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PubMedDate not supplied

Factors affecting plasma bilirubin in preterm infants ventilated for respiratory distress syndrome.

OBJECTIVE: To evaluate the contribution of various factors to plasma bilirubin level in preterm infants with a birth weight of < 1500 gm in need of mechanical ventilation for respiratory distress syndrome (RDS) during their first week of life. METHODOLOGY: A total of 50 very low birth weight (< 1500 gm) preterm infants consecutively admitted to the neonatal intensive care unit were studied. Plasma bilirubin levels were determined every 8 hours for the first week of life. Data relating to daily body weight, daily fluid intake, age at onset of gavage feeds, daily caloric intake, and grade of intraventricular hemorrhage (IVH) were collected. Data relating to mechanical ventilation were collected every 4 hours as follows: fractional inspired O2, arterial PO2, arterial PCO2, and mean airway pressure. An arterial/alveolar PO2 ratio and a corrected oxygenation index were computed for the first 2 days of life. A bilirubin index (BI), defined as the ratio of peak plasma bilirubin level to birth weight1/3, was used to study the association between bilirubin and the above variables. A BI was also used as a criterion for starting and discontinuing phototherapy. Multiple linear regression analysis was used to model BI. RESULTS: IVH (p < 0.0001), age at onset of gavage feeds (p < 0.003), oxygenation index (p < 0.007), and gestational age (p < 0.05) made a significant contribution to variations in BI (37.16%, 43.71%, 48.99%, and 53.33%, respectively). CONCLUSION: Hyperbilirubinemia in ventilated preterm infants with RDS is most likely multifactorial; entities quite distinct from RDS (such as nutrition and IVH) may significantly contribute to its variation.

Aging↗
PubMed1986

Nutritional survey of highly trained women runners.

Mean daily intakes from 3-day dietary records for calories, energy-providing nutrients, and selected minerals were calculated for 51 highly trained women runners. Selected blood constituents relating to mineral status were also measured. Intakes of calcium, magnesium, iron, and copper were above the amounts recommended by the National Research Council whereas zinc intake was below the recommended dietary allowances (RDA). Caloric intakes, although above the RDA for sedentary women, appeared low for women running 10 miles/day. Concentrations of serum ferritin and plasma zinc were indicative of marginal iron and zinc status in many of the women. Whether the nutrient content of the diets consumed by these women is adequate relative to energy output or whether training lowers nutrient requirements by enhancing metabolic efficiency will require further investigation.

Adult↗
PubMed2005

A comparison of the clinical and cost-effectiveness of 3 intervention strategies for AIDS wasting.

OBJECTIVE: To compare oxandrolone (OX) or strength training with nutrition alone (NA) for AIDS wasting. SUBJECTS: Fifty patients with AIDS; 47 completing the study. INTERVENTIONS: Randomization to (1) NA with placebo pills, (2) nutrition with 10 mg of OX administered orally twice a day, or (3) nutrition with progressive resistance training (PRT) for 12 weeks. MAIN OUTCOME MEASURES: Midthigh cross-sectional muscle area (CSMA), physical functioning (PF), costs, and cost-effectiveness in dollars/quality-adjusted life-years (dollars/QALYs). RESULTS: The OX and PRT subjects had increases in CSMA (7.0% +/- 2.5%, P = 0.01; 5.0% +/- 2.0%, P = 0.04, respectively), although these increases did not differ significantly from the NA arm (NA: 1.0% +/- 1.0%; OX vs. NA: P = 0.09; PRT vs. NA: P = 0.26). Only PRT caused significant improvements in PF (mean +/- SE: 10.4 +/- 3.8 points on a 100-point scale) and 7 measures of strength (P values: 0.04 to <0.001). There were no overall differences between groups in PF change. Among patients with impaired baseline PF, however, OX was significantly less effective than NA and PRT was significantly better than NA. All treatments led to increases in protein intake and performance; NA and PRT also increased caloric intake. The institutional costs per subject in this trial were 983 dollars for NA, 3772 dollars for OX, and 3189 dollars for PRT. At a community-based level of intensity, the institutional costs per QALY were 45,000 dollars (range: 42,000 dollars-64,000 dollars) for NA, 147,000 dollars (range: 147,000 dollars-163,000 dollars) for OX, and 31,000 dollars (range: 21,000 dollars-44,000 dollars) for PRT. CONCLUSIONS: OX and PRT induce similar improvements in body composition, but PRT improves quality of life more than nutrition or OX, particularly among patients with impaired PF. PRT was the most cost-effective intervention, and OX was the least cost-effective intervention.

Adult↗
PubMed1988

Metabolic differences between AGA- and SGA-infants of very low birthweight. I. Relationship to intrauterine growth retardation.

Metabolic response to human milk feeding was studied in 12 appropriate (AGA) and 12 small for gestational age (SGA) infants of very low birthweight (VLBW) on the eighth day of life. Protein intake ranged from 1.98 to 2.47 g/kg/day and caloric intake from 94 to 126 kcal/kg/day with no significant differences between the groups. Alpha-amino-nitrogen, the total bile acid concentration in serum and total- as well as alpha-amino-nitrogen excretion in the urine were estimated. The alpha-amino-nitrogen and the total bile acid concentration in serum increased with increasing degree of intrauterine growth retardation. Also renal total- and alpha-amino-nitrogen excretion increased significantly in relation to the degree of intrauterine growth retardation. Thus, despite a relatively low protein intake in severely growth retarded VLBW-infants, metabolic changes could be found similar to those observed in AGA-infants on high protein intakes. The data suggest that during the first weeks of postnatal life VLBW-infants with intrauterine growth retardation have a decreased capacity to utilize or to metabolize protein when compared to AGA-infants with comparable birthweights. These metabolic differences have to be considered in the nutritional management of VLBW-infants.

Dietary Proteins↗
PubMed2005

Effects of high-fat diets with different carbohydrate-to-protein ratios on energy homeostasis in rats with impaired brain melanocortin receptor activity.

Changes in dietary macronutrient composition and/or central nervous system neuronal activity can underlie obesity and disturbed fuel homeostasis. We examined whether switching rats from a diet with high carbohydrate content (HC; i.e., regular chow) to diets with either high fat (HF) or high fat/high protein content at the expense of carbohydrates (LC-HF-HP) causes differential effects on body weight and glucose homeostasis that depend on the integrity of brain melanocortin (MC) signaling. In vehicle-treated rats, switching from HC to either HF or LC-HF-HP feeding caused similar reductions in food intake without alterations in body weight. A reduced caloric intake (-16% in HF and LC-HF-HP groups) required to maintain or increase body weight underlay these effects. Chronic third cerebroventricular infusion of the MC receptor antagonist SHU9119 (0.5 nmol/day) produced obesity and hyperphagia with an increased food efficiency again observed during HF (+19%) and LC-HF-HP (+33%) feeding. In this case, however, HF feeding exaggerated SHU9119-induced hyperphagia and weight gain relative to HC and LC-HF-HP feeding. Relative to vehicle-treated controls, SHU9119 treatment increased plasma insulin (2.8-4 fold), leptin (7.7-15 fold), and adiponectin levels (2.4-3.7 fold), but diet effects were only observed on plasma adiponectin (HC and LC-HF-HP<HF). Finally, SHU9119-treated LC-HF-HP-fed rats were less glucose tolerant than others. Relatively low plasma adiponectin levels likely contributed to this effect. Thus HF feeding amplifies obesity induced by impaired MC signaling, provided that the carbohydrate-to-protein (C/P) ratio is high enough. Reduction of the C/P ratio within a HF diet ameliorates hyperphagia and obesity in rats with impaired MC signaling but aggravates associated disturbances in fuel homeostasis.

Animals↗
PubMed1989

Vitamin A, cigarette smoking, and airway obstruction.

The hypothesis that vitamin A, or foods rich in vitamin A such as milk, protects against the development of airway obstruction was tested in a subsample of data from the 1971-1975 National Health and Nutrition Examination Survey. The relative risk (estimated by relative odds) of having airway obstruction, defined as a FEV1/FVC less than or equal to 65%, was measured for different levels of nutrient and food group intakes after adjustment for age, sex, Quetelet Index, caloric intake, and cigarette smoking. Among the white respondents (never smokers or current smokers) whose recalled diet could be considered as typical of their usual diet, the relative odds of having airway obstruction was inversely related to vitamin A intake (x2 for trend = 7.2, p less than 0.01). In the analysis by food groups, the adjusted relative odds of airway obstruction for meat and poultry were 2.4 (95% confidence limits: 1.0 to 5.8) and for milk 1.6 (95% confidence limits: 1.0 to 2.5). The association of airway obstruction with lack of vitamin A or milk intake was clearer among smokers. These findings suggest that a diet poor in vitamin A increases the risk of airway obstruction, and are consistent with the previously reported association of chronic bronchitis, milk intake, and smoking.

Adult↗
PubMed2005

The effect of purified compared with nonpurified diet on bone changes induced by hindlimb suspension of female rats.

The purpose of this study was to compare the bone changes induced by unloading in rats fed different diets, because space flight studies use a semipurified diet, whereas space flight simulation studies typically use nonpurified diets. Female Sprague-Dawley rats were fed a purified American Institute of Nutrition (AIN) 93G diet or a standard nonpurified diet and kept ambulatory or subjected to unloading by hindlimb suspension (HLS) for 38 days. Bone mineral content (BMC), mechanical strength, and factors related to the diet that affect bone (i.e., urinary calcium excretion, estradiol, and corticosterone) were measured. Average food intakes (grams per day) differed for diets, but caloric intake (kilocalories per day) and the final body masses of treatment groups were similar. The HLS-induced decrease in femoral BMC was not statistically different for rats fed a nonpurified diet (-8.6%) compared with a purified AIN-93G diet (-11.4%). The HLS-induced decrease in femoral mechanical strength was not statistically different for rats fed a nonpurified diet (-24%) compared with a purified AIN-93G diet (-31%). However, bone lengths were decreased (P < 0.05) in rats fed a nonpurified diet compared with a purified diet. Plasma estradiol levels were lower (P < 0.05) in the HLS/AIN-93G group but similar in the HLS and ambulatory rats fed a nonpurified diet. Plasma estradiol was related to femoral BMC (r = 0.85, P < 0.01). Urinary calcium excretion was higher (P < 0.05) in rats fed a nonpurified diet than those fed a purified AIN-93G diet, which is consistent with the higher level of calcium in the nonpurified diet. Urinary corticosterone levels were higher (P < 0.05) in rats fed a nonpurified diet than rats fed the AIN-93G diet. Although the osteopenia induced by unloading was similar in both diet groups, there were differences in longitudinal bone growth, calcium excretion, plasma estradiol levels, and urinary corticosterone levels. Results indicate that the type of standard diet used is an important factor to consider when measuring bone end points.

Animals↗
PubMed1990

Dietary treatment of hypercholesterolemia.

Diet is the first line of treatment for hypercholesterolemia. Patients should be encouraged to make simple and stepwise changes in their diets to lower elevated cholesterol levels. General dietary guidelines from the American Heart Association (AHA) Step-One Diet include limiting the amount of total fat to less than 30% of total calories, decreasing cholesterol intake to less than 300 mg/day, and adjusting caloric intake to levels required to attain or maintain ideal body weight. Diets must be individualized to meet therapeutic needs within the limits of the patient's abilities, knowledge, and motivation.

Cholesterol, Dietary↗
PubMed1987

Effects of postoperative carbohydrate overfeeding.

Forty-three indirect calorimetric studies were performed on 24 patients who received postoperative supplemental nutrition for a total of 1088 days. Patients were retrospectively grouped into Group 1 (G1) (respiratory quotient greater than 0.95) and Group 2 (G2) (respiratory quotient less than 0.95). The two groups had similar preoperative biochemical values, prognostic nutritional index, nitrogen intake and excretion, predicted resting energy expenditure and caloric intake. Minimal postoperative biochemical changes were noted between the two groups. Postoperative length of stay was longer for GI than GII patients (P = NS). However, septic episodes and mortality were higher (100% vs 40% and 28% vs 10%, P greater than 0.05), respectively, in G1 than in G2 patients. It is concluded that carbohydrate overfeeding may be associated with a high morbidity and mortality.

Adult↗
PubMed1978

Dietitians as behavior--change agents.

The traditional relationship between the client and the dietitian or nutritionist has been that of student and teacher. In the past, a patient has received excellent dietary counseling and advice from the dietitian, but has often ignored what he or she has taught. Until recently, the referring physician could only blame the patient, the dietitian, or both for this failure. Dietitians needed some new tools. The behavioral sciences have taken a new look at the problems of obesity, including a new assumption, viz.at some time, the obese have learned to eat in a way that results in excess caloric intake. Treatment now includes not only nutritional and caloric instruction, but also an attempt to change eating habits and behaviors. With these new tools, the dietitian-teacher becomes a dietitian-behavior-change agent; in addition to food content, the context of food becomes important in dietary counseling. Although dietitians are not usually trained in behavioral counseling, the weight loss in groups led by dietitans, after only minimal instruction, is comparable to that reported for groups led by psychiatry residents.

Behavior Therapy↗
PubMed1991

Bidirectional effects of clonidine on carbohydrate intake in genetically obese (ob/ob) mice.

Hypothalamic noradrenergic mechanisms contribute to altered caloric intake in genetically obese (C57BL/6J, ob/ob) mice. Noradrenergic mechanisms, principally in the paraventricular hypothalamus and of the alpha 2 subtype, have also been implicated in the macronutrient intake regulation of nonpathological models. Accordingly, this study assessed the extent to which clonidine, an alpha 2 agonist, altered macronutrient intake in genetically obese (ob/ob) and lean (C57BL/6J, +/?) mice. Following adaptation to a 6-h feeding regimen, mice were injected intraperitoneally with either clonidine (0.1, 0.5 mg/kg) or 0.15 M NaCl (Experiment 1) or 0.025 mg/kg clonidine or saline (Experiment 2) 30 min prior to simultaneous access to separate sources of carbohydrate, fat, and protein. Clonidine doses of 0.1 mg/kg or greater reduced total energy intake and intake of carbohydrate and fat (p less than 0.005) in all mice (Experiment 1). However, 0.025 mg/kg clonidine selectively increased ingestion of carbohydrate in obese mice by 212% of vehicle-injected values (p less than 0.001) without altering intake in lean mice (Experiment 2). These results implicate an alpha 2 receptor mechanism in genetic obesity.

Animals↗
PubMed1989

Attenuation of response to antidepressants in animals induced by reduction in food intake.

A salient feature of depression is eating disorders (reduced appetite and caloric intake) and/or weight loss. In the present study, reduction in food intake in rats, resulting in moderate weight loss, markedly attenuated the ability of various antidepressant drugs to reverse depressive-like behaviors: escape deficits provoked by previous exposure to uncontrollable stress. Further data support the notion that hypofunctioning of central noradrenergic processes, perhaps linked to reduced thyroid hormone levels, might contribute to such an altered response to antidepressants. These findings suggest that current nutritional status, even with marginal weight loss, could be an intervening factor in the delayed therapeutic response to antidepressants and/or in drug-resistant depression.

Animals↗
PubMed2006

Increased resting energy expenditure, fat oxidation, and food intake in patients with highly active antiretroviral therapy-associated lipodystrophy.

Highly active antiretroviral therapy (HAART) is associated with metabolic adverse events such as lipodystrophy in human immunodeficiency virus (HIV)-infected patients. The objective of the present study was to evaluate the effects of HAART-associated lipodystrophy on resting energy expenditure and caloric intake. In this cross-sectional study we compared resting energy expenditure (REE) and energy intake in 30 HAART-treated patients with lipodystrophy (HAART+LD+) with 13 HAART-treated patients without lipodystrophy (HAART+LD-). REE was measured using indirect calorimetry, and energy intake was recorded as a 3-day diary of food intake. REE (5,180+/-160 vs. 4,260+/-150 J/min, P<0.01) and also REE expressed per fat-free mass (86+/-1 vs. 78+/-2 J.kg fat-free mass-1.min-1, P<0.01) were significantly higher in the HAART+LD+ than the HAART+LD- group. Rate of lipid oxidation was significantly higher in the HAART+LD+ than the HAART+LD- group. Total energy and fat intakes were significantly increased in the HAART+LD+ compared with the HAART+LD- group. These results imply that HAART-associated lipodystrophy is associated with increased REE and lipid oxidation and with increased caloric and fat intake.

Adult↗
PubMed1991

Preschool children maintain intake of other foods at a meal including sugared chocolate milk.

Dietary self-selection was examined in 40 preschool children who were offered high-energy chocolate-flavored or plain milk with a lunchtime meal. Children aged 20-56 months were served various nutritious menus for lunch twice a week, for 8 weeks, and the chocolate milk was offered with half of the meals. The children consumed large quantities of the high-energy chocolate milk when it was offered, without decreasing their intake of other food items in the meal. Thus, significantly more energy was consumed during each of the different meals in which chocolate milk was served. These results open the possibility that, by offering palatable, high-energy drinks to preschool children at a mealtime, one might be able to increase children's caloric intake without compromising the rest of the diet at that meal. The effect of this increased caloric consumption on intake during subsequent meals, as well as the effect of repetition of the test meals, remains to be tested.

Animals↗
PubMed1993

Alcoholic beverage consumption and risk of breast cancer in Spain.

The relation between alcoholic beverage consumption and risk of breast cancer was examined. We used data from a population-based, case-control study that included almost all incident cases occurring in five Spanish regions from February 1990 to July 1991. A total of 762 women between 18 and 75 years of age, with a histologically confirmed, first diagnosis of breast cancer, were compared with 988 control women. Alcoholic beverage intake was measured by an interviewer-administered, semiquantitative food-frequency questionnaire. We used 'nondrinkers' as the reference category and divided the remainder into four categories according to alcohol intake. The multiple logistic analyses included not only alcohol intake but also possible confounding factors such as total caloric intake, age, socioeconomic status, and reproductive and medical histories. Even at moderate levels of alcohol intake (less than 8 g/day), a 50 percent increase in risk of breast cancer was found. The trend across categories of intake was statistically significant for wine and distilled drinks, as well as total alcohol intake. Consumption of 20 g or more of alcohol per day was associated with a 70 percent elevation in breast cancer risk compared with that of nondrinkers (adjusted relative risk (RR) = 1.7, 95 percent confidence interval = 1.3-2.3). Although the magnitude of the RR observed in our study was modest, our findings provide further support for a positive association between alcohol consumption and risk of breast cancer.

Adolescent↗
PubMed2006

A prospective study of fish, marine fatty acids, and bladder cancer risk among men and women (United States).

OBJECTIVE: To evaluate prospectively the association between intakes of fish, marine fatty acids, and bladder cancer risk in two ongoing cohorts, the Health Professionals Follow-up Study and the Nurses' Health Study. METHODS: During 16 and 18 years of follow-up, 501 and 235 incident cases of bladder cancer were diagnosed among men and women, respectively. Cox proportional hazard models were used to estimate incidence rate ratios (RR) and 95% confidence intervals (CI) between fish intake and bladder cancer risk adjusting for age, total caloric intake, pack-years of cigarette smoking, and current smoking. RESULTS: We observed no significant overall association between total fish intake and bladder cancer risk, even when we compared >/=1 servings of fish per day to fish intake </=1-3 servings per month. Among men, a statistically significant lower risk of bladder cancer was observed among men consuming fish or high marine fatty acid, after excluding the first 4 years of follow-up (MV RR = 0.60; 95% CI, 0.38-0.94, for >/=1 total fish servings per day compared to </=1-3 servings per month). CONCLUSIONS: Overall, these findings suggest that fish intake is not likely to be appreciably associated with the risk of bladder cancer.

Adult↗
PubMed1984

Age changes in hepatic metabolic characteristics and their modulation by dietary manipulation.

Starting at 6 weeks of age, male Fischer 344 rats were provided five different dietary regimens: group 1, fed ad libitum; group 2, restricted to 60% of the food intake of group 1; group 3, restricted to 60% of the food intake of group 1 until 6 months of age and then fed ad libitum; group 4, fed ad libitum until 6 months of age and then restricted to 60% of the food intake of group 1; group 5, given the same caloric intake as group 1 but 60% of the protein intake. The weight of the liver was maintained at about 2.5% of body weight over the wide range of body weight, age (6 through 30 months of age) and diets of this study. Liver cholesterol concentration increased with age in the rats of group 1 but not in the other groups; the hepatic cholesterol concentration was lower in the rats of groups 2 and 4 than in the others. The liver microsomal 3-hydroxy-3-methyl-glutaryl-coenzyme A reductase activity was higher in 4-month-old rats than in rats 12 months of age and older; also, the microsomal activity from group 2 and group 4 rats was higher than that from rats of the other groups. Liver triglyceride levels increased with age in groups 1, 2, 3 and 5 but not in group 4. At all ages, postabsorptive (15 h without food) hepatic glycogen concentrations were much higher in groups 2 and 4 than in the other groups. Liver phospholipid concentration was not affected by age or diet. Basal adenylate cyclase activity in liver homogenates increased with age in all but group 4, but hormone-stimulated adenylate cyclase activity was little affected by age or diet. The age-related hepatic changes in lipids and in hormone responsiveness noted in the present study were much less marked than those previously found in blood and adipose tissue.

Adenylyl Cyclases↗
PubMed1997

From the Miocene to olestra: a historical perspective on fat consumption.

Given the extraordinary dietary and geographic diversity of Pleistocene hominids, there is no single "Paleolithic diet" or average pre-Holocene fat intake. Even the Neanderthals initially were scavengers, possibly becoming seasonal hunters of large game at a later period. Fat intakes of greater than 20 g/day (11% of total caloric intake) developed after the domestication of mammals and then by selective breeding of genetically fatter animals in suitably temperate climates. By the late 1940s, the percent of fat in the diet rose to more than 40% in many Western countries (including France), decreasing somewhat to about 35% by the late 1980s in the United States, following reduced consumption of whole milk, fried meats, and other high-fat foods. Overall, fat reductions to less than 30% may be facilitated by no-fat or low-fat substitutes or texturizers or (perhaps more effectively) by increased intakes of fiber and calcium and greater reliance on fats that are poorly absorbed because of their stearate content.

Animals↗