ISSN:0731-5724    

DOI:10.1080/07315724.1992.10718222

出版商:Routledge    

年代:1992

数据来源: Taylor

ISSN:0731-5724    

DOI:10.1080/07315724.1992.10718223

出版商:Routledge    

年代:1992

数据来源: Taylor

摘要:

Caloric restriction during pregnancy is contraindicated for women with a normal body mass index (BMI) of 19.8-26 kg/m2. Reduction of caloric intake in obese pregnant normal and diabetic women has been a controversial topic for many years. This paper reviews several clinical studies initiated in 1978 at the University of California, San Diego. One focus of this review concerns modest caloric reduction in obese women with gestational diabetes mellitus (GDM). Metabolic observations of diabetes during pregnancy in the past decade include extensive use of a 400 kcal isocaloric breakfast meal tolerance test to assess maternal glucose:insulin relationships and the degree of insulin resistance in obese pregnant subjects. We have previously reported that maternal hyperinsulinemia with or without maternal hyperglycemia is an important factor in fetal macrosomia. We suggest for obese pregnant diabetic women implementation of nutritional recommendations of the 1990 Committee on Nutritional Status During Pregnancy and Lactation, Food and Nutrition Board, Institute of Medicine, National Academy of Sciences that advise a lower caloric intake for obese normal pregnant women with BMIs greater than 26. In obese noninsulin-dependent diabetic women and those with GDM, we urge that a large prospective epidemiologic study be undertaken to assess the respective roles of modest maternal caloric restriction and maternal glucose:insulin relationships on neonatal and long-term longitudinal measurements of growth and development of children of diabetic mothers.

ISSN:0731-5724    

DOI:10.1080/07315724.1992.10718224

出版商:Routledge    

年代:1992

数据来源: Taylor

摘要:

Variations in nutritional intake during pregnancy have measurable effects on the circulating levels of maternal nutrients, maternal weight gain, and birth weight of the offspring. A growing body of evidence indicates that alterations in maternal metabolism can also have long-term consequences in the offspring in relation to adult adiposity, glucose tolerance, and perhaps intellectual development. Therefore, recommendations for diet during pregnancy must be made with great care, and with as much scientific understanding as possible. Nutritional advice traditionally given to all pregnant women, including those with gestational diabetes mellitus (GDM) or noninsulin-dependent diabetes, does not allow for individual differences in caloric needs as a function of the degree of maternal obesity and thus, may encourage excessive weight gain. Evidence reviewed below suggests that adjusting caloric intake to meet new guidelines for weight gain during pregnancy may be advantageous in reducing maternal blood sugar and insulin levels, without producing abnormalities in other metabolic variables. Modest caloric reduction which limits excessive weight gain in the mother may also be associated with a small reduction of fetal weight. However, more stringent dietary manipulations in obese gravida should be discouraged as a routine measure until more knowledge is available from large-scale clinical trials about their effects on the entire panoply of maternal nutrients and their impact on the offspring.

ISSN:0731-5724    

DOI:10.1080/07315724.1992.10718225

出版商:Routledge    

年代:1992

数据来源: Taylor

摘要:

A pilot study with four women (40-60% above ideal weight, 32-42 years old) was conducted for 6 weeks of weight maintenance, 12 weeks at 50% calories (1000 and 1200 kcal/day) and 6 weeks of weight maintenance after weight loss. Two women consumed 17% and two 32% of their calories from protein during restriction; their energy metabolism and body composition changes were examined. The use of doubly labeled water for measuring energy expenditure during weight loss was evaluated. Although the 32% protein diet did not reduce lean body tissue loss, the apparent increased efficiency of calorie utilization compared to the 17% protein diet is worthy of further investigation. Thermic effect of a meal was greatly reduced in these women compared to previously reported responses. Further refinements of the doubly labeled water method are needed prior to application in weight loss studies.

ISSN:0731-5724    

DOI:10.1080/07315724.1992.10718226

出版商:Routledge    

年代:1992

数据来源: Taylor

摘要:

The aim of this study was to investigate the effect of daytime on resting energy expenditure (REE) and thermic effect of food (TEF), REE and TEF were measured in 11 obese boys (mean age +/−SD 11.9 +/−1.6 years; body mass index 30.1 +/−4.0 kg/m2) by indirect calorimetry (SensorMedics 2900) on two consecutive days: early in the morning (7:30 a.m.) on one day and at 12 noon on the other day or vice versa. REE was measured for 30 minutes and TEF for 180 minutes after a 600 kcal liquid meal containing 13% protein, 39% fat and 48% carbohydrates. REE measured in the morning was not statistically different from that measured at noon (2191 +/−358 vs 2223 +/−319 kcal/24 hours) and morning values were highly correlated with afternoon values (r2 = 0.805). Therefore we conclude that the effect of daytime is negligible for measurements of REE if the patients are in a postabsorptive state and avoid physical activity and stress 10-12 hours prior to measurements. The thermic effect of food calculated in the morning also was not statistically significantly from values found in the afternoon (8.2 +/−8.8% in the morning and 6.6 +/−7.5% in the afternoon). However, because of very high within-patient variability the correlation between morning and afternoon values was weaker than for REE (r2 = 0.289).

ISSN:0731-5724    

DOI:10.1080/07315724.1992.10718227

出版商:Routledge    

年代:1992

数据来源: Taylor

摘要:

To assess the need for postoperative vitamin supplements, intakes and nutritional status of thiamin (B1) and vitamin B6 were studied in 18 female gastroplasty patients who received a placebo or different levels of supplemental vitamins. Postoperative erythrocyte transketolase basal (BA) and thiamin pyrophosphate-stimulated (SA) activities and activity coefficients (AC) correlated significantly with B1 intake. Despite a decrease in apotransketolase, low thiamin intakes were associated with increased AC values during the first 3 months. With return to low B1 intakes following repletion during month 4, the AC values remained normal with low total activities. Both alanine (EALT) and aspartate (EAST) aminotransferase apoenzyme levels declined and AC values increased significantly during the first 3 months. Although the EALT-indices were more sensitive to changes in B6 intake than the EAST-indices, the EASTBA and SA correlated most consistently with the intake. Postoperative dietary intakes of both vitamins were inadequate for maintenance of normal activities of these erythrocyte enzymes. Although B1 intake of greater than or equal to 1.0 mg/day was adequate for maintenance of normal thiamin status in most subjects of this study, supplementation with greater than or equal to 1.5 mg/day is prudent even though it may not prevent the early postoperative loss of apotransketolase. Vitamin B6 intake at the current recommended dietary allowance (1.6 mg) was not adequate to maintain coenzyme saturation of the erythrocyte aminotransferases. Marginal intake of other nutrients may have affected the utilization of both thiamin and vitamin B6.

ISSN:0731-5724    

DOI:10.1080/07315724.1992.10718228

出版商:Routledge    

年代:1992

数据来源: Taylor

摘要:

Dietary intake surveys of rural and urban communities in three Pacific Island countries were conducted using an adjusted 24-hour dietary recall method. Dietary survey samples were drawn from noncommunicable disease surveys of Melanesians and Indians in Fiji, Micronesians in Kiribati and Melanesians in Vanuatu. Comparisons of total energy and macronutrient intakes and of obesity, hypertension, diabetes mellitus, serum cholesterol and physical activity levels revealed similar rural/urban trends. Urban subjects were more obese than rural ones, had higher prevalence rates of diabetes and hypertension, and generally had higher cholesterol levels. Rural subjects were leaner, suffered less from diabetes and hypertension, and had greater total energy intakes than urban dwellers. Rural people ate a greater proportion of carbohydrates, while urban subjects ate proportionally more protein and fat, apart from the outer Kiribati atolls with high coconut intakes. Rural subjects in all three studies had higher levels of physical activity. These studies provide persuasive evidence that exercise as well as diet has a significant effect on rural/urban differentials in obesity and noncommunicable disease, and that energy intake reflects energy expenditure.

ISSN:0731-5724    

DOI:10.1080/07315724.1992.10718229

出版商:Routledge    

年代:1992

数据来源: Taylor

摘要:

Iodine-enriched (IE) eggs are produced by chickens fed a diet containing kelp. These eggs have been reported to reduce plasma cholesterol in humans and experimental animals. The purpose of this study was to determine the effect of the ingestion of one IE egg/day on the plasma lipoprotein cholesterol in borderline and hyperlipidemic individuals ingesting a low-fat diet. One hundred three subjects with entry cholesterol levels greater than 5.17 mmol/L were placed on a low-fat, low-cholesterol diet for 12 weeks. Between weeks 4 and 12, approximately half of the subjects were randomly assigned to either a diet control group (n = 53), or a group who ingested one IE egg/day in addition to this diet (n = 50). Subjects in both the egg group and the diet control group had a significant reduction in total plasma cholesterol (TC) at the end of the study compared with study entry; addition of the egg in the diet did not abolish the TC reduction in the egg group. However, paired comparisons of total and lipoprotein cholesterol levels at the end of the egg intervention period with the end of the initial dietary period demonstrated that the egg group had a significantly greater increase than the diet control group in TC (egg group: 7.2 +/−1.5% increase; diet controls: 1.5 +/−0.9% increase; p less than 0.01) and low-density lipoprotein cholesterol (egg group: 9.2 +/−1.7% increase; diet controls: 3.9 +/−1.5% increase; p less than 0.01). This effect was most pronounced in subjects with higher initial cholesterol levels and subjects with mixed hyperlipidemia (elevated cholesterol and triglyceride). Results suggest that these particular groups of subjects are most susceptible to cholesterol changes associated with ingestion of IE eggs.

ISSN:0731-5724    

DOI:10.1080/07315724.1992.10718230

出版商:Routledge    

年代:1992

数据来源: Taylor

摘要:

In this study, levels and sources of omega-3 fatty acids (FA) available for consumption in the US food supply, dating from 1935, are estimated. omega-3 FA assessed are eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and linolenic acid (LNA). Estimates are based on annual per capita food use data and data on the omega-3 FA content of foods. Although fish use increased, the EPA level was slightly lower in 1985 than in 1935-1939, reflecting a marked decline in use of certain fatty fish. The level of DHA increased, due to greater use of poultry. The level of LNA increased because of greater use of soybean oil. These estimates are currently the only source of data on omega-3 FA in the American diet.

ISSN:0731-5724    

DOI:10.1080/07315724.1992.10718231

出版商:Routledge    

年代:1992

数据来源: Taylor