摘要:

Eight obese children and adolescents, mean age (+/−SD) 12.0 +/−2.5 years, were treated for 3 weeks with a liquid formula very low calorie diet (VLCD), containing 320 kcal/1339 kj (44 g protein, 33 g carbohydrate, 0.9 g fat). Weight loss after 3 weeks was 8.0 +/−1.8 kg resulting in 15.3 +/−4.6% reduction of body overweight. During the dietary period no patient complained of hunger and no serious side effects were observed. Four patients achieved positive N-balance during the second week, all but one in the third week. Mean cumulative N-balance after 3 weeks was calculated to be−23.2 +/−31.6 gN. Great interindividual variances were observed in the rate of N-loss during the course of the study. No significant correlation was found between cumulative N-balance and weight loss or initial body weight. Blood parameters remained unaffected, except for glucose and urea, which decreased slightly from 74.6 +/−13.6 to 50.4 +/−20.1 mg/dl and from 14.1 +/−4.3 to 8.6 +/−7.4 mg/dl, respectively. Uric acid concentrations increased slightly, three of eight patients had levels higher than 8 mg/dl and therefore were treated with allopurinol. Total serum protein decreased; serum albumin values did not change. The type of VLCD used in this study proved therapeutically useful in achieving rapid weight loss. Compared with VLCD containing 30% less protein and carbohydrate, a marked improvement of N-balance in 3 weeks could be achieved with the VLCD containing 1 g protein/kg IBW/day. This amount of protein seems to be necessary to obtain the nitrogen sparing effect in children and adolescents undergoing weight reduction with VLCDs.

ISSN:0731-5724    

DOI:10.1080/07315724.1987.10720205

出版商:Routledge    

年代:1987

数据来源: Taylor

摘要:

Dietary factors ingested in excess, deficient, or in imbalance have been implicated in the etiology, and corrected in the management of cardiovascular diseases, namely atherosclerosis and hypertension. Dietary factors include: calories; fats; cholesterol and other sterols; complex and simple carbohydrates; animal and vegetable protein; alcohol; and minerals. Atherogenesis from diets high in total and saturated fat and cholesterol may relate to increases in plasma total, low- or very low-density lipoprotein cholesterol or triglycerides, or decrease in high density lipoprotein cholesterol, or altered apolipoproteins. A variety of dietary manipulations can influence these lipid and lipoprotein levels and thereby reduce cardiovascular risk. Plasma lipid and lipoprotein levels in the population vary with age, gender, and race; cardiovascular risk is increased when cholesterol levels exceed the 75th or 90th percentile for healthy men and women for age. Abnormally high levels of plasma cholesterol or triglycerides in different lipoprotein carriers comprise the various hyperlipoproteinemias. The clinical presentations and dietary management of elevated LDL cholesterol, and/or VLDL and/or chylomicron triglycerides, or increased intermediate density lipoproteins are reviewed and discussed. Attention should be paid to family screening, and hyperlipidemias secondary to diseases or medication should be considered. Dietary counseling and management is advised for children at risk of hyperlipidemia and for adult patients up to 70 years of age. If lipids and lipoproteins are not normalized, then lipid-lowering drug therapy should be considered in adults. For control of hypertension, attention should be paid to calories and alcohol, and to calcium, potassium, and sodium.

ISSN:0731-5724    

DOI:10.1080/07315724.1987.10720206

出版商:Routledge    

年代:1987

数据来源: Taylor

摘要:

Folate, thiamin, nicotinate, biotin, riboflavin, pantothenate, vitamins A, B6, B12, C, E, and beta-carotene were determined in: (a) eight patients before and after one plasma exchange; (b) in one patient after five consecutive treatments; (c) in three patients before and 2-8 weeks after plasmapheresis. Vitamin B12, beta-carotene, vitamin B6, and vitamins A, C, E were depressed after acute or chronic plasmapheresis. Concentrations of folate, thiamin, nicotinate, biotin, riboflavin, and pantothenate were essentially unchanged after one plasma exchange.

ISSN:0731-5724    

DOI:10.1080/07315724.1987.10720207

出版商:Routledge    

年代:1987

数据来源: Taylor

摘要:

Hepatic concentrations of copper (Cu) and zinc (Zn) were studied in 38 fetuses and infants, who died of various causes, from 26 weeks of gestation up to 16 weeks post-natally. The six fetuses of 28-32 weeks gestation had median and mean hepatic Cu concentrations micrograms/g fresh tissue) comparable to those found in the 21 born at term, but the range of values was much narrower: all of the Cu values for those born prematurely were at or below 40 micrograms/g. Values at 10 micrograms/g and below were found in five infants at term and five who died at 1-4 months of age. There was a comparable range of Zn values for both pre-term and term babies (10 to 300 micrograms/g fresh tissue). The value of 10 micrograms/g was found only in one 4-month-old infant. The accumulation of both Cu and Zn occurs independently in the fetuses. The socioeconomic status did not influence significantly the concentration of liver Cu or Zn in babies born at term. However, size of babies as measured by liver weight showed that larger babies had significantly higher mean Cu concentration (37 +/−24 micrograms/g) than smaller babies (21 +/−14 micrograms/g. The same trend, but without significant difference, was observed for hepatic Zn between larger (104 +/−78 micrograms/g) and smaller (74 +/−59 micrograms/g babies.

ISSN:0731-5724    

DOI:10.1080/07315724.1987.10720208

出版商:Routledge    

年代:1987

数据来源: Taylor

摘要:

Seven elderly male subjects (69 +/−3 yr, 67.8 +/−9.2 kg, 24.5 +/−3.6% body fat) lived for 12 consecutive weeks in a metabolic unit and maintained their weight with two different diets fed for 6 weeks each: Diet A, consisted of their habitual protein intake as determined on the outside by a dietary record (mean +/−SD, 1.12 +/−0.22 g/kg d). Diet B was an isocaloric diet with reduced protein intake (70 mgN/kg d, i.e., 0.44 g protein/kg d) at the level of physiological protein requirement [7]. After 3 weeks on each diet, the thermogenic response to single meals A and B containing 38% of weight maintenance energy for each subject (731-994 kcal) was studied by indirect calorimetry under two situations: (1) at rest over a 4 hr period and (2) during graded exercise on a bicycle ergometer at four stepwise workloads (0,80, 200, and 300 kg/min). A postabsorptive control exercise was also performed in order to assess the net effect of the meal during exercise. Eating alone increased the energy expenditure by +0.18 +/−0.07 kcal/min with meal A and +0.13 +/−0.06 kcal/min with meal B. There was a positive correlation (r = 0.84, p less than 0.01) between the % energy derived from protein and the thermogenic response expressed as % of the energy content of test meal. Exercise failed to influence the thermogenic response to meals since the overall net increase in energy expenditure induced by the meals while exercising was not different from that obtained at rest: +0.22 +/−0.17 kcal/min and +0.15 +/−0.13 kcal/min with meal A and meal B, respectively. This study failed to show any interaction between exercise and postprandial thermogenesis in elderly individuals.

ISSN:0731-5724    

DOI:10.1080/07315724.1987.10720209

出版商:Routledge    

年代:1987

数据来源: Taylor

摘要:

Carbohydrate intolerance is positively correlated with animal fat consumption and is more common in beef eating populations. In contrast, individuals consuming diets comprised of polyunsaturated fats have a lower incidence of diabetes mellitus. To test the hypothesis that dietary fats may influence carbohydrate metabolism, serum glucose, insulin, and gastric inhibitory polypeptide (GIP) responses to three mixed test meals of varying fatty acid composition were assessed in 12 normal subjects. Fatty acids in the meals were either saturated fats or polyunsaturated fats derived from vegetables or fish. Each test meal provided 40% of a subject's calculated daily caloric requirement and contained approximately 45% carbohydrate, 40% fat, and 15% protein. Serum insulin responses were 62% higher (p less than 0.01) after the fish and 39% higher (p less than 0.01) after the vegetable meals compared to the saturated fat meal. No significant differences in insulin responses were observed between the vegetable and fish meals. Serum glucose concentration was slightly higher (p less than 0.02) during the fish meal than with the vegetable or saturated fat meals. The GIP levels were comparable following the fish and vegetable meals and were 25% lower than those observed with the saturated fat meal. These findings suggest that diets enriched with polyunsaturated fatty acids augment insulin secretion significantly more than a diet comprised primarily of saturated fatty acids. The mechanism for this increased insulin secretion is unknown but did not appear to be mediated through differences in serum glucose values or through the insulin-otrophic effects of GIP.(ABSTRACT TRUNCATED AT 250 WORDS)

ISSN:0731-5724    

DOI:10.1080/07315724.1987.10720210

出版商:Routledge    

年代:1987

数据来源: Taylor

摘要:

We describe five patients who developed acute kwashiorkor-like hypoalbuminemia during their hospitalization in the intensive care unit. With the initiation of enteral alimentation, diarrhea ensued and continued for at least 48 hours. Routine evaluation for the cause of diarrhea including stool culture for enteric pathogens, white blood cells, ova and parasites, Clostridium difficile cytotoxin, and flexible sigmoidoscopy was negative. When a peptide based formula (Vital HN, Ross Laboratories, Columbus, OH) was initiated, there was a significant reduction in stool output within 24 hours. In three of the five cases, hypoalbuminemia corrected within 2 weeks. Four of the five patients were discharged from the hospital. Although several reports have acknowledged the association between hypoalbuminemia and impaired gastrointestinal absorption, no previous enteral formula has been tolerated in these acutely ill patients until serum albumin levels had improved. Further studies will be required to confirm the better gastrointestinal tolerance of this peptide based formula in patients with severe hypoalbuminemia.

ISSN:0731-5724    

DOI:10.1080/07315724.1987.10720211

出版商:Routledge    

年代:1987

数据来源: Taylor

摘要:

In a prospective, single blind study, 51 adult diabetic, male outpatients at or below ideal body weight (IBW), all but four of whom were insulin-treated, were randomly assigned to a calorically defined exchange diet (EXCH) or an unmeasured diet avoiding refined sugars (UNMEAS). Fasting chemistries, weights and 48-hr dietary recalls were obtained every 3 months for 3 years. There was no difference between groups in mean body weight, mean caloric intake, percentages of carbohydrate or fat intake, day to day consistency of caloric intake, or fasting chemistries. The patients whose actual weight tended to be less than IBW consumed more calories than their theoretical calculated needs (p = 0.002) without effect on glycemic control or stability of weight. Patients with low carbohydrate intake (less than 30%) had significantly higher triglyceride levels (p = 0.015). Otherwise, variations in dietary patterns were not reflected in fasting clinical chemistries. Individual fasting serum glucose levels were not related to consistency of carbohydrate intake, caloric distribution throughout the day or composition of diets. These results suggest that actual dietary patterns of subjects following exchange diabetic diets with precise caloric prescriptions are similar to those resulting from unmeasured diets with restriction of simple sugars. Other than correlation between carbohydrate intake and triglycerides, there was no detectable effect of variations in dietary patterns upon conventional chemical metabolic levels.

ISSN:0731-5724    

DOI:10.1080/07315724.1987.10720212

出版商:Routledge    

年代:1987

数据来源: Taylor

摘要:

This study provides preliminary data on the influence of ingestion of 15 g of dietary fiber daily for 4 weeks on weight change and serum iron concentrations in obese children. During two consecutive 4-week periods, subjects received either fiber/placebo supplements or placebo/fiber supplements. Initially, and after the fourth and eighth weeks, height, weight, and serum iron concentration were obtained. Diet records were maintained throughout the study. No significant differences (p less than or equal to 0.05) were found in weight change, energy, iron, and crude fiber intakes and serum iron concentrations of the subjects between periods of fiber and placebo supplementation. However, mean weight loss of subjects (336 g) was greater during fiber ingestion than during placebo ingestion (33 g). Due to the small sample size and the subjects' poor compliance, further studies are needed, with a larger sample size, to determine the effectiveness of different fibers in the treatment of obesity.

ISSN:0731-5724    

DOI:10.1080/07315724.1987.10720213

出版商:Routledge    

年代:1987

数据来源: Taylor

ISSN:0731-5724    

DOI:10.1080/07315724.1987.10737931

出版商:Routledge    

年代:1987

数据来源: Taylor