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PubMedDate not supplied

Dietetic treatment with hypercaloric and hyperprotein intake in patients following severe brain injury.

Sixty four patients, following severe acute brain injury were fed according to a strict dietetic therapy at the Intensive Care Unit at the Institute of Neurological Surgery, University of Turin. We used mixtures composed of simple nutritional elements consisting of carbohydrate as glucose polymers from 7 to 15 units, free aminoacids and MCT oil, integrated with natural elements. The solutions were administered via a nasogastric tube with the maximum caloric intake of 6.000 Kcal and 186 grams proteins/24 hr. After recording a series of hematochemical and clinical parameters we obtained the following results: 1) the average blood sugar level was always found to be pathological among the 11 patients who eventually died during their hospitalization, while 30% of the discharged patients had normal blood sugar values; 2) kidney function was significantly more affected among eventually deceased patients than among discharged ones; 3) the hospitalization time had a negative influence on the hepatic functions. Total serum albumins and proteins cease their decline respectively at average values of 2 and 5.5% gr, cholesterol maintains a constant level between 180 and 200% gr, calcium between 8 and 9 mg% and phosphorous around 3 mg%. Alkaline phosphatase in all patients rose significantly to pathological values only after a week of hospitalization. All other tests presented an irregular course. The survival period of our group of patients was significantly longer than that of control group. Within our group the survival rate was better among patients who received, within 10 days from cerebral damages, a hypercaloric and hyperprotein diet of more than 5.000 Kcal and 120 grams of proteins in 24 h, as compared to those whom the same diet was administered more gradually or following a longer period of time after having sustained cerebral damage.

Adolescent↗
PubMed1981

Effects of androgens on dietary self-selection and carcass composition in male rats.

The aromatizable androgen testosterone propionate (TP; .2 mg/day) increased protein and carbohydrate intake and stimulated body weight gain in gonadectomized (Gdx) male rats. A higher dose of TP (2.0 mg/day) increased protein, but not carbohydrate, intake and was less effective in stimulating body weight gain than the lower dose of TP. Postmortem carcass analyses revealed that the elevated protein intake of both TP-tested groups was associated with increased carcass protein content. The decreased weight of rats treated with the high dose of TP was due to a reduction in body fat content. The nonaromatizable androgen 5 alpha-dihydrotestosterone propionate (DHTP; .2 or 2.0 mg/day) also increased protein (but not carbohydrate) intake and body weight gain in Gdx male rats, but it did not alter carcass composition. Unlike TP, the two doses of DHTP were equally effective, but neither dose of DHTP was as effective as the low dose of TP in stimulating protein and carbohydrate intake and body weight gain. The results of these experiments suggest that (a) androgens can increase selection of dietary protein whether or not they exert significant protein anabolic effects, (b) the 5 alpha-reduced product of testosterone, 5 alpha-dihydrotestosterone, is not the major metabolite responsible for the increases in protein and caloric intake and in body weight caused by TP, and (c) the decreases in carbohydrate intake and adiposity in rats treated with the high dose of TP may be mediated by aromatized (estrogenic) metabolites of the androgen.

Animals↗
PubMedDate not supplied

Weight, nutrition, and immune status in postpartal women.

Postpartal weight loss, nutritional intake, and immune status were examined in 65 women. Although 80% of the women lost weight and were not overweight by the 4th postpartal month, the majority had diets that were inadequate in fat content (> or = 30% of calories from fat) or protein content (< or = 12% of calories from protein), or in terms of caloric intake (< or = 1,200 calories or > or = 2,200 calories). Differences in some immune cell subsets were noted between women with high-fat and normal-fat diets. Women with high-fat diets had lower percentages of specific immune cell subsets than women with normal-fat diets. Protein intake was not related to immune cell phenotypes.

Adult↗
PubMed2004

Relationship between body mass index, diet, exercise and gastro-oesophageal reflux symptoms in a community.

BACKGROUND: Body mass index (BMI) is a risk factor for gastro-oesophageal reflux but may simply be explained by diet and lifestyle. AIM: We aimed to determine the contribution of BMI, diet and exercise to GER. METHODS: Community subjects (n = 211, mean age = 36 years, 43% males) completed validated questionnaires on gastro-oesophageal reflux, energy expenditure (Harvard Alumni Activity Survey), dietary intake (Harvard Food Frequency Questionnaire) and measures of personality and life event stress. Diet, exercise, BMI and other potential risk factors for reflux were analysed using logistic regression analyses. RESULTS: The overall mean (+/- s.d.) BMI was 26.6 (+/- 5.7); 79 (37%) reported infrequent (< weekly) reflux and 16 (8%) reported frequent (> or = weekly) reflux. The median caloric intake was 2097 cal/day and the median daily energy expenditure was 1753 cal/day. Among those with BMI > 25, 10% reported frequent reflux compared to 4% of those with BMI < or = 25. In a model which included age, sex and Symptom Checklist-90 somatisation T-score, BMI was associated with reflux (OR per 5 units = 1.9, 95% CI: 1.2, 3.0). In models which included diet and exercise variables, BMI but not diet or exercise was associated with reflux. CONCLUSION: BMI may be associated with symptomatic gastro-oesophageal reflux independent of diet and exercise.

Adult↗
PubMedDate not supplied

The effects of different percentages of dietary fat intake, exercise, and calorie restriction on body composition and body weight in obese females.

PURPOSE: The goal of this study was to determine the effect of varying the amount of dietary fat, while holding calories at 1,200 kcals/day, on body weight and percent body fat in 35 obese women. DESIGN: A pretest, midtest, posttest experimental design was employed, and subjects were randomly divided into one of four dietary fat groups, with 10%, 20%, 30%, or 40% of caloric intake as dietary fat. INTERVENTION: Subjects consumed 1,200 kcals/day and a specified percentage of total energy as fat, depending on their dietary group. Protein was held constant at 20%. All subjects engaged in a five day/week walking program. SETTING: Participants were recruited from the general community using newspaper advertisements. SUBJECTS: Thirty-five obese women 25 to 45 years of age (means=38 +/- 4.97) served as subjects. All were at least 20% above ideal weight and 30% to 52% body fat. MEASURES: Percent body fat, body weight, and anthropomorphic measurements were taken at baseline, six and 12 weeks. Dietary intake was recorded daily by each subject, and exercise walking logs were maintained by each participant. RESULTS: All subjects lost body weight and body fat; however, there were no significant differences in the rate or amount of body weight or percent body fat lost across the four groups during the intervention. CONCLUSIONS: It appears that during calorie restriction and exercise for 12 weeks, percent of calories derived from dietary fats does not influence loss of body weight or percent body fat in adult obese women.

Adult↗
PubMedDate not supplied

Continuation of transpyloric feeding during weaning of mechanical ventilation and tracheal extubation in children: a randomized controlled trial.

BACKGROUND: Nutrition support is essential in the management of critically ill children. There is no current literature to support the common practice of discontinuing enteral nutrition delivered through a transpyloric feeding tube during the tracheal extubation process. We conducted a prospective, randomized controlled trial in mechanically ventilated children to examine the safety and efficacy of continuous transpyloric feeding compared with interrupted transpyloric feeding at the time of tracheal extubation. METHODS: Subjects were randomly assigned to receive transpyloric feeding throughout the tracheal extubation process (Continuous Group) or to have transpyloric feeding discontinued 4 hours before tracheal extubation and restarted 4 hours after tracheal extubation (Interrupted Group). Data consisting of patient demographics, admission pediatric risk of mortality (PRISM) score, diagnoses, adverse events (feeding intolerance, gastroesophageal reflux, and pulmonary aspiration), daily feeding volume, and caloric intake were recorded for the 3 days surrounding tracheal extubation. RESULTS: Fifty-nine patients completed the study (29 in Continuous Group, 30 in Interrupted Group). There was no episode of pulmonary aspiration in either group. The Continuous Group experienced 4 adverse events, whereas the Interrupted Group experienced 3 adverse events (p = not significant). The Continuous Group received 92 +/- 2.5% of their caloric goal on the day of weaning from the ventilator (day 1) and 93 +/- 3.2% on the day of tracheal extubation (day 2) compared with 76 +/- 4.2% and 43 +/- 4.3%, respectively, in the Interrupted Group (p < .004 and p < .0001, respectively). CONCLUSIONS: Continuous transpyloric feeding during weaning from the ventilator and tracheal extubation is safe and results in the delivery of more optimal nutrition.

Critical Illness↗
PubMedDate not supplied

Dietary intake of community-based HIV-1 seropositive and seronegative injecting drug users.

Dietary intake was assessed in a subsample of a cohort of inner-city injecting drug users (IDUs). In this population of predominantly African-American IDUs, including both HIV -1-infected and noninfected men and women, a food frequency questionnaire (FFQ) and a 24-h recall were administered. One hundred seven volunteers participated. Although total caloric intake was consistently higher with the food frequency method, percent of total calories from fat, protein, and carbohydrates were similar between the FFQ and 24-h recall. Spearman's correlations for agreement between the 24-h recall and the FFQ ranged from 0.22 for vitamin E to 0.52 for carbohydrates. HIV-1 seropositives reported higher protein (p = 0.05) and fat (p = 0.02) consumption than seronegatives according to the 24-h recall. The difference in total fat consumption was due to higher intakes of saturated and monounsaturated fats (p = 0.01). Median intakes of vitamins B2 and B12, pantothenic acid (p < or = 0.05), phosphorous (p < or = 0.01), and selenium (p < or = 0.005) were also greater in HIV-1 seropositives. Reported intake of vitamins A and E, calcium, and zinc were below the recommended daily allowances for both HIV-1 seropositives and seronegatives. Although intakes of most nutrients appeared adequate for the group as a whole, extreme ranges were observed and may be the result of imbalanced food selections and day to day variation. Food group analysis indicated low intakes of fruits, vegetables, milk, and milk products. More research is needed to fully understand the implication of dietary habits and nutritional status in the free-living HIV-1-infected and noninfected IDUs.

Adult↗
PubMed1988

Dietary fat:carbohydrate ratio and obesity in middle-aged men.

Nutrient intakes from 7-d diet records were compared with hydrostatically determined body composition in 155 sedentary obese men aged 30-59 y. Percent body fats ranged from 18.6 to 40.3. The men ate (mean +/- SD) 2570 +/- 514 kcal/d: 15.6 +/- 2.6% from protein, 40.7 +/- 5.7% from fat, 37.5 +/- 6.9% from carbohydrate, and 6.2 +/- 6.0% from alcohol. Percent body fat correlated positively (p less than 0.05) with g/1000 kcal intake of total, saturated, and monounsaturated fatty acids and negatively with carbohydrates and plant protein. Total calories, number of meals, and distribution of calories were unrelated to percent body fat, total weight, or fat-free mass. The higher proportion of fat and carbohydrate in the diet may contribute to obesity in men. The modest caloric intake of these men and the lack of correlation between percent body fat and total calories suggest that calorie differences are not the major cause of the variations in obesity in these men.

Adipose Tissue↗
PubMed1990

Dietary factors and their relation to respiratory symptoms. The Second National Health and Nutrition Examination Survey.

Dietary factors may influence inflammatory and antioxidant activity, and hence the development of chronic respiratory symptoms. To examine this hypothesis, the authors analyzed data from the Second National Health and Nutrition Examination Survey (NHANES II). NHANES II was conducted on a sample representative of the civilian, noninstitutionalized US population, which included 9,074 white and black adults aged 30 years or older. Dietary factors were derived from serum levels and from a 24-hour dietary recall questionnaire. The authors examined the relations of these dietary factors to the presence of currently active respiratory symptoms. The relation of serum vitamin C, dietary vitamin C intake, dietary fish intake, the ratio of dietary sodium to dietary potassium, and the ratio of serum zinc to serum copper to the respiratory symptoms of bronchitis and wheezing was assessed. Initially, nutrient-specific logistic regression analysis was performed, controlling for age, race, sex, calories, and pack-years of cigarette smoking. When multiple nutrients and total caloric intake were considered for each respiratory symptom outcome, bronchitis was negatively associated with serum vitamin C and with the serum zinc:copper ratio and was positively associated with the sodium:potassium ratio. Wheezing was negatively associated with serum vitamin C, niacin, and the serum zinc:copper ratio. Interactions between nutrients and smoking status were not significant. These data suggest that several dietary constituents may influence the occurrence of respiratory symptoms in adults, independently of cigarette smoking.

Adult↗
PubMed1987

[Zinc nutrition in young Chilean adults].

To evaluate the effect of dietary factors on plasma zinc levels, dietary zinc intake was estimated and plasma levels were measured in 37 healthy young adults of low and middle socioeconomic status. Our study included 16 males aged 29 +/- 7 and 21 females aged 26 +/- 6 years. Dietary intake of zinc and protein was determined from a 24-hour dietary recall survey. Plasma zinc was measured by atomic absorption spectrophotometry. Alkaline phosphatase (AP) in plasma was also measured and the weight/height percentage for each subject calculated according to Jelliffe's standards. The average diet was composed of cereals, legumes, eggs, bread and noodles, caloric intake was 2051 +/- 154 kcal/day for men and 1767 +/- 158 (x +/- SD) kcal/day for women. The daily intake of zinc was 8.3 +/- 3.0 mg/day for males, and 9.7 +/- 2.0 mg/day for females. Cereals were the main source of zinc for men, while egg and dairy products were for women. Plasma zinc values were 82 +/- 22 micrograms/dl for men and 94 +/- 19 micrograms/dl for women (p less than 0.01). For the whole group plasma zinc concentration was 89 +/- 21 micrograms/dl. Seven males and two females had low plasma zinc values (70 micrograms/dl or less). Alkaline phosphatase (AP) levels were 110 +/- 10 IU for males and 71 +/- 4 IU for females (p less than 0.001). These values did not correlate with the zinc levels. Average weight/height was 99 +/- 18 for men, and 108 +/- 18 for females. Results indicate that on the average, in our study group plasma zinc levels were within the normal range, although they were significantly lower in men. Dietary intake of zinc was below the recommendations, being higher for women as related to values presented by men. The observed low plasma levels of zinc may be caused by a low intake, and/or poor bioavailability.

Adult↗
PubMed1978

Alcohol and nutrient intake of elderly men.

The effect of alcohol consumption on the intake of food nutrients was investigated in elderly residents in a Veterans Administration Domiciliary. When compared with a group of abstainers from the same institution, the imbibers ate fewer food calories (2,140 vs. 2,415 kcal per day) and had lower serum albumin levels (54 vs. 58 per cent total serum protein). The lower caloric intake extended to the three main energy sources (fat, protein, and carbohydrate) and occurred even though ample food was available. In view of the reduced nutrient intake and known impairment of the absorptive process by ethanol, institutionalized elderly alcoholics require special attention to maintain a satisfactory nutritional status.

Aged↗
PubMed1983

[Food consumption of children eating lunch in school restaurants].

In order to study the dietary intakes of children having lunch at school, 150 children were observed: 60 aged 5-6 years, 60 aged 9-10 years and 30, aged 5-13 years, attending 5 different schools (4 in town, 1 in the country). The estimation of spontaneous ingesta was made according to the weighing method. Energizing rations, the percentages of caloric intakes, the amounts of total, animal and vegetal lipids, of total carbohydrates and pure carbohydrates, of total, animal and vegetal proteins were estimated for each meal and each child. The analysis of these ingesta suggests that the dietary habits of children at school is a major factor of nutritional lack of balance, much more important than that related with the quality of the proposed food.

Adolescent↗
PubMed1994

Dietary lactose intake, lactose intolerance, and the risk of epithelial ovarian cancer in southern Ontario (Canada).

A case-control study of dietary factors and cancer of the ovary was conducted during 1989-92 in metropolitan Toronto and surrounding areas of southern Ontario, Canada. Four hundred and fifty women aged 35-79 years, with newly diagnosed, histologically verified, primary epithelial ovarian-cancer were interviewed concerning reproduction and diet. Over the same period, 564 randomly-selected population controls, frequency-matched to the cases within three 15-year age groups, also were interviewed. From information obtained by quantitative diet history, average daily macro- and micronutrient intake values were calculated through use of the United States Department of Agriculture Food Composition Databank, which was extended and modified for Canadian items and recipes. Analysis was performed with continuous, unconditional logistic-regression methods, adjusting for age at interview, number of full-term pregnancies, total duration of oral contraceptive use, and total daily caloric intake. Neither reported history of lactose intolerance, nor average daily consumption of lactose or free galactose, were found to be associated with risk of ovarian cancer. Lactose intake or intolerance did not appear to modify the protective effects of parity and oral contraceptive use. Nevertheless, other studies suggest that ovarian galactose metabolism still may have a relationship with risk of ovarian cancer, though more evidence is needed.

Adult↗
PubMed2003

Peptides that regulate food intake: antagonism of opioid receptors reduces body fat in obese rats by decreasing food intake and stimulating lipid utilization.

Agonists to opioid receptors induce a positive energy balance, whereas antagonists at these receptors reduce food intake and body weight in rodent models of obesity. An analog of 3,4-dimethyl-4-(3-hydroxyphenyl)piperidine, LY255582, is a potent non-morphinan antagonist for mu-, kappa-, and delta-receptors (K(i) of 0.4, 2.0, and 5.2 nM, respectively). In the present study, we examined the effects of oral LY255582 treatment on caloric intake, calorie expenditure, and body composition in dietary-induced obese rats. Acute oral treatment of LY255582 produced a dose-dependent decrease in energy intake and respiratory quotient (RQ), which correlated with the occupancy of central opioid receptors. Animals receiving chronic oral treatment with LY255582 for 14 days maintained a negative energy balance that was sustained by increased lipid use. Analysis of body composition revealed a reduction in fat mass accretion, with no change in lean body mass, in animals treated with LY255582. Therefore, chronic treatment with LY255582 reduces adipose tissue mass by reducing energy intake and stimulating lipid use.

Adipose Tissue↗
PubMed2004

Does food restriction increase life span in lean rats?

The effect of food restriction on survival of lean animals was investigated using WAG/Rij rats. In this strain, body weight of males and females fed ad libitum reached a plateau of 350 g and 220 g, respectively, at the age of 10 months. Their spontaneous food intake was 15 g per 24 h in males and 10 g in females, values which were 50 to 40 % lower than that reported for most strain of laboratory rats. A 30 % food restriction was initiated at the age of 10 months in both gender, and also at 20 months in males. In females, reduction in caloric intake had no effect on mean survival until 30 months, but change the slope of the survival curve in the last part of life. As a result, mean and maximal life span were increased by 10 %. In males, when reduction in food intake was initiated at 10 months, the survival curve of the restricted animals was shift to the right, also corresponding to a 10 % increase in mean and maximal survival, without change in the slope of mortality curve. When started at 20 months, diet restriction has no significant effect on survival of male rats. It was concluded that food restriction initiated in adults is mostly efficient to increase survival in rodents with large spontaneous food intake, but have a minor effect on lean strain, although it has beneficial effect on several aging processes.

Aging↗
PubMed1991

Behavioral assessment and management of food refusal in children with cystic fibrosis.

Four children with cystic fibrosis, ranging in age from 10 to 40 months, were admitted to a specialized pediatric unit for evaluation and treatment of malnutrition. All were below the fifth percentile for weight despite appropriate pancreatic enzyme replacement and outpatient nutritional counseling. Dietary evaluation revealed oral intake of 48% to 62% of that required for growth. Standardized nursing and psychological assessments of feeding behaviors during meals indicated a low acceptance rate of foods and a high rate of maladaptive feeding behaviors. Treatment consisted of behavioral management using positive reinforcement of food acceptance, extinction of negative behaviors, and parent training. Mean percentage of caloric intake increased from 54% to 92% for the four patients. At long-term follow-up, the patients who continued the program demonstrated substantial and persistent catch-up growth. Behavioral feeding disorders may contribute to failure to thrive in patients with cystic fibrosis and must be considered when growth failure occurs despite correct medical management and apparently mild pulmonary and gastrointestinal involvement.

Behavior Therapy↗
PubMed1987

Effects of dietary sugar and of dietary fat on food intake and body fat content in rats.

The long term ingestion of a sugar-rich diet (low fat) caused severe obesity in adult rats. In a separate experiment, the habitual consumption of a fat-rich diet (40% kcal from fat) also caused severe obesity. Severe obesity developed in both groups of animals even though they did not overeat. Voluntary food intake for the sugar-fed rats averaged 28,314 +/- 756 calories/rat per 55 wks which was similar to the value of 28,884 +/- 953 calories/rat per 55 wks for the fat-fed rats. However, both values were lower than that of 32,869 +/- 588 for the control rats eating Purina chow. Despite a lower caloric intake, carcass fat averaged 45 +/- 1% for rats eating the sugar-rich diet and 46 +/- 2% for rats eating the fat-rich diet, but only 33 +/- 2% for rats eating a diet of Purina chow. These results provide evidence that severe obesity can develop in the absence of hyperphagia in animals eating a sugar-rich or fat-rich diet. Finally, a rat model for severe obesity is presented in which carcass fat ranged from 18% (lean) to 61% (severe obesity) using dietary intervention alone at critical stages of the animal's life.

Adipose Tissue↗
PubMed1988

Obesity: thermodynamic principles in perspective.

The energy balance equation applicable to all living organisms was used as a framework on which to construct a critical review of some of the more controversial aspects of the obesity problem. The equation matches energy intake against all the known forms of work that the body does in utilizing that energy, including external and internal work and the work of adipose tissue synthesis (stored energy). Equations representing everyday living conditions, resting, fasting and basal conditions were constructed. The equation applicable to everyday living (working, non-fasting) was used to develop a set of model paradigms to illustrate some of the devices that can be invoked to decrease expenditure and conserve energy. These served as models of how obesity can arise in the absence of calorie overconsumption. The same equation was then used to create a set of opposite paradigms showing how obesity can be prevented by increasing expenditure to waste energy and stabilize body weight when challenged by hyperphagia. In order to see caloric intake and the various work terms in their proper quantitative relationships it was necessary to assign numerical values to the equation. These were selected from published reports of caloric values representative of a non-obese adult of average size engaged in a typical white collar occupation. It was then easy to adjust these assigned values commensurate with the objectives described in the preceding paragraph. Since obesity research is hampered by a confusing array of metabolic interactions it was essential to alter only one of the energy terms at a time, excluding all metabolic interactions except for those unavoidable ones dictated by the laws of thermodynamics. Only in this way could we see the body's multiple energy forms in clear perspective with regard to their real quantitative significance in the energy balance sheet and their potential impact on body weight. Creating these models gave us the added advantage of enabling us better to evaluate the scientific literature because the data we generated, although theoretical, served as excellent standards against which to compare the real data that have emanated from research laboratories.(ABSTRACT TRUNCATED AT 400 WORDS)

Adipose Tissue↗