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Nutritional support and growth in thalassaemia major Twelve thalassaemic children under 3 years of age received intensive nutritional support for one month and were discharged on a prescribed diet of locally available foods. Anthropometry, bioelectrical impedance analysis and dietary intake were longitudinally assessed. Mean energy intake was 20% greater than the recommended dailyallowance during nutritional supplementation as compared with below the recommended dailyallowance before
course of intravenous ceftazidime (200 mg/kg/day) and either amikacin (35 mg/kg/day) or tobramycin (15 mg/kg/day). Nutritional evaluation on days 1 and 14 involved measurements of weight, weight/height ratio (per cent of predicted value), energy intake (per cent of recommended dailyallowances), serum prealbumin, and body composition assessed by two methods: bioelectrical analysis (BIA) and skinfold anthropometry. The non-parametric Wilcoxon t test was used for statistical analysis, with a Bland (...) -Altman plot to assess the degree of agreement between the two methods of evaluating body composition.Weight increased by 1.0 (0.8) kg (p < 0.001); weight/height increased from 94.4(12.2)% to 98(12.7)% (p < 0.001), energy intake from 107(32)% to 119(41)% (p < 0.02), and prealbumin from 183 (63) to 276 (89) mg/l (p < 0.001). Fat mass increased by 0.8 (1.0) kg (p < 0.001), without any significant change in fat-free mass. The limits of agreement between BIA and anthropometry were -0.7 kg and +1.1
Factors affecting the variation in plasma phenylalanine in patients with phenylketonuria on diet. The optimal dietary management of children with phenylketonuria (PKU) has rarely been rigorously explored. The aim of this study was to assess longitudinally the effects of three factors thought to influence plasma phenylalanine concentrations in PKU: total energy intake; protein intake from natural foods allowed freely in addition to allocated phenylalanine exchanges; and the distribution (...) % of pre-evening meal plasma phenylalanine concentrations were less than 100 mumol/l in children who had taken at least 65% of their protein substitute by the time of their evening meal. There was no correlation between excess natural protein intake from freely allowed foods and (a) pre-breakfast or pre-evening meal plasma phenylalanine concentrations or (b) the daily change between pre-breakfast and pre-evening meal concentrations. Nor was there any correlation between excess natural protein intake
Definition and prevalence of sedentarism in an urban population. The present study sought to formulate a precise definition of sedentarism and to identify activities performed by active people that could serve as effective preventive goals.A population-based sample of 919 residents of Geneva, Switzerland, aged 35 to 74 years, completed a 24-hour recall. Sedentary people were defined as those expending less than 10% of their dailyenergy in the performance of moderate- and high-intensity (...) activities (at least 4 times the basal metabolism rate).The rates of sedentarism were 79.5% in men and 87.2% in women. Among sedentary and active men, average dailyenergy expenditures were 2600 kcal (95% confidence interval [CI] = 2552, 2648) and 3226 kcal (95% CI = 3110, 3346), respectively; the corresponding averages for women were 2092 kcal (95% CI = 2064, 2120) and 2356 kcal (95% CI = 2274, 2440). The main moderate- and high-intensity activities among active people were sports (tennis, gymnastics
Why does congenital heart disease cause failure to thrive? Metabolisable energy intake, determined by bomb calorimetry of food, vomit, stool and urine, and resting metabolism, assessed by respiratory gas exchange, were studied in 21 infants with congenital heart disease and nine control infants. Weight for age, growth rates, and daily metabolisable energy intake per kg tended to be lower in infants with heart disease than in control infants. Resting oxygen consumption was high in those infants (...) with pulmonary hypertension and persistent cardiac failure. Energy intake, as a percentage of that recommended for age, correlated with weight gain, and resting oxygen consumption correlated inversely with both percentage body mass index and relative fatness. Failure to thrive in infants with congenital heart disease may be due to a combination of low energy intakes and, in some cases, high energy requirements allowing insufficient energy for normal growth. Increasing the energy intakes of infants
Growth hormone stimulates protein synthesis during hypocaloric parenteral nutrition. Role of hormonal-substrate environment. The influence of growth hormone (GH) on protein metabolism and fuel utilization was investigated in eight paired studies of normal volunteers. GH (10 mg) was given daily during one period, and saline was injected during control studies. For 6 days, subjects received parenteral nutrition that provided adequate dietary nitrogen, vitamin, and minerals, but energy intake (...) retention and protein synthesis. GH may be beneficial in promoting protein synthesis in surgical patients, particularly in association with hypocaloric glucose infusions that allow utilization of body fat as an energy source.
on a daily and cumulative basis. The presence of ketosis was not related to an improvement in nitrogen balance. In conclusion, the addition of glycerol to dilute amino acid solutions is safe and improves nitrogen balance in the postoperative period. Additionally, use of the nonreducing sugar, glycerol, allows the manufacturer to sterilize amino acids and an energy substrate in a single unit. By precluding the need for admixing in the hospital pharmacy, risk of contamination may be reduced. (...) received the control solution and 48 patients received the experimental solution in a double-blind, randomized trial for five consecutive postoperative days. A complete hematologic and biochemical assessment was carried out daily throughout the five day infusion period and two days after the termination of infusion. Nitrogen balance data were collected on each infusion day. Results indicate that the glycerol containing solution is safe and contributes to an improvement in nitrogen homeostasis
) of epinephrine to affect MR was 90 pg/ml, a concentration frequently occurring in daily life. Thus epinephrine may play an important role in weight maintenance by affecting energy expenditure. (...) Physiological increments in epinephrine stimulate metabolic rate in humans. Markedly elevated plasma epinephrine is known to increase metabolic rate (MR), but such levels of epinephrine are encountered infrequently in normal free-living subjects. We studied whether epinephrine levels common in usual daily activities can affect MR and thus possibly regulate caloric expenditure. To aid definition of a MR threshold, we first measured the hourly and daily variation in MR within individuals
on substitution of lower-fat foods for high-fat foods and maintenance of nutritional adequacy. Nutrient intakes were calculated from 4-day food records collected at baseline and after 3 months of diet intervention. Mean daily fat intake for the 17 patients on the low-fat diet dropped significantly from 38.4 +/- 4.3% of energy intake at baseline to 22.8 +/- 7.8% at 3 months (p less than .001). A 25% reduction in mean energy intake, from 1,840 +/- 419 kcal at baseline to 1,365 +/- 291 kcal at 3 months (...) , was accompanied by significant increases in protein and carbohydrate as percent of energy intake. A mean weight loss of 2.8 kg and a 7.7% reduction in serum cholesterol were observed; both changes were significant at the p less than .01 level. Absolute intakes of zinc and magnesium were significantly reduced. However, mean intake on the low-fat diet for 14 vitamins and minerals, including zinc and magnesium, exceeded two-thirds of the 1989 Recommended Dietary Allowances (RDAs). When expressed as nutrient
, and 48 to receive no nutritional counseling and consumption of an ad lib oral intake. The intervention group was counseled to achieve a dailyenergy and protein intake according to recommended dietary allowances. Counseling was standardized and performed by a trained dietitian, and took place twice monthly during a 5-month period from start of chemotherapy.Dietary counseling increased dailyenergy intake by approximately 1 MJ and protein intake by 10 g over the entire study period
The polyp prevention trial I: rationale, design, recruitment, and baseline participant characteristics. The Polyp Prevention Trial (PPT) is a multicenter randomized controlled trial examining the effect of a low-fat (20% of total energy intake), high-fiber (18 g/1000 kcal), high-vegetable and -fruit (5-8 daily servings) dietary pattern on the recurrence of adenomatous polyps of the large bowel, precursors of most colorectal malignancies. Eligibility criteria include one or more adenomas removed (...) ) to T(4)), which permits a 1-year lag time for the intervention to work and allows a more definitive clearing of lesions at T(1), given that at least 10-15% of polyps may be missed at baseline. The final (T(4)) colonoscopies are expected to be completed in early 1998.
mg acutely (n = 6) or a placebo (n = 5). A dose of dF 15 mg twice daily or placebo was then administered over 15 days (chronic). To obtain serum peak level of the drug, dF was administered 2 hours before starting palmitate infusion. A free diet was allowed throughout the study, and the group treated with dF lost approximately 0.5 kg body weight. Acute and chronic dF administration resulted in a significant increase in FFA oxidation, expressed as a percentage of the dose of radiocarbon (...) ratio (WHR) was 0.91 +/- 0.04. Fat body mass and lean body mass, assessed by dual-energy x-ray densitometry, were 32.0 +/- 1.5 and 49.30 +/- 2.67 kg, respectively. All patients had an average hemoglobin A1 of 6.3% +/- 0.3% in the month preceding the study and had not received oral hypoglycemic agents. Gas exchange was measured both basally and during a ventilated-hood system, indirect-calorimetry session. The protocol was a randomized, placebo-controlled, single-blind design. Subjects received dF 30
Effects of dairy products on bone and body composition in pubertal girls. To study the effect of calcium supplementation with dairy products on the bone and body composition of pubertal girls.Randomized control study with 12-month follow-up.General community.Forty-eight white girls whose mean age was 11 years and sexual development at Tanner stage 2.One group's diet was supplemented with dairy products to the recommended dietary allowance of 1200 mg calcium daily. The other group ate (...) their usual diet.Bone mineral content and density were measured at the radius, femoral neck, lumbar spine, and total body bone mineral by single-photon and dual-energy x-ray absorptiometry at the start of the study and after 3, 6, 9, and 12 months. Body composition (lean body mass and body fat) was measured by dual-energy x-ray absorptiometry at the same intervals. Serum calcium, phosphate, 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D, alkaline phosphatase, magnesium, and albumin concentrations were
Weight-bearing exercise and ground reaction forces: a 12-month randomized controlled trial of effects on bone mineral density in healthy postmenopausal women. The effects of brief daily exercise on bone mineral density (BMD) were assessed in a randomized controlled trial in 44 healthy postmenopausal women using weight-bearing exercise in a regimen adapted from osteogenic protocols reported in animal studies. BMD was assessed masked using dual energy X-ray absorptiometry at 0, 6, and 12 months (...) . The control group also attended a weekly exercise class run by the same teacher, which included only low-impact activity, and did flexibility exercises at home daily. The ground reaction forces (as a ratio of body weight) during heel drops were 2.5 to 3.0 N/N, with a rate of rise of 50-100 kN/sec. A patient with an instrumented femoral implant allowed comparison of compressive axial forces in the shaft of the proximal femur with the ground reaction forces, and these appeared to be transmitted undamped
care consisting of wound cleaning twice daily, application of moist dressings, and continuous relief of pressure until the wounds were healed. The laser protocol consisted of three treatments weekly using a cluster probe with an 820-nm laser diode and 30 superluminous diodes (10 each at 660, 880, and 950 nm), and energy density of 4J/cm2, and a pulse repetition rate of 5,000 pulses per second. The US/UVC regimen consisted of five treatments weekly, alternating the treatment modality daily (...) -Scan Measurement System. Weekly percentage changes in wound area were compared.Results showed that US/UVC treatment had a greater effect on wound healing than did nursing care, either alone or combined with laser.Ultrasound/ultraviolet-C may decrease healing time and may allow faster return to rehabilitation programs, work, and leisure activities for patients with spinal cord injury who have pressure ulcers.
injured (injury severity score [ISS] = 31 +/- 2), highly catabolic (N loss = 19 +/- 2 g/d), hypermetabolic (resting energy expenditure [REE] = 141 +/- 5% basal energy expenditure [BEE]), adult (age 46 +/- 5 y) multiple-trauma victims, before starting nutrition therapy and its modification after 1 wk of rhGH supplementation with TPN (1.1 x REE calories, 250 mg N.kg-1.d-1). Group H (n = 10) randomly received at 8:00 a.m. on a daily basis rhGH (0.15 mg.kg-1.d-1) and Group C (n = 10) received the vehicle (...) of infusion. Protein metabolism (turnover, synthesis and breakdown rates, and N balance); glucose kinetics (production, oxidation, and recycling); lipid metabolism, (lipolysis and fat oxidation rates), daily metabolic and fuel substrate oxidation rate (indirect calorimetry); and plasma levels of hormones, substrates, and amino acids were quantified. In group H compared to group C: N balance is less negative (-41 +/- 18 vs -121 +/- 19 mg N.kg-1.d-1, P = 0.001); whole body protein synthesis rate is 28 +/- 2
energy expenditure-fat diet, where fat intake was =20% resting energy expenditure): Group B on a low fat diet from the National Cholesterol Education program (National Cholesterol Education Program step 2 diet): Group C on resting energy expenditure-fat diet+simvastatin 10mg daily; Group D on National Cholesterol Education Program step 2 diet+simvastatin 10mg daily. For all patients the prescribed energy intakes were equal to their respective resting energy expenditures.At 6 months, the average (...) hundred and twenty-six male patients (all ex-smokers) with coronary heart disease and a serum LDL cholesterol >3.37mmol x l-1 were investigated 12-14 weeks after an acute coronary event. After overnight fasting each patient had (a) his resting energy expenditure measured (indirect calorimetry using standard protocol) and (b) venous blood sampled from a forearm vein to determine lipid profile. All the patients were randomly allocated to four groups of treatment: Group A on a very low fat diet (resting
after gastrectomy.At this time point we found normal blood levels of vitamin D, calcium, and phosphate. Food intakes of phosphate, calcium, magnesium, and vitamin D reached the recommended dailyallowances. Bone mineral density was similar to that of a control population, and increasing values were seen concomitant with an increase in body weight with the time after gastrectomy.Calcium homeostasis and bone mineral densities seem not to be affected by total gastrectomy, at least when studied over (...) Osteoporosis after total gastrectomy. Results of a prospective, clinical study. Osteopenia and enhanced risk of fractures have been reported after partial gastrectomy, but the significance of total gastrectomy is still unknown.Twenty-six patients were followed up for at least 3 years after total gastrectomy. The intake and S-levels of vitamin D, phosphate, magnesium, and calcium were prospectively studied, and a whole-body dual-energy X-ray absorptiometry scan was performed at a mean of 5 years
/day. The effect varied significantly and was greater in patients with a high output, but did not allow parenteral nutrition to be discontinued. Absorption of energy, macronutrients, electrolytes, and divalent cations was not improved. The effect of ranitidine was not significant, possibly because the dose was too low. (...) Effect of intravenous ranitidine and omeprazole on intestinal absorption of water, sodium, and macronutrients in patients with intestinal resection. H2 receptor blockers and proton pump inhibitors reduce intestinal output in patients with short bowel syndrome.To evaluate the effect of intravenous omeprazole and ranitidine on water, electrolyte, macronutrient, and energy absorption in patients with intestinal resection.Thirteen patients with a faecal weight above 1.5 kg/day (range 1.7-5.7 kg/day
subjects have not been tested thoroughly. A 17-wk randomized controlled trial was performed in 145 free-living frail elderly people (43 men, 102 women, mean age, 78 +/- 5.7 y). Based on a 2 x 2 factorial design, subjects were assigned to one of the following: 1) nutrient-dense foods, 2) exercise, 3) both (1) and (2) or 4) a control group. Foods were enriched with micronutrients, frequently characterized as deficient [25-100% of the recommended dailyallowance (RDA)] in elderly people. Exercises focused (...) on skill training, including strength, endurance, coordination and flexibility. Dietary intake, blood vitamin levels and nutritional and health indicators, including (pre)albumin, ferritin, transferrin, C-reactive protein, hemoglobin and lymphocytes were measured. At baseline, 28% of the total population had an energy intake below 6.3 MJ, up to a maximum of 93% having vitamin intakes below two thirds of the Dutch RDA. Individual deficiencies in blood at baseline ranged from 3% for erythrocyte