摘要:

In order to study the usefulness of upper mid-arm circumference (MAC) and mid-arm circumference:head circumference ratio (MAC:HC) measurements in assessing longitudinal growth in hospitalized preterm infants, we prospectively measured weights, lengths, occipitofrontal head circumferences (OFC), MACs, MAC:HCs, weight/length for age, nutritional intakes, and serum transthyretin and albumin levels in 50 preterm, low-birth-weight, appropriate for gestational age newborn infants during their first 4 postnatal weeks and at hospital discharge. At some time during hospitalization, weight measurements were abnormal (greater than or equal to 2SD from the gestational age mean) in 48% of the infants as compared with 24% with abnormal MAC measurements (p = 0.002). Abnormal MAC:HCs occurred in 25% of the infants as compared with 68% with abnormal weight/length for age values (p less than 0.001). During weeks 2-4, when nutritional intakes were adequate and serum transthyretin and albumin levels were normal, mean weight gain velocity was less than intrauterine rates and was significantly slower than MAC velocities, which were at or greater than intrauterine rates (p less than 0.001). At discharge, when all infants were gaining weight at intrauterine rates, weight measurements were still abnormal in 28% of the infants as compared with 10% of infants who had abnormal MACs (p = 0.005). Similarly, only 12% of infants had abnormal MAC:HCs as compared with 25% of infants with abnormal weight/length for age values at discharge (p = 0.05). The MAC and MAC:HC are useful for assessing longitudinal growth in preterm infants since they do not overestimate the prevalence of malnourishment during periods of apparent protein-calorie sufficiency.

ISSN:0731-5724    

DOI:10.1080/07315724.1989.10720316

出版商:Routledge    

年代:1989

数据来源: Taylor

摘要:

This study compared bioelectrical impedance analysis (BIA) measurements with current bedside techniques for determination of body composition in 18 normal volunteers to evaluate the relative usefulness of these methods as adjuncts to assessment in surgical nutrition. Anthropometrics (weight, height, and two skinfold thicknesses) and age and sex were used to derive body density (D) or total body water (TBW) by two methods. Method 1: D was calculated from the logarithm of skinfold thickness according to Durnin and Womersley, adapted for age and sex. Method 2: TBW was calculated from height, weight, and sex according to Hume and Weyers. Resistance and reactance were measured with a four terminal impedance plethysmograph; from these data plus height, weight, and sex, lean body mass (LBM) was derived. In each instance, Siri's and Pace and Rathburn's equations were used to derive the remaining parameters of body composition: D, total body fat (TBF), TBW, and LBM. Using the paired t-test, no statistically significant differences were seen in any parameter determined by the different methods. These results show that D, TBW, TBF, and LBM in a population of healthy individuals under steady-state conditions can be estimated by anthropometric-derived formulas with the same relative accuracy as that provided from estimates based upon BIA measurements.

ISSN:0731-5724    

DOI:10.1080/07315724.1989.10720317

出版商:Routledge    

年代:1989

数据来源: Taylor

摘要:

Essential hypertension has long been assumed to be a multifactorial disease. However, recent evidence suggests that it is a syndrome rather than a disease with a common symptom–an elevated blood pressure. One large segment of the hypertensive population–approximately 60%–has in common an increased blood pressure sensitivity to salt intake. Further analysis of this subgroup suggests that it is also heterogeneous, consisting of at least six major entities: renal parenchymal disease, bilateral renal artery stenosis, primary aldosteronism, acromegaly, low renin essential hypertension, and the most recently described entity–nonmodulating essential hypertension. This subset's name is derived from the fact that sodium intake does not modify (modulate) renovascular and adrenal responses to angiotensin II, as occurs in normotensives and modulating hypertensive patients. The following abnormalities have been reported in these patients: (1) a failure of renal blood flow to increase with salt loading; (2) a reduced ability to excrete a salt load; (3) reduced renin suppression both by salt and angiotensin II; and (4) a hypertensive response to salt load. These patients also have a strong family history for hypertension and an increase in erythrocyte sodium countertransport. With a better understanding of the mechanisms underlying the elevated blood pressure in a specific patient, a more rational approach to therapy is possible. For example, in the salt-sensitive hypertensive patient a diuretic would be the presumed treatment of choice. While this is correct for some salt-sensitive hypertensives, in nonmodulators diuretics may be relative ineffective while converting enzyme inhibitors may be more effective because they specifically correct the underlying pathophysiologic derangement.

ISSN:0731-5724    

DOI:10.1080/07315724.1989.10720318

出版商:Routledge    

年代:1989

数据来源: Taylor

摘要:

Changes in electrolyte intake have been advocated to lower the prevalence of hypertension in the normal population. To elucidate the potential impact of such strategies, we conducted a comprehensive analysis of data from three interventions, namely, salt (NaCl) restriction, calcium (Ca) supplementation, and potassium (K) supplementation in normal volunteers. Eighty-two adults lowered their Na intake from 157 +/−6 S.E. to 68 +/−3 mEq/day for 12 weeks. Population mean systolic and diastolic blood pressure decreased less than or equal to 2 mm Hg. Ca supplementation, 1.5 g daily for 12 weeks in 37 men, decreased blood pressure compared to 38 men receiving placebo. Ca supplementation, 1 g daily for 8 weeks in an older group of 44 normal subjects, decreased supine diastolic and standing systolic blood pressure. K supplementation with a nonchloride salt in 64 normal adults for 4 weeks had no effect on systolic or diastolic blood pressure even though urinary excretion was increased by 20 mmol/day. The responses to all interventions were Gaussian in distribution. A potentially adverse effect on blood pressure in some normal individuals cannot be excluded on the basis of the currently available data. Although all three interventions may benefit some hypertensive and some normal individuals, the data from these relatively short-term cross-sectional studies are insufficient to warrant generalized dietary recommendations for the normal population.

ISSN:0731-5724    

DOI:10.1080/07315724.1989.10720319

出版商:Routledge    

年代:1989

数据来源: Taylor

摘要:

Since there is evidence that fat distribution is a better predictor of cardiovascular disease than the degree of obesity, some risk factors for atherosclerosis have been evaluated in middle age Type II male diabetics and in obese subjects with and without glucose intolerance. In non-insulin-dependent diabetics (NIDD), abdominal obesity reflected by the waist/hip-circumference ratio (WHR) is related to parameters of metabolic control, lipid parameters, insulin status and response, hypertension, and vascular complications. High WHR is associated with: (a) significantly (p less than 0.01) higher HbA1 values than in the group without abdominal fat distribution; (b) a highly significant (p less than 0.001) negative correlation with high-density-lipoprotein cholesterol (HDL-C) and a positive correlation with the total/HDL-C ratio, which remains after correction for the body mass index; (c) higher apolipoprotein B concentrations; and (d) an elevated atherogenic index. Both fasting and postprandial insulin and C-peptide values may be a link between abdominal fat deposits and metabolic disturbances. Obese patients with upper body fat accumulation have significantly lower HDL-C levels, and a higher prevalence of glucose intolerance and diabetes than do patients with lower body fat obesity. Fasting glycemia, insulin, and the insulin area under the curve during an oral glucose load are significantly (p less than 0.005) increased in those with the greatest WHR, which is similar to that in NIDD and central obesity. An excess of abdominally located fat, even without manifest obesity, is associated with metabolic disturbances that indicate increased risk of atherogenesis and of higher morbidity and mortality, which may be due to characteristics of abdominally located adipocytes.

ISSN:0731-5724    

DOI:10.1080/07315724.1989.10720320

出版商:Routledge    

年代:1989

数据来源: Taylor

摘要:

In developed countries, the health outcome most under scrutiny with respect to food intake is macrovascular disease. Since food is so complex, global indices of food intake are required to assess the relation. In the present study, an index of food variety was examined for its ability to predict changes in the arterial wall. Arterial wall indices were measured noninvasively by Doppler ultrasound in patient with Type II diabetes and in matched apparently healthy subjects. Each subject kept a 7-day food record, which was cross-checked by a nutritionist so as to calculate an index of food variety. The arterial wall indices measured were compliance over the aorto-iliac segment and pulse wave damping at the common femoral and posterior tibial arteries. Significant correlations, both parametric and nonparametric, were found between total food variety, and plant food variety, and each arterial wall index when the diabetics and apparently healthy subjects were grouped together (p less than 0.01 in all cases for total variety and at least less than 0.05 for plant food variety). Between 13 and 19% of the variance in arterial wall indices was explained by food variety.

ISSN:0731-5724    

DOI:10.1080/07315724.1989.10720321

出版商:Routledge    

年代:1989

数据来源: Taylor

摘要:

A total of 89 subjects including 30 breast cancer patients with distal metastases, 29 patients with benign breast disease, and 30 healthy subjects were studied. Serum samples from these subjects were obtained from the National Cancer Institute (NCI) Breast Cancer Serum Bank, Bethesda. Serum concentrations of vitamin A and its transport proteins (prealbumin and retinol-binding protein [RBP]), beta-carotene, vitamin E, and selenium were determined. For each of these parameters the mean for the breast cancer patients was lower than that of the healthy subjects. The differences between healthy subjects and patients with either breast cancer or benign breast disease were, however, statistically significant only in the case of RBP (p less than 0.05). In the case of vitamin A and its transport proteins these differences were reduced by comparing the cancer patients with the benign breast disease patients rather than with the healthy controls. This indicates that the low serum levels for those three parameters may be merely a consequence of disease in general rather than a feature of cancer per se.

ISSN:0731-5724    

DOI:10.1080/07315724.1989.10720322

出版商:Routledge    

年代:1989

数据来源: Taylor

摘要:

The impact of feeding a hypercaloric parenteral solution on N balance, energy metabolism, and muscle strength has been investigated in cachectic patients with gastrointestinal cancer and in malnourished patients without evidence of cancer (controls). Patients were examined during 5% dextrose administration (D5W) for 2 days, followed by an infusion of a carbohydrate-based (53% carbohydrate, CB) or fat-based (55% fat, FB) diet with a constant protein intake. Diets were administered for 1 week each, in a randomized crossover design. During D5W, cancerous patients demonstrated a similar energy expenditure, but significantly lower N balance (p less than 0.005) than controls. Compared to control patients, N balance in cancerous patients was similar on the CB diet and significantly lower during the FB diet (p less than 0.025). Unlike the control patients, muscle strength and endurance tests did not improve after 2 weeks of feeding in cancerous patients. The cancerous patients differ from controls because they are hypercatabolic (especially during D5W administration), and they showed no improvement in muscle strength with 2 weeks of feeding.

ISSN:0731-5724    

DOI:10.1080/07315724.1989.10720323

出版商:Routledge    

年代:1989

数据来源: Taylor

摘要:

The purpose of this study was to assess the effects of addition of L-glutamine to an IV nutritional solution on the urinary excretion of 3-methylhistidine (3-MeH) and the morphology of the musculature of the gut in rats. Two experiments were run. In experiment 1 glutamine was added to a mildly hypocaloric IV solution which contained no other amino acids. For experiment 2 glutamine was added to an isocaloric balanced amino acid mixture. In both experiments L-alanine was added in equimolar amounts in place of the L-glutamine for the control groups. Providing glutamine in an IV diet without other amino acids significantly decreased urinary 3-MeH excretion (p less than 0.05). Electron microscopy and morphometric analysis of the jejunum showed an approximate 50% loss of musculature from the gut wall in alanine-treated animals. Glutamine supplementation of a balanced amino acid regime had no effect on urinary 3-MeH excretion or the musculature of the jejunum. We concluded that (1) glutamine is a preferred fuel for jejunal smooth muscle as well as for mucosal cells of the jejunum and (2) only when amino acids are limiting does exogenous glutamine prevent atrophy of the gut musculature.

ISSN:0731-5724    

DOI:10.1080/07315724.1989.10720324

出版商:Routledge    

年代:1989

数据来源: Taylor

摘要:

The effect of a low calorie (1100 kcal), low protein (35 g) intake for 9 days on nutritional and laboratory parameters was studied in six young and six elderly healthy subjects. All subjects lost weight on the test diet (an average of 2.0 kg in the young and 2.1 kg in the elderly). Basal serum albumin, serum transferrin, creatinine height index, and creatinine clearance in the elderly subjects were lower than in the young (p less than 0.05). Serum albumin remained unchanged at the end of diet in both groups. There was, however, a significant decrease in the transferrin level in the younger subjects (p less than 0.01). The decrease in creatinine height index was not significant in either group. Baseline nitrogen balance of the elderly was -1.1 g/day compared to +0.5 g/day (p less than 0.01) in the young subjects. The test diet caused a negative nitrogen balance of about -5 g/day in both groups (p less than 0.005). Blood urea nitrogen was significantly lower at the end of the test diet and was related to the intake of protein in both groups. At the end of the diet the serum potassium and GGT were significantly lower in the young (p less than 0.01); serum creatinine was unchanged but creatinine clearance was significantly lower in both groups. From this study it appears that significant changes occur in nutritional and laboratory parameters within 9 days on a diet deficient in calories and protein in normal healthy subjects. These changes need to be recognized as having nutritional basis and should not be attributed to illness or drug therapy.

ISSN:0731-5724    

DOI:10.1080/07315724.1989.10720325

出版商:Routledge    

年代:1989

数据来源: Taylor