Nutrition

The 13th John M. Kinney Nestlé Nutrition Awards

Michael M. Meguid — 2010-07-01

In recognition of Dr. John M. Kinney's significant and seminal contributions to the field of clinical nutrition , The Nestlé Nutrition Institute, in conjunction with Nutrition: The International Journal of Applied and Basic Nutritional Sciences and with the Nutritional Sciences, Education and Research Fund, established three awards. The $6000 cash award is given to the first author of a paper that was accepted for publication in Nutrition on an annual basis. The topic areas are pediatric nutrition, general nutrition, and nutrition and metabolism. The winning paper in each category is selected by an international committee of experts. The award ceremony occurs usually in conjunction with the annual congress of the EUROPEAN SOCIETY OF PARENTERAL AND ENTERAL NUTRITION (ESPEN), alternating with the AMERICAN SOCIETY OF PARENTERAL AND ENTERAL NUTRITION (ASPEN).

Metabolic actions of insulin in men and women

Faidon Magkos, Xuewen Wang, Bettina Mittendorfer — 2010-04-15

Abstract: Insulin is an important regulator of glucose, lipid, and protein metabolism. It suppresses hepatic glucose and triglyceride production, inhibits adipose tissue lipolysis and whole-body and muscle proteolysis, and stimulates glucose uptake in muscle. In this review we discuss what is currently known about the control of substrate metabolism by insulin in men and women. The data available so far indicate that women are more sensitive to insulin with regards to glucose metabolism (both in the liver and in muscle), whereas there are no differences between men and women in insulin action on lipolysis. Potential differences exist in the regulation of plasma triglyceride concentration and protein metabolism by insulin and in changes in insulin action in response to stimuli (e.g., weight loss and exercise) that are known to alter insulin sensitivity. However, these areas have not been studied comprehensively enough to draw firm conclusions.

More than the sum of its parts? Nutrition in Alzheimer's disease

Christine A.F. von Arnim, Ute Gola, Hans K. Biesalski — 2010-04-09

Abstract: The aim of this article is to emphasize the importance of malnutrition and micronutrient deficiencies in Alzheimer's disease and discuss recent supplementation trials. Alzheimer's disease (AD) is a devastating neurodegenerative disease with increasing socio-economic impact. It leads to cognitive decline over the years, finally resulting in brain atrophy and gradually destroying a person's ability to learn, reason, make judgments, and communicate. Most of the cases are sporadic and risk factors evolve. There is evidence that malnutrition, oxidative stress, and homocysteine-related vitamins play a role in the pathogenesis of AD. A plethora of epidemiologic studies have explored the associations between nutrients and AD. In addition, more and more data from recent trials are evolving to analyze the impact of micronutrient supplementation in AD and incipient AD concerning B vitamin status and antioxidants. Available data do not support definitive conclusions regarding specific recommendations on micronutrient supplementation for the prevention or treatment of AD; however, more data from prospective trials are needed. Approaches with multiple nutritional components might be promising.

Immunonutrition and critical illness: An update

Barry A. Mizock — 2010-04-09

Abstract: Dietary supplementation with nutrients that have physiologic effects on immune function has been shown to be beneficial in subsets of patients with surgical and medical critical illness. However, several meta-analyses have suggested potential harm when immune nutrients are used inappropriately. This has led to concern among clinicians that in turn has curtailed the more widespread use of immunonutrition as a therapeutic modality. This article discusses the mechanisms by which immune nutrients can be used to modulate alterations in innate and acquired immunity associated with critical illness. In addition, recent evidence-based clinical practice guidelines for use of immunonutrition in adults is reviewed as a means to clarify some of the more controversial issues and provide a “roadmap” for the practitioner.

Borage oil in the treatment of atopic dermatitis

Rachel H. Foster, Gil Hardy, Raid G. Alany — 2010-07-01

Abstract: Nutritional supplementation with omega-6 essential fatty acids (ω-6 EFAs) is of potential interest in the treatment of atopic dermatitis. EFAs play a vital role in skin structure and physiology. EFA deficiency replicates the symptoms of atopic dermatitis, and patients with atopic dermatitis have been reported to have imbalances in EFA levels. Although direct proof is lacking, it has been hypothesized that patients with atopic dermatitis have impaired activity of the delta-6 desaturase enzyme, affecting metabolism of linoleic acid to gamma-linolenic acid (GLA). However, to date, studies of EFA supplementation in atopic dermatitis, most commonly using evening primrose oil, have produced conflicting results. Borage oil is of interest because it contains two to three times more GLA than evening primrose oil. This review identified 12 clinical trials of oral or topical borage oil for treatment of atopic dermatitis and one preventive trial. All studies were controlled and most were randomized and double-blind, but many were small and had other methodological limitations. The results of studies of borage oil for the treatment of atopic dermatitis were highly variable, with the effect reported to be significant in five studies, insignificant in five studies, and mixed in two studies. Borage oil given to at-risk neonates did not prevent development of atopic dermatitis. However, the majority of studies showed at least a small degree of efficacy or were not able to exclude the possibility that the oil produces a small benefit. Overall, the data suggest that nutritional supplementation with borage oil is unlikely to have a major clinical effect but may be useful in some individual patients with less severe atopic dermatitis who are seeking an alternative treatment. Which patients are likely to respond cannot yet be identified. Borage oil is well tolerated in the short term but no long-term tolerability data are available.

Polyunsaturated fatty acids and atopic dermatitis

Undurti N. Das — 2010-07-01

Atopic dermatitis (a type of eczema) is a familial and an inflammatory, chronically relapsing, non-contagious, and pruritic skin disease. The skin in atopic dermatitis reacts abnormally and easily to irritants, food, and environmental allergens and becomes red, flaky, and very itchy and is vulnerable to bacterial infections. Atopic dermatitis often occurs with other atopic diseases such as hay fever, asthma, and conjunctivitis. The primary treatment involves prevention. Topical treatments aimed at decreasing the dryness and inflammation of the skin and to combat the severe dryness associated with eczema are often recommended. Although there is no cure for atopic eczema, it can be treated effectively in the short term through a combination of prevention (learning what triggers the allergic reactions) and drug therapy that may include topical steroids, immunosuppressants tacrolimus and pimecrolimus, cyclosporine, azathioprine and methotrexate, and ultraviolet radiation.

Comparison of nutritional risk screening tools for predicting clinical outcomes in hospitalized patients

2009-12-07

Abstract: Objective: International nutritional screening tools are recommended for screening hospitalized patients for nutritional risk, but no tool has been specifically evaluated in the Brazilian population. The aim of this study was to identify the most appropriate nutritional screening tool for predicting unfavorable clinical outcomes in patients admitted to a Brazilian public university hospital.Methods: The Nutritional Risk Screening 2002 (NRS 2002), Mini-Nutritional Assessment–Short Form (MNA-SF), and Malnutrition Universal Screening Tool (MUST) were administered to 705 patients within 48 h of hospital admission. Tool performance in predicting complications, very long length of hospital stay (LOS), and death was analyzed using receiver operating characteristic curves.Results: NRS 2002, MUST, and MNA-SF identified nutritional risk in 27.9%, 39.6%, and 73.2% of the patients, respectively. NRS 2002 (complications: 0.6531; very long LOS: 0.6508; death: 0.7948) and MNA-SF (complications: 0.6495; very long LOS: 0.6197; death: 0.7583) had largest areas under the ROC curve compared to MUST (complications: 0.6036; very long LOS: 0.6109; death: 0.6363). For elderly patients, NRS 2002 was not significantly different than MNA-SF (P>0.05) for predicting outcomes.Conclusion: Considering current criteria for nutritional risk, NRS 2002 and MNA-SF have similar performance to predict outcomes but NRS 2002 seems to provide a best yield.

Effects of fruit consumption on body mass index and weight loss in a sample of overweight and obese dieters enrolled in a weight-loss intervention trial

Kerstin E.E. Schroder — 2009-12-21

Abstract: Objective: Fruit and vegetable consumption is an important part of a healthy diet and assumed to aid in the reduction of energy intake and body weight. Fruits and vegetables may display differential effects on weight and weight loss; however, the effects of the two food groups have rarely been investigated separately.Methods: The present study focused on the effects of fruit consumption on body weight and weight loss in a sample of 77 overweight and obese dieters enrolled in an intervention program. Food consumption was assessed at baseline by food diaries and after the introduction of nutrition software through electronic food records. Body weight and additional physiologic outcomes were assessed three times, once before the intervention and again at the 3- and 6-mo follow-ups.Results: Vegetable and fruit consumption differed in their associations with body weight and weight loss. Although vegetable consumption increased as a result of the intervention (P<0.01), fruit consumption did not. However, only fruit consumption was associated with body mass index, showing an inverse relation with body weight in cross-sectional and longitudinal analyses (r=−0.27 to −0.44). The relation between fruit consumption and body weight remained significant after controlling for age, gender, physical activity level, and daily macronutrient consumption (ΔR2=0.06–0.13). Further, increases in fruit consumption were associated with subsequent weight loss, controlling for the same covariates (ΔR2=0.05–0.07).Conclusion: The results indicate unique contributions of fruit consumption to the management of body weight and indicate that a separation of effects for fruit and vegetable food groups may be warranted.

Effect of nutritional support team restructuring on the use of parenteral nutrition

Krishnan Sriram, Tissy Cyriac, Louis F. Fogg — 2009-12-17

Abstract: Objective: The inappropriate use of parenteral nutrition (PN) continues to be a problem, despite several decades of efforts to improve the situation. We restructured our existing nutritional support team employing methods involving the institution's systems and individual physician interaction and education. Our aim was to study the effects of these changes on the use of PN in our institution.Methods: Records of all non-critically ill patients seen by our nutritional support team for PN during 2003–2004 (phase I, before restructuring) and 2005–2006 (phase II) were reviewed. Patients were classified under “appropriate,” “inappropriate,” and “marginal” categories based on published guidelines. During phase II, a new committee was formed, policies and procedures were updated, educational activities were increased, emphasis was placed on evidence-based guidelines, and periodic bedside rounds with the team physicians were initiated. Communication with referring physicians was improved.Results: Three hundred three of 335 patients in phase I and 271 of 333 patients in phase II were eligible for inclusion in analysis. Appropriate PN increased from 71.3% to 83.4%; inappropriate PN decreased from 16.5% to 8.9% (P = 0.002).Conclusion: Restructuring of the nutritional support team improved the proper utilization of PN and decreased inappropriate use of PN in a public teaching hospital.

Expression of retinoic acid receptors in intestinal mucosa and the effect of vitamin A on mucosal immunity

Ping Dong, Yuehong Tao, Yi Yang, Weiping Wang — 2009-11-23

Abstract: Objective: To explore the mechanism of vitamin A (VA) modulation of mucosal immunity, the expression of retinoic acid receptors in intestinal mucosa was measured, and the effect of VA on intestinal dendritic cells (DCs) and mucosal cytokine production was examined.Methods: The expression of retinoic acid receptor (RAR-α, RAR-β, RAR-γ, RXR-α, RXR-β, RXR-γ) mRNA, the distribution and number of DCs, and the protein secretion of interleukin (IL)-12, T-helper type 1/2 cells (interferon [IFN]-γ/IL-4), and regulatory (IL-10) cytokines in the mucosa of terminal ileum in normal rats and rats with VA deficiency (VAD) were detected by reverse transcriptase polymerase chain reaction, immunohistochemistry, and enzyme-linked immunosorbent assay, respectively. The effect of all-trans retinoic acid on the number and maturation of DCs and the gene expression of RAR-α and cytokines listed earlier in cultured Peyer's patches were examined by flow cytometry and reverse transcriptase polymerase chain reaction, respectively.Results: In the intestinal mucosa of VAD rats, RAR-α mRNA was downregulated, DC number increased, the protein secretion of IL-12 was increased, but the secretion of IFN-γ and IL-10 decreased. In in vitro cultured Peyer's patches, all-trans retinoic acid promoted DC maturation, upregulated RAR-α mRNA, reduced IL-12 and IFN-γ, but increased IL-10 gene expression; these effects of all-trans retinoic acid were reversed when cultured with Ro 41-5253 (a specific antagonist of RAR-α).Conclusion: Vitamin A may be potent in reducing intestinal inflammation and restoring impaired antibody responses in a VAD situation. The effect of VA on DCs could be an important mechanism contributing to altered mucosal immunity. RAR-α may mostly play a role in the action of VA.

Late introduction and poor diversity were the main weaknesses of complementary foods in a cohort study in rural Burkina Faso

2010-07-01

Abstract: Objective: In developing countries, the complementary feeding period is critical to the growth of children, notably because of inappropriate complementary feeding practices. A longitudinal study was carried out in a food vulnerable area in Burkina Faso to better understand and describe these practices.Methods: A cohort of 114 children was followed at the ages of 6, 9, 12, 15, 18, and 24 mo. At each visit details on the complementary foods (CF) were recorded and intakes were measured by direct weighing.Results: At 6 mo of age all infants were breastfed and 61% were still breastfed at 24 mo. Infants not receiving any CF were 97% at enrollment, 53% at 9 mo, and 11% at 12 mo (mean age of introduction = 9.2 ± 1.7 mo). Porridge was the type of CF introduced first (46%) but was of poor diversity; special dishes were less often given but did contain more numerous ingredients. However, less than half of the children received the recommended minimum of four different food groups/d before being 2 y old. At 12 mo and after, more than 75% of the children had at least 3 meals/d. Quantities of CF consumed increased from 133 ± 121 g/d (19 ± 17 g per kg of body weight/d) at 9 mo to 480 ± 237 g/d (49 ± 25 g/kg/d) at 24 mo (for breastfed children).Conclusion: Late introduction of CF and poor diversity of ingredients, more than quantity of food, were the main weaknesses observed in this context. At least part of these issues can be addressed through educational activities.

Fat-free mass depletion in cystic fibrosis: Associated with lung disease severity but poorly detected by body mass index

2009-11-20

Abstract: Objective: Malnutrition in cystic fibrosis (CF) is associated with poorer survival, but the determinants of fat-free mass (FFM) depletion are not well-characterized. It is unknown whether routine nutritional indicators, including body mass index (BMI), are adequate for detecting FFM depletion. This study aimed to determine the prevalence of FFM depletion in adults with CF, to compare fat-free mass index (FFMI) with BMI, and to identify predictors of FFM depletion.Methods: This was a prospective cross-sectional study of 86 adults with CF (19–59 y old). Body composition was assessed using dual-energy X-ray absorptiometry to determine FFMI and BMI. FFMI percentiles and Z-scores were derived from a reference population of 156 healthy adults. FFM depletion was defined as an FFMI below the fifth percentile for age and gender and low BMI as <18.5kg/m2. Univariate and multivariate analyses identified predictors of FFMI and FFMI Z-score.Results: Mean FFMIs were 18.3±1.9kg/m2 in men with CF and 15.8±1.1kg/m2 in women with CF (P<0.0005). FFM depletion was found in 14% of adults with CF, and low BMI was found in 18.6%. The sensitivity of BMI for detecting FFM depletion was 42%. Forced expiratory volume in 1 s as a percentage of predicted was independently associated with FFMI in women (r=0.62, P<0.0001) and men (r=0.28, P=0.045) and FFMI Z-score (r=0.41, P<0.0001).Conclusion: FFM depletion was found in 14% of adults with CF, but was undetectable by BMI in 58% of these patients. These findings, together with the association of FFMI with forced expiratory volume in 1 s predicted, suggest a role for body composition assessment in adult CF care.

Melanocortin-3 receptor gene variants: Association with childhood obesity and eating behavior in Chilean families

A.M. Obregón, P. Amador, M. Valladares, G. Weisstaub, R. Burrows, J.L. Santos — 2010-02-08

Abstract: Objective: To evaluate the association between melanocortin-3 receptor common genetic polymorphisms with childhood obesity and eating behavior in Chilean families.Methods: Two hundred twenty-nine obese children (6–12 y old, body mass index >95th percentile of Centers for Disease Control and Prevention/National Center for Health Statistics, 2000) and 270 parents were selected. Genotypes for MC3R genetic markers −239A>G, 17C>A (Thr6Lys), 241G>A (Val81Ile), +2138InsCAGACC, and microsatellite D20s32e were determined. Eating behavior scores were computed using the Child Eating Behavior Questionnaire and a shorter version of the Three Factor Eating Questionnaire adapted for evaluating eating inclinations in children. Genotype-obesity associations were assessed by the Transmission Disequilibrium Test. Non-parametric tests were used to compare eating behavior scores across study groups.Results: Allelic frequencies of −239G, 17A, 241A, and +2138InsCAGACC were estimated as 4.5%, 5.9%, 5.6%, and 17.6%, respectively, in obese children. The Transmission Disequilibrium Test in case–parent trios revealed no significant associations between childhood obesity and genetic markers, including the microsatellite D20s32e. In girls, we found significantly higher scores of the emotional eating subscale in carriers of the +2138InsCAGACC compared with non-carriers (P=0.04). In boys, carriers of 17A and 241A showed lower scores for the emotional eating subscale (P=0.01), whereas carriers of +2138InsCAGACC showed significantly lower scores for the enjoyment of food subscale compared with non-carriers (P=0.04).Conclusions: There is not sufficient evidence to support the contribution for common melanocortin-3 receptor variants in childhood obesity. However, our results are concordant for a role of melanocortin-3 receptor variants in some dimensions of eating behavior such as emotional eating and enjoyment of food.

Nutritional status assessed by the Patient-Generated Subjective Global Assessment (PG-SGA) is associated with qualities of diet and life in Korean cerebral infarction patients

Hyun Jung Lim, Ryowon Choue — 2010-01-18

Abstract: Objective: Assessment of the nutritional status of patients with cerebral infarction (CI) is important because their nutritional status influences disease outcome. The purpose of this study was to assess the nutritional status of patients with CI using the scored Patient-Generated Subjective Global Assessment (PG-SGA) and to investigate the relation of the quality of their diet and life with their nutritional status.Methods: Seventy-three patients with CI were recruited from Kyung Hee University Oriental Medical Center in Seoul, Korea, from May to July 2007. The subjects' PG-SGA, dietary quality (Dietary Diversity Score, Dietary Variety Score, and Diet Quality Index–International), and quality of life (Stroke-Specific Quality of Life, modified Barthel Index, and Beck Depression Inventory) were investigated.Results: The patients were classified by PG-SGA categories as well nourished (26.0%), moderately malnourished (49.3%), or severely malnourished (24.7%). Quality of diet assessed by the Dietary Diversity Score and Dietary Variety Score was significantly lower in severely malnourished patients (P < 0.001). The overall dietary quality expressed by the Diet Quality Index–International was significantly greater in the well-nourished group, followed by the moderately malnourished and severely malnourished groups. Quality of life assessed by the Stroke-Specific Quality of Life and modified Barthel Index was significantly lower in the malnourished group (P < 0.05). Quality of diet (P < 0.001) and life (P < 0.05) in patients with CI were significantly correlated with their nutritional status.Conclusion: The PG-SGA is a useful nutritional assessment tool for patients with CI with stable vital signs. When patients with CI were categorized according to their PG-SGA score, well-nourished patients demonstrated better diet quality and better quality of life.

Eating habits, lifestyle factors, and body weight status among Turkish private educational institution students

Unal Ayranci, Nazan Erenoglu, Osman Son — 2009-11-16

Abstract: Objective: The purposes of this study were to assess the prevalence of underweight, overweight, and obesity and to evaluate the effects of eating habits, lifestyle, and sociodemographic characteristics on students' weight.Methods: This cross-sectional study was carried out from February to May 2008 in the city of Eskisehir, western Turkey. A total of 2258 students 15–20 y of age (1137 boys and 1121 girls) were examined. The questionnaires, including items related to eating habits, lifestyle, and sociodemographic characteristics, were completed by the students. The data were evaluated using chi-square test and percent ratios. In addition, Student's t test for means and reliability analysis was employed to test the reliability of the questionnaire scale. Differences were considered statistically significant at P < 0.05.Results: About 70% of the students (69.9%) were of normal weight; more than one-fourth (25.7%) were underweight; and 4.4% were overweight/obese students, with just 0.6% being obese (n = 14). According to 21 of the 29 items in the questionnaire found to be positively significant, girls had more accurate habits than boys (13 versus 7 items, respectively). Compared with those underweight or of normal weight, the proportion of those overweight/obese was smaller for those having milk or juice at breakfast (P < 0.05), special meals prepared at least once daily at home (P < 0.05), and not selecting fast food such as hamburgers at meals (P < 0.01).Conclusion: The results of this study suggest that the prevalence of overweight and obesity is much lower than the prevalence of underweight in Turkish school-based adolescents, important data that merit consideration. Health professionals, teachers, and family environment may play a key role in the promotion of a healthy lifestyle.

Impact of probiotic supplementation on mortality of induced 1,2-dimethylhydrazine carcinogenesis in a mouse model

2010-07-01

Abstract: Rationale: Probiotic bacterial strains have been increasingly used in clinical practice as many health benefits result from their use. However, severe side effects such as bacteremia and fungemia have been reported in inmunocompromised patients and those with chronic disease.Objective: The purpose of this study was to report the impact of probiotic supplementation on the mortality of mice undergoing carcinogenesis induction with 1,2-dimethylhydrazine (DMH).Methods: Two treatment protocols were used. In experiment 1, Lactobacillus delbrueckii UFV-H2b20, Bifidobacterium animalis var. lactis Bb12, and Saccharomyces boulardii were added to the drinking water, to control mice and those undergoing injections of DMH daily. Probiotic supplementation was started 1 wk before and continued throughout the 6 wk of DMH injections. In experiment 2, the same probiotics were administered daily, except on the first day that DMH was administered. The mortality of these animals was recorded. Bacterial translocation was determined in mice in experiment 1.Results: Groups with DMH-induced injury treated with lactobacilli, bifidobacteria, and the mixture of lactobacilli and bifidobacteria presented with 40%, 30%, and 60% mortality, respectively. Death happened mainly between 48 h and 72 h after the first injection of DMH. On the other hand, no mice in experiment 2 died during the study period. Bacteria were found to be translocated to mesenteric lymph nodes, spleen, and liver.Conclusion: Supplementation of L. delbrueckii UFV-H2b20 and B. animalis var. lactis Bb12 in mice with DMH-induced injury led to death in some animals. The results suggest that increased bacterial translocation was probably related to mortality. These findings are an alert to the potentially severe side effects associated with the use of probiotics under extremely stressful situations.

Influence of traumatic brain injury on potassium and phosphorus homeostasis in critically ill multiple trauma patients

2009-12-17

Abstract: Objective: The intent of this study was to ascertain whether multiple trauma patients with traumatic brain injury (TBI) had lower serum concentrations of potassium and phosphorus and required more aggressive supplementation than multiple trauma patients without TBI.Methods: Ventilator-dependent adult patients without renal impairment who were admitted to the trauma intensive care unit or neurosurgical intensive care unit and who received enteral nutrition were evaluated for the first 14 d after hospital admission. Patients were grouped according to the presence or absence of TBI. Target serum concentrations for potassium and phosphorus were 4 mEq/L and 4 mg/dL, respectively. Electrolyte repletion therapy was given according to the nutritional support service guidelines.Results: Fifty trauma patients (25 with and without TBI) were studied. Daily serum potassium concentrations were consistently lower for those with TBI (P ≤ 0.001), whereas the mean net potassium intake was greater (1.3 ± 0.5 versus 0.7 ± 0.3 mEq · kg−1 · d−1, respectively, P ≤ 0.001). Serial serum phosphorus concentrations were similar between groups (P = NS) except for a significantly lower serum phosphorus concentration for trauma patients with TBI on day 3 after hospital admission (2.5 ± 0.5 versus 2.9 ± 0.7 mg/dL, respectively, P ≤ 0.05). However, the mean net phosphorus intake was significantly greater for trauma patients with TBI (0.65 ± 0.25 versus 0.45 ± 0.17 mmol · kg−1 · d−1, P ≤ 0.001).Conclusion: Potassium and phosphorus requirements are greater for multiple trauma patients with TBI compared with those without TBI.

Trends in nutritional inequality by educational level: A case of South Korea

Kirang Kim, Seo Ah Hong, Mi Kyung Kim — 2009-12-07

Abstract: Objective: There is much evidence of a cross-sectional relation between socioeconomic position and dietary intakes but the trend of this relation is little studied. This study aimed to examine the extent and trend of nutritional inequality by educational level based on the prevalence of inadequate nutrient intakes.Methods: Three cross-sectional nationwide surveys (1998, 2001, 2005) of the Korean National Health and Nutrition Examination Survey were used. A total of 20 777 participants ≥20 y old were included. The socioeconomic position indicator was educational level. Dietary nutrient intakes were assessed by a 24-h recall and inadequacy of intake for nutrients was assessed on the basis of the percentage of attainment of the dietary reference intakes for Koreans. To assess nutritional inequality by educational level, the prevalence ratio, relative index of inequality, and slope index of inequality were used.Results: Poorer dietary intakes and higher estimated prevalence of nutrient inadequacy were more apparent in the lower education group than the higher education group for both genders and each survey year. Graded patterns of inequalities in nutrient intakes by educational level were generally clear at each survey year. The trend of the relative nutritional inequalities in Korean men and women remained unchanged from 1998 to 2005, with some exceptions.Conclusion: The inequality in nutrient intakes by educational level was persistently apparent for both genders in the Korean adult population, although the relative inequalities did not increase over time.

Gastrointestinal tolerance to an inulin-rich soluble roasted chicory extract after consumption in healthy subjects

2009-11-20

Abstract: Objectives: We aimed to assess in healthy subjects 1) the effect of two doses of a new naturally inulin-rich soluble chicory extract (IRSCE) on overall gastrointestinal discomfort after short-term ingestion and 2) the effect on gastrointestinal symptoms of long-term consumption of IRSCE administered at a dose compatible with its future commercial use.Methods: First, the effect of IRSCE was assessed on overall gastrointestinal discomfort in a double-blind, crossover study where 18 subjects received in a randomized order a morning coffee drink including 10 g of sucrose alone (control period) or with IRSCE at two doses (8.9 and 14.0 g containing 5.0 and 7.8 g of inulin, respectively) during three consecutive 6-d periods. Second, 35 subjects were followed during a randomized, double-blind protocol where they were asked to take twice a day an instant coffee drink containing IRSCE (8.1 g/d containing inulin 5.0 g/d) or sucrose 8.1 g/d during 4 wk. The effects of the treatment on flatulence, bloating, abdominal pain, stool consistency, and number were recorded.Results: In the first study a significant slight increase (P = 0.05) in overall abdominal discomfort was observed with the morning coffee drink containing 7.8 g of inulin after 1 wk of consumption. In the second study, no significant differences between the IRSCE and placebo groups were evidenced with respect to gastrointestinal symptoms during the consumption period.Conclusion: Short- and long-term consumptions of IRSCE, given at a daily dose containing 5 g of inulin, are well tolerated by healthy subjects.

Diet supplementation with acai (Euterpe oleracea Mart.) pulp improves biomarkers of oxidative stress and the serum lipid profile in rats

2009-12-21

Abstract: Objective: We investigated the antioxidant potential and hypocholesterolemic effects of acai (Euterpe oleracea Mart.) pulp ingestion in rats fed a standard or hypercholesterolemic diet.Methods: Female Fischer rats were fed a standard AIN-93 M diet (control) or a hypercholesterolemic diet that contained 25% soy oil and 1% cholesterol. The test diet was supplemented with 2% acai pulp (dry wt/wt) for control (group CA) and hypercholesterolemic rats (group HA) for 6 wk. At the end of the experimental period, rats were sacrificed and the blood and livers were collected. To evaluate the effect of acai consumption, levels of protein carbonyl and sulfhydryl groups, superoxide dismutase and paraoxonase activities, and lipid profiles of the sera were measured.Results: Animals that were fed the hypercholesterolemic diet presented increased levels of total and non–high-density lipoprotein cholesterol and decreased levels of high-density lipoprotein cholesterol. Supplementing the diet of this group with acai caused a hypocholesterolemic effect by reducing total and non–high-density lipoprotein cholesterol. Serum levels of carbonyl proteins and total, free, and protein sulfhydryl groups were reduced by acai ingestion in animals receiving the standard or hypercholesterolemic diet. Acai supplementation induced a significant reduction in superoxide dismutase activity only in the hypercholesterolemic rats, indicating an association between diet and acai treatment. Also, acai supplementation increased paraoxonase activity in the CA and HA groups.Conclusion: These results suggest that the consumption of acai improves antioxidant status and has a hypocholesterolemic effect in an animal model of dietary-induced hypercholesterolemia.

Effects of different ratios of monounsaturated and polyunsaturated fatty acids to saturated fatty acids on regulating body fat deposition in hamsters

Fang-Hsuean Liao, Tsan-Hon Liou, Ming-Jer Shieh, Yi-Wen Chien — 2009-12-21

Abstract: Objective: Effects of monounsaturated fatty acid (MUFA) and polyunsaturated fatty acid consumption on regulating body fat accumulation and body weight gain are controversial between animal and human studies.Methods: We designed a 2 × 2 factorial study, with two levels of MUFAs (60% and 30%) and two levels of polyunsaturated-to-saturated fatty acid (P/S) ratio (5 and 3) to prepare four kinds of experimental oils consisting of 60% MUFAs with a high or low P/S ratio (HMHR or HMLR, respectively) or 30% MUFAs with a high or low P/S ratio (LMHR or LMLR, respectively). Thirty-two male golden Syrian hamsters were randomly divided into four groups and fed the experimental diets containing 15% (w/w) fat for 12 wk.Results: No difference was observed in the mean daily food intake. Hamsters fed the LMLR diet had increased weight gain, epididymal and retroperitoneal white adipose tissues, plasma non-esterified fatty acids, insulin, hepatic acetyl coenzyme A carboxylase and malic enzyme activities, and mRNA expressions of peroxisome proliferator-activated receptor-α and sterol regulatory element-binding protein-1c among all groups (P < 0.05). Hamsters fed the HMHR diet had lower plasma insulin levels and hepatic acetyl coenzyme A carboxylase activities among groups (P < 0.05) and elevated hepatic acyl coenzyme A oxidase and carnitine palmitoyltransferase-I activities compared with those fed the LMLR diet (P < 0.05).Conclusion: Hamsters fed the LMLR diet had increased weight gain and body fat accumulation, whereas the HMHR diet appeared to be beneficial in preventing white adipose tissue accumulation by decreasing plasma insulin levels and increasing hepatic lipolytic enzyme activities involved in β-oxidation.

Effects of different arginine concentrations on angiogenic protein production induced by HeLa cells

2010-01-13

Abstract: Objectives: This in vitro study investigated the effects of different arginine (Arg) concentrations on angiogenic protein expressions of HeLa cells and endothelial cells (ECs) after stimulation. In addition, an inducible nitric oxide (iNO) synthase inhibitor (1400W) was used to investigate the possible role of iNO in angiogenesis.Methods: Endothelial cells and HeLa cells were treated with different concentrations of Arg and 1400W: Arg 0, 50, 100, and 1000 μmol/L; Arg 100 μmol/L+1400W 10 μmol/L; and Arg 1000 μmol/L+1400W 10 μmol/L for 24h. Then, ECs and HeLa cells were cocultured for 2h, and the supernatant in the transwell was collected for analysis of angiogenic protein secreted. The expression of CD51/CD61 by ECs was also analyzed.Results: The productions of vascular endothelial growth factor, basic fibroblast growth factor, prostaglandin E2, and matrix metalloproteinase-2 were higher with Arg 100 and 1000 μmol/L than with Arg 0 and 50 μmol/L Arg, and this was consistent with the expression of CD51/CD61 by ECs. Inhibition of iNO production resulted in lower angiogenic protein expressions comparable with groups with low Arg administration.Conclusion: The findings of this study suggest that Arg administration at levels similar to or higher than physiologic concentrations enhance the production of angiogenic protein and iNO may partly play a role in promoting angiogenesis in the presence of HeLa cells.

Effect of whole walnuts and walnut-skin extracts on oxidant status in mice

2010-01-29

Abstract: Objective: To evaluate the effect of the intake of whole walnuts and walnut fractions on the oxidant status in mice.Methods: Thirty-six C57BL/6J male mice were randomized to be fed one of three diets: 1) a standard diet (control group), 2) a standard diet with 10% of whole walnuts (walnut-diet group), or 3) a standard diet with 2% of walnut skins (walnut-skin-diet group) for 8 wk. The plasma antioxidant capacity was measured by oxygen radical-absorbance capacity and plasma ferric-reducing antioxidant potential. Conjugated diene formation and reduced glutathione levels were also analyzed.Results: We observed no changes in plasma oxidation capability between the walnut and walnut-skin groups with the exception of conjugated dienes. Plasma total antioxidant capacity and the ratio between reduced and oxidized forms of glutathione were lower in the walnut and walnut-skin groups than in the control group.Conclusion: The decrease in the antioxidant burden observed in enzymatic and non-enzymatic antioxidant systems after sustained consumption of a whole-walnut or a walnut-skin diet in mice may be related to the plasma oxidation capability being maintained in the groups consuming the walnut diets.

Low ω-6/ω-3 polyunsaturated fatty acid ratios reduce hepatic C-reactive protein expression in apolipoprotein E–null mice

Liang Zhang, Yue Geng, Miao Yin, Liufeng Mao, Shun Zhang, Jie Pan — 2009-12-09

Abstract: Objective: Expression characteristics of C-reactive protein (CRP) for the ω-6/ω-3 polyunsaturated fatty acid (PUFA) ratios have not been evaluated in the well-qualified experimental atherosclerotic mouse model. This work focused on characteristics of CRP expression in the liver of apolipoprotein E–null (apoE−/−) mice influenced by ω-6/ω-3 PUFA ratios.Methods: Varying ratios of ω-6/ω-3 PUFAs (group 1, 1.28; group 2, 5.03; group 3, 9.98; and group 4, 68.26, respectively) on hepatic and aortic CRP expressions were assessed in male apoE−/− mice fed a diet containing 5% (w/w) experimental fat for 6 wk. Hepatic peroxisome proliferator-activated receptor-γ mRNA abundance, hepatic interleukin (IL)-6 protein level, atherosclerotic lesions, and serum cytokines including IL-1β, IL-6, and tumor necrosis factor-α were examined.Results: As the dietary ratio of ω-6/ω-3 fatty acids ascended, so did the expression of hepatic and aortic CRP and hepatic IL-6 protein. However, peroxisome proliferator-activated receptor-γ mRNA level had a tendency to decrease. Serum IL-1β, IL-6, and tumor necrosis factor-α levels did not show a statistical difference among the mice fed the four ratios of the ω-6/ω-3 PUFA diet. The group 4 mice developed a significant increase in atherosclerotic lesions compared with the other groups.Conclusion: The results indicated that low ratios of ω-6/ω-3 PUFAs (1.28–9.98) downregulated the hepatic and aortic CRP expressions and reduced aortic en face lesions in apoE−/− mice compared with the high ratio of the ω-6/ω-3 PUFA diet.

Supplementation with engineered Lactococcus lactis improves the folate status in deficient rats

2009-11-20

Abstract: Objective: The aim of this study was to establish the bioavailability of different folates produced by engineered Lactococcus lactis strains using a rodent depletion–repletion bioassay.Methods: Rats were fed a folate-deficient diet, which produces a reversible subclinical folate deficiency, supplemented with different L. lactis cultures that were added as the only source of folate. Three bacterial strains that overexpressed the folC, folKE, or folC + KE genes were used. These strains produce folates with different poly glutamyl tail lengths. The growth response of the rats and the concentration of folates in different organs and blood samples were monitored.Results: The folate produced by the engineered strains was able to compensate the folate depletion in the diet and showed similar bioavailability compared with commercial folic acid that is normally used for food fortification. Folate concentrations in organ and blood samples increased significantly in animals that received the folate-producing strains compared with those that did not receive bacterial supplementation. Hematologic studies also showed that administration of the L. lactis strains was able to revert a partial megaloblastic anemia caused by folate deficiency. No significant differences were observed in the bioavailability of folates containing different glutamyl tail lengths.Conclusion: To our knowledge, this is the first study that demonstrated that folates produced by engineered lactic acid bacteria represent a bioavailable source of this essential vitamin.

High-fructose diet elevates myocardial superoxide generation in mice in the absence of cardiac hypertrophy

2009-11-23

Abstract: Objective: Dietary fructose intake has increased considerably in recent decades and this has been paralleled by an increase in the incidence of insulin resistance, especially in children and adolescents. The impact of a high-fructose diet on the myocardium is not fully understood. The aims of this study were to characterize the murine metabolic and cardiac phenotypes associated with a high-fructose diet and to determine whether this diet imparts differential effects with age.Methods: Juvenile (4 wk) and adult (14 wk) C57Bl/6 mice were fed a 60% fructose diet or isoenergetic control (starch) diet for 6 wk.Results: At completion of the dietary intervention (at ages 10 and 20 wk), fructose-fed mice were normotensive; hyperinsulinemia and cardiac hypertrophy were not evident. Interestingly, fructose-fed mice exhibited lower blood glucose levels (10 wk: 4.81±0.28 versus 5.42±0.31mmol/L; 20 wk: 4.88±0.30 versus 5.96±0.42mmol/L, P<0.05) compared with controls. Nicotinamide adenosine dinucleotide phosphate–driven myocardial superoxide production was significantly increased in fructose-fed mice at both ages (by approximately 29% of control at 10 wk of age and 16% at 20 wk, P<0.01). No increase in aortic superoxide production was observed. Fructose feeding did not alter gene expression of the antioxidant thioredoxin-2, suggesting an imbalance between myocardial reactive oxygen species generation and antioxidant induction.Conclusion: These findings indicate that increased myocardial superoxide production may represent an early and primary cardiac pathologic response to the metabolic challenge of excess dietary fructose in juveniles and adults that can be detected in the absence of cardiac hypertrophy and hypertension.

Internal mammary artery injury during central venous catheter insertion for TPN: Rare but fatal

2010-04-15

Abstract: Vascular injuries caused by subclavian central venous catheter (CVC) insertion can be associated with major complications. Such injuries differ in clinical presentation as well as optimal management, which ranges from observation only to surgical or endovascular repair. We report an injury to a branch of the internal mammary artery following an attempt to introduce a subclavian CVC, resulting in a massive hemothorax. This very rare injury was diagnosed and treated by angiography and embolization; however, the patient later succumbed to multi-organ failure. Suspicion of such an injury in a similar clinical setting should result in immediate angiography that can be lifesaving. To the best of our knowledge, this is the only report of such an adverse event in an adult.

Malabsorption may contribute to malnutrition in the elderly

Terry Bolin, Marian Bare, Gideon Caplan, Suzie Daniells, Margaret Holyday — 2010-01-25

Abstract: Malnutrition, either actually malnourished or at risk, is present in 80% of the elderly population presenting to hospital for admission. Although many factors contribute to this situation, one yet to be explored is malabsorption. We therefore aimed to assess nutritional status as well as the prevalence of altered mucosal permeability and celiac disease among a group of elderly patients presenting for rehabilitation. Forty-eight subjects were recruited (16 females) with a mean age of 83.7 (SD 6.1), body mass index 21.8kg/m2 (SD 3.9), mini-nutritional assessment (MNA) 19.5 (SD 3.4). They had no current gastrointestinal symptoms and undertook an assessment of mucosal permeability using the dual sugar absorption test of lactulose (7.5g) and rhamnose (1g). Ten of the 48 subjects had increased mucosal permeability with an L:R ration ranging from 0.0860 to 7.706 (N 0.01–0.08). These subjects were all at risk or malnourished according to the MNA score and they had a significantly lower mean MNA score of 17.2 (SD 3.5) compared to normal absorbers with a mean of 19.5 (SD 3.4). Two of the subjects had positive tissue trans-glutaminase antibodies. The higher risk of potential malabsorption in this elderly population has significant implications both for nutritional supplementation and for drug absorption as well as being a possible major contributor to malnutrition.

2010-07-01

Nutrition

The 13th John M. Kinney Nestlé Nutrition Awards

Metabolic actions of insulin in men and women

More than the sum of its parts? Nutrition in Alzheimer's disease

Immunonutrition and critical illness: An update

Borage oil in the treatment of atopic dermatitis

Polyunsaturated fatty acids and atopic dermatitis

Comparison of nutritional risk screening tools for predicting clinical outcomes in hospitalized patients

Effects of fruit consumption on body mass index and weight loss in a sample of overweight and obese dieters enrolled in a weight-loss intervention trial

Effect of nutritional support team restructuring on the use of parenteral nutrition

Expression of retinoic acid receptors in intestinal mucosa and the effect of vitamin A on mucosal immunity

Late introduction and poor diversity were the main weaknesses of complementary foods in a cohort study in rural Burkina Faso

Fat-free mass depletion in cystic fibrosis: Associated with lung disease severity but poorly detected by body mass index

Melanocortin-3 receptor gene variants: Association with childhood obesity and eating behavior in Chilean families

Nutritional status assessed by the Patient-Generated Subjective Global Assessment (PG-SGA) is associated with qualities of diet and life in Korean cerebral infarction patients

Eating habits, lifestyle factors, and body weight status among Turkish private educational institution students

Impact of probiotic supplementation on mortality of induced 1,2-dimethylhydrazine carcinogenesis in a mouse model

Influence of traumatic brain injury on potassium and phosphorus homeostasis in critically ill multiple trauma patients

Trends in nutritional inequality by educational level: A case of South Korea

Gastrointestinal tolerance to an inulin-rich soluble roasted chicory extract after consumption in healthy subjects

Diet supplementation with acai (Euterpe oleracea Mart.) pulp improves biomarkers of oxidative stress and the serum lipid profile in rats

Effects of different ratios of monounsaturated and polyunsaturated fatty acids to saturated fatty acids on regulating body fat deposition in hamsters

Effects of different arginine concentrations on angiogenic protein production induced by HeLa cells

Effect of whole walnuts and walnut-skin extracts on oxidant status in mice

Low ω-6/ω-3 polyunsaturated fatty acid ratios reduce hepatic C-reactive protein expression in apolipoprotein E–null mice

Supplementation with engineered Lactococcus lactis improves the folate status in deficient rats

High-fructose diet elevates myocardial superoxide generation in mice in the absence of cardiac hypertrophy

Internal mammary artery injury during central venous catheter insertion for TPN: Rare but fatal

Malabsorption may contribute to malnutrition in the elderly

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