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PubMed1998

Energy expenditure in Alzheimer's disease.

Alzheimer's disease type dementia is a growing health problem and is one of the leading causes of death among elderly people. Unexplained weight loss and cachexia is a frequent clinical finding in patients with Alzheimer's disease. It has been postulated that Alzheimer's disease may by characterized by dysfunction in body weight regulation. This brief review examines energy intake, energy expenditure and body composition in Alzheimer's disease. We consider whether inappropriately high levels of energy expenditure may contribute to unexplained weight loss and decline in nutritional status. Specifically, we will consider studies that have examined body composition, daily energy expenditure and its components. The application of doubly labeled water and indirect calorimetry to problems of "wasting" has increased our knowledge regarding energy expenditure and physical activity levels in Alzheimer's patients. Although the number of studies are limited, results do not support the notion that a "hypermetabolic" state contributes to unexplained weight loss in Alzheimer's disease, even in cachectic patients. Clinical strategies aimed at developing feeding strategies to maintain adequate caloric intake and the restoration of energy balance should be a future area of investigation in Alzheimer's research.

Alzheimer Disease↗
PubMed1998

Gonadal steroids and hypothalamic galanin and neuropeptide Y: role in eating behavior and body weight control in female rats.

The neuropeptides, galanin (GAL) and neuropeptide Y (NPY), based on studies in male rodents, are believed to have a role in controlling energy balance, both nutrient ingestion and metabolism. Whereas these peptides are also involved in reproduction, little is known about their specific function in energy balance in females. In rats consuming lab chow or macronutrient diets, measurements across the estrous cycle were taken of hypothalamic GAL and NPY, using RIA and immunohistochemistry; of the circulating hormones, estradiol, progesterone, and LH; and also of food intake and body weight. Levels of GAL and NPY peak during the proestrous phase of the female cycle when circulating estradiol and progesterone also rise. As previously reported for GAL, this peak is detected in two areas, the medial preoptic area (MPOA; +110%; P < 0.05) and the external zone of the median eminence (+57%; P < 0.05). In addition, this proestrous peak is seen in the paraventricular nucleus (PVN), specifically the anterior parvocellular portion (+35%; P < 0.05). Similarly, NPY rises during proestrous in the medial region of the PVN (+21%; P < 0.05) in addition to the MPOA (+78%; P < 0.05) and arcuate nucleus (+35%; P < 0.05). This peak in peptide levels is accompanied by an increase in caloric intake in rats receiving the lab chow diet and a specific increase in preference for fat in rats receiving macronutrient diets. Animals showing a preference for a fat-rich diet exhibit higher levels of GAL in the MPOA as well as the PVN and median eminence and also of NPY specifically in the MPOA. These peptides in the MPOA are similarly enhanced in animals with greater body fat, independent of diet. This evidence suggests that in the female rat, both GAL and NPY in the MPOA may contribute to the overeating and increased weight gain that occur during a fat-rich diet.

Animals↗
PubMed1999

Nutritional status and nutrient intake of preschool children in northern Ghana.

OBJECTIVE: To determine the nutritional status and nutrient intake of preschool children in a sub-Sahelian setting so as to ascertain whether they meet the acceptable standards. DESIGN: Prospective/investigative study. SETTING: The study was carried out in Saboba, a rural sub-Sahelian village in northern Ghana. SUBJECTS: Five hundred and eighteen preschool children (2.5-6 years) drawn from three kindergartens and five other localities were used. INTERVENTION: Anthropometric measures of age, weight, and height were assessed. Blood and stool samples were taken for analyses. RESULTS: The nutritional status was generally poor, with 27% (140/519) stunted, 4.4% (23/519) wasted and 1.9% (10/519) wasted and stunted. Majority of the children (92%) were anaemic and 16.3% had deficient level of vitamin A (< 10 micrograms/dL). Total caloric intake was low (only 26.5% met RDA values) and apart from protein and iron whose RDA were met by the majority of the children (> 90%), the intake of other nutrients-calcium, vitamin C, vitamin A and provitamin A, were low and unacceptable, compared to their respective RDA values. In the case of iron, even though intake was adequate, the high anaemic rate of 92% was due to high incidence of malaria (32%), hookworm infestation, low intake of vitamin C and low bioavailability of iron from the mainly cereal diet. CONCLUSION: The poor nutritional status of the children was largely due to the low intake of essential nutrients.

Anthropometry↗
PubMed1996

What's New in the Treatment of Anorexia Nervosa and Bulimia?

The 3 eating disorders--anorexia nervosa, bulimia nervosa, and binge eating--occur at a frequency far greater than usually realized. Anorexia has been found to be present in up to 1% of teenage and young adult women, whereas estimates of bulimia have ranged up to 5%. The prevalence of binge-eating disorder is not known, but may be higher than bulimia. Anorexia nervosa is characterized by weight loss, body image disturbance, and a morbid fear of weight gain. Bulimia nervosa is characterized by binge eating and compensatory purging by vomiting; use of laxatives, diuretics, or diet pills; exercise; or fasting. Binge-eating disorder is characterized by binge behavior and loss of control of food intake, with an absence of purging. Eating disorders create significant mortality and morbidity. Medical complications associated with anorexia are those related to malnutrition and semistarvation. Medical complications associated with bulimia are those related to electrolyte imbalance and the physical effects of vomiting. The mortality rate of eating disorders may be as high as 15%, including deaths from arrhythmia, gastric hemorrhaging, and suicide. The core struggle within women with anorexia is the "2 Ps": feeling powerless and striving towards perfectionism. The core conflict within a bulimic person appears to be the "2 Ds": deprivation and dependency. The treatment of eating disorders includes psychotherapy, and, frequently, psychopharmacologic intervention. The psychotherapy primarily addresses issues of chaotic eating, hunger, inadequate caloric intake, conditioned response, and profound fear of expressing impulses and feelings, especially those of anger and sadness. Antidepressants, especially serotonergic agents, have been found to be useful, particularly in the treatment of bulimia.

Journal Article↗
PubMed1988

Gonadotropin-releasing hormone sensitivity in underfed prepubertal female rats.

Studies were conducted to investigate the effect of reduced food intake on pituitary gonadotropin-releasing hormone (GnRH) sensitivity as a possible link in the delay of puberty by underfeeding. Immature female rats (30-32 days old at the start of each experiment) were used throughout the study. Rats on reduced food intake (R) received 60% of normal food intake beginning at the age of 21 days, whereas control (C) animals were fed ad libitum. In ovariectomized (OVX), estradiol benzoate-progesterone-treated R rats, low doses (less than 5 ng/100 g body wt) of GnRH injected intravenously produced higher serum luteinizing hormone (LH) concentration than in comparable C rats. No difference was found at 5 ng GnRH but response to high doses (15 and 45 ng/100 g body wt) was sharply reduced in R rats. No difference in serum follicle-stimulating hormone concentrations was found. In contrast to the OVX-steroid treated animals, in intact R rats, GnRH evoked higher serum LH concentrations at both low and high doses. These studies indicate that reduced caloric intake can affect pituitary GnRH sensitivity and that the effect depends on both the dose of GnRH and the internal, gonadal steroid hormone milieu.

Animals↗
PubMed1987

Mandibular growth retardation in growing rats chronically exposed to hypobaria.

Weanling male Wistar rats aged 21 days were divided into three groups: initial control, normobaric, and hypobaric (C, N, and H, respectively). C rats were killed three days after being weaned. H rats were placed into an altitude chamber and maintained at 456 mb (6100 m) for 14 days. N rats were maintained at sea-level conditions. Body weight, body and tail lengths, and food intake were recorded every day. Animals were killed at the end of the experimental period, and four linear dimensions of the dried mandible were measured. The amount of food eaten by the H rats during the entire exposure period was 54.6% of that consumed by N ones. Body weight gain in H rats was 32.7% of that seen in N rats. Body length was 49.0% and tail length was 56.6% of normal. All mandibular dimensions were significantly reduced in H rats when compared with N rats and were, in general, in close relation with the reduction observed in skeletal growth. Only one dimension was reduced out of proportion, which indicates some deformation of the mandible. The average daily caloric intake related to metabolic body weight (body weight 0.75) of H rats was 60% of the N value. Efficiency of protein utilization for growth was not significantly different between both groups of rats. These results indicate that chronic exposure to hypobaria induces overall skeletal and mandibular growth retardation, which appears to be the result of a diminution in food intake because of decreased appetite.

Altitude↗
PubMed1989

The effect of increased adiposity on food intake of juvenile rats.

The regulation of feeding by body adiposity, as proposed by the lipostatic theory, has been well demonstrated in adult animals. However, mechanisms controlling long-term feeding in juvenile animals have not been well defined. In this study, increased adiposity was induced in young rats through oral gavage. Four-week-old rats were divided into three groups; ad lib feeding (100%-AL), tubefed 100% (100%-TF) or 150% (150%-TF) of ad lib intake. Animals were tube-fed these levels for one week. At the end of this period, one third of each group were killed and all remaining animals were returned to ad lib feeding for either 4 or 29 days later. During this recovery period, the 150%-TF group had significantly depressed food intakes for the first 4 days in comparison to the 100%-TF group. Afterwards, there were no significant differences between these two groups for the remainder of study. Overfeeding induced significant increases in total body fat in the 150%-TF group (24.8 grams) in comparison to the 100%-AL group (11.0 grams) and the 100%-TF group (14.0 grams). By day five of recovery, only the 150% group exhibited a significant loss of body fat. Total carcass protein and ash were not different between groups at any period. At day 29 of recovery, there were no treatment differences in carcass weight or fat content. Loss of body fat from the 150%-TF rats was associated with the decline in caloric intake. It appears that food intake is affected by relative adiposity during the dynamic phase of growth.

Adipose Tissue↗
PubMed2005

Circulating peptide YY concentrations are higher in preterm than full-term infants and correlate negatively with body weight and positively with serum ghrelin concentrations.

BACKGROUND: Peptide YY (PYY) and ghrelin are gastrointestinal tract-derived hormones that play roles in the regulation of food intake and energy balance. Negative energy balance often occurs in hospitalized preterm infants. METHODS: To measure serum concentrations of PYY in preterm and full-term infants and to investigate their correlations with anthropometric characteristics, food intake, and serum ghrelin concentrations, we measured serum PYY and ghrelin concentrations by RIA in 62 healthy preterm infants [mean (SD) gestational age, 32.0 (2.1) weeks; postnatal age, 40.9 (14.8) days] and 15 healthy full-term infants of comparable postnatal age. All of the infants were formula-fed every 3 h. RESULTS: PYY concentrations were significantly higher in preterm [1126.2 (215.4) ng/L] than in full-term infants [825.3 (234.4) ng/L; P < 0.001]. In the entire study population, serum PYY concentrations correlated negatively with gestational age and anthropometric measurements (birth weight, body weight, body length, body mass index, and head circumference) and positively with serum ghrelin concentrations, whereas there was no significant correlation between PYY concentration and caloric intake or weight gain. Multiple regression analysis, after correction for prematurity, revealed that serum PYY concentrations correlated independently with serum ghrelin concentrations and infant body weight or body mass index. CONCLUSIONS: Circulating concentrations of PYY may increase in preterm infants to compensate for the negative body-weight balance. The physiologic mechanisms behind the correlation between PYY and ghrelin remain to be elucidated.

Anthropometry↗
PubMed1993

Neuropeptide Y projection from arcuate nucleus to parvocellular division of paraventricular nucleus: specific relation to the ingestion of carbohydrate.

Neuropeptide Y (NPY) injection into the hypothalamic paraventricular nucleus (PVN) stimulates feeding behavior and specifically carbohydrate intake in rats. The present study investigated the relation between endogenous levels of NPY and natural ingestion for carbohydrate. It also examined the possible importance of a specific NPY projection in this relationship, which traverses from cell bodies in the arcuate nucleus (ARC) to terminals in the parvocellular division of the PVN (pPVN). Sprague-Dawley rats were given pure macronutrient diets (carbohydrate, protein and fat), and their daily nutrient intake was recorded for 3 weeks. The rats were sacrificed, and 8 hypothalamic nuclei were micropunched and examined via RIA for endogenous NPY levels. The results demonstrate a strong, positive correlation between daily carbohydrate intake and hypothalamic NPY levels. The relationship was specific to the pPVN (r = +0.71; P < 0.001), ARC (r = +0.57; P < 0.001) and dorsomedial nucleus (DMN, r = +0.52; P < 0.01), and was not observed in any other hypothalamic area, including the magnocellular division of the PVN. In the pPVN, the NPY levels of animals that consumed > 50 kcal of carbohydrate (49 pg/microgram protein) were almost twice that of animals that consumed < 20 kcal of carbohydrate (28 pg/microgram protein: P < 0.01). Furthermore, NPY levels in the ARC were positively correlated with NPY in the pPVN and DMN but not any other nuclei. No relation between hypothalamic NPY and measures of protein or fat ingestion was detected. Levels of NPY were also unrelated to total caloric intake, to body weight at sacrifice, and to body weight gain during the 3-week measurement period. These results, together with other findings, provide support for a role of endogenous NPY and its projection from the ARC to the pPVN, perhaps via the DMN, in controlling natural appetite for carbohydrate.

Animals↗
PubMed1999

[Serial assessment of the nutritional status of patients infected by the human immunodeficiency virus. Role of tumor necrosis factor/its receptors].

In order to analyze the nutritional status of HIV infected patients and the involvement of the tumour necrosis factor-alpha (TNF-alpha) and its soluble receptors (sTNFRI and sTNFRII) in such an status, forty HIV infected patients, with no associated systemic opportunist infections, were prospectively followed for eight months. From each patient the following were obtained: clinical history, dietetic survey, anthropometric measurements, CD4+ T lymphocyte/mm3 count, HIV load, and serum concentration of TNF and sTNFRI and sTNFRII. Patients showed a nutritional disorder which involved mainly the fat compartment (mean tricipital skin fold 9.8 +/- 4.2 mm, that is, 65.7 +/- 27.4% of the ideal fold), associated with a hypocaloric intake (mean daily intake 1,659.5 +/- 543.0 kcal), with normal proportions of the different organic principles. Serum concentrations of TNF (87.9 +/- 79.2 vs 8.7 +/- 6.1 pg/ml, p = 0.048) and its receptors, sTNFRI (6.1 +/- 2.6 vs 1.0 +/- 0.8 pg/ml, p < 0.001) and sTNFRII (41.9 +/- 18.6 vs 6.3 +/- 3.6 pg/ml, p < 0.001) were significantly higher than those detected in a sample of ten healthy controls. No correlation was found between nutritional alterations and concentrations of TNF or its receptors, viral load, and counts of CD4+ T lymphocytes/mm3. Seventeen patients completed the follow-up period. During this period, no significant modifications in the analyzed parameters were observed: tricipital skin fold, arm circumference, serum concentrations of albumin or transferrin, concentrations of tumoral necrosis factor or its receptor and caloric intake. The conclusion is that, despite the detected nutritional alterations in the nutritional status and those in the TNF/receptor system, our data no support and interrelationship between them.

Acquired Immunodeficiency Syndrome↗
PubMed1991

The CARDIA dietary history: development, implementation, and evaluation.

To meet the objectives for dietary assessment in the Coronary Artery Risk Development in Young Adults (CARDIA) prospective study, we developed a dietary history to provide accurate and reliable quantitative data on habitual individual nutrient intakes at baseline. The CARDIA dietary history was an interviewer-administered method that included a short questionnaire regarding general dietary practices followed by a comprehensive food frequency questionnaire about typical intake of foods using the previous month as a reference for recall. For each broad category of foods, participants were questioned in detail about specific foods only if they indicated that they consumed foods from that category. Follow-up questions for selected foods concerned serving size, frequency of consumption, and common additions to these foods. Provision was made for reporting foods not found in the food frequency list. The interview took approximately 45 minutes. Cue cards prompted responses and plastic food models assisted in estimating usual amounts consumed. A precoded format standardized coding for reported items and established the detail needed for recall during the interview. Baseline nutrient analyses from the CARDIA dietary history provided estimates that agreed reasonably well with expected caloric intake for body mass index according to the age- and sex-specific Recommended Dietary Allowances, but were higher than those reported from 24-hour recalls for comparable age, sex, and race groups in the second National Health and Nutrition Examination Survey. The CARDIA dietary history is a comprehensive assessment tool that can provide a dietitian with detailed information regarding habitual eating patterns and nutrient intakes among adults.

Adult↗
PubMed2003

Glucoprivic regulation of estrous cycles in the rat.

Previous research has shown that glucoprivation induced by chronic 2-deoxy-D-glucose (2DG) treatment extends estrous cycle length and disrupts reproductive behaviors in female hamsters, similar to food deprivation. Such treatment also suppresses food intake, which is reversed in male rats by reducing brain histamine levels prior to 2DG treatment. We, therefore, determined if 2DG extends estrous cycles in the female rat and if this is due to elevated brain histamine levels. We measured estrous cycle length during 2DG-induced glucoprivation, in the presence and absence of alpha-fluoromethylhistidine (FMH), a treatment that reduces brain histamine levels. Adult female rats were treated for 72 h with either saline (n = 8), 2DG (200 mg/kg S.C. every 6 h; n = 9), or FMH (100 mg/kg i.p. daily) + 2DG (200 mg/kg; n = 7). An additional group was treated with FMH (100 mg/kg i.p.; n = 5) alone. To determine if 2DG extends estrous cycles due to glucoprivation or to decreased caloric intake, a group of rats (n = 7) received a reduced diet equal to the mean daily food intake of rats receiving 2DG alone. 2DG induced more long estrous cycles compared to rats receiving saline, FMH + 2DG, or FMH alone. In rats treated with FMH + 2DG, the percentage of 4-5-day cycles was similar to that of saline-treated rats, and a high percentage of 4-5-day cycles was also observed in rats receiving a reduced diet. These data suggest that 2DG does not suppress estrous cycles through a decrease in total calorie intake, but rather by inducing glucoprivation. In addition, during 2DG-induced glucoprivation, elevated brain histamine levels contribute to the mechanism that suppresses reproductive function.

Animals↗
PubMed1985

Dietary fibre: consensus and controversy.

Technological advances have reduced and refined man's plant food intake and consequently brought about an unprecedented decline in his consumption of dietary fibre (DF). The emergence of certain diseases selectively in regions which have been affected the most by this dietary change has led to an enhanced awareness of the functions of DF. DF is a heterogeneous group of substances which resist digestion by the endogenous enzymes of the human gut, although they are fermented to a substantial extent by the bacterial flora of the large intestine. Chemically, DF essentially consists of nonstarch polysaccharides and lignin, and its major constituents are cellulose, hemicelluose, lignin and pectin. The physiological effects of DF are attributable largely to its physicochemical properties. DF primarily affects gastrointestinal (GI) function; its effects are observable at all stages from ingestion through defaecation. It restricts caloric intake, shows gastric and small intestinal transit, and affects the activity of digestive enzymes and release of GI hormones. Its overall impact is to reduce apparent digestibility of nutrients marginally but consistently. In the large intestine, DF accelerates transit, supports bacterial growth and serves to hold water. As a result, the faecal weight and water content increase, and the transit time generally becomes shorter. Secondary to its GI effects, DF attenuates postprandial glycaemia and has long term effects on glucose tolerance and lipoprotein metabolism. These effects have important implications in the aetiopathogenesis of constipation and its sequelae including diverticulosis, cholesterol gallstones, colorectal cancer, obesity, diabetes mellitus and atherosclerosis. DF has traditionally been used therapeutically for constipation; now its use in diabetes is also well established. Our appreciation of the role of DF in human nutrition has undergone a major change in the last two decades. From a redundant constituent of plant foods, it has now moved to the position of an essential nutrient, the deficiency of which seems to have serious consequences.

Animals↗
PubMed1996

Anorexia during acute and chronic disease.

Anorexia is associated with disorders of all systems. Anorexia represents a consistent clinical manifestation during acute and chronic pathophysiological processes (infection, inflammation, injury, toxins, immunological reactions, malignancy and necrosis). Anorexia during disease can be beneficial or deleterious depending on the timing and duration. Temporary anorexia during acute disease may be beneficial to an organism since a restriction in the intake of micro- and macro-nutrients will inhibit bacterial growth. Long-term anorexia during chronic disease, however, is deleterious to an organism and may be associated with cachexia, which can ultimately result in death. Various mechanisms participate in the anorexia observed during disease, including cytokine action. Anorexia induced by cytokines is proposed to involve modulation of hypothalamic-feeding associated sites, prostaglandin-dependent mechanisms, modifications of neurotransmitter systems, gastrointestinal, metabolic, and endocrine factors. In addition, the anorexia-cachexia syndrome is multifactorial and may involve chronic pain, depression or anxiety, hypogeusia and hyposmia, chronic nausea, early satiety, malfunction of the gastrointestinal system, metabolic alterations, cytokine action, production of other anorexigenic substances and/or iatrogenic causes (chemotherapy, radiotherapy). Cachexia may result not only from anorexia and a decreased caloric intake, but also from malabsorption and losses from the body (ulcers, hemorrhage, effusions), or a change in body metabolism. Research has focused on potential interventions to modify anorexia during disease and the anorexia-cachexia syndrome. Nutritional modifications and the use of specific steroids (such as megestrol acetate) are being tested in the clinical setting. Understanding the specific mechanisms responsible for anorexia during disease as well as their interactions is essential to develop interventions for the control of anorexia (during a critical time in a specific disease), and to devise less toxic immunotherapeutic regimens using cytokines.

Acute Disease↗
PubMed1997

Energy intake and net weight gain in pregnant women according to body mass index (BMI) status.

OBJECTIVE: To investigate whether body mass index (BMI) is related to energy intake during pregnancy, and whether BMI, energy intake and other factors are related to net weight gain. DESIGN: Longitudinal, duration of pregnancy. SUBJECTS: 156 healthy pregnant women residing in Quedlinburg county, Germany. METHODS: Weighed 7 d food records and standardized anthropometric measures in the first, second and third trimester. The analysis of variance (ANOVA) statistical technique was used to analyze differences in energy intake, net weight gain and birthweight across BMI groups, and the Cochran-Mantel Haenszel test was used to analyze food group intake by BMI group. RESULTS: Women at the highest level of BMI were significantly less often in the high energy intake category than women at the medium or low level of BMI (15% vs 36% and 48%). Net weight gain during pregnancy was independently influenced by BMI status and energy intake. Women at the highest level of BMI gained significantly less weight (4.2 kg) from first to third trimester than women at the medium or low levels of BMI (weight gains of 6.2 kg and 5.9 kg, respectively). Women with a low daily energy intake gained 4.6 kg during pregnancy, while women with medium and high energy intakes gained 6.0 kg and 6.1 kg, respectively. Examination of net weight gain simultaneously across BMI and parity groups revealed a much lower net weight gain among multigravid women at the highest BMI level (3.3 kg). Primigravid high BMI women, in contrast, gained 6.9 kg, whereas multigravid and primigravid women at medium and low BMI levels gained average of 4.8 kg and 6.5 kg, respectively. The mean birth weight in the three BMI groups did not differ and was not influenced by age, marital status, education, parity or smoking. CONCLUSION: Because other studies have shown that weight gain during pregnancy increases the risk of subsequent overweight, multigravid high BMI women may prevent an increased weight retention after pregnancy due to lower weight gain in the current gestation. A lower caloric diet may help to accomplish a lower weight gain during pregnancy in overweight women without increased risk of low birth weight infants. These findings indicate further investigation of the associations between BMI, parity and caloric intake during pregnancy are needed to increase understanding of factors affecting subsequent weight gain.

Adult↗
PubMed1996

Fruit juice consumption by infants and children: a review.

The pattern of fruit juice consumption has changed over time. Fifty years ago, orange juice was the major juice produced and it was consumed primarily to prevent scurvy. Now, apple juice is the juice of choice for the under 5 age group. While fruit juice is a healthy, low-fat, nutritious beverage, there have been some health concerns regarding juice consumption. Nursing bottle caries have long been recognized as a consequence of feeding juice in bottles, using the bottle as a pacifier, and prolonged bottle feeding. Non-specific chronic diarrhea or "toddler's" diarrhea has been associated with juice consumption, especially juices high in sorbitol and those with a high fructose to glucose ratio. This relates to carbohydrate malabsorption, which varies by the type, concentration, and mixture of sugars present in different fruit juices. Fruit juice consumption by preschoolers has recently increased from 3.2 to about 5.5 fl oz/day. Consumption of fruit juice helps fulfill the recommendation to eat more fruits and vegetables, with fruit juice accounting for 50% of all fruit servings consumed by children, aged 2 through 18 years, and 1/3 of all fruits and vegetables consumed by preschoolers. Concomitant with the increase in fruit juice consumption has been a decline in milk intake. This is concerning as milk is the major source of calcium in the diet, and at present, only 50% of children, aged 1 through 5 years, meet the RDA for calcium. Studies of newborn infants and preschool-aged children have demonstrated a preference for sweet-tasting foods and beverages. Thus, it is not surprising that some children, if given the opportunity, might consume more fruit juice than is considered optimal. Eleven percent of healthy preschoolers consumed > or = 12 fl oz/day of fruit juice, which is considered excessive. Excess fruit juice consumption has been reported as a contributing factor in some children with nonorganic failure to thrive and in some children with decreased stature. In other children, excessive fruit juice consumption has been associated with an increased caloric intake and obesity. This paper reviews the role of fruit juice in the diets of infants and children and outlines areas for future research. Recommendations regarding fruit juice consumption based on current data are also given.

Beverages↗
PubMedDate not supplied

Enteral feeding in the hypoalbuminemic patient.

Previous studies have correlated intolerance of isotonic, intact protein enteral solutions with hypoalbuminemia. The purpose of this retrospective study was to determine whether the level of serum albumin (SA) influenced tolerance of such an enteral nutrient solution (ENS). All patients who received Entrition during 1987 for a minimum of 48 hr were studied for the first 10 days of enteral feeding. Documentation included SA, medications, stool frequency, gastric residuals (GR), and daily caloric intake. ENS intolerance was defined as greater than 3 stools/day for greater than 48 hr or GR greater than twice the hourly infusion rate for greater than 48 hr. Patients were categorized into two groups: those with SA greater than or equal to 2.5 g/dl (group I) and those with SA less than 2.5 g/dl (group II). Of 88 patients studied, 48 (86%) in group I and 28 (88%) in group II tolerated the ENS. Eight (14%) in group I and 4 (12%) in group II experienced ENS intolerance. There was no statistically significant difference in the frequency of ENS intolerance between these two groups (p less than 0.05). Also, 97% of all those with a SA less than 2.5 g/dl were fed 80% or more of their estimated caloric requirements. We concluded that ENS tolerance was not affected by the SA level and patients with hypoalbuminemia (SA less than 2.5 g/dl) could be fed enterally.

Adult↗
PubMed1979

Acute regulation of insulin release by the pituitary gland in relation to hyperinsulinaemia and obesity.

The pituitary glands from mice rendered obese by gold thioglucose treatment and by dietary manipulation, and pituitary glands from lean mice after a high food intake or a glucose load, were shown to stimulate insulin secretion from isolated pancreatic islets. The insulin releasing activity of pituitary glands from obese (ob/ob) mice was reduced by fasting for 24 and 48 h. Results obtained with pituitary glands from ob/ob and from lean ob/+ and +/+ mice suggest that the insulin releasing property manifests a gene dosage effect. Pituitary glands from 3-week-old (young) ob/ob mice stimulated insulin secretion to the same extent as pituitary glands from 3-month-old (adult) ob/ob mice. The pancreatic islets of young ob/ob mice were shown to be somewhat more responsive to stimulation by the pituitary factor than were lean ob/+ or +/+ islets from this age group. The concept that high insulin level, partly under pituitary control, and high caloric intake may be interlinked and may, in combination, be a major factor in producing obesity is discussed. Furthermore, it is suggested that the pituitary insulin releasing factor may play a role in the early development of obesity in the animal models studied.

Aging↗