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Dietary practices and lipid intake in relation to plasma lipid profile in Hong Kong Chinese.

OBJECTIVE: To study dietary lipid intake and plasma lipid profile of the Hong Kong Chinese population as part of a territory wide survey on cardiovascular risk factors. DESIGN: Randomised age and sex stratified survey. SUBJECTS: 1010 subjects aged 25-74 y (500 men, 510 women). MEASUREMENTS: A food frequency method with food tables compiled for Hong Kong was used for nutrient quantitation, while a separate questionnaire was used to examine dietary practices. Plasma lipid profile was estimated using standard laboratory methods. RESULTS: Total calorie, fat, saturated fatty acid (SFA), poly- and mono-unsaturated fatty acid (PUFA and MUFA), and cholesterol intake were higher in men; however when adjusted for caloric intake no difference was observed. Men had lower intake of PUFA as percentage of total energy had a higher Hegsted Score compared with women. Subjects consuming beans twice or more per week had lower total cholesterol and LDL-cholesterol concentrations. Overall, the population dietary intake was close to the ideal for cardiovascular health: percentage fat not greater than 30% of the total calorie intake, saturated fat intake not greater than 10% of calories, and cholesterol less than 180 mg/1000 Kcal. CONCLUSION: The dietary pattern for Hong Kong Chinese appear to be satisfactory with respect to cardiovascular health.

Adult↗

The effect of dietary fiber supplementation in man. I. Modification of eating habits.

Six subjects were studied for an 8-week period that consisted of a 3-week control period, followed by a 3-week period during which their daily diets were supplemented with 3 oz of a high fiber breakfast food, All-bran, and a final 2 weeks on their regular diet. Daily diet records of food intake were recorded and analyzed for seven dietary constituents; carbohydrates, proteins, fats, cholesterol, fiber, alcohol, and total calories. The most significant change in eating behavior due to the fiber food supplementation was a decrease in eating eggs, butter, and breakfast meats. These foods were most often replaced because all six subjects chose to eat the major portion of All-bran during breakfast. An increase in milk and fruit also occurred during the supplemented feeding. These particular foods were added to make All-bran more palatable and served to increase carbohydrate and protein intake. Five subjects added the supplement to the between meal-time intake and thus caused an increase in total daily caloric intake. At lunch and dinner few foods were altered with no particular pattern of substitution. Notwithstanding the knowledge that increased fiber content may have beneficial effects, none of the subjects modified his eating behavior to include even 1 oz of a high fiber food daily after the experimental period was concluded. Thus behavior modification by forced diet intake of a high fiber breakfast food resulted in definite diet pattern changes that did not persist following the experimental period.

Adult↗

Measured energy expenditure in mechanically ventilated very low birth weight infants.

Forty-nine calorimetric studies were performed on 24 very low birth weight infants with respiratory distress syndrome on mechanical ventilation during the first seven postnatal days. Mean resting energy expenditure for the entire study was 59 +/- 21 kilocalories/kg daily, with a respiratory quotient of 0.93 +/- 0.1, reflecting the predominance of carbohydrate calories. A comparison of mean energy intake with mean resting energy expenditure showed a mean caloric deficit of 31 kcal/k daily during the first 4 postnatal days, followed by 3 days where resting energy expenditure was met by equivalent caloric intake. Wide variation was noted in resting energy expenditure.

Energy Metabolism↗

Results of feeding a special formula to very low birth weight infants.

Fifty-eight premature infants weighing less than 1,600 g at birth were fed a special formula. The formula contained nutrients in amounts recommended by the Committee ono Nutrition of the American Academy of Pediatrics for very low birth weight (VLBW) infants. The feeding studies were carried out at newborn nurseries in Tampa, Florida (study A, n = 25), Pittsburgh, Pennsylvania (study B, n = 20), and Oaklawn, Illinois (study C, n = 13). Study subjects were comparable in birth weight, gestational age, and in the duration of follow-up in the nurseries. All study subjects grew at rates of weight acquisition equivalent to the comparative fetal counterpart. Routine anthropometric measurements were similar to those of fetal development curves. Mean protein intake ranged from 2.3 to 3.7 g/kg/day and mean caloric intake from 105 to 150 kcal/kg/day. Late metabolic acidosis in association with prematurity was absent in all subjects studied as demonstrated by normal pH values, bicarbonate, and partial pressure of carbon dioxide. Serum sodium and serum chloride levels were normal. Serum calcium ranged from 8.3 to 10.1 mg/dl and serum phosphorus from 6.0 to 7.5 mg/dl. Total serum protein levels ranged from 4.5 to 5.1 g/dl. Blood urea nitrogen diminished progressively from 5.1 to 2 mg/dl in the course of the study. Serum glucose levels in samples taken prior to and 2 h after feeding did not demonstrate any evidence of reactive hypoglycemia.

Blood Glucose↗

Dietary recommendations for children and adolescents: a guide for practitioners: consensus statement from the American Heart Association.

Since the American Heart Association last presented nutrition guidelines for children, significant changes have occurred in the prevalence of cardiovascular risk factors and nutrition behaviors in children. Overweight has increased, whereas saturated fat and cholesterol intake have decreased, at least as percentage of total caloric intake. Better understanding of children's cardiovascular risk status and current diet is available from national survey data. New research on the efficacy of diet intervention in children has been published. Also, increasing attention has been paid to the importance of nutrition early in life, including the fetal milieu. This scientific statement summarizes current available information on cardiovascular nutrition in children and makes recommendations for both primordial and primary prevention of cardiovascular disease beginning at a young age.

Adolescent↗

Differential effects of short-term fasting on pulsatile thyrotropin, gonadotropin, and alpha-subunit secretion in healthy men--a clinical research center study.

In healthy subjects, short term fasting suppresses the hypothalamic-pituitary-thyroid and hypothalamic-pituitary-gonadal (HPG) axes, with decreased serum levels of TSH and LH. However, effects of fasting on pulsatile release of TSH, LH, FSH, and alpha-subunit are less clear. Eleven healthy young men each underwent two 2-day studies: a baseline study during normal caloric intake and a fasting study during 56 h of caloric deprivation. During the final 24 h of each study, blood samples were drawn every 15 min for measurement of serum TSH, LH, FSH, and alpha-subunit pulses. Fifty-six hours of fasting caused a 50% suppression of mean TSH levels and TSH pulse amplitude, without altering TSH pulse frequency. Nocturnal TSH pulse amplitude decreased by 60%, with abolition of the usual nocturnal TSH surge. Fasting suppressed mean LH levels and LH pulse amplitude by 30%, without affecting LH pulse frequency. In contrast, mean FSH levels only decreased by 13%, without changes in FSH pulse parameters, whereas mean alpha-subunit levels and pulse amplitude decreased by 20%. These data show that short term fasting has a greater suppressive effect on the hypothalamic-pituitary-thyroid axis than on the HPG axis. Within the HPG axis, FSH is more resistant to fasting-induced suppression than LH, implying discordant regulation of the two gonadotropins during nutritional deprivation. alpha-Subunit suppression during fasting appears to parallel that seen for LH.

Adult↗

Dietary recommendations for children and adolescents: a guide for practitioners.

Since the American Heart Association last presented nutrition guidelines for children, significant changes have occurred in the prevalence of cardiovascular risk factors and nutrition behaviors in children. Overweight has increased, whereas saturated fat and cholesterol intake have decreased, at least as percentage of total caloric intake. Better understanding of children's cardiovascular risk status and current diet is available from national survey data. New research on the efficacy of diet intervention in children has been published. Also, increasing attention has been paid to the importance of nutrition early in life, including the fetal milieu. This scientific statement summarizes current available information on cardiovascular nutrition in children and makes recommendations for both primordial and primary prevention of cardiovascular disease beginning at a young age.

Adolescent↗

Dietary factors and risks for prostate cancer among blacks and whites in the United States.

Prostate cancer is the most common malignancy in men in the United States, with substantially higher rates among American blacks than whites. We carried out a population-based case-control study in three geographic areas of the United States to evaluate the reasons for the racial disparity in incidence rates. A total of 932 men (449 black men and 483 white men) who had been newly diagnosed with pathologically confirmed prostate cancer and 1201 controls (543 black men and 658 white men) were interviewed in person to elicit information on potential risk factors. This report evaluates the impact of dietary factors, particularly the consumption of animal products and animal fat, on the risk of prostate cancer among blacks and whites in the United States. Increased consumption (grams/day) of foods high in animal fat was linked to prostate cancer (independent of intake of other calories) among American blacks [by quartile of intake, odds ratio (OR) = 1.0 (referent), 1.5, 2.1, and 2.0; Ptrend = 0.007], but not among American whites [by quartile of intake, OR = 1.0 (referent), 1.6, 1.5, and 1.1; Ptrend = 0.90]. However, risks for advanced prostate cancer were higher with greater intake of foods high in animal fat among blacks [by quartile of intake, OR = 1.0 (referent), 2.2, 4.2, and 3.1; Ptrend = 0.006] and whites [by quartile of intake, OR = 1.0 (referent), 2.2, 2.6, and 2.4; Ptrend = 0.02]. Increased intake of animal fat as a proportion of total caloric intake also showed positive but weaker associations with advanced prostate cancer among blacks (Ptrend = 0.13) and whites (Ptrend = 0.08). No clear associations were found with vitamin A, calcium, or specific lycopene-rich foods. The study linked greater consumption of fat from animal sources to increased risk for prostate cancer among American blacks and to advanced prostate cancer among American blacks and whites. A reduction of fat from animal sources in the diet could lead to decreased incidence and mortality rates for prostate cancer, particularly among American blacks.

Adult↗

Changes in protein, RNA and DNA content in various rat organs after long-term intake of ethanol.

Male Wistar rats were given ethanol (approximately 25% of total caloric intake), while two different control groups were pair-fed isocaloric amounts of lipids or sucrose. After 7--10 weeks the following organs were studied: liver, cerebrum, heart, diaphragm, kidneys and testes. In fasted, ethanol treated rats there was a reduction in the hepatic concentration of RNA and the cerebral RNA/DNA ratio, when compared to both control groups, while no effects were found with respect to organ weight and amounts of protein, RNA or DNA in heart, diaphragm, kidneys and testes. When fed, ethanol treated animals were compared to both control groups, no effects on organ weight and composition were found in any tissue studied. Several significant differences were registered in the ethanol group as compared to one control group only, as well as between the two control groups. The consumption of ethanol (25% of total calories) thus caused only minor alterations in gross organ composition. These results also indicate the importance of interpreting with care any apparent effect of ethanol ingestion, unless at least two different control groups have been employed.

Alcoholism↗

Assessing dietary intake in the management of obesity.

This paper focuses on assessing the caloric-intake side of the energy balance equation in clinical settings. In the treatment of obesity, dietary assessment may have many purposes including the following: 1) establishing a baseline of eating patterns to determine targets of intervention and to gauge progress, 2) providing a means of monitoring change in the targeted dietary areas and behaviors, and 3) allowing for ongoing feedback to the patient. The types of data to be gathered in dietary assessment will depend on the purposes of the assessment. The nature, advantages, and disadvantages of the following dietary assessment methods are reviewed: 24-hour recall, diet history interview and questionnaire, and self-monitoring. When used on an ongoing basis in treatment, self-monitoring enhances weight-loss outcomes. However, compliance with self-monitoring varies widely across patients and over time. Possible methods of increasing compliance are discussed. Recent technological advances in software and hardware systems offer promise in improving compliance and effectiveness of self-monitoring.

Diet↗

[Nutritional study of alcoholics with specific reference to calcium and phosphorus].

We performed a nutritional study of 80 alcoholic males at least 15 days after an acute episode of alcoholic intake. 43 patients were intermittent drinkers with mean age 37.9 years and 37 patients were continuous drinkers with mean age 440.30 healthy subjects were studied as controls. Body mass index was 23.7 (range 19.2-37.9) in intermittent drinkers compared to 23.1 (range 18.1-29.8) in continuous drinkers (NS). Wine was the main alcoholic beverage in 70% and 89%, respectively. Mean daily alcohol intake was 170 g for 17 years and 358 g for 23 years, respectively. Mean caloric intake and % of calories from alcohol were 3387 and 42% for intermittent compared to 4271 and 66% for continuous drinkers, respectively. Daily calcium intake was 757 g and 774 g in each group. Alcoholic beverages supplied 16% and 34% of calcium intake, respectively. The intake of phosphorus was adequate. Alcoholic subjects did not manifest anemia or hypoalbuminemia, compared to controls. The present study fails to disclose significant caloric and protein undernutrition in alcoholic subjects. However, the intake of calcium is inadequate and a high percentage of it is provided by alcoholic beverages. This deficiency in conjunction with alcoholic damage to intestinal mucosa may lead to osteopenia in alcoholic patients.

Adult↗

Anorexia and the effect of internal biliary drainage on food intake in patients with obstructive jaundice.

BACKGROUND: Anorexia is a frequent finding in patients with biliary obstruction (BO). This study investigates the role of biochemical and hormonal factors in the pathogenesis of reduced food intake in BO and the effects of internal biliary drainage. STUDY DESIGN: Sixty-two patients with BO were prospectively investigated. Transaminases, amylase, cholecystokinin, secretin, bile acids, tumor necrosis factor-alpha, and endotoxin were determined at admission. Caloric intake was quantified by a controlled diet. In a subset of 27 patients, studies were repeated after internal biliary drainage. RESULTS: Sixty-six percent of patients had spontaneous food intakes below the estimated caloric requirements. Serum bilirubin, alkaline phosphatase, and cholecystokinin plasma levels were independent predictor factors for calorie intake (p = 0.0001). After internal biliary drainage, cholestasis parameters and cholecystokinin concentrations decreased significantly; this was associated with an improvement of spontaneous food intake in both benign and malignant biliary obstruction (p < 0.01 and p < 0.05, respectively). CONCLUSIONS: Decreased food intake in BO was associated with the degree of obstruction and with increased cholecystokinin plasma levels. Biliary drainage improved biochemical and food intake derangements.

Adult↗

The effect of dietary fortification on blood ethanol concentrations, caloric consumption, and weight gain during ethanol consumption in mice.

The objectives of this study were to determine the effects of dietary fortification on caloric consumption, weight gain, and blood ethanol concentration (BEC) in mice consuming ethanol-containing liquid diets. These diets have been used previously in this laboratory for ethanol fetotoxicity studies. To achieve these objectives, mice were adapted to a commonly used liquid mouse diet and randomly allocated to one of two experimental groups. One group received the liquid diet containing 4.1% (w/v) ethanol. The second group received the 4.1% w/v ethanol diet fortified with protein, carbohydrates, fats, vitamins, and minerals. Animals in both groups were monitored for weight changes and caloric intake. On days 5 and 12 of exposure (day 0- initial day), animals were sampled for BEC at 3-hour time intervals throughout a 24-hour period. All animals not previously sampled for BEC were also monitored every 3 hours for dietary intake. The animals receiving the fortified diet had a greater caloric consumption and weight gain during the 13 days of treatment than did the nonfortified diet animals. Blood ethanol levels determined on both sample days were significantly lower in the fortified diet group than in the nonfortified group. BEC values in both groups were significantly correlated with ethanol consumption during the previous 6-hour period. In conclusion, dietary modification could significantly alter the outcome of ethanol toxicity studies both by direct effects on growth and caloric/nutrient intake and by altering blood ethanol levels achieved during exposure.

Alcohol Drinking↗

Dietary flaxseed alters tumor biological markers in postmenopausal breast cancer.

PURPOSE: Flaxseed, the richest source of mammalian lignan precursors, has previously been shown to reduce the growth of tumors in rats. This study examined, in a randomized double-blind placebo-controlled clinical trial, the effects of dietary flaxseed on tumor biological markers and urinary lignan excretion in postmenopausal patients with newly diagnosed breast cancer. EXPERIMENTAL DESIGN: Patients were randomized to daily intake of either a 25 g flaxseed-containing muffin (n = 19) or a control (placebo) muffin (n = 13). At the time of diagnosis and again at definitive surgery, tumor tissue was analyzed for the rate of tumor cell proliferation (Ki-67 labeling index, primary end point), apoptosis, c-erbB2 expression, and estrogen and progesterone receptor levels. Twenty-four-hour urine samples were analyzed for lignans, and 3-day diet records were evaluated for macronutrient and caloric intake. Mean treatment times were 39 and 32 days in the placebo and flaxseed groups, respectively. RESULTS: Reductions in Ki-67 labeling index (34.2%; P = 0.001) and in c-erbB2 expression (71.0%; P = 0.003) and an increase in apoptosis (30.7%; P = 0.007) were observed in the flaxseed, but not in the placebo group. No significant differences in caloric and macronutrient intake were seen between groups and between pre- and posttreatment periods. A significant increase in mean urinary lignan excretion was observed in the flaxseed group (1,300%; P < 0.01) compared with placebo controls. The total intake of flaxseed was correlated with changes in c-erbB2 score (r = -0.373; P = 0.036) and apoptotic index (r = 0.495; P < 0.004). CONCLUSION: Dietary flaxseed has the potential to reduce tumor growth in patients with breast cancer.

Administration, Oral↗

High-density lipoprotein-cholesterol in marathon runners during a 20-day road race.

Plasma high-density lipoprotein (HDL)-cholesterol and lipid levels were measured in 12 male marathon runners (mean age, 40 years) who ran an average of 28 km/day for ten days, rested 70 hours, then continued to run for eight more days, covering a total distance for both running periods of 500 km. Blood samples were obtained on eight mornings. After one week of running, HDL-cholesterol levels increased 18% and triglyceride levels decreased 22%. However, the three-day rest period reversed these changes. As running resumed, HDL-cholesterol levels again increased and triglyceride levels decreased. There were no significant changes in total cholesterol, body weight, or skinfold thickness despite an average caloric intake of 4,800 kcal/day. Heavy beer drinking had no discernible effect on HDL-cholesterol levels, but may have caused mild hepatic injury as suggested by significantly increased serum alanine transferase and gamma-glutamyl transferase values. This study demonstrates that HDL-cholesterol levels increase with higher running mileage and decrease within days of stopping exercise when caloric and alcohol intake remain elevated.

Adult↗

Dietary therapy in two patients with vitamin B12-unresponsive methylmalonic acidemia.

The biochemical and therapeutic responses to dietary therapy were studied in a 25-month-old girl and a 1-month-old girl with methylmalonic acidemia (MMA-emia), which was unresponsive to vitamin B12. The minimum daily intake of protein which patients could tolerate and display a good development was between 1.0 and 1.2 g per kg body weight. Supplementation with amino acid mixture devoid of toxic amino acids was required to prevent protein malnutrition when daily protein intake was restricted to 0.6 g per kg body weight. Caloric intake should be sufficient, not only to promote growth but also to prevent a rise in MMA level, especially when a patient has ketoacidosis. It was found that MMA excretion per mg creatinine in random urine specimens correlated significantly with serum MMA and twenty four-hour output of MMA per kg body weight. Therefore measurement of MMA in a single urine specimen is useful for evaluating the in vivo accumulation of MMA.

Acidosis↗

Effects of diets high in simple sugars on urinary chromium losses.

Thirty-seven subjects, 19 men and 18 women, consumed reference diets for 12 weeks formulated by nutritionists to contain optimal levels of protein, fat, carbohydrate, and other nutrients; the following 6 weeks, subjects consumed high sugar diets. The reference diets contained 35% of total calories from complex carbohydrates and 15% from simple sugars while the high sugar diets contained 15% complex carbohydrates and 35% simple sugars. Chromium contents of the reference and high sugar diets were both approximately 16 micrograms per 1000 calories. Compared to the reference diets, consumption of the high sugar diets increased urinary Cr losses from 10% to 300% for 27 of 37 subjects. Urinary Cr excretion of males and females was similar, and there was no significant difference in Cr absorption (calculated from urinary excretion divided by intake times 100) between sexes when adjusted for the increased caloric intake of males. These data demonstrate that consumption of diets high in simple sugars stimulates Cr losses; this coupled with marginal intake of dietary Cr may lead to marginal Cr deficiency, which is associated with impaired glucose and lipid metabolism.

Adult↗

Intake of fruits and vegetables in smokers.

OBJECTIVES: To examine intake of fruits and vegetables in smokers and non-smokers. DESIGN: Secondary analysis using general linear modelling approaches. Food intake measured using a food frequency questionnaire approach. SETTING: The community (the population of the province of Ontario, Canada). SUBJECTS: Members of the general public (n = 38,000). RESULTS: Smokers ate substantially less fruit and fruit juice then non-smokers with heavy smokers eating the least. Heavy smokers were between four and six times more likely to be eating less fruit than recommended. Similar but less marked differences were noted for vegetable intake. Smokers also obtained a larger part of their total caloric intake from fats. CONCLUSIONS: While smoking cessation remains the primary target for lung cancer prevention, attention should also be given to dietary interventions in smokers in order to improve their nutrition. Such interventions might also be expected to reduce the risk of other cancers (e.g. colon cancer).

Adult↗