 patients with fixed partial dentures. MATERIAL AND METHODS: Dietary logs recorded before the initiation of treatment and 6-months after the baseline period after partial denture treatment were analyzed for 30 nutritional variables of food intakes including total calories, fats, carbohydrates, proteins, fiber, and a number of vitamins and minerals. RESULTS: Both before and after treatment, intakes of various nutrients were more than 25% above or below the RDAs for approximately half of the patients in both groups. No significant differences were observed between the mean scores of the two groups for any of the 30 variables either before or after treatment. However, beneficial treatment effects were seen in subsets of patients with low and high caloric intakes at entry. Both treatments increased the intakes of calories and 27 nutrients in the low caloric group and decreased the intakes of calories and 27 nutrients in the high caloric group. The decreases in the caloric intake and eight nutrients, including total protein, fat, carbohydrates, and cholesterol, were significantly greater (p < 0.05) in the fixed partial denture group than those in the removable partial denture group. CONCLUSIONS: These beneficial effects of partial dentures, if verified by other studies, may have profound clinical implications for the undernourished and obese patients.

Adult↗
PubMed1984

Feeding behavior during experimentally induced obesity in monkeys.

In order to investigate the effects of the induction and remission of obesity on feeding behavior, male rhesus monkeys were made obese by sustained intragastric (IG) feeding of a complete liquid diet. Intragastric diet infusion levels of 100, 125, 145, and 165% of the baseline oral intake of each monkey were successively administered. During the initial overfeeding period (100% of the baseline oral intake), at least one week was required to reduce voluntary oral intake to less than 25% of the baseline levels and complete suppression of oral intake did not occur. This increased total caloric intake (IG infusion plus oral intake) resulted in a rapid rate of weight gain of at least 5 times the baseline rate. With successive increases in caloric infusion level, oral intake was eventually suppressed, and rapid weight gain was sustained. When the IG infusion was abruptly terminated after 50 to 130 days, 3 monkeys refused all food for 14 to 35 days. The monkeys' oral intakes stabilized three to ten weeks after the end of the overfeeding period. The length of this period prior to the resumption of normal oral intake was not related to length of overfeeding nor to the amount of weight gained. The monkeys' body weights dropped rapidly in the initial post-overfeeding period and then stabilized, sometimes at levels higher than their baseline body weights. In 2 monkeys, at the end of overfeeding the amounts infused were gradually reduced in order to determine the calories required to maintain their body weights at peak levels. Significantly fewer kcal/kg were required to maintain peak body weights than were ingested during the baseline periods.

Animals↗
PubMed1996

Effect of fenfluramine on food intake, mood, and performance of humans living in a residential laboratory.

Five male and four female normal weight research volunteers, participating in 13-day residential studies, received oral fenfluramine (20, 40 mg) or placebo at 09:30 and 17:00. Food intake, performance, and subjective ratings were measured throughout the day. Carbohydrate intake was manipulated by providing lunch meals high (males: 120 g; females: 80 g) or low (males: 25 g; females: 16 g) in carbohydrate on 8 days; on the remaining days subjects self-selected lunch. Total caloric intake (approximately 2800 Kcal) did not differ among the low- and high-carbohydrate, and self-selected lunch conditions when subjects received placebo, indicating caloric compensation. Total carbohydrate intake was significantly less, however, when subjects consumed the low-carbohydrate lunch compared to the other lunch conditions. Fenfluramine significantly decreased total caloric intake (approximately 500 kcal) by decreasing meal size, not number, only when subjects consumed the low-carbohydrate lunch. Fenfluramine was only an effective anorectic drug when subjects consumed a lunch with fewer calories and a lower carbohydrate:protein ratio than self-selected baseline. Also, fenfluramine improved performance on a range of computer tasks and increased ratings of "Alert," "Friendly," and "Talkative," while decreasing ratings of "Tired" and "Irritable."

Adult↗
PubMed1986

Alcohol and nutrition: caloric value, bioenergetics, and relationship to liver damage.

Alcoholic beverages contribute an appreciable percentage (4-6%) to the total caloric intake in Western societies. The caloric value of ethanol as fuel may be dose-related. Most evidence suggests that at moderate intake levels of less than 45 g/day (3 drinks) ethanol is efficiently utilized as a fuel by the liver. At high intakes, ethanol calories may not be utilized for cellular synthesis of ATP and maintenance of weight. The exact mechanism for this inefficient utilization remains unknown but may be related, in part, to metabolism of ethanol by the microsomal ethanol-oxidizing system, a reaction that does not contribute to generation of reducing equivalents for ATP synthesis. Although ethanol is utilized for ATP synthesis after single-dose administration, chronic consumption leads to morphological changes in hepatic mitochondria and to decreased ATP synthesis. Reductions in the activities of the enzymes of the mitochondrial electron transport chain have been reported after alcohol feeding and may help to explain decreases in hepatic ATP synthesis. There is some evidence that ATP degradation by "Na-K ATPase" is increased after ethanol feeding and that hepatic O2 consumption is likewise enhanced. However, other studies have failed to demonstrate enhanced O2 consumption. Current evidence suggests that malnutrition alone is not sufficient to explain the pathogenesis of chronic liver disease in alcoholics. Although the daily amount of alcohol consumed and the duration of excessive consumption are clearly important factors in the development of alcoholic hepatitis and cirrhosis, other factors, particularly nutritional deficiencies, may modulate the risk of developing alcohol-related liver damage. The prevalence of malnutrition is exceedingly high in alcoholics with clinically severe liver disease. Nutritional deficiencies are better correlated with a clinical index of severity than with histologic severity of alcoholic hepatitis. Prognosis and outcome of patients with alcoholic liver disease may be affected by nutritional deficiencies, which thus provides a rationale for aggressive nutritional management of these patients.

Acetaldehyde↗
PubMed2006

Early enteral nutrition within 24h of colorectal surgery versus later commencement of feeding for postoperative complications.

BACKGROUND: The role of early postoperative enteral nutrition after gastrointestinal surgery is controversial. Traditional management consist of 'nil by mouth', where patients receive fluids followed by solids when tolerated. Although several trials have implicated lower incidence of septic complications and faster wound healing upon early enteral feeding, other trials have shown opposite results. The immediate advantage of caloric intake could be a faster recovery with fewer complications, to be evaluated systematically. OBJECTIVES: To evaluate whether early commencement of postoperative enteral nutrition compared to traditional management (no nutritional supply) is associated with fewer complications in patients undergoing gastrointestinal surgery SEARCH STRATEGY: We searched the Cochrane Central Register of Controlled Trials, PUBMED, EMBASE, and LILACS from 1979 (first RCT published) to March 2006. We manually scanned the references from the relevant articles, and consulted primary authors for additional information. SELECTION CRITERIA: We looked for randomised controlled trials (RCT's) comparing early commencement of feeding (within 24 hours) with no feeding in patients undergoing gastrointestinal surgery. Early enteral nutrition is defined as all oral intakes (i.e. registered oral intake, supplemented oral feeding) and any kind of tube feeding (gastric, duodenal or jejunal) containing caloric content. No feeding is traditional management, defined as none caloric oral intake or any kind of tube feeding before bowel function. The definition 'no nutrition' includes non caloric placebo and water. DATA COLLECTION AND ANALYSIS: The three authors independently assessed the identified trials, and extracted the relevant data using a specifically developed data extraction sheet. Primary end points of interest were: Wound infections and intraabdominal abscesses, postoperative complications such as acute myocardial infarction, postoperative thrombosis or pneumonia, anastomotic leakages, mortality, length of hospital stay, and significant adverse effects. We combined data to estimate the common relative risk of postoperative complications, and calculated the associated 95% confidence intervals. For analysis, we used fixed effects model (risk ratios to summarise the treatment effect) whenever feasible. The treatment effect on length of stay was estimated using effect size (presented as mean +/- SD). Some outcomes were not analysed but presented in a descriptive way. We used a random effects model to estimate overall risk ratio and effect size. MAIN RESULTS: We identified thirteen randomised controlled trials, with a total of 1173 patients, all undergoing gastrointestinal surgery. Individual clinical complications failed to reach statistical significance, but the direction of effect indicates that earlier feeding may reduce the risk of post surgical complications. Mortality was the only outcome showing a significant benefit, but not necessarily associated with early commencement of feeding, as the reported cause of death was anastomotic leakage, reoperation, and acute myocardial infarction. AUTHORS' CONCLUSIONS: Although non-significant results, there is no obvious advantage in keeping patients 'nil by mouth' following gastrointestinal surgery, and this review support the notion on early commencement of enteral feeding.

Colon↗
PubMed1995

Dietary factors in epidemic neuropathy on the Isle of Youth, Cuba.

An epidemic neuropathy that broke out in Cuba in late 1991 has exhibited clinical manifestations similar to those of other polyneuropathies of nutritional origin. To investigate its possible association with diet, a study was conducted on the Isle of Youth in 1993, at the start of an outbreak there. Thirty-four subjects with cases and 65 controls were interviewed regarding their diets, measured anthropometrically, and evaluated. As a whole, the subjects with cases demonstrated greater weight loss before the onset of disease, lower body mass indexes (BMI), lower percentages of body fat, and more deficient diets than the control subjects. Analysis of individual variables found associations between occurrence of the disease and the following: weight loss, low BMI, a broad range of specific dietary deficiencies, a sugar intake exceeding 15% of total caloric intake, alcohol consumption, and smoking. Also, protective associations were found between absence of the disease and regular consumption of certain foods at or above specified levels. Multivariate analysis indicated that while smoking and alcohol consumption reinforced the effects of the dietary deficiencies, they did not account for occurrence of the disease by themselves. Overall, the results indicate that diets which are deficient in caloric energy, protein, fat, and the micronutrients included in the study, and which reflect an imbalance resulting from a relative excess of sugar, with consequent effects on body weight, are strongly associated with, and causally related to, the occurrence of epidemic neuropathy in Cuba.

Adult↗
PubMed1994

Overfeeding the critically ill child: fact or fantasy?

Overfeeding occurs when the administration of calories and/or specific substrate exceeds the requirements to maintain metabolic homeostasis. These requirements are substantially altered during periods of injury-induced acute metabolic stress. Excess nutritional delivery during this period can further increase the metabolic demands of acute injury and place an added burden on the lungs and liver. The result is to increase pulmonary and hepatic pathophysiology, as well as to increase the risk of mortality. It is important, therefore, to ensure that caloric intake not exceed demand. Precise caloric delivery is best determined during acute injury states by measuring energy expenditure. Due to substantial interpatient variability, estimates of energy needs on the basis of disease categories, subject age, or body composition can be misleading and usually result in overfeeding. The delivery of caloric amounts normally required for healthy infants is inappropriate for acutely-stressed, critically ill infants in whom total energy requirements are much lower due to inhibited growth, reduced insensible losses, and decreased activity. Such nutritional administration can result in overfeeding by 200% of measured energy expenditure. Overfeeding cannot reverse tissue catabolism until the acute metabolic stress response has resolved. In these acutely-stressed infants, measured energy expenditure constitutes the total energy requirement, and caloric delivery in excess of this amount should be avoided until metabolic stress parameters indicate resolution of the acute injury state. Enteral delivery should be used in preference to parenteral feeding. Even if total caloric delivery cannot be achieved enterally, the provision of a small amount of the total energy budget via the enteral route is generally possible and is likely advantageous.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗
PubMed1991

Weight control and exercise.

Obesity in the United States can truly be called a national epidemic. The associated health risks and diseases present a tremendous drain to the economy. The most effective program to lose and maintain a desirable body weight incorporates a combination of restriction in caloric intake with an increase in caloric expenditure through exercise. A gradual approach of losing 1 or 2 pounds per week has proved to be the most effective. Men should strive to maintain approximately 15% body fat and women 25% body fat. Weight-reduction programs that demonstrate phenomenal weight loss in a short period will not work over the long term and may represent a significant health risk. The ability to lose fat and maintain a desirable body weight is not easy but can be attained through a firm commitment to a healthy life style.

Adipose Tissue↗
PubMed1998

[Psychosomatic aspects of obesity].

Obesity is characterised by an imbalance of caloric intake and energy expenditure. Increased caloric uptake and reduced physical activity are important. No specific psychopathology exists in obesity. Obese people view their body weight and form significantly more negative than lean controls and often experience depression and anxiety. Quality of life is often impaired. Obesity causes many disadvantages in interpersonal and social aspects. 30% of the obese subjects report binge eating. Whether binge eating should be considered as an independent syndrome is currently under discussion. The treatment of obesity is not satisfactory. Pharmacological approaches have so far failed. Behavioral therapy including dieting of different forms is not successful in long terms. 95% of the patients regain body weight within five years. Surgical therapy are very successful but should be only applied in severe obesity.

Body Image↗
PubMed1993

Dietary associations in a case-control study of endometrial cancer.

Despite the established role of obesity in the etiology of endometrial cancer, limited data are available from analytical epidemiologic studies on the association of risk with dietary factors. A case-control study of 399 cases and 296 controls conducted in five areas of the United States from 1 June 1987 to 15 May 1990, enabled evaluation of risk related to dietary intakes adjusted for potential confounders. Caloric intake was associated modestly with increased risk (odds ratio [OR] = 1.5, 95 percent confidence interval [CI] = 0.9-2.5 for highest cf lowest quartiles of intake), with the principal contributors being fat and protein calories. After adjustment for other risk factors, including body mass, increased risk was associated with higher intakes of fat. Several components of fat investigated were associated with increased risk, although associations were slightly stronger for saturated fat (OR = 2.1, CI = 1.2-3.7) and oleic acid (OR = 2.2, CI = 1.2-4.0) than for linoleic acid (OR = 1.6, CI = 0.9-2.8). Food-group analyses showed intake of complex carbohydrates--and specifically of breads and cereals--associated with reduced risks (OR = 0.6, CI = 0.4-1.1), whereas animal fat and fried foods were associated with elevated risks (OR = 1.5 and 1.7, respectively). The relations of endometrial cancer with animal fat and complex carbohydrates were independent. No consistent associations were noted for intakes of cholesterol, fiber, vitamins A and C, individual carotenoids, or folate-rich foods. These data imply an etiologic role for a diet rich in total fat and/or animal fat and low in complex carbohydrates with endometrial cancer.(ABSTRACT TRUNCATED AT 250 WORDS)

Body Mass Index↗
PubMed1990

Effect of low-calorie diets on plasma retinol-binding protein concentrations in overweight women.

The concentrations of total protein, albumin and retinol-binding protein, a major transport protein for vitamin A, are significantly decreased by protein-calorie malnutrition. Weight-loss diets, sometimes involving severe energy deficits over prolonged periods of time, are common in the United States. The effect, if any, of prolonged low calorie weight-loss diets with normal intakes of protein on albumin, total protein and retinol-binding protein concentrations (and potentially on vitamin A metabolism) had not been extensively studied. We measured total protein, albumin, apo + holo retinol-binding protein and holo-free- and holo-transthyretin-bound retinol-binding protein concentrations during the course of a nutritionally adequate weight-loss diet (50% calorie restriction). We found that this type of dieting did not affect total protein, albumin or apo + holo, holo-free or holo-transthretin-bound retinol-binding protein concentrations significantly. This suggests that protein intake is more critical than caloric intake for retinol-binding protein status.

Journal Article↗
PubMed2006

"Tasting and wasting" behavior in non-human primates: aberrant behavior or normal behavior in "times of plenty".

The purpose of this study was to develop a foraging model that engenders large meals. Eight free-feeding baboons were first given periodic access to a chocolate sugar-coated candy (M & Ms) and then a jelly sugar-coated candy (Skittles). Baboons had access to food 24 h each day, but they had to complete a two-phase operant procedure in order to eat. Responding on one lever during a 30-min appetitive phase was required before animals could start a consumption phase, where responding on another lever led to food delivery, i.e., a meal. 3 days a week for 8 or 9 weeks baboons received candy during the first meal and then food pellets were available: a 2 month interval when only pellets were available separated periods of candy access. All baboons ate as much candy in the single candy meal as they did pellets throughout the remainder of the day. Beginning week 5 of M & M access, five baboons began to waste a large number of M & Ms by spitting them out. Baboons wasted few Skittles or pellets. Pellet intake was less, but total caloric intake was greater on days that animals had access to either candy. Pellet, but not candy eating varied between males and females: males began eating pellets sooner in the day, ate more pellet meals and more pellets. Periodic access to a preferred candy food engendered large amounts of candy consumption in all baboons, and periodic access to M & Ms engendered food tasting and wasting behavior in 5 of 8 baboons.

Animals↗
PubMed1988

Macronutrient selection in an animal model of cholestatic liver disease.

Diet selection was investigated in an animal model of cholestatic liver disease produced by bile duct ligation. Animals self-selected diets from separate sources of macronutrients (protein, fat, carbohydrate). Diet selection was evaluated when the fat source was comprised of either a primarily medium-chain fat (coconut oil) or a primarily long-chain fat (Crisco vegetable shortening). Relative to intakes of control animals, bile duct ligated (BDL) animals consuming the long-chain fat decreased fat intake, decreased protein intake, and increased carbohydrate intake. Consumption of the fat source was decreased in BDL rats fed the medium-chain fat relative to intakes of control animals, however carbohydrate and protein intakes were not affected. Total caloric intake was comparable to control intakes by day 16 post-ligation in BDL rats fed the long-chain fat and by day 11 in BDL rats fed the medium-chain fat. Body weight gain was significantly greater in BDL rats fed the medium-chain fat than in those fed the long-chain fat. Mortality was 44% in BDL animals fed the long-chain fat, and 0% in those fed the medium-chain fat. The results suggest that BDL animals make dietary selections which may decrease the severity of liver disease. Differences between ligated animals consuming either medium- or long-chain fats suggest that some fat sources may be more beneficial during cholestasis.

Alkaline Phosphatase↗