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[Dietary intake of a group of patients with irritable bowel syndrome; relation between dietary fiber and symptoms].

OBJECTIVES: The aim of our study was to evaluate the oral dietary intake of a group of patients with irritable bowel syndrome and to compare with international recommendations. PATIENTS AND METHODS: A total of 53 patients with irritable bowel syndrome was enrolled in a non-propabilistic sample. Patients were diagnose with Roma II criteria. In all patients were determined, weight, height, body mass index, dietary intake of 3 days and a symptoms scoring system. RESULTS: The average age of 53 patients was 45.67+/-13.6 years with a distribution of sex (22 males/31 females). Caloric intakes was right in absolute terms and corrected by weight. Distribution of calories was 41.5% of carbohydrates, a 19.8% of proteins, and a 38.7% of lipids, showing a high intake of lipids and low of carbohydrates. A low intake of vitamin A and D was detected. High intake of vitamin B12, vitamin C and niacine was observed. A low intake of calcium, magnesium, yodo and zinc was detected. Intake of soluble fiber was lower than insoluble fiber (1.46+/-0.74 g/day) (19%) vs 6.21+/-2.67 g/day (71%). Intake of fiber corrected by calories was low 4.5+/-1.2 g/1000 calories. In correlation analysis, insoluble fiber (r=0.46; p < 0.05) and soluble fiber (r=0.42; p < 0.05) were inverse correlated with general symptoms. CONCLUSIONS: Patients with irritable bowel syndrome showed a deviation of mineral and vitamin dietary. Fiber intake is low, a correlation between fiber intake and general symptoms was detected.

Dietary Fiber↗

Serum leptin and insulin levels during chronic diurnal fasting.

Ramadan fasting is a unique model that is associated with restriction of the timing of food and fluid intake food from dawn to sunset and reduction in meal frequency and sleep duration. Leptin levels are thought to play a role in long-term regulation of caloric intake and fat deposition. However, the long-term changes in leptin levels during this pattern of fasting are not known. The study was conducted on lean (N=6, BMI=22.5+/-0.4) and obese (N=18, BMI=33.1+/-1.0) healthy female volunteers. Fasting serum levels of leptin, insulin and glucose were estimated at baseline (day 1), days 14 and 28 of the month of Ramadan and 2 weeks after Ramadan. Baseline serum levels of leptin were significantly higher in obese (13.5+/-1.96 microg/L,P<0.05) compared with lean subjects (9.60+/-0.80 microg/L) and correlated positively with body fat (r=0.82, P=0.0004). Serum leptin levels exhibited a significant and comparable increase by 39% and 37% throughout the month in lean and obese subjects, respectively. In addition, a significant correlation (r=0.52, P=0.003) was found between changes in serum leptin and serum insulin levels. We conclude that chronic diurnal fasting is associated with significant elevations in serum leptin. These elevations appear to be mediated by changes in serum levels of insulin. These data support the role of insulin in the long-term regulation of leptin secretion during chronic diurnal fasting followed by nocturnal eating during the month of Ramadan.

Adolescent↗

[Feasibility survey on the reliability of questionning on past eating habits in a group of men (author's transl)].

Among men 50-57 years old surveyed in 1969 and again in 1974 on their food intake, both questionaires of 37 who stated in 1974 that they had changed their eating habits in the preceding 5 years were selected for analysis. The mean reported caloric intake had dropped very significantly, but about 500 calories. When these persons were questioned in 1974 on their 1969 food consumption, the results compared to the 1969 questionary were identical for almost all food catergories and for total calories. Thus, a food consumption survey retrospective over a 5 years span appears no less reliable than a survey on present eating habits.

Feeding Behavior↗

Early postoperative alterations in infant energy use increase the risk of overfeeding.

AIM OF STUDY: Energy needs in infants are decreased after surgery because of growth inhibition (resulting from catabolic stress metabolism), decreased insensible losses, and inactivity. Using standardized formulas that account for growth, activity, and insensible losses during this stress period can lead to overfeeding in excess of 200% of the actual measured requirement. Overfeeding during this acute injury period can result in increased CO2 production from lipogenesis. This study determined the effects of a reduced rate of mixed caloric repletion on infant energy use during the early postoperative period. METHODS: C-reactive protein (CRP), oxygen consumption (VO2), carbon dioxide production (VCO2), measured energy expenditure (MEE), and total urinary nitrogen (TUN) were measured serially in seven infants (average age, 78 days) during the first 72 hours after abdominal or thoracic surgery. Nonprotein respiratory quotient (RQnp), and values for oxidation of carbohydrate (Ce) and fat (Fe) were calculated. Injury severity was stratified based on serum CRP concentrations of > or = 6.0 mg/dL (high stress) or < 6.0 mg/dL (low stress). Recovery from acute stress was analyzed by comparing studies in which CRP had decreased to < or = 2.0 mg/dL (resolving stress group) with those in which CRP values were greater than 2.0 mg/dL (acute stress group). RESULTS: Average total caloric intake (64.56 +/- 18.51 kcal/kg/d; approximately 50% of predicted energy requirement) exceeded average MEE (42.90 +/- 9.98 kcal/kg/d) by approximately 50%. Average TUN was 0.18 +/- 0.07 g/kg/d (high stress 0.2 +/- 0.05 versus low stress 0.16 +/- 0.09 g/kg/d). Average RQnp was 1.05 +/- 0.13 and average Ce was 37.28 +/- 16.86 kcal/kg/d. The average calculated Fe was 0.0 +/- 12.27 kcal/kg/d, reflecting approximately equal amounts of fat oxidized compared with fat generated from excess glucose (lipogenesis). When individual studies were analyzed at a CRP cutpoint of 2.0 mg/dL, overfeeding (RQ > 1.0) was significantly less likely in the resolving (2/6 studies, 33.4%) versus acute stress (9/13 studies, 69.2%, Z test P < .001) group. Five of seven (5/7) patients (9/19 individual studies) had negative Fe values (average -9.89 +/- 10.02) reflecting net lipogenesis. The RQnp for these nine studies was 1.14 +/- 0.11 versus 0.97 +/- 0.09 for the remaining 10, and this difference was significant (P < .01). A significant correlation existed between carbohydrate intake and VCO2 (Pearson r = .6951, P < .01). In addition, there was a good correlation between carbohydrate intake and VCO2 (Pearson r = .6591, P < .01). The coefficient of variation for MEE was 8.0% (low stress) versus 30.2% (high stress). CONCLUSION: Lipogenesis with increased CO2 production is substantial, even at reduced caloric delivery rates that exceeded MEE by only 50%, during the early postoperative acute metabolic stress period in infants. These data suggest that caloric requirements during stress are likely equal to or only minimally in excess of actual MEE. Intersubject variability, especially in more severely stressed infants, underscores the importance of serial measurements of energy expenditure to enable precise caloric delivery and avoid overfeeding. In the absence of calorimetric measurement, the data suggest that PBMR (predicted basal metabolic rate) should be used to estimate caloric delivery until CRP values are < or = 2.0 mg/dL.

Abdomen↗

A longitudinal study of changes in aerobic fitness, body composition, and energy intake in primigravid patients.

Sixteen primigravid patients were studied on four occasions (once in each trimester and again at 4 weeks' post partum) for predicted VO2 max (Canadian Home Fitness Test), body weight, and percentage of body fat (skin folds) and caloric intake (3 day food diary). The VO2 max declined significantly from first to second to third trimester and rose post partum to the second-trimester level. Energy intake was constant but body weight and fat rose progressively until after birth. When subjects were divided into "fit" (n = 8) and "unfit" (n = 8) groups, the fit group had significantly greater VO2 max, lower heart rate and diastolic pressure, and less body fat. These differences were not present at third trimester but were present again in the postpartum data. There were no differences in delivery or neonatal data.

Adult↗

Age-related changes in adaptive macronutrient intake in swimming male and female Lou rats.

To evaluate the age-related changes in capacity to adjust the nutrient intake to needs, self-selecting male and female Lou/C/jall rats of 4, 6, 12, 16 and 23 months of age were submitted to a swimming exercise. They were given 6 consecutive days of moderate intensity training (3 x 15 minutes per day). Exercise and postexercise periods were compared with results from the pretraining period. During swimming, a body weight loss and a decrease in both caloric intake and fat selection were observed. This effect was more marked in older groups compared to 4 month-old groups. An increase in protein intake was observed in females, specially in older groups, whereas no effect was seen in males. The ability to increase caloric ingestion and regain weight during the postexercise period decreased with advancing age and was better in females than in males. We also showed an age-related effect on the recovery of initial nutrient intake rate that was more pronounced and more precocious for males. Moreover, males tended to decrease their protein intake, whereas females significantly increased it. The present findings suggest a decrease of capacity of adjusting feeding behavior to metabolic needs in aged rats, may be due to a deterioration of the central control of food intake.

Adaptation, Physiological↗

Coordinated multitissue transcriptional and plasma metabonomic profiles following acute caloric restriction in mice.

Caloric restriction (CR) increases healthy life span in a range of organisms. The underlying mechanisms are not understood but appear to include changes in gene expression, protein function, and metabolism. Recent studies demonstrate that acute CR alters mortality rates within days in flies. Multitissue transcriptional changes and concomitant metabolic responses to acute CR have not been described. We generated whole genome RNA transcript profiles in liver, skeletal muscle, colon, and hypothalamus and simultaneously measured plasma metabolites using proton nuclear magnetic resonance in mice subjected to acute CR. Liver and muscle showed increased gene expressions associated with fatty acid metabolism and a reduction in those involved in hepatic lipid biosynthesis. Glucogenic amino acids increased in plasma, and gene expression for hepatic gluconeogenesis was enhanced. Increased expression of genes for hormone-mediated signaling and decreased expression of genes involved in protein binding and development occurred in hypothalamus. Cell proliferation genes were decreased and cellular transport genes increased in colon. Acute CR captured many, but not all, hepatic transcriptional changes of long-term CR. Our findings demonstrate a clear transcriptional response across multiple tissues during acute CR, with congruent plasma metabolite changes. Liver and muscle switched gene expression away from energetically expensive biosynthetic processes toward energy conservation and utilization processes, including fatty acid metabolism and gluconeogenesis. Both muscle and colon switched gene expression away from cellular proliferation. Mice undergoing acute CR rapidly adopt many transcriptional and metabolic changes of long-term CR, suggesting that the beneficial effects of CR may require only a short-term reduction in caloric intake.

Animals↗

Caloric restriction and aging in primates: Relevance to humans and possible CR mimetics.

For nearly 70 years it has been recognized that reduction in caloric intake by 30-40% from ad libitum levels leads to a significant extension of mean and maximal lifespan in a variety of short-lived species. This effect of caloric restriction (CR) on lifespan has been reported in nearly all species tested and has been reproduced hundreds of times under a variety of different laboratory conditions. In addition to prolonging lifespan, CR also prevents or delays the onset of age-related disease and maintains many physiological functions at more youthful levels. Studies in longer-lived species, specifically rhesus and squirrel monkeys, have been underway since the late 1980s. The studies in nonhuman primates are beginning to yield valuable information suggesting that the effect of CR on aging is universal across species and that this nutritional paradigm will have similar effects in humans. Even if CR can be shown to impact upon human aging, it is unlikely that most people will be able to maintain the strict dietary control required for this regimen. Thus, elucidation of the biological mechanisms of CR and development of alternative strategies to yield similar benefits is of primary importance. CR mimetics, or interventions that "mimic" certain protective effects of CR, may represent one such alternative strategy.

Aging↗

Caloric restriction increases longevity substantially only when the reaction norm is steep.

Evolutionary theory leads to the general expectation that dietary restriction will often result in increased survival probabilities, and thus increased lifespan. The reaction norm is a basic tool of evolutionary analysis that quantifies the relationship between environmental parameters and functional characters, including reproduction and longevity. In rodents, the reaction norm connecting adult longevity to caloric intake is fairly steep; small changes in intake lead to large changes in longevity. If this strong quantitative relationship were evolutionarily conserved among all mammals, then the prospects for a substantial increase in human lifespan from caloric restriction would be very good. In theory, however, reaction norms are expected to evolve for fitness related characters such as reproduction and survival. It has been shown experimentally in Drosophila that dietary reaction norms readily evolve in the laboratory, suggesting that they can do so among mammals as well, particularly over the millions of years since contemporary rodents and primates last shared a common ancestor. Our previous work crudely estimates that the dietary reaction norms of rodents and humans have diverged substantially, with a very flat dietary reaction norm for human longevity. These general principles and our specific results suggest that the benefits from human caloric restriction would be minor.

Adaptation, Physiological↗

Effect of intragastric and intravenous ethanol on food intake in rats.

The effects of a continuous intragastric (via a gastrostomy) and intravenous (via an indwelling jugular catheter) infusion of 3% ethanol at 3 ml/h on food intake was examined in rats randomly assigned to a two period crossover study. The 3% ethanol solution provided 19 kcal/day, which was equivalent to about 50% of the daily caloric intake of the rats. Ethanol significantly decreased food intake irrespective of the route administered. But, reduction in food intake did not result in a calorie-to-calorie compensation. Instead, providing 50% of calories as 3% ethanol via the intragastric route led to a 16% reduction in food intake, while only a 9% reduction in food intake occurred when the 3% ethanol solution was given intravenously.

Animals↗

Multiple factors in short-term behavioral control of protein intake in rats.

The availability and concentration of dietary protein was varied in an examination of the nature of the day-to-day intake of protein solutions by 60-day-old male rats. It was found that the rats consumed a remarkably constant absolute amount of protein each day, adjusting overall caloric intake to maintain protein at a roughly constant proportion of total calories. Factors such as the time of access to a protein source or the extent of prior experience with a protein source were seen to influence the overall constancy of protein intake, whereas daily shifts in preference between two available concentrations of protein did not interfere with such short-term control. The mechanism for this behavioral control is likely to be different from mechanisms mediating the conditioned response to dietary protein, as in the response to dietary amino acid imbalance.

Animal Nutritional Physiological Phenomena↗

Major nutritional findings from the First Health and Nutrition Examination Survey in the United States of America, 1971-1974.

Some of the major findings from the First Health and Nutrition Examination Survey in the United States were presented related to the Nutritional Status of the American people. These findings cover a range from possible deficiencies to possible escesses. Among the deficiencies, iron is the most frequent, affecting particularly young children and women of childbearing age as reflected by relatively low intakes and relatively high prevalences of low hemoglobin values and percent transferrin saturations. Mean hemoglobin values of blacks were significantly lower than those of whites in spite of higher iron intakes in many black females. Low mean intakes of calcium in black women were found associated with higher prevalences of Chvostek's sign, and low mean vitamin A intakes in younger black men and women of all ages were associated with follicular hyperkeratosis. On the excess side of the range were total fat, saturated fat and cholesterol intakes which are among the highest known. These high intakes are associated with relatively high serum cholesterol levels and a high frequency of obesity. Obesity in white women aged 20-45 years was associated with a lower reported caloric intake and a lower exercise score.

Adolescent↗

Growth and energy and protein intake of preterm newborns in the first year of gestation-corrected age.

CONTEXT: There are few longitudinal studies that analyze the growth and nutritional status parameters of children born prematurely. OBJECTIVE: To evaluate the growth and dietary intake of preterm newborns in the first year of gestation-corrected age. DESIGN: Prospective clinical study. SETTING: Tertiary care hospital. PATIENTS: 19 children (7 male) who were born prematurely, with birth weight between 1000 g and 2000 g, which was adequate for the gestational age. PROCEDURES: At 3, 6, 9 and 12 months of gestation-corrected age, children were evaluated in relation to weight, height and cephalic perimeter, using the National Center for Health Statistics as the standard reference, and the Rozalez-Lopez and Frisancho standards for brachial perimeter and triceps and subscapular skinfolds. The calculated dietary intake was compared to the Recommended Dietary Allowances. MAIN MEASUREMENTS: The Z score was calculated for the weight/age, height/age and weight/height relationships, and the percentiles of the perimeters and skinfolds were considered. Dietary intake records were made using the 24-hour Dietary Recall and the Food Frequency Intake Questionnaire methods. The Virtual Nutri software was used to calculate energy and protein intake. RESULTS: The weight/age, height/age and weight/height relationships and the brachial perimeter and triceps skinfold were statistically greater in the first semester in relation to the second. The cephalic perimeter remained above the 50th percentile for the ages studied and there was no difference in the subscapular skinfold between the first and second semesters, remaining below the 50th percentile. The calorie and protein intake, although statistically lower in the first than in the second semester, always remained above the recommended. CONCLUSIONS: The pace of growth is greater in the first semester than in the second, not reaching the standard expected for full-term newborns, with the exception of the cephalic perimeter, which remains adequate. Calorie/protein intake shows an inverse relationship with growth speed, remaining above the recommended for full-term newborns, although with difficulty in depositing subcutaneous fat, in spite of the high caloric intake.

Birth Weight↗

The feeding pattern of the fruit bat Rousettus aegyptiacus in captivity.

An electrical apparatus was designed to record continuously the feeding activity of either a colony of 30 fruit bats (Rousettus aegyptiacus) or single bats in captivity. The endogenous feeding activity rhythm was synchronized by change in the external light-dark cycle. During June to August (winter), the bats consumed an average of 96 g sliced banana, equal to 76 g wet weight/100 g body weight per 24 hours or 15 g dry weight/100 g body weight per 24 hours. The feeding period began shortly after sunset and continued for 10,6 h. Feeding consisted of 6-14 separate small meals. The mean or overall feeding rate was 9,1 g banana/h, and the feeding rate during the first 3 h, 13,1 g/h. The bat regulated its food intake by varying the rate of food consumption and not by changing the duration of the feeding period. It is suggested that clustering of the bats may influence the caloric intake by reducing the energetic cost of thermoregulation.

Animals↗

[Heterogenicity of hypertension: the various effects of electrolyte intake].

Nonpharmacologic approaches to patients with hypertension are a worthwhile avenue to treatment as well as a laudable public health goal. Reduced salt intake has been the primary dietary measure. However, recently attention has also been directed at potassium, calcium, magnesium, and the anions accompanying these cations. Further, the importance of total caloric intake and confounding dietary variables such as alcohol consumption have been appreciated. It is important to recognize that nutrients are not ingested in isolation, but rather as interactive constituents of a total diet. This principle may account for some of the heterogeneity of the human blood pressure response to variations of individual electrolyte intake. Moreover, failure to appreciate this heterogeneity and interactive effects may result in other than the desired effect in the population at risk.

Blood Pressure↗

Eating, exercise, and "thrifty" genotypes: connecting the dots toward an evolutionary understanding of modern chronic diseases.

Survival of Homo sapiens during evolution was dependent on the procurement of food, which in turn was dependent on physical activity. However, food supply was never consistent. Thus it is contended that the ancient hunter-gatherer had cycles of feast and famine, punctuated with obligate periods of physical activity and rest. Hence, gene selection in the Late-Paleolithic era was probably influenced by physical activity and rest. To ensure survival during periods of famine, certain genes evolved to regulate efficient intake and utilization of fuel stores. Such genes were termed "thrifty genes" in 1962. Furthermore, convincing evidence shows that this ancient genome has remained essentially unchanged over the past 10,000 years and certainly not changed in the past 40-100 years. Although the absolute caloric intake of modern-day humans is likely lower compared with our hunter-gatherer ancestors, it is nevertheless in positive caloric balance in the majority of the US adult population mainly due to the increased sedentary lifestyle in present society. We contend that the combination of continuous food abundance and physical inactivity eliminates the evolutionarily programmed biochemical cycles emanating from feast-famine and physical activity-rest cycles, which in turn abrogates the cycling of certain metabolic processes, ultimately resulting in metabolic derangements such as obesity and Type 2 diabetes. In this context, we postulate that perhaps a crucial mechanism to break the stall of the metabolic processes would be via exercise through the regulation of "physical activity genes," some of which may also be potential candidates for the "thrifty genes" of our hunter-gatherer ancestors. Therefore, the identification of such "thrifty gene" candidates would help provide insight into the pathogenetic processes of the numerous physical inactivity-mediated disorders.

Biological Evolution↗

Energy expenditure and intake in children with sickle cell disease during acute illness.

BACKGROUND: Children with sickle cell disease have frequent bouts of pain and infection which may increase energy expenditure, decrease energy intake and lead to a subsequent energy deficit. METHODS: Two groups of African-American children with sickle cell disease-SS genotype were enrolled in this study upon hospital admission for a sickle cell disease related illness: a younger (<6 years, n=14, 7 M) and older group (> or =6 years, n=17, 8 M). Body composition and dietary intake were assessed, and sleeping (younger) or resting energy expenditure (older) were measured by indirect calorimetry at admission and one month later at steady state. RESULTS: Energy expenditure was not different between the two timepoints for younger children, but was slightly elevated at steady state (+50 kcal/d, P=0.049) in the older group. After controlling for gender, changes in fat-free mass and dietary intake, the significance disappeared. Energy intake in both groups was significantly depressed at admission compared to follow-up (P<0.01). CONCLUSIONS: These children and adolescents did not expend excess energy during their acute illness, however, an energy deficit was observed secondary to poor energy intake. Since 20% of patients with sickle cell disease have multiple hospitalizations per year, these results provide justification for the development and evaluation of nutrition care protocols to maintain adequate caloric intake during hospitalization and recovery.

Acute Disease↗