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PubMed2005

Consuming fructose-sweetened beverages increases body adiposity in mice.

OBJECTIVE: The marked increase in the prevalence of obesity in the United States has recently been attributed to the increased fructose consumption. To determine if and how fructose might promote obesity in an animal model, we measured body composition, energy intake, energy expenditure, substrate oxidation, and several endocrine parameters related to energy homeostasis in mice consuming fructose. RESEARCH METHODS AND PROCEDURES: We compared the effects of ad libitum access to fructose (15% solution in water), sucrose (10%, popular soft drink), and artificial sweetener (0% calories, popular diet soft drink) on adipogenesis and energy metabolism in mice. RESULTS: Exposure to fructose water increased adiposity, whereas increased fat mass after consumption of soft drinks or diet soft drinks did not reach statistical significance (n = 9 each group). Total intake of energy was unaltered, because mice proportionally reduced their caloric intake from chow. There was a trend toward reduced energy expenditure and increased respiratory quotient, albeit not significant, in the fructose group. Furthermore, fructose produced a hepatic lipid accumulation with a characteristic pericentral pattern. DISCUSSION: These data are compatible with the conclusion that a high intake of fructose selectively enhances adipogenesis, possibly through a shift of substrate use to lipogenesis.

Adipose Tissue↗
PubMed1993

The importance of dietary protein in healing pressure ulcers.

OBJECTIVE: To determine the effect of dietary protein on healing of pressure ulcers in malnourished patients. DESIGN: Nutritional intervention trial with the non-randomized assignment of patients by pressure ulcer stage and bed type. SETTING: Long-term care facility. PATIENTS: Twenty-eight malnourished patients (age = 72 +/- 18 years, mean +/- SD) with a total of 33 truncal pressure ulcers. Nine patients had stage II ulcers, eight had stage III ulcers, and 16 had stage IV ulcers. METHODS: Patients received liquid nutritional formulas as tubefeedings or meal supplements containing either 24% protein (61 g protein/L; n = 15) or 14% protein (37 g protein/L; n = 13) for 8 weeks. RESULTS: There was a significant decrease in total truncal pressure ulcer surface area of the 15 patients in the 24% protein group (-4.2 +/- 7.1 cm2, P < 0.02), but not in the 13 patients in the 14% protein group (-2.1 +/- 11.5 cm2, P = NS). The change in total ulcer area correlated with both dietary protein intake per kg body weight (rs = -0.50, P < 0.01) and caloric intake per kg body weight (rs = -0.41, P < 0.03). The decrease in stage IV ulcer area in eight patients in the 24% protein group (-7.6 +/- 5.8 cm2, P < 0.02) was significantly greater (P < 0.05) than in eight patients in the 14% protein group (-3.2 +/- 16.4, P = NS). In these 16 patients, the decrease in ulcer size also correlated with dietary protein intake per kg body weight (rs = -0.63, P < 0.01). CONCLUSION: High protein diets may improve the healing of pressure ulcers in malnourished nursing home patients.

Aged↗
PubMed1983

Effect of long-term administration of sodium benzoate to a patient with partial ornithine carbamoyl transferase deficiency.

An 8-year-old girl with partial ornithine carbamoyl transferase deficiency was treated with sodium benzoate (200 mg/kg/day) for 13 months. Before administration of sodium benzoate, her protein intake was reduced to 1.0 to 1.5 g/kg/day and her caloric intake fluctuated. Hyperammonemic attacks were frequently observed in winter. After the start of administration of sodium benzoate, the severity and frequency of these attacks decreased, although her protein intake was increased to 1.5 to 2.0 g/kg/day. No adverse effect of sodium benzoate were detected by clinical and laboratory examinations. It is concluded that long-term oral administration of sodium benzoate was effective in reducing the frequency and severity of hyperammonemic attacks in this patient. Sodium benzoate therapy in combination with dietary manipulation may improve the growth and development of these patients by allowing reduced dietary protein restriction.

Amino Acid Metabolism, Inborn Errors↗
PubMed1985

Dietary fluoride intake of 15-19-year-old male adults residing in the United States.

The average daily dietary fluoride intakes of 15-to-19-year-old males were estimated from the analysis of 24 FDA "market basket" food collections made from 1975 to 1982. The data indicate that 15-to-19-year-old males residing in fluoridated (greater than 0.7 ppm) cities had an average daily dietary fluoride intake of 1.85 mg/day when the diet provided an estimated caloric intake of 11.72 megajoules (2800 calories). In non-fluoridated cities, with less than 0.3 ppm in the drinking water, the average dietary fluoride intake was 0.86 mg/day. The beverages and drinking water contributed an average of 75 +/- 2% of the daily dietary fluoride intake.

Adolescent↗
PubMed2000

Diet and sex hormone-binding globulin.

The serum concentration of sex hormone-binding globulin (SHBG) is inversely related to weight and in animal studies is inversely related to protein intake. As SHBG can affect the biological activity of testosterone and estradiol, we wished to determine the role of protein intake on SHBG levels in men. Using data from the Massachusetts Male Aging Study we examined cross-sectional relationships between dietary components and SHBG levels in 1552 men (aged 40-70 yr) for whom these factors were known. Analyzed by multiple regression, controlling for testosterone and estradiol levels, age (P<0.001) and fiber intake (P = 0.02) were positively correlated to SHBG concentration, whereas body mass index (P<0.001) and protein intake (P<0.03) were negatively correlated to SHBG concentration. The intakes of calories, fat (animal or vegetable), and carbohydrate were not related to SHBG concentration. We conclude that age and body mass index are major determinants of SHBG concentrations in older men, and fiber and protein intake are also significant contributors to SHBG levels, but total caloric intake and the intake of carbohydrate or fat are not significant. Thus, diets low in protein in elderly men may lead to elevated SHBG levels and decreased testosterone bioactivity. The decrease in bioavailable testosterone can then result in declines in sexual function and muscle and red cell mass, and contribute to the loss of bone density.

Adult↗
PubMedDate not supplied

Therapeutic lifestyle changes and pharmaceutical care in the treatment of dyslipidemias in adults.

OBJECTIVE: To review each therapeutic lifestyle change (TLC) component listed in the National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III) cholesterol guidelines and discuss how the guidelines can be used by pharmacists in the treatment of patients with dyslipidemias. DATA SOURCES: Published guidelines and abstracts identified through PubMed (May 1987-March 2004), Medline (January 1966-March 2004), using the search terms cholesterol, hypercholesterolemia, dyslipidemia, hyperlipidemia, diet, saturated fats, unsaturated fats, trans-fatty acids, overweight, obese, exercise, physical activity, program adherence, and guidelines; as well as the NCEP ATP III guidelines, the 2004 ATP III update, National Heart, Lung, and Blood Institute Obesity Guidelines, and Dietary Guidelines for Americans 2005. STUDY SELECTION: Performed manually by author. DATA EXTRACTION: Performed manually by author. DATA SYNTHESIS: TLC components are recommended in the NCEP ATP III guidelines for treatment of patients with dyslipidemias independent of medication use. Dietary modifications are the primary focus of TLC therapy. Saturated fat intake should be limited to less than 7% of total caloric intake and trans-fatty acid intake should be low for patients with dyslipidemias. Persons who are overweight or obese with dyslipidemias should reduce body weight through a combination of physical activity, total calorie reduction, and behavior therapy modifications. CONCLUSION: Pharmacists, given the proper training, can be effective at offering preventive pharmaceutical care for decreasing high blood cholesterol and the risk for coronary heart disease through patient counseling on TLC components as well as drug therapy in patients with dyslipidemias.

Adult↗
PubMed2006

Rats submitted to gastric banding are leaner and show distinctive feeding patterns.

BACKGROUND: Bariatric surgery is expanding to meet the global epidemic of morbid obesity, because this surgery is successful in achieving sustained weight loss. After having recently established a rat model of gastric banding, our aim now was to investigate the relative fat mass content and the feeding patterns of gastric banded rats. METHODS: Two groups of Wistar rats, submitted either to gastric banding or to sham surgery, were followed-up for 26 days regarding weight, daily food intake and feeding patterns both under resting conditions and when refed after fasting. Weight of the epididymal fat pad was used as a measure to evaluate changes in white adipose tissue in the rats. RESULTS: 10 days after surgery and thereafter, rats submitted to gastric banding showed the same daily food intake that was observed in sham-operated rats. Nevertheless, gastric banded rats kept lower body weights and were leaner than controls. These differences were associated with distinctive feeding patterns, both under resting conditions and when refed after fasting, suggesting that gastric banded rats present a significant increase in feeding frequency when compared with controls. CONCLUSION: This data is the first experimental evidence that an increase in feeding frequency is associated with weight loss after gastric banding, even if there is no decrease in total energy intake. Thus, medical advice on the advantages of fractionating daily caloric intake into multiple meals is further supported by the herein new information obtained in an animal model of gastric banding.

Animals↗
PubMed2002

[Standards, options and recommendations for nutritional support in bone marrow transplant patients].

CONTEXT: The "Standards, Options and Recommendations" (SOR) project, started in 1993, is a collaboration between the Federation of French Cancer Centers (FNCLCC), the 20 French cancer centers and specialists from French public university and general hospitals and private clinics. Its main objective is the development of clinical practice guidelines to improve the quality of health care and outcome for cancer patients. The methodology is based on literature review and critical appraisal by a multidisciplinary group of experts, with feedback from specialists in cancer care delivery. OBJECTIVES: To develop, according to the definitions of the Standards, Options and Recommendations, clinical practice guidelines for nutritional support in bone marrow transplant patients. METHODS: Data were identified by searching Medline , web sites and the personal reference lists of members of the expert groups, then submitted for review to 75 independent reviewers. RESULTS: The main recommendations for nutritional support in bone marrow transplant patients are: 1) Nutritional evaluation and monitoring may be proposed to bone-marrow transplant recipients (options). 2) Nutritional evaluation consists of body weight assessment and percent weight loss evaluation (standard, expert agreement). 3) Nutritional monitoring should include daily weight monitoring, clinical monitoring of hydration and assessment of daily dietary intake (standard, expert agreement). 4) Artificial nutrition is recommended in immuno-suppressed bone marrow transplant patients. This is not systematically indicated in other situation (standard). 5) Artificial nutrition, intravenous hydration and oral nutrition can be proposed to bone-marrow transplant recipients (option). 6) There is no standard modality for artificial nutrition (level of evidence B 1). Exclusive enteral or parenteral nutrition and enteral plus parenteral nutrition may be proposed to bone-marrow transplant patients (options). 7) Lipid intake representing up to 30% of the non-protein caloric intake should be supplied to patients undergoing bone marrow transplantation (standard, level of evidence B1). 8) Oral supplementation with nitrogen substrates or glutamine is not recommended. Parenteral glutamine supplementation may be proposed (option).

Algorithms↗
PubMed1992

[Management of patients with impaired glucose tolerance following esophagectomy in carcinoma of the esophagus].

We demonstrated the effectiveness of the "sliding scale" insulin infusion in diabetic patients undergoing esophagectomy. Fifty-eight patients were followed after esophagectomy to clarify differences in energy expenditure and caloric contributions of substrates. Energy expenditure was measured by indirect calorimetry on the 1st, 3rd, 5th, and 7th days after esophagectomy. Out of 58 patients, 7 were divided into diabetic (D), 30 into borderline (B), 21 into normal (N), according to a 75 g oral glucose tolerance test, preoperatively. Forty-four patients underwent esophagectomy by means of right thoracotomy, and blunt esophagectomy was done on 14 patients. The results were as follows: 1) No relation was found between postoperative morbidity and severity of glucose intolerance. 2) There was no significant difference in changes in energy expenditure following operation among groups D, B, and N. No difference was found in ratio of caloric intake to energy expenditure among groups D, B, and N. Caloric contributions of substrates seemed to be comparable among groups D, B, and N. These results suggest that "sliding scale" insulin infusion with total parenteral nutrition enable us to control not only blood glucose level but energy metabolism following esophagectomy in diabetic patients.

Diabetes Complications↗
PubMedDate not supplied

Comparison of nutritional status after total or subtotal gastrectomy.

Forty-four disease-free patients were evaluated a mean of three years after total gastrectomy (TG) or subtotal gastrectomy (SG) for cancer. The investigation encompassed nutritional assessment by standard anthropometric and biochemical indices; evaluation of the nutritional intake based on 24 h recall and of appetite status on a visual analogue scale; and anamnestic analysis of postcibal symptoms and syndromes. Body weight had declined progressively until the 15th postoperative month after both TG and SG. Weight loss, as well as the general nutritional status index (actual body weight/usual body weight +/- actual body weight/desirable body weight + measured arm muscle circumference/reference arm muscle circumference x 33), had dropped more significantly in patients undergoing TG than those having SG (p less than 0.05). The principal body compartment change was observed in the fat content which was severely depleted, whereas the somatic proteins were relatively spared and the visceral proteins and remaining biochemical variables were in the normal range. Protein intake was not significantly different in the two groups, but caloric intake was significantly lower and the number of meals significantly higher after TG (p less than 0.05). These data suggest that malnutrition after TG is relatively mild and that this operation causes only a limited impairment of the nutritional state, and spares most of the nutritional variables of clinical interest in comparison with SG. These findings argue in favor of TG when clinically indicated without excessive concern about postoperative nutrition.

Adult↗
PubMed1981

[Changes in the nutritional status of the lactating women during exclusive lactation].

In order to evaluate the influence of breast feeding upon selected nutritional parameters of lactating women, several anthropometric and biochemical measurements were performed during the interval between 40 and 180 postpartum days in 54 women in full and satisfactory nursing. Only one significant change was detected in measurements done for nutritional assessment: loss of body weight. No changes were detected in hemoglobin levels or in serum protein and albumin. There was high variability in body weight changes with a mean loss of 1.5 kg due especially to a loss in fat body mass and, in a lesser proportion, to loss in lean body mass. The mean food intake did not change during the observation period. The mean caloric intake was 2,771 cal/day at the beginning and 2,737 cal/day in the end of the study. A significant correlation was established between the individual energetic intake and the body weight changes of lactating women. The allowance of 2,750 cal/day suggested by FAO/WHO for lactating women seems adequate for the health of women in a normal nutritional condition, but apparently insufficient to overcome undernutrition in women who initiate lactation with this condition. In spite of the small nutritional impact observed, our results support the need for food supplementation programs destined to lactating women, with special orientation to undernourished women of low socioeconomic level.

Adolescent↗
PubMed1998

Resting energy expenditure and nitrogen balance in critically ill pediatric patients on mechanical ventilation.

Nutritional support is important in critically ill patients, with variable energy and nitrogen requirements (e.g., sepsis, trauma, postsurgical state) in this population. This study investigates how age, severity of illness, and mechanical ventilation are related to resting energy expenditure (REE) and nitrogen balance. Nineteen critically ill children (mean age, 8 +/- 6 [SD] y and range 0.4-17.0 y) receiving total parenteral nutrition (TPN) were enrolled. We used indirect calorimetry to measure REE. Expected energy requirements (EER) were obtained from Talbot tables. Pediatric Risk of Mortality (PRISM) and Therapeutic Intervention Scoring System (TISS) score were calculated. Total urinary nitrogen was measured using the Kjeldahl method. PRISM and TISS scores were 9 +/- 5 and 31 +/- 6 points, respectively. REE was 62 +/- 25 kcal.kg-1.d-1, EER was 42 +/- 11 kcal.kg-1. d-1, and caloric intake was 49 +/- 22 kcal.kg-1.d-1. Nitrogen intake was 279 +/- 125 mg.kg-1.d-1, total urinary nitrogen was 324 +/- 133 mg.kg-1.d-1, and nitrogen balance was -120 +/- 153 mg.kg-1.d-1. The protein requirement in this population was approximately 2.8 g.kg-1.d-1. These critically ill children were hypermetabolic, with REE 48% higher (20 kcal.kg-1.d-1) than expected. Nitrogen balance significantly correlated with caloric and protein intake, urinary nitrogen, and age, but not with severity of illness scores or ventilatory parameters.

Adolescent↗
PubMed2000

A perspective on fat intake in athletes.

Performance in endurance events is dependent upon the maximal aerobic power, the percentage of that power that can be sustained and the availability of substrates (carbohydrates [CHO] and fats). The purpose of this paper is to present a perspective of recent studies that demonstrate the role of fat intake and oxidation on endurance performance. Studies have shown that fatigue is associated with reduced muscle glycogen and that increasing muscle glycogen or blood glucose prolongs performance while increasing fat and decreasing CHO decreases performance. This has led to an emphasis on CHO intake in athletes in endurance sports, which quite often leads to low caloric intake. It is well known that trained subjects have higher levels of fat oxidative capacity, which spares glycogen during endurance sports. Data from recent studies in trained athletes, who were fed iso-caloric high-fat diets (42% to 55%) that maintained adequate CHO levels, have shown an increase in endurance in both men and women when compared to diets composed of low fat intake (10% to 15%). The magnitude of the effect on endurance was significant at high percentages of maximal aerobic power and increased as the percentage of maximal aerobic power decreased. Based on this review, a baseline diet comprising 20% protein, 30% CHO and 30% fat, with the remaining 20% of the calories distributed between CHO and fat based on the intensity and duration of the sport, is recommended for discussion and future research.

Adult↗
PubMed1980

Effect of food intake on hypermetabolic response to burn injury in guinea pigs.

We have studied the effect of caloric intake on metabolic rate in normal and burned (20-25% body surface area, BSA) guinea pigs. Food intake was standardized by means of infusing a liquid diet (48 kcal/day) through chronic gastrostomy tubes continuously for 16 hours per day. We found that feeding control animals a diet insufficient to meet their daily caloric requirements nevertheless resulted in a significantly higher basal oxygen consumption (VO2) 8 hours after food than during fasting. The incremental increase in basal VO2 induced by feeding burned animals (20-25% BSA) was even greater than in controls. Thus, although basal VO2 was similar in control fasted and burned-fasted animals, basal VO2 in burned-fed animals was significantly greater than in control-fed animals.

Animals↗
PubMed1982

Caloric compensation following insulin administration in rats.

Caloric intakes following injections of insulin were examined in male rats maintained on diets of different caloric densities. Following saline or insulin injections, food intake was measured every two hours for six hours or food was withheld for six hours until recovery of normo-glycemia and total intake was measured at seven and eight hours post-injection. Additionally, levels of plasma metabolic fuels, liver glycogen and stomach contents were measured following saline and insulin injections. Animals in both the continuous and delayed access conditions consumed the same number of calories following injections of insulin. Similarly, the increases in intake relative to saline baseline conditions were comparable across diet groups in both conditions although animals tested in the delayed access paradigm were less variable in their response. Changes in levels of metabolic fuels, stomach contents and liver glycogen were found to be consistent with the known effects of insulin and counter-regulatory responses to the induced hypoglycemia.

Animals↗
PubMed1984

The satiating efficiency of foods.

Experiments were undertaken to test the general hypothesis that some foods are more satiating than others, to find a mechanism for their differential satiating efficiencies, and to determine whether certain soups had a high enough satiating efficiency to recommend their addition to a meal as a way of reducing total caloric intake of that meal. In the first experiment it was found that intake of a test meal was lower after a large preload of tomato soup than after a small preload in women, but not in men. However, the total energy intake (soup plus test meal) was no less with meals which included the large soup preload than it was with meals that did not include a preload. Therefore adding a normal portion of tomato soup to a meal would not reduce its total energy intake. We noted the interesting incidental finding that total energy intake (i.e., preload plus test meal) of the meals which contained the larger amount of soup was less than the total energy intake of the meals which contained a combination of crackers , jelly, and juice. In the second experiment we confirmed this finding by showing that when equal weights of tomato soup preloads and a preload of crackers , cheese, and apple juice, which contains more energy, were given, total energy intake was less in meals which included soup. Therefore, substituting tomato soup for a more calorically dense first course could reduce total energy intake of that meal. In the third experiment, the hypothesis suggested by the second was confirmed. Two soups were more satiating than crackers , cheese, and juice. When two calorie levels were used for each preload, it was shown that calorie for calorie, these soups decreased intake of the test meal more than crackers , cheese, and juice. In the fourth experiment we showed that the mechanism for this differential satiating efficiency is not readily attributable to either bulk related factors or fat content. We suggest that the differential satiating efficiencies are related to differences in nutrient dispersion, orosensory cues, or temperature. Finally, reductions in intake were accompanied by reductions in the initial rate of eating and not by increases in the rate of deceleration. This reduction was small but consistent and suggests that foods which are more satiating reduce intake by decreasing desire to eat (i.e., hunger), not by accelerating the onset of meal termination (i.e., satiety). In fact the duration of meals was unaffected by the preloads.

Adolescent↗
PubMed1988

Diet composition alters the satiety effect of cholecystokinin in lean and obese Zucker rats.

Although exogenous administration of the peptide cholecystokinin (CCK) has been shown to reduce food intake in a variety of experimental situations, few studies have examined the influence of dietary content upon CCK's effectiveness, particularly in obese states. To evaluate the effectiveness of CCK administration in animals consuming high fat diets, groups of obese and lean Zucker rats were maintained on laboratory chow (CH), a high fat diet isocaloric to chow (IF), or a hypercaloric fat diet (HF). After a 17 hr fast, rats were given intraperitoneal injections of saline or ascending doses of 0.06 to 2.0 micrograms/kg of the synthetic octapeptide of CCK. On all diets, obese rats required higher doses of CCK to significantly reduce feeding and showed smaller intake reductions than lean rats (p less than 0.001). Despite higher baseline caloric intakes (p less than 0.001), rats of both genotypes maintained on HF displayed larger reductions of intake than those fed IF or CH (p less than 0.001). Intake reductions by either genotype maintained on IF or CH were not reliably different. The manner in which the satiety effect of CCK was enhanced in rats consuming the calorically dense, palatable HF diet is unclear but may be related to orosensory and/or postingestive attributes of the diet.

Animals↗
PubMed1991

[Caloric substrates in postoperative parenteral nutrition].

The paper describes the carbohydrate, lipidic and nitrogen metabolism of the postoperative period which is subdivided into an early and a late phase. Since the metabolism of caloric substrates in the early postoperative period is a stress metabolism with glucose intolerance and wide protein catabolism, the authors emphasise that an insufficient caloric intake is worse than the fasting state and suggest that alternative caloric sources, such as branched chain amino acids, fatty acids and, even, ketonic bodies, should be used.

Amino Acids, Branched-Chain↗