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Modulation of chemical toxicity by modification of caloric intake.

Caloric restriction increases maximum achievable lifespan and offsets the time to development of degenerative disease. Part of these desirable effects may result from positive modulation of toxic events. We have shown that when rodents are placed on a diet that is reduced in total calories by 40%, several beneficial changes on biochemical systems which impact on toxicologic processes are positively enhanced. Lipid metabolism is reduced and, therefore, the potential for lipoperoxidation is reduced. Additionally, activity of enzymes that produce free radicals as byproducts (cytochrome P4502C11) are also reduced. Concurrently, we have shown that the "effective" activity of catalase and the activity of superoxide dismutase (which are required for the detoxification of toxic oxygen radicals) are significantly increased by caloric restriction. The activities of enzymes of drug and xenobiotic metabolism are also altered by caloric restriction. The effect upon activity may be to either decrease or increase activity, dependent upon whether the enzyme activates compounds to intermediates which may be more toxic or whether the enzyme acts to reduce toxicity. We have also shown that caloric restriction may affect the initiation stage of carcinogenesis. Aflatoxin B1 binding to hepatic nuclear DNA was reduced by caloric restriction (caloric restriction reduced both major adducts that are formed upon exposure to aflatoxin B1). caloric restriction also reduced cytochrome P4502C11 which converts aflatoxin B1 to its toxic epoxide, and may partly explain the reduction in binding. These results suggest that caloric restriction may, in part, extend the time to development of degenerative disease by altering basic biochemical mechanisms of toxicity.

Animals

Effects of excessive caloric intake and caloric restriction on body weight and energy expenditure at rest and light exercise.

The individual response to overeating and semistarvation on energy expenditure at rest and light work before and after a test meal was investigated. This response was related to the change in dry body weight, measured as weight (W) minus total body water (TBW). Experiments were performed on 9 non-obese subjects: (a) with a normal habitual energy intake; (b) (overfeeding) with an extra energy intake of 12 MJ per day for two weeks; and (c) (semistarving) with an energy intake of only 2.1 MJ per day for 2 weeks. Measurements of VO2, VCO2, W and TBW were obtained at the end of each of the three periods. It was found that the perturbation in energy intake from normal to 20-25 MJ per day increased the energy expenditure. The magnitude of this increase was highly individual and inversely related to the change in dry body weight. Energy expenditure, measured under the four standardized conditions, after 2 weeks of starvation was lower than that obtained after the preceding overeating period. This decrease was also roughly inversely related to the change in dry body weight. The results support the idea that part of the regulation of body energy content takes place by way of a change in the efficiency of energy utilization and that the response to a perturbed energy intake varies considerably between subjects.

Adult

Caloric intake necessary for weight maintenance in anorexia nervosa: nonbulimics require greater caloric intake than bulimics.

In the past decade, patients with anorexia nervosa have been subdivided by the presence or absence of binging-and-purging behavior. Psychologic, physiologic, and premorbid weight differences have also been discovered between these subgroups. We now report that nonbulimic anorectics required 30-50% more caloric intake than bulimic anorectics to maintain a stable weight. This difference in caloric intake was independent of phase of illness; it was present at low weight and at intervals after weight restoration. Subjects were closely supervised on an inpatient hospital ward so that they could not binge or purge. Motor activity did not appear to explain these alterations in caloric requirements. Such differences in caloric intake could be trait related or a consequence of many years of starving or binging behavior. These findings are clinically relevant for advising eating disorder patients of caloric requirements necessary to maintain a normal weight.

Adult

Diagnosis of Gilbert's syndrome: role of reduced caloric intake test.

Reduction in caloric intake to 400 a day for 72 hours resulted in a significant increase in the plasma bilirubin concentration in patients with Gilbert's syndrome and in normal subjects. This was due to an increase in unconjugated pigment. There was no significant increase in the bilirubin concentration in patients with liver disease or haemolytic anaemia.The increase in unconjugated bilirubin was signficantly greater in Gilbert's syndrome than in normals but only when the initial bilirubin concentration was raised. It was usually seen within 24 hours of reducing the caloric intake. An increase of 100% or more suggests that unconjugated hyperbilirubinaemia is due to Gilbert's syndrome. In the normal subjects the unconjugated bilirubin level did not exceed 1.0 mg/100 ml.The increase in unconjugated bilirubin concentration on reducing the caloric intake may be due to decreased hepatic bilirubin uridine diphosphate glucuronyl transferase activity, which was shown to be present in seven rats starved for 72 hours. The effect of a 400 calorie diet for 24 hours on the unconjugated bilirubin level may distinguish Gilbert's syndrome from other causes of unconjugated hyperbilirubinaemia.

Anemia, Hemolytic

Caloric intake patterns of nonpurge binge-eating women.

Daily caloric intake of nonpurge binge-eating women was monitored over 28 days using food diaries to determine how caloric intake patterns were related to binge eating. The majority of participants had extreme fluctuations in daily caloric intake. Caloric intake for both nonbinge days and days preceding the highest-calorie binge days was significantly lower than caloric intake on binge days and highest-calorie binge days. The lower caloric intake was not low enough to cause physiological deprivation. Although there was not physiological deprivation of calories, the individual may have felt that she ate less than desired, which may have contributed to subsequent binge eating.

Adult

An assessment of caloric intake as an indicator of physical activity.

Caloric intake has been suggested as a surrogate measure of physical activity, provided that energy balance is maintained. In this study we assessed caloric intake in relation to other measures of physical activity in a free-living population by a single 24-hr recall in white adult males, ages 22-79 years, examined in 1957-1960 as part of the U.S. Railroad Study. Intake was positively related to leisure time and occupational activity. Men with higher levels of caloric intake had lower exercise test heart rates indicating that they were probably more fit. Caloric intake was also significantly and inversely related to body mass index, the sum of the triceps and subscapular skinfold thickness measurements, blood pressure, and total serum cholesterol. These results suggest that caloric intake, even as measured in a 24-hr dietary recall, is an indicator of physical activity level. Therefore, caloric intake may be a useful indicator of physical activity in some population-based epidemiologic studies.

Adult

Metabolic effects of increased caloric intake in man.

In order to determine if increased caloric intake could be responsible for the insulin resistance and elevated plasma glucose, insulin, and triglyceride levels commonly associated with obesity, hypercaloric diets were fed for 3 wk to eight normal subjects, and the metabolic consequences of this diet were assessed before significant weight gain had occurred. One wk of increased caloric intake led to statistically significant increases in fasting plasma insulin (22 per cent), glucose (5 per cent), and triglyceride (30 per cent) levels, as well as an increased insulin response (20 per cent) to oral glucose. Since the average weight gain during this period was only 1.6 kg, the observed changes appear to be secondary to increased caloric consumption, not obesity. Most of these changes returned toward baseline values during the succeeding 2 wk of increased caloric intake, but statistically significant elevations of fasting plasma glucose (10 per cent), insulin (8 per cent) and cholesterol (15 per cent) levels were still seen at the end of the hypercaloric dietary period. On the other hand, insulin resistance, as estimated by direct measurement of insulin responsiveness, did not change as a result of 3 wk of increased caloric intake. These results indicate that acute increases in caloric intake can lead to elevated plasma glucose, insulin, cholesterol, and triglyceride levels. These changes occurred before significant weight gain had taken place, and raised the possibility that at least some of the abnormalities of carbohydrate and lipid metabolism attributed to obesity may be due to increased caloric intake. However, this conclusion would not seem to apply to the insulin resistance associated with obesity, as 3 wk of increased caloric intake did not produce any change in the responsiveness of these subjects to insulin's action.

Adult

Effects of marihuana use on body weight and caloric intake in humans.

Body weight and caloric intake were measured in a group of heavy and casual marihuana users prior to, during and following 21 days of marihuana smoking under research ward conditions. A group of control subjects were studied under identical conditions, but they did not smoke marihuana. Both heavy and casual marihuana users had a significant increase in caloric intake and gained weight during the marihuana smoking period. Heavy and casual users gained an average of 3.7 and 2.8 lbs respectively during the first 5 days of marihuana smoking. In contrast, control subjects gained only a small amount of weight (0.2 lbs) during the same time interval. Water retention did not appear to be a major factor in weight gain by the marihuana users. These findings are in agreement with both anecdotal reports and previous experimental data that marihuana use is associated with increased caloric intake and weight gain.

Body Weight

Caloric intake, body weight, and cancer: a review.

The literature is reviewed for evidence concerning the relation between caloric intake, body weight, and cancer. Convincing experimental data regarding caloric intake and benign and malignant tumor incidence have been available since the 1940s and demonstrate that caloric restriction significantly reduces tumor incidence for a variety of tumor types in several animal models. Some epidemiological investigations provide evidence for a positive calorie-cancer association in humans, although it is difficult (in these studies) to separate the effects of calories per se from those of dietary fat. A larger number of investigations have evaluated body weight alone, and high relative body weight or high caloric intake has been associated with increased risk of cancer of the breast, colon, rectum, prostate, endometrium, kidney, cervix, ovary, thyroid, and gallbladder. In contrast, lung, bladder, and stomach cancers appear to be inversely associated with body weight, and some prospective studies of men demonstrate greater total cancer mortality among lean individuals. However, in their analyses, few of these latter investigations considered the effects of cigarette smoking, antecedent illness, or competing causes of death. While the relations between caloric intake, other dietary macronutrients (e.g., fat), and body weight are complex and require further investigation, a complete review of the data suggests that reducing caloric intake and relative body weight may lead to a considerable decrease in cancer risk in humans.

Animals

Nicotine's effects on female rats' body weight: caloric intake and physical activity.

Caloric intake and physical activity contribute to the inverse relationship between nicotine and body weight in male rats. In contrast, the relative contribution of these behavioral variables to the nicotine/body weight relationship in female rats has has not been investigated. Recent research indicates that males and females respond differently to nicotine. The present study was designed to determine the role of physical activity and food consumption in body weight changes associated with nicotine administration in female rats. Nicotine or saline was administered chronically to 24 female rats for 19 days. Body weight, food consumption, water consumption, and physical activity were measured before, during, and after nicotine administration. Body weight and food consumption decreased during and increased after nicotine administration. However, there were no changes in physical activity that could account for these changes in body weight. These results corroborate the report that males and females respond differently to nicotine.

Animals

Eating habits and caloric intake of physically active young boys, ages 10 to 14 years.

Eating habits of 104 male participants (ages 10 to 14 years) in organized ice hockey were compared across age groups and levels of competition. The boys were members of either a highly skilled and intensively active competitive league group (CL) or a less skilled, moderately active house league group (HL). Eating habits were recorded during a school day from a 24 hour recall questionnaire administered by a trained interviewer. The types and amounts of foods eaten were recorded and caloric intake was calculated. The total caloric intakes were not significantly different by age or competitive group. The boys had higher caloric intakes by age (200 kcal day-1) than reported by other studies but the caloric intake by kilogram of body weight was similar. There was a trend towards larger caloric intake by the CL boys (ages 10 and 11 years), however when divided by body weight the differences were not significant suggesting that this trend was due to a greater body weight of the CL boys and not a significantly increased caloric expenditure. The types of foods eaten (fruit, vegetables, dairy, meat, bread or "empty calories") were similar for the two activity groups and across ages 10 to 14 years. The caloric intakes of dairy and meat products of both groups were significantly higher than for the other food groups.

Adolescent

Effects of smoking cessation on caloric intake and weight gain in an inpatient unit.

The present research was designed to assess the amount of weight gain that would occur when male smokers in an inpatient setting were deprived of cigarettes for 10 days, and to evaluate factors that could contribute to that weight gain, such as caloric intake and activity level. Subjects were 17 healthy male smokers who either smoked ad libitum (n = 8) or quit smoking (n = 9) for 10 days after a 3 day smoking baseline. Caloric intake, activity levels, and body weight were assessed daily. Abstainers gained more weight than did smokers and ate more over time. There were no group differences in activity level. An analysis of energy needs versus actual energy intake suggests that caloric intake accounted for a large percentage of the post-cessation weight gain. However, considerable individual variability exists in caloric intake after smoking cessation. In addition, the study found post-cessation increases in caloric intake that were quite similar to those found in studies with females, suggesting that gender may have little to do with overall post-cessation caloric intake. Further research assessing dietary and metabolic changes after smoking cessation in a larger sample of both males and females is needed so that the reasons for and implications of dietary variability can be evaluated.

Adolescent

Small intestine of artificially reared rat pups: effect of caloric intake and dietary composition on growth and disaccharidase activities.

When rats were fed a cow milk formula (CMF) from 12 to 16 days of age at a caloric intake sufficient to support a body weight gain equal to mother-fed (MF) rats, their small intestine outweighed that of MF rats by 40%. If the caloric intake was reduced by approximately 40%, artificially reared (AR) rats exhibited intestinal weights similar to MF rats, but their body weight was lower than MF rats. Sucrase specific activity was precociously increased in all AR rats; this increase was higher in rats with low caloric intake than rats with high caloric intake. Conversely, lactase specific activity was significantly decreased in the ileum of all AR rats. As compared to MF rats, the total lactase activity was significantly lower only in rats with low caloric intake. When AR rats were fed a modified Ross Carbohydrate-Free formula (RCF) containing the same caloric density of protein, fat, and carbohydrate as rat milk, the intestinal growth and disaccharidase activities were the same as those of AR rats fed CMF. It is concluded that the weight gain of small intestine depends on the caloric intake of AR rats and both CMF and RCF are nutritionally equal in supporting intestinal growth. Changes in sucrase and lactase activities in AR rats appear to have no relation to compositional differences in CMF and RCF.

Animals

Study of daily caloric intake of patients in the coronary intensive care unit.

A retrospective analysis of the caloric intake of patients in the coronary intensive care unit was undertaken after discovery of two cases of severe hypoglycemia. An unsuspected number of extremely low daily caloric intakes were found after careful analyses. The surviving group (50 patients) had less than 600 calories on 19.5% of the patient days and under 800 calories on 28.8% of patient days. In the nonsurviving group (29 patients) caloric intake was under 600 calories on 48.8% of patient days and under 200 calories on 22.7% of patient days. This study indicates the importance of monitoring actual caloric intake to avoid unrecognized extreme caloric deprivation and its possible complications.

Coronary Care Units

Caloric intake and activity levels are related in young children.

In this study the relationship between caloric intake and activity levels was examined in forty-three 18-month-old children. Caloric consumption was measured during a laboratory meal, and activity levels were assessed using an ambulatory monitor over a 24-hour period. Caloric intake was found to be significantly correlated with activity levels, such that children with a high caloric intake tended to have lower activity levels. This finding suggests that two risk factors influencing the development of obesity, caloric intake and physical activity levels, are likely to occur together in a subset of young children. A possible mechanism underlying this association is discussed.

Child Behavior

Excessive dietary protein and suboptimal caloric intake have a negative effect on the growth of children with chronic renal disease before and during growth hormone therapy.

Although diet and nutrition are an integral part of the management of individuals with chronic renal failure (CRF), little has been written on the effect of nutrition on the growth response to growth hormone (GH) in CRF. We studied the GH axis and nutritional status of 31 prepubertal children aged 8.7 +/- 0.5 years with a height standard deviation score (SDS) of -3.2 +/- 0.2 (mean +/- SEM) with CRF. Sixteen CRF patients on hemodialysis and 15 on peritoneal dialysis were studied. Forty-four age-matched normal short children without GH deficiency served as controls. Spontaneous 12-hour GH and stimulated GH values were significantly higher and GH binding protein (GHBP) was significantly lower in the CRF patients than in the normal short children. Both before the initiation of GH therapy and after the first year of treatment, the growth velocity (SDS) was inversely correlated with dietary protein intake and positively correlated with caloric intake. GH was administered at a dosage of 28 and 21 IU/m2/wk to the CRF group and the normal short children, respectively, divided into seven daily doses. The growth response of the normal short children was significantly greater than that of the CRF patients. GH therapy induced a smaller increment in GHBP and IGF-I in the CRF patients versus the normal short children (8.8 +/- 2.2 and 10.2 +/- 2.7 v 24.8 +/- 1.3 and 27.6 +/- 2.5 nmol/L, respectively, P < .01). The 1-year growth velocity of the CRF children was most closely correlated with dietary protein and caloric intake. The nutritional status of CRF patients is concluded to be a major factor in growth both before and during GH therapy.

Alkaline Phosphatase

Daily caloric intake in intact and chronic decerebrate rats.

Daily caloric intake regulation was studied in chronic supracollicular decerebrate rats with a complete transection of the neural axis at the meso-diencephalic juncture and in intact controls. For 1 week, each rat received 3 intraorally delivered meals per day. They were challenged to maintain their 3-meal daily intake over 1 week in which only 2 meals per day were delivered. Intact rats increased meal size to compensate for the lost opportunity to feed, whereas chronic decerebrate rats did not. Results suggest that, although the caudal brainstem, as previously shown (Grill & Kaplan, 1990), is sufficient to modulate ingestive behavior in taste reactivity and single-meal tests, it is not sufficient to regulate daily caloric intake. Although it is possible that chronic decerebrate rats retain a long-term regulatory competence that is somehow masked under the meal omission paradigm, forebrain-hindbrain interactions appear necessary for the coordination of short- and long-term intake control processes.

Animals