Nutrition - Articles in Press

Postprandial substrate use in overweight subjects with the metabolic syndrome after isomaltulose (Palatinose™) ingestion - Corrected Proof

Daniel König, Stephan Theis, Gunhild Kozianowski, Aloys Berg — 2012-01-24

Abstract: Objective: Dietary interventions with a low glycemic index have shown to be successful for the prevention and therapy of the metabolic syndrome. In the present study, we investigated the postprandial metabolic response at rest and during physical activity the low glycemic carbohydrate isomaltulose (Palatinose™) intake compared with a conventional carbohydrate (glucose syrup/sucrose [glc/suc]) with a higher glycemic index.Methods: Twenty overweight or obese men (32–64 y old) with the metabolic syndrome and insulin resistance were enrolled in this double-blinded, randomized, cross-over study. In the morning, a breakfast consisting of a 250-mL drink and 140 g of cookies containing in a total of 50 g of Palatinose™ or glc/suc was consumed. Two hours after breakfast, subjects exercised at moderate intensity on a treadmill for 30 min. Thereafter, subjects ingested a standardized lunch consisting of a 250-mL drink with 10% Palatinose™ or glc/suc, mini pizzas, and an apple.Results: Blood levels of glucose and insulin were measured and the postprandial substrate metabolism was determined. The glycemic and insulinemic responses were considerably lower after the ingestion of Palatinose™ (incremental area under the curve, P < 0.05). The total fat oxidation was significantly higher with Palatinose™ from breakfast to the beginning of lunch including the exercise and postexercise periods (P < 0.05). Fat oxidation with Palatinose™ was numerically higher throughout the entire examination period (P = 0.09).Conclusion: In obese subjects with insulin resistance and the metabolic syndrome, the partial substitution of carbohydrates with a higher glycemic index in foods and drinks by Palatinose™ resulted in greater postprandial fat oxidation at rest and during physical activity. It is hypothesized that this increased fat oxidation may confer further benefits for long-term weight management and for an improvement in metabolic risk factors.

Effect of conjugated linoleic acid supplementation on weight loss and body fat composition in a Chinese population - Corrected Proof

2012-01-20

Abstract: Objective: Conjugated linoleic acid (CLA) has several benefits, including body fat reduction, as proved in animals. However, the results of CLA-induced body composition alterations in humans are inconsistent, and no related data are available for Chinese populations. This study aimed to determine whether CLA affects body weight (BW) loss and body composition of overweight and obese Chinese subjects.Methods: In this randomized, double-blind, placebo-controlled trial, subjects with a body mass index (BMI) of 24 to 35 kg/m2 randomly received 1.7 g of cis-9,trans-11 and trans-10,cis-12 CLA (n = 30) or placebo (salad oil; n = 33) in 200 mL of sterilized milk twice daily for 12 wk. Changes in body composition were determined by bioimpedance measurements.Results: Sixty-three subjects completed the study (CLA, n = 30). After 12 wk, compared with the baseline, the BW, BMI, total fat mass, fat percentage, subcutaneous fat mass, and waist-to-hip ratio decreased in the CLA group (P < 0.05). The CLA group was stratified by BMI and gender. The BW, BMI, subcutaneous fat mass, and waist-to-hip ratio decreased in 27 subjects with a BMI ≥ 27, and these indices, except subcutaneous fat mass, were lower in female subjects. The levels of total cholesterol, triacylglycerol, low-density lipoprotein, and plasma fasting glucose increased, whereas those of high-density lipoprotein decreased after 3 mo of CLA treatment. The changes were not significantly different from the baseline values.Conclusion: The supplementation of CLA for 12 wk in overweight and grade I obese Chinese subjects yielded lower obesity indices, with no obvious adverse effects.

Japanese traditional miso soup attenuates salt-induced hypertension and its organ damage in Dahl salt-sensitive rats - Corrected Proof

2012-01-20

Abstract: Objective: We investigated the effects of long-term miso soup drinking on salt-induced hypertension in Dahl salt-sensitive (Dahl S) rats.Methods: Dahl S rats were divided into four groups that consumed 1) water, 2) a 0.9% NaCl solution, 3) a 1.3% sodium NaCl solution, or 4) miso soup containing 1.3% NaCl. They were followed for 8 wk. Systolic blood pressure and hypertensive organ damage were determined.Results: Systolic blood pressure increased in an age- and dose-dependent manner in Dahl S rats drinking salt solutions. The systolic blood pressure increase was significantly less in the Dahl S rats that drank miso soup, although the ultimate cumulative salt loading was greater than that in the Dahl S rats given the 1.3% NaCl solution. This blood pressure decrease was associated with a morphologic attenuation of glomerular sclerosis in the kidney and collagen infiltration in the heart. Urinary protein excretions were less in the miso group than in the rats given the 1.3% NaCl solution. The fractional excretion of sodium was increased and that of potassium was decreased in Dahl S rats given the 1.3% NaCl solution, and these effects were reversed in rats given miso soup toward the values of the control.Conclusion: We found that long-term miso soup drinking attenuates the blood pressure increase in salt-induced hypertension with organ damage. This may be caused by a possible retardation of sodium absorption in the gastrointestinal tract or by the direct effects of nutrients in the miso soup from soybeans. The decrease was associated with decreases in cardiovascular and renal damage.

Arginine decreases Cryptosporidium parvum infection in undernourished suckling mice involving nitric oxide synthase and arginase - Corrected Proof

2012-01-20

Abstract: Objective: This study investigated the role of L-arginine supplementation to undernourished and Cryptosporidium parvum–infected suckling mice.Methods: The following regimens were initiated on the fourth day of life and injected subcutaneously daily. The C. parvum–infected controls received L-arginine (200 mmol/L) or phosphate buffered saline. The L-arginine–treated mice were grouped to receive NG-nitro-arginine methyl ester (L-NAME) (20 mmol/L) or phosphate buffered saline. The infected mice received orally 106 excysted C. parvum oocysts on day 6 and were euthanized on day 14 at the infection peak.Results: L-arginine improved weight gain compared with the untreated infected controls. L-NAME profoundly impaired body weight gain compared with all other groups. Cryptosporidiosis was associated with ileal crypt hyperplasia, villus blunting, and inflammation. L-arginine improved mucosal histology after the infection. L-NAME abrogated these arginine-induced improvements. The infected control mice showed an intense arginase expression, which was even greater with L-NAME. L-arginine decreased the parasite burden, an effect that was reversed by L-NAME. Cryptosporidium parvum infection increased urine NO3−/NO2− concentrations compared with the uninfected controls, which was increased by L-arginine supplementation, an effect that was also reversed by L-NAME.Conclusion: These findings show a protective role of L-arginine during C. parvum infection in undernourished mice, with involvement of arginase I and nitric oxide synthase enzymatic actions.

High-carbohydrate/low-protein–induced hyperinsulinemia does not improve protein balance in children after cardiac surgery - Corrected Proof

2012-01-20

Abstract: Objective: In pediatric cardiac surgery, fluid-restricted low-protein (LoProt) diets account for cumulative protein deficits with increased morbidity. In this setting, we aimed to inhibit proteolysis by a high-carbohydrate (HiCarb)-intake–induced hyperinsulinemia and improve protein balance.Methods: The effect of a HiCarb/LoProt (glucose 10 mg · kg−1 · min−1/protein 0.7 g · kg−1 · d−1) versus a normal-carbohydrate (NormCarb)/LoProt (glucose 7.5 mg · kg−1 · min−1/protein 0.3 g · kg−1 · d−1) enteral diet on whole-body protein breakdown and balance was compared in a prospective, randomized, single-blinded trial in 24 children after cardiac surgery. On the second postoperative day, plasma insulin and amino acid concentrations, protein breakdown (endogenous rate of appearance of valine), protein synthesis (non-oxidative disposal of valine), protein balance, and the rate of appearance of urea were measured by using an isotopic infusion of [1-13C]valine and [15N2]urea.Results: The HiCarb/LoProt diet led to a serum insulin concentration that was three times higher than the NormCarb/LoProt diet (596 pmol/L, 80–1833, and 198 pmol/L, 76–1292, respectively, P = 0.02), without differences in plasma glucose concentrations. There were no differences in plasma amino acid concentrations, non-oxidative disposal of valine, and endogenous rate of appearance of valine between the groups, with a negative valine balance in the two groups (−0.65 μmol · kg−1 · min−1, −1.91 to 0.01, and −0.58 μmol · kg−1 · min−1, −2.32 to −0.07, respectively, P = 0.71). The serum cortisol concentration in the HiCarb/LoProt group was lower compared with the NormCarb/LoProt group (204 nmol/L, 50–544, and 532 nmol/L, 108–930, respectively, P = 0.02).Conclusion: In children with fluid restriction after cardiac surgery, a HiCarb/LoProt diet compared with a NormCarb/LoProt diet stimulates insulin secretion but does not inhibit proteolysis further and therefore cannot be advocated for this purpose.

The obesity paradox in elderly patients with heart failure: Analysis of nutritional status - Corrected Proof

2012-01-20

Abstract: Objective: The obesity paradox refers to the improved survival of obese compared with non-obese elderly or diseased patients for reasons that are not clear. To assess the relative roles of fat and other factors in this improved survival, we analyzed the prognostic value of overweight and obesity elderly patients with heart failure (HF), controlling for other nutritional data such as midarm anthropometrics, serum proteins, and muscle strength.Methods: Two hundred forty-four patients (83.2 ± 0.5 y old) hospitalized for HF were included. A nutritional survey was performed in all patients. After discharge, the patients were followed up by telephone.Results: Fourteen patients (5.7%) died during hospitalization. The median survival was 984 d. Patients with better nutritional status as assessed by the body mass index (BMI), subjective score, midarm muscle area, triceps skinfold thickness, handgrip, lymphocyte count, and serum albumin, prealbumin, and cholesterol levels showed better short- and long-term prognoses. Obese patients with a BMI above 30 kg/m2 showed a better long-term prognosis than those with a BMI from 25 to 30 kg/m2, those with a BMI from 20 to 25 kg/m2, and those with a BMI lower than 20 kg/m2. However, survival was not significantly related to a triceps skinfold thickness above the 95th percentile. Obese and overweight patients were younger and had better a nutritional status than those with a normal or decreased BMI as shown by the anthropometrics, subjective score, handgrip, lymphocyte count, hemoglobin, and serum albumin, prealbumin, and cholesterol levels. All the nutritional data correlated closely with each other. New York Heart Association class also correlated with nutrition-derived data: as the HF class increased, the nutritional status deteriorated. On multivariate analysis, to predict long-term survival, neither BMI nor triceps skinfold thickness showed an independent predictive value, whereas a larger midarm muscle area did.Conclusion: The obesity paradox was confirmed in this series of elderly patients with HF. Those with a high BMI and improved survival had a better nutritional status and New York Heart Association functional class than those with a lower BMI, which may explain the differences in survival.

Dietary α-linolenic acid–rich formula reduces adhesion molecules in rats with experimental colitis - Corrected Proof

2012-01-20

Abstract: Objective: The ω-3 polyunsaturated fatty acid therapy in inflammatory bowel disease is focused on the effects on fish oil–derived polyunsaturated fatty acids. We speculated that a vegetal oil rich in α-linolenic acid (ALA) might also inhibit colitis. Therefore, we evaluated whether dietary ALA would decrease the expression of adhesion molecules by inducing the protective enzyme heme oxygenase-1 (HO-1) in a rat colitis model.Methods: Colitis was induced at day 0 by an intrarectal injection of 2-4-6-trinitrobenzen sulfonic acid (TNBS), whereas control rats received the vehicle. Rats were fed an ALA-rich formula 450 mg · kg−1 · d−1, whereas the other colitic group (TNBS) and the control group were fed an isocaloric corn oil formula for 14 d (from day −7 to day 7). The colonic expressions of intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), vascular endothelial growth factor A receptor-2 (VEGFR2), and HO-1 were studied by immunohistochemistry.Results: The ALA-rich diet significantly decreased the expression of ICAM-1, VCAM-1, and VEGFR-2 compared the TNBS group, but it did not affect the expression of HO-1.Conclusion: A vegetal ALA-rich formula decreases the expression of ICAM-1, VCAM-1, and VEGFR-2 and independently of HO-1 in rats with TNBS-induced colitis. Further studies are required to evaluate its therapeutic potential in inflammatory bowel disease as an alternative to fish oil.

Aronia melanocarpa extract suppresses the biotoxicity of homocysteine and its metabolite on the hemostatic activity of fibrinogen and plasma - Corrected Proof

Joanna Malinowska, Karolina Babicz, Beata Olas, Anna Stochmal, Wieslaw Oleszek — 2012-01-20

Abstract: Objective: Aronia melanocarpa fruits (Rosaceae) are one of the richest plant sources of phenolic substances, and it has been shown to have various biological activities. Berries of A. melanocarpa (chokeberry) have been supposed to be beneficial for the prevention of cardiovascular events. In this study the influence of aronia extract on the clot formation (using human plasma and purified fibrinogen) and the fibrin lysis during the model of hyperhomocysteinemia was investigated.Methods: Hyperhomocysteinemia was induced using a reduced form of Hcys (at final dose of 0.1mM) and the most reactive form of Hcys – its cyclic thioester, homocysteine thiolactone (HTL, 1 μM). The aim of our study in vitro was also to investigate the modifications of human plasma total proteins and the oxidative stress (by measuring the total antioxidant level – TAS) in plasma after incubation with Hcys, HTL and/or aronia extract. The biological properties of aronia extract were compared with the action of a well characterized antioxidative commercial polyphenol - resveratrol (3,4',5- trihydroxystilbene).Results: The HTL, like its precursor, Hcys stimulated polymerization of fibrinogen. The results also demonstrated that Hcys (0.1mM) and HLT at lower doses than Hcys (1 μM) reduced the fibrin lysis in human plasma. Moreover, Hcys and HTL change the level of thiol and amino groups in plasma total proteins and induce the oxidative stress in plasma. Our results indicate that aronia extract reduced the biotoxicity action of Hcys and HTL on hemostatic properties of fibrinogen or plasma, suggesting its possible protective properties in hyperhomocysteinemia – induced cardiovascular diseases. Moreover, our results showed that the extract from berries of A. melanocarpa due to antioxidant action, significantly reduced the oxidative stress (measured by TAS) in plasma during the model of hyperhomocysteinemia.Conclusion: In the comparative studies, the extract from berries of A. melanocarpa and reseveratrol had similar protective properties. It gives hopes for development of diet supplements, which may be preventing thrombosis in pathological states where plasma procoagulant activity and oxidative stress are observed e.g. in hyperhomocysteinemia.

Plasma glutathione of HIV+ patients responded positively and differently to dietary supplementation with cysteine or glutamine - Corrected Proof

2012-01-20

Abstract: Objective: Patients with positivity for the human immunodeficiency virus (HIV+) present low concentrations of antioxidant nutrients, including total glutathione (GSH) and its precursors. We investigated the responses of the sulfur-containing amino acid pathway to cysteine and glutamine (Gln) dietary supplements in patients with HIV+ compared with healthy controls.Methods: Twelve treated patients (six men and six women, 22–45 y old) and 20 healthy controls (10 men and 10 women, 20–59 y old) were randomly assigned to 7-d dietary supplements containing N-acetylcysteine (NAC; 1 g/d) or Gln (20 g/d), with a 7-d washout period ingesting their usual diet. Blood samples were drawn after an overnight fast. High-performance liquid chromatographic plasma analysis of sulfur-containing amino acids (methionine, homocysteine, cysteine, and taurine), GSH, oxidized GSH, and serine, glycine, glutamic acid, and Gln was carried out moments before and after 7-d supplementations. Statistical comparisons were undertaken between groups and between dietary supplements (P < 0.05).Results: Patients with HIV+ showed higher oxidized GSH and lower concentrations of GSH and all amino acids except homocysteine. The HIV+ group responded to the NAC by increased levels of sulfur-containing amino acids and GSH and equalized taurine and GSH levels in the control group. The Gln supplements also equalized the levels of GSH, Gln, and glycine in the control group.Conclusion: An increase in GSH may be attained by NAC or Gln supplementation, with NAC acting by increasing cysteine levels and Gln likely acting by replenishing the glycine pool (trial registered at http://www.clinicaltrials.gov, identifier NCT00910442).

25-Hydroxyvitamin D deficiency is associated with fatal stroke among whites but not blacks: The NHANES-III linked mortality files - Corrected Proof

2012-01-20

Abstract: Objective: Deficient 25-hydroxyvitamin D (25[OH]D) levels are associated with cardiovascular disease (CVD) events and mortality. 25(OH)D deficiency and stroke are more prevalent in blacks. We examined whether low 25(OH)D contributes to the excess risk of fatal stroke in blacks compared with whites.Methods: The Third National Health and Nutrition Examination Survey, a probability sample of U.S. civilians, measured 25(OH)D levels and CVD risk factors from 1988 through 1994. Vital status through December 2006 was obtained by a linkage with the National Death Index. In white and black adults without CVD reported at baseline (n = 7981), Cox regression models were fit to estimate hazard ratios (HR) for fatal stroke by 25(OH)D status and race.Results: During a median of 14.1 y, there were 116 and 60 fatal strokes in whites and blacks, respectively. The risk of fatal stroke was greater in blacks compared with whites in models adjusted for socioeconomic status and CVD risk factors (HR 1.60, 95% confidence interval 1.01–2.53). Mean baseline 25(OH)D levels were significantly lower in blacks compared with whites (19.4 versus 30.8 ng/mL, respectively). In multivariable-adjusted models, deficient 25(OH)D levels lower than 15 ng/mL were associated with fatal stroke in whites (HR 2.13, 1.01–4.50) but not blacks (HR 0.93, 0.49–1.80).Conclusions: Vitamin D deficiency was associated with an increased risk of stroke death in whites but not in blacks. Although blacks had a higher rate of fatal stroke compared with whites, the low 25(OH)D levels in blacks were unrelated to stroke incidence. Therefore 25(OH)D levels did not explain this excess risk.

Intravenous free and dipeptide-bound glutamine maintains intestinal microcirculation in experimental endotoxemia - Corrected Proof

2012-01-06

Abstract: Objective: The administration of glutamine (Gln), which is depleted in critical illness, is associated with an improvement of gut metabolism, structure, and function. The aim of the present study was to evaluate the effects of intravenous Gln and its galenic formulation, l-alanyl-l-glutamine dipeptide (AlaGln), on the intestinal microcirculation during experimental endotoxemia using intravital fluorescence microscopy. Gln or AlaGln administration was performed as pretreatment or post-treatment, respectively. To identify further the underlying mechanisms, amino acid levels were studied.Methods: Sixty male Lewis rats were randomly divided into six groups (n = 10/group): control, LPS (lipopolysaccharide 5 mg/kg intravenously), Gln/LPS (LPS animals pretreated with Gln 0.75 g/kg Gln intravenously), AlaGln/LPS (LPS animals pretreated with AlaGln intravenously, 0.75 g/kg Gln content), LPS/Gln (LPS animals post-treated with Gln 0.75 g/kg intravenously), and LPS/AlaGln (LPS animals post-treated with AlaGln intravenously, 0.75 g/kg Gln content). Two hours after the endotoxin challenge, the microcirculation of the terminal ileum was studied using intravital fluorescence microscopy. Blood samples were drawn at the beginning, during, and the end of the experiment to determine the amino acid levels.Results: The Gln and AlaGln pre- and post-treatment, respectively, prevented the LPS-induced decrease in the functional capillary density of the intestinal muscular and mucosal layers (P < 0.05). The number of adherent leukocytes in the submucosal venules was significantly attenuated after the Gln and AlaGln pre- and post-treatment (P < 0.05).Conclusion: The Gln and AlaGln administrations improved the intestinal microcirculation by increasing the functional capillary density of the intestinal wall and decreasing the submucosal leukocyte activation.

The pathophysiology underlying the obesity paradox - Corrected Proof

Peter B. Soeters, Lubos Sobotka — 2012-01-06

Obesity is known to cause a multitude of ailments including cardiovascular disease, diabetes, some forms of cancer, arthrosis, biliary disease, etc. Leading to decreased quality of life and inducing early mortality. Unexpectedly and contrary to expectations, it has been shown in several studies that patients admitted to the hospital because of cardiac failure have lower mortality and live longer when they are obese compared with patients with a normal or low body mass index (BMI; see references 5–16 in Casas-Vara et al. in this issue of Nutrition). Unfortunately, in most of the often huge epidemiologic studies, the only nutritional parameter assessed was the BMI, which is an inadequate indicator of the health status of the individual. Very high levels correctly indicate an abundance of adipose tissue but do not indicate the quantity of the fat-free mass. In fact, muscle mass decreases in chronic illness and in aging (sarcopenia), whereas fat mass may still be abundant or even increase, resulting in a high BMI (). Muscle mass is an important determinant of the health/nutritional state, which, with inflammatory activity (e.g., expressed by high C-reactive protein or low albumin serum levels), determines functional capacity (muscle force and endurance, immune function, and cognitive function). These functional parameters have logically been confirmed as risk factors for the ability to heal well after (surgical) trauma, to react adequately to different types of treatment, to recover from acute illness, and to predict longevity.

Protein restriction inhibits gastric cell proliferation during rat postnatal growth in parallel to ghrelin changes - Corrected Proof

Ariane Kasai, Patrícia Gama, Eliana Parisi Alvares — 2012-01-03

Abstract: Objective: Gastric development depends directly on the proliferation and differentiation of epithelial cells, and these processes are controlled by multiple elements, such as diet, hormones, and growth factors. Protein restriction affects gastrointestinal functions, but its effects on gastric growth are not fully understood.Methods: The present study evaluated cell proliferation in the gastric epithelia of rats subjected to protein restriction since gestation. Because ghrelin is increasingly expressed from the fetal to the weaning stages and might be part of growth regulation, its distribution in the stomach of rats was investigated at 14, 30, and 50 d old.Results: Although the protein restriction at 8% increased the intake of food and body weight, the body mass was lower (P < 0.05). The stomach and intestine were also smaller but increased proportionately throughout treatment. Cell proliferation was estimated through DNA synthesis and metaphase indices, and lower rates (P < 0.05) were detected at the different ages. The inhibition was concomitant with a larger number of ghrelin-immunolabeled cells at 30 and 50 d postnatally.Conclusion: Protein restriction impairs cell proliferation in the gastric epithelium, and a ghrelin upsurge under this condition is parallel to lower gastric and body growth rates.

S–carboxyethylcysteine (a constituent of Acacia seed) negatively affects casein protein utilization by rats - Corrected Proof

Olumuyiwa S. Falade, Steve R.A. Adewusi, Chris E. Harwood — 2012-01-03

Abstract: Objective: Two rat bioassay experiments are reported. The first investigated the first limiting amino acid in Acacia colei and the second experiment investigated the effect of S-carboxyethylcysteine (CEC; a compound present in acacia seed) on protein use.Methods: In the first experiment, Wistar rats were fed A. colei seed supplemented with three levels of methionine, cysteine, and tryptophan (0.1%, 0.2%, and 0.4%). In the second experiment, the Wistar rats were fed CEC-incorporated casein diets.Results: Supplementation of A. colei with tryptophan had no significant effect on the protein efficiency ratio, cysteine showed the highest protein efficiency ratio value at the 0.4% level, and the protein efficiency ratio increased significantly with the increase in methionine content, making methionine the first limiting amino acid. The methionine-induced growth rate was suppressed by the incorporation of CEC, which also had a negative effect on the plasma amino acid levels.Conclusion: The results indicated that methionine is the first limiting amino acid in A. colei and that CEC could affect the seed’s protein use. Acacia colei seed can be used effectively as famine food only if it is complemented with other cereals known to be rich in sulfur amino acids.

Triacylglycerols and body fat mass are possible independent predictors of C3 in apparently healthy young Brazilian adults - Corrected Proof

Ana Carolina Pinheiro Volp, Kiriaque Barra Ferreira Barbosa, Josefina Bressan — 2011-12-30

Abstract: Objective: To evaluate the association between serum concentrations of complement factor-3 (C3) with anthropometric, biochemical, and lifestyle features in healthy young adults.Methods: From 157 young healthy adults 18 to 35 y old, anthropometric measurements and body composition, systolic and diastolic blood pressures, and lifestyle data were collected and analyzed. Blood samples were collected after a 12-h fast for the determination of glucose, triacylglycerols, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, insulin, C3, ceruloplasmin, and uric acid.Results: Complement factor-3 correlated directly with body mass index (r = 0.23417, P = 0.0032), body fat mass (bioelectrical impedance analysis; r = 0.33407, P < 0.0001), percentage of body fat (bioelectrical impedance analysis; r = 0.26873, P = 0.0007), waist circumference (r = 0.21266, P = 0.0075), insulin (r = 0.26152, P = 0.0009), homeostasis model assessment of insulin resistance (r = 0.24831, P = 0.0017), total cholesterol (r = 0.23335, P = 0.0033), triacylglycerols (r = 0.38435, P < 0.0001), and other outcome measurements. In the multiple linear regression analysis, triacylglycerols (r2 = 0.1379, P < 0.0001) and body fat mass (bioelectrical impedance analysis; r2 = 0.0621, P = 0.0010) were independently associated with the C3 concentration after adjusting for age, gender, smoking status, and physical activity.Conclusion: Complement factor-3 seems to be related to several anthropometric and biochemical measurements in healthy young adults. These results demonstrate an independent role of triacylglycerols, a component of the metabolic syndrome, and body fat mass as possible predictors of C3 concentrations. Thus, C3 can be used as an early marker for metabolic syndrome manifestations.

Weight loss and resting energy expenditure in patients with chronic hepatitis C before and during standard treatment - Corrected Proof

2011-12-26

Abstract: Objective: Infection with hepatitis C virus (HCV) is a serious public health problem worldwide. In clinical studies, weight loss has been reported in 11% to 29% of patients treated with pegylated interferon-α-2a/2b. Few reports have tried to explain such a weight loss. The aim of this study was to evaluate nutritional status, body composition, and resting energy expenditure (REE) in patients with chronic hepatitis C before and during treatment with pegylated interferon and ribavirin.Methods: This was a prospective study with the evaluation of patients with hepatitis C virus before and after 12 wk of treatment with pegylated interferon and ribavirin. The evaluation consisted of anthropometry (weight, height, body mass index, and waist circumference), and body composition was determined by bioelectrical impedance analysis. The REE of each individual was obtained by indirect calorimetry. To compare the two phases of treatment, the Wilcoxon test was used. The significance level was 5%.Results: Subjects had significant weight loss during treatment with a consequent decrease in body mass index. This weight decrease was accompanied by a significant decrease in body fat and no decrease in fat-free mass. There was a significant decrease in energy intake as assessed by 24-h recall. However, there was no change in REE and in REE corrected for fat-free mass.Conclusion: Our study of patients with hepatitis C treatment showed that these patients had significant weight loss and this was not associated with changes in energy expenditure. However, we observed a significant decrease in energy intake, pointing to a possible need for intervention measures to decrease the damage.

High salt intake fails to enhance plasma adiponectin in normotensive salt-sensitive subjects - Corrected Proof

2011-12-22

Abstract: Objective: Evidence shows that salt can modulate adiponectin and inflammation levels in normal individuals. Therefore, we hypothesized that abnormalities in adiponectin and inflammation might be the potential mechanism of salt sensitivity. The aim of this study was to investigate whether different alterations of adiponectin and inflammation levels in response to a high-salt intake were exhibited between normotensive salt-sensitive and salt-resistant subjects.Methods: Thirty normotensive subjects (25 to 50 y old) were selected from a rural community of northern China. They were sequentially maintained on a normal diet for 3 d at baseline, a low-salt diet for 7 d (NaCl 3 g/d), and then a high-salt diet for 7 d (18 g/d).Results: Salt sensitivity was diagnosed in 10 subjects who exhibited an increase of at least 10% in mean blood pressure from the low-salt to the high-salt periods. Plasma adiponectin was significantly higher with the high-salt intake than with the low-salt intake (6.1 ± 1.3 versus 7.1 ± 1.7 μg/mL, P = 0.047) in normotensive salt-resistant subjects but not in the normotensive salt-sensitive subjects (6.4 ± 2 versus 5.9 ± 2.1 μg/mL, P = 0.481). The high-salt intake markedly increased plasma tumor necrosis factor-α (P < 0.0001) and monocyte chemoattractant protein-1 (P < 0.0001) in normotensive salt-sensitive and salt-resistant subjects. No signiﬁcant change in plasma high-sensitivity C-reactive protein was observed.Conclusions: Our data indicate that the disturbance of adiponectin exists in normotensive salt-sensitive subjects during a high-salt diet, which may be a novel underlying mechanism of salt sensitivity.

Spreading intake of a leucine-rich fast protein in energy-restricted overweight rats does not improve protein mass - Corrected Proof

2011-12-22

Abstract: Objective: Energy restriction decreases fat mass and fat-free mass. Our aim was to prevent the latter using type and timing of protein nutrition as tools.Methods: Young male Wistar rats were given a high-energy diet for 5 wk and then energy restricted and fed a high-protein diet containing caseins, milk-soluble proteins (MSP), or a casein–MSP mixture (n = 9 per group) as the only source of protein for 3 wk. Food intake was spread over 12 h, whereas in a previous experiment rats consumed their daily ration within 2 to 3 h. Weight and food intake were recorded. The body composition was measured by dual-energy x-ray absorptiometry before and after energy restriction. After 3 wk, the hind-limb muscles, the kidney, intestine, liver, and spleen weights, metabolic plasma parameters, and the liver and extensor digitorum longus muscle protein synthesis rates were measured in the postprandial state.Results: The food intake was similar in all groups. Energy restriction induced a significant decrease in body weight and fat mass (P < 0.001) and stopped the slow growth of lean body mass, with no differences between groups. Among all tissues, a significant effect was detected only for the intestine (P = 0.0012), with a higher weight in the casein group. Postprandial liver and muscle protein synthesis rates were not different between groups.Conclusion: When using a high-protein diet spread over 12 h, the nature of the protein intake has no influence on the sparing of lean body mass during energy restriction in young overweight rats.

Effect of vitamin supplementation on cisplatin-induced intestinal epithelial cell apoptosis in Wistar/NIN rats - Corrected Proof

2011-12-22

Abstract: Objective: Chemotherapeutic agents induce small intestinal mucositis that is characterized structurally by crypt loss and villus atrophy and functionally by absorptive and barrier impairments. We studied the effect of selected individual vitamins and multiple-vitamin mixture supplementation in modulating cisplatin-induced intestinal damage and apoptosis.Methods: Thirty-six male Wistar/NIN rats 20 wk old and fed the control diet (AIN-93G) were randomly divided into six groups. Five groups were administered cisplatin (2.61 mg/kg of body weight) once a week for 3 wk and were concomitantly provided the control diet or riboflavin, folate, α- tocopherol, or a multiple-vitamin mixture supplemented diet. The sixth group served as a control for cisplatin and received saline as the vehicle. Intestinal epithelial cell apoptosis was monitored by morphometry, M30 staining, DNA fragmentation, and caspase-3 activity. Functional and structural integrities were determined by measuring activities of alkaline phosphatase and lysine ala-dipeptidyl aminopeptidase and the villus height/crypt depth ratio. Oxidative burden was assessed as the formation of thiobarbituric acid-reactive substances and protein carbonyls. Plasma levels of selected vitamins were also measured.Results: Cisplatin administration significantly increased intestinal apoptosis in the villus and crypt regions that correlated with increased oxidative damage, decreased Bcl-2/Bax, and compromised functional integrity. Riboflavin, folate, and the multiple-vitamin mixture supplementation attenuated the cisplatin-induced increase in apoptotic indices, with a decrease in oxidative burden, increased Bcl-2/Bax, and improved functional and structural integrities. The α-tocopherol supplementation, although effective in attenuating oxidative stress and improving functional integrity, failed to lower the apoptotic indices.Conclusions: Riboflavin, folate, and the multiple-vitamin supplementation proved to be more efficacious in attenuating the cisplatin-induced intestinal damage and associated changes in apoptosis.

Arginase I and the very low-density lipoprotein receptor are associated with phenotypic biomarkers for obesity - Corrected Proof

2011-12-22

Abstract: Objective: Obesity is a serious health problem implicated in many metabolic disorders (i.e., hypertension, dyslipidemia, and cardiovascular disease). We examined whether the mRNA of tested genes were linked to blood lipid concentrations and vascular endothelial function as features of obesity.Methods: In healthy subjects (30–69 y old; normal weight, n = 22, body mass index 18.5–23 kg/m2; overweight, n = 25, body mass index ≥23 kg/m2) the following parameters were measured in the blood circulation: total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triacylglycerol, apolipoprotein AI, apolipoprotein B, adiponectin, high-sensitivity C-reactive protein, and soluble intercellular adhesion molecule-1. The mRNA levels of genes (arginase I [ARG1], very low-density lipoprotein receptor [VLDLR], adiponectin receptor-1 [ADIPOR1], ADIPOR2, and nitric oxide synthase-3 [NOS3]) were tested in the subjects’ peripheral blood mononuclear cells.Results: The expression levels of all tested genes were investigated for their associations with the blood concentrations of each parameter. In the expression study, only ARG1 (4.5-fold) and VLDLR (4-fold) expressions were significantly upregulated in the overweight group compared with the normal-weight group. The ARG1 mRNA levels were positively associated with blood concentrations of total cholesterol, low-density lipoprotein cholesterol, apolipoprotein B, and soluble intercellular adhesion molecule-1. The VLDLR mRNA levels showed a positive relation with triacylglycerol and glucose concentrations and a negative relation with adiponectin levels.Conclusion: Significant upregulations of ARG1 and VLDLR were observed in the overweight condition and their expression levels are likely to be closely linked to the phenotypic biomarkers for obesity (disturbed lipid profiles and endothelial dysfunction).

Ascorbic acid protects the diaphragm muscle against myonecrosis in mdx mice - Corrected Proof

2011-12-22

Abstract: Objective: Oxidative stress contributes to myonecrosis in the dystrophin-deficient fibers of mdx mice and in Duchenne’s muscular dystrophy. We examined the effects of ascorbic acid (AA), an antioxidant and free radical scavenger, on the dystrophic diaphragm muscle.Methods: Mdx mice (14 d old) received AA for 14 d. Control mdx mice received saline. The muscle damage was visualized by the penetration of Evans blue dye into myofibers and the extent of inflammation was assessed by histologic analysis. Creatine kinase levels were measured for the biochemical evaluation of muscle fiber degeneration. The levels of tumor necrosis factor-α (a proinflammatory cytokine) and 4-hydroxynonenal (a marker of lipid peroxidation) were analyzed by immunoblotting.Results: Ascorbic acid decreased creatine kinase levels, myonecrosis, inflammation, and the levels of tumor necrosis factor-α and 4-hydroxynonenal.Conclusion: The present results suggest that AA plays a protective role in dystrophic muscle degeneration, possibly by decreasing reactive oxygen species, and support further investigations of AA as a potential therapy for dystrophinopathies.

Abrogation of maternal and fetal oxidative stress in the streptozotocin-induced diabetic rat by dietary supplements of Tinospora cordifolia - Corrected Proof

Mahesh Mysore Shivananjappa, Muralidhara — 2011-12-22

Abstract: Objective: Diabetes during pregnancy increases the incidences of congenital anomalies, morbidity, and mortality in the mother and her fetus/newborn. Oxidative stress (OS) has been implicated to be responsible because various antioxidants have been demonstrated to be beneficial in diabetic embryopathy. In this study, we examined the propensity of Tinospora cordifolia (TC) to attenuate embryopathy and OS in pregnant diabetic rats.Methods: Pregnant rats were rendered diabetic with streptozotocin (45 mg/kg of body weight, on gestation day 4) and fed a normal or a TC-supplemented (1% or 2%) diet. After monitoring diet intake, body weight gain, and urine output, dams were sacrificed on gestation day 20 and the markers of OS were determined in the maternal liver and the fetal brain and liver.Results: Although streptozotocin induced a significant (40%) increase in embryopathy, the dietary supplements offered significant protection (63%). Interestingly, TC significantly offset the diabetes-associated OS in the maternal liver as evidenced by the lower levels of malondialdehyde (25%) and reactive oxygen species (72%) and the higher levels of glutathione (53%) and total thiols (45%). The protective effects of TC could be observed even in the fetal milieu, with higher levels of antioxidant molecules and enzymes.Conclusion: These data suggest that TC during pregnancy may provide significant protection against diabetes-induced OS and thus serve as an effective therapeutic supplement.

Anemia prevalence and its determinants in Brazilian institutionalized elderly - Corrected Proof

2011-12-22

Abstract: Objective: To estimate the prevalence of anemia and analyze the factors associated with anemia in elderly residents of long-term care institutions.Methods: This cross-sectional study was performed in male and female elderly volunteers selected in a two-stage random sampling from long-term care institutions in the city of Maringá, Brazil (2008). A diagnosis of anemia was based on the plasma hemoglobin concentration. The independent variables analyzed were gender, age, time of residence at an institution, body mass index, and serum iron and albumin concentrations. The association between anemia and the variables was assessed using the Poisson regression with robust variance in unadjusted and adjusted analyses, considering a complex sample and a significance level of 5%.Results: The sample included 124 adults older than 60 y residing in long-term care institutions (53.0% female). The prevalence of anemia was 29% and was not significantly associated with gender, serum iron concentration, time of residence at an institution, or body mass index. Conversely, hypoalbuminemia was considered a risk factor for anemia.Conclusion: There is a high prevalence of anemia in the institutionalized elderly and hypoalbuminemia is a factor associated with this outcome. Interventions are necessary to promote improvements in the health and welfare of this population.

Consumption and factors influencing consumption of fruit and vegetables among elderly Chinese people - Corrected Proof

2011-12-19

Abstract: Objective: There is substantial evidence that the low intake of fruit and vegetables (FV) is a major risk factor for many nutrition-related non-communicable diseases. The purpose of our study was to assess FV consumption and the variables that influence FV consumption among Chinese people age 60 and older.Methods: Twenty-four-hour dietary recall data from the 1991, 1993, 1997, 2000, 2004, 2006, and 2009 China Health and Nutrition Surveys were used to collect the FV intake and sociodemographic variables examined in this article. Data were analyzed using t tests, χ2 tests, and logistic regression.Results: Between 1991 and 2009, elderly Chinese adults experienced an improvement in dietary FV intake. The FV consumption increased from 325.7 g/d in 1991 to 379.0 g/d in 2009. During this 18-y period, the proportion of daily consumers increased from 11.0% to 32.5% for fruit and remained over 95% for vegetables. Age, gender, educational attainment, community, activity level, marital status, and drinking were significantly associated with FV consumption.Conclusion: The findings of this study indicated that FV intake among elderly adults in China was lower than the minimum of 400 g/d recommended by the World Health Organization. Greater public health efforts and approaches are needed to promote FV consumption in elderly Chinese adults.

Additive, antagonistic, and synergistic effects of procyanidins and polyunsaturated fatty acids over inflammation in RAW 264.7 macrophages activated by lipopolysaccharide - Corrected Proof

2011-12-15

Abstract: Objective: Macrophages play an important role in immunogenic challenges and can aggravate and propagate local inflammation. Nuclear factor-kappa B (NF-κB) and activator protein 1 pathways can regulate these inflammatory processes by modulating expression of proinflammatory genes. Bioactive molecules present in food, such as procyanidins and polyunsaturated fatty acids, possess antiinflammatory effects in vivo and in vitro. Our aim was to assess whether they have synergistic antiinflammatory effects in murine macrophages.Methods: A nitric oxide production assay, a phosphoprotein assay, and a low-density array for 91-gene expression related to inflammation, oxidative stress, and metabolism were performed to assess the synergistic antiinflammatory effects of dimeric procyanidins (B1, B2, B3, B4) (5 μg/mL), and the polyunsaturated fatty acids, docosahexaenoic acid, and eicosapentaenoic acid (30 μM) coincubated with lipopolysaccharide for 19 h to mimic inflammation in RAW 264.7 macrophages (mouse leukaemic monocyte macrophage cell line).Results: Adding eicosapentaenoic acid plus B3 had synergistic effects leading to decreased nitric oxide levels; the modulation of phosphoprotein levels, such as P-nuclear factor-[kappa] B p65 and P-stress-activated protein kinase/Jun-amino-terminal kinase; the down-regulation of proinflammatory genes, such as interleukins, chemokines, transcription factors; and up-regulation of antioxidant genes.Conclusion: This combination has a stronger antiinflammatory effect than either of these molecules separately in RAW macrophages. These results could lead to in vivo studies that may yield novel preventive or palliative nutritional treatments for obesity, atherosclerosis, and cardiovascular diseases.

Proactive screening identifies alarming prevalence of malnutrition among hospitalized patients—Action is needed - Corrected Proof

2011-12-15

Abstract: Objective: Malnourished patients suffer from higher morbidity and mortality rates than well-nourished patients do. However, few studies have controlled the outcomes for the underlying illnesses. Our aim was to determine the prevalence of malnutrition among patients admitted to the internal medicine ward and to determine whether malnutrition is an independent risk factor for adverse outcomes in these settings.Methods: Consecutive patients screened for malnutrition with the MUST (Malnutrition Universal Screening Tool), admitted to an internal medicine department, were included in this study. Demographic data, background disease, laboratory results, length of stay, and mortality rates were retrieved from the computerized file and Charlson Comorbidity Index (CCI) was calculated. Univariate and multivariate analyses were used to check for the association of malnutrition and outcome measures.Results: One thousand consecutive patients were included in the study. Mean age was 67.6 y; 25.4% of patients were found to be at high risk for malnutrition. Patients at high risk for malnutrition had significantly longer length of stay and mortality rates than well-nourished patients (9.7 d versus 6.2 d and 19.3% versus 3.2%; accordingly [P < 0.001]). On multivariate analyses, increased mortality was found to be associated with a high risk for malnutrition as well as pneumonia, acute myocardial infarction, acute renal failure, or shock on admission and a high CCI score.Conclusion: The prevalence of malnutrition among hospitalized patients, as measured by the MUST score, is common. Malnutrition is prevalent and represents an independent and significant risk factor for in-hospital mortality and increased length of stay in patients admitted to the internal medicine ward.

Effects of a normolipidic diet containing trans fatty acids during perinatal period on the growth, hippocampus fatty acid profile, and memory of young rats according to sex - Corrected Proof

Amanda Santos de Souza, Mônica Santos Rocha, Maria das Graças Tavares do Carmo — 2011-12-15

Abstract: Objective: To investigate whether dietary trans fatty acids (TFAs) are incorporated in the hippocampus and its effects on the growth and aversive and spatial memories of young rats.Methods: Wistar rat offspring whose mothers were fed with normolipidic diets containing soybean oil (soy group) or hydrogenated vegetable oil (trans group) during gestation and lactation were used. Male and female pups received the same diets as their mothers until the end of behavioral testing. The composition of fatty acids in the total lipids of the diets and hippocampus was quantified by gas chromatography. The results were evaluated by Student’s t test or analysis of variance followed by the Bonferroni correction.Results: The trans male and female body weights were higher during lactation and after weaning, with trans males having the lower body weight of the two. There was incorporation of 0.11% and 0.17% of TFAs in the hippocampi of male and female rats, respectively. During passive avoidance test, there was no significant difference. In the water maze test, there was no significant difference between male groups in the training and retention phases, except on day 4, when there was a significant decrease in latency in trans males. Trans females were worse on day 2 only and showed an improvement in spatial memory during the probe trial.Conclusion: The TFAs were incorporated in small amounts in the hippocampus and did not affect aversive memory. However, spatial memory was modified in young rats fed with a diet rich in TFAs. These findings suggested that, in addition to the TFA content of the diet provided, it is important to consider the provision of essential fatty acids and the ω-6/ω-3 ratio.

Counteraction of oxidative damage in the rat liver by an ancient grain (Kamut brand khorasan wheat) - Corrected Proof

2011-12-02

Abstract: Objective: We previously demonstrated in rat plasma the antioxidant protective effect of whole-grain bread, particularly when made from Kamut brand khorasan wheat. In the present study, we investigated the effects of the same experimental breads in rat liver using two different bread-making procedures (baker’s yeast and sourdough fermentation).Methods: Rats were examined in the basal condition and after the administration of doxorubicin, a pro-oxidative agent. The following parameters were measured in liver homogenates: glutathione peroxidase and thioredoxin reductase activities, as antioxidant enzymes containing selenium; glutathione, α-tocopherol and β-carotene, as major non-enzymatic cell antioxidants; malondialdehyde and advanced oxidation protein products, as markers of oxidative damage to lipids and proteins, respectively. A histologic evaluation of liver tissue was also conducted.Results: In agreement with our previous work, we observed a lower oxidative status and a different activity of glutathione peroxidase and thioredoxin reductase in rats fed the whole-grain Kamut khorasan bread than in rats fed the modern whole-grain durum wheat bread. Histologic evaluation of the hepatic tissue showed the onset of inflammation in response to doxorubicin only in rats fed the modern durum wheat bread.Conclusion: Our data confirm that bread made from whole-grain Kamut khorasan protects rats from oxidative stress better than bread made from whole-grain durum wheat. This is consistent with their different antioxidant profiles. The type of wheat used for bread-making appeared to be the main determinant of the observed protective effect.

Probiotic yogurt improves antioxidant status in type 2 diabetic patients - Corrected Proof

2011-12-02

Abstract: Objective: Oxidative stress plays a major role in the pathogenesis and progression of diabetes. Among various functional foods with an antioxidant effect, probiotic foods have been reported to repress oxidative stress. The objective of this clinical trial was to assess the effects of probiotic and conventional yogurt on blood glucose and antioxidant status in type 2 diabetic patients.Methods: Sixty-four patients with type 2 diabetes mellitus, 30 to 60 y old, were assigned to two groups in this randomized, double-blind, controlled clinical trial. The patients in the intervention group consumed 300 g/d of probiotic yogurt containing Lactobacillus acidophilus La5 and Bifidobacterium lactis Bb12 and those in the control group consumed 300 g/d of conventional yogurt for 6 wk. Fasting blood samples, 24-h dietary recalls, and anthropometric measurements were collected at the baseline and at the end of the trial.Results: Probiotic yogurt significantly decreased fasting blood glucose (P < 0.01) and hemoglobin A1c (P < 0.05) and increased erythrocyte superoxide dismutase and glutathione peroxidase activities and total antioxidant status (P < 0.05) compared with the control group. In addition, the serum malondialdehyde concentration significantly decreased compared with the baseline value in both groups (P < 0.05). No significant changes from baseline were shown in insulin concentration and erythrocyte catalase activity within either group (P > 0.05).Conclusion: The consumption of probiotic yogurt improved fasting blood glucose and antioxidant status in type 2 diabetic patients. These results suggest that probiotic yogurt is a promising agent for diabetes management.

Effect of zinc- and micronutrient-rich food supplements on zinc and vitamin A status of adolescent girls - Corrected Proof

Shashi A. Chiplonkar, Rama Kawade — 2011-12-02

Abstract: Objectives: The present study was aimed at assessing the effect of zinc- and micronutrient-rich food supplementation compared with ayurvedic zinc tablets on the blood levels of zinc and vitamin A in adolescent girls.Methods: One hundred eighty apparently healthy schoolgirls (12.5 ± 0.85 y old) were recruited for a 10-wk intervention trial. They were randomized to three groups: one group received a food supplement that was prepared using zinc- and micronutrient-rich foods and by adopting food-processing methods that increase zinc bioavailability; the second group received ayurvedic zinc (Jasad) tablets as a natural elemental zinc supplement; and the third group served as the control without any supplementation. Diet was assessed by 24-h recall on 3 non-consecutive days. Fasting blood samples were analyzed for plasma levels of zinc, β-carotene, retinol, vitamin C, and hemoglobin at baseline and the end of the study period.Results: Food supplementation showed a significant increase in plasma levels of zinc (9.9%), β-carotene (56.2%), and vitamin C (28.0%, P < 0.05) and a non-significant increase in hemoglobin (1.7%), although small, non-significant changes in blood micronutrient levels were observed in the control group (P > 0.1). Food supplementation decreased the prevalence of zinc deficiency (73% to 53.1%), β-carotene deficiency (31.1% to 17.4%), and mild anemia (32.2% to 23.7%). Ayurvedic zinc supplementation significantly improved plasma zinc (61.3%) and plasma retinol (38.2%) and decreased the prevalence of zinc deficiency (73.7% to 36.2%) and vitamin A deficiency (65.4% to 20.4%, P < 0.05).Conclusion: Zinc- and micronutrient-rich food supplementation was effective in improving the zinc and vitamin A status of adolescent girls.

Factors leading to discrepancies between prescription and intake of enteral nutrition therapy in hospitalized patients - Corrected Proof

2011-11-28

Abstract: Objective: We investigated factors leading to a reduction in enteral nutrition (EN) prescribed by a nutritional support team (NST) at a general hospital in Brazil.Methods: In this prospective, observational study, hospitalized adults receiving only EN therapy via tube feeding were followed for up to 21 d from July to October 2008.Results: The 152 subjects analyzed included 38 (23.5%) ward patients and 124 (76.5%) intensive care unit (ICU) patients. Eighty percent of the targeted feeding volume was achieved on day 4 by 80% of the patients. Reasons for not receiving the total amount of EN prescribed included delay in EN administration (3.1%), abdominal distention (5.6%), patient refusal of treatment (6.8%), feeding tube obstruction (8.6%), vomiting (10.5%), diarrhea (17.9%), unknown causes (17.9%), interference by a non-NST physician (25.9%), accidental feeding tube loss (34%), presence of high gastric residual (34%), and operational logistics at the hospital's Nutrition and Dietetics Service (99.4%). There was a significant association between patients who received <60% of the prescribed EN and external physician interference (P < 0.016). ICU patients also received inadequate EN (P < 0.025). Neurologic patients had a greater chance of receiving >81% of the prescribed EN amount than cardiac patients (odds ratio 3.75, P < 0.01).Conclusion: Major reasons for inadequate EN intake are (in decreasing order) operational logistical problems, gastric stasis, accidental loss of enteral feeding tube, and interference by an external physician (not an NST member). Cardiologic patients and ICU patients are at a higher risk for inadequacy than neurologic patients.

Superiority of a fish oil–enriched emulsion to medium-chain triacylglycerols/long-chain triacylglycerols in gastrointestinal surgery patients: A randomized clinical trial - Corrected Proof

Jin Wang, Jian-Chun Yu, Wei-Ming Kang, Zhi-Qiang Ma — 2011-11-24

Abstract: Objective: Compared with soybean oil, a fish oil–enriched emulsion can improve the clinical outcomes of patients requiring parenteral nutrition. However, the superiority of fish oil emulsion to medium-chain triacylglycerols/long-chain triacylglycerols for short-term administration has seldom been discussed.Methods: Sixty-four adult patients with gastrointestinal diseases were randomly assigned to receive isocaloric and isonitrogenous total parenteral nutrition with an ω-3 fatty acid–enriched emulsion (Lipoplus; study group, n = 32) or medium-chain triacylglycerols/long-chain triacylglycerols (Lipofundin; control group, n = 32) for 5 d after surgery. Safety and efficacy parameters were assessed on postoperative days 1, 3, and 6.Results: Clinical outcomes including infectious complications and systemic inflammatory response syndrome were comparable between the two groups. Total bilirubin decreased over time in the study group versus an increase in the control group (P = 0.017). Activated partial thromboplastin time in the study group was prolonged significantly compared with the control group from days 1 to 3 (P = 0.002), although the prolongation stopped at the study termination. There were no differences in changes of C-reactive protein, interleukin (IL)-1, IL-8, IL-10, vascular endothelial growth factor (VEGF), and the distribution of the T-cell subpopulation between the two groups. However, fish oil consumption led to an increase in leukotriene B5/ leukotriene B4 and significant decreases in IL-6, tumor necrosis factor-α, and nuclear factor-κB. Furthermore, the overall changes in tumor necrosis factor-α and nuclear factor-κB were positively associated (R2 = 0.295, P < 0.001).Conclusions: Gastrointestinal surgery patients benefited from a fish oil–enriched emulsion rather than medium-chain triacylglycerols/long-chain triacylglycerols in the amelioration of liver function and immune status. The positive association of tumor necrosis factor-α and nuclear factor-κB might be involved in the potential anti-inflammation mechanism of fish oil.

Dietary intake of Agaricus bisporus white button mushroom accelerates salivary immunoglobulin A secretion in healthy volunteers - Corrected Proof

Sang Chul Jeong, Sundar Rao Koyyalamudi, Gerald Pang — 2011-11-24

Abstract: Objective: Secretory immunoglobulin A (SIgA) acts as the first line of adaptive humoral immune defense at mucosal surfaces. A lack of SIgA or the inability to produce antigen-specific SIgA can lead to an increased risk of infections. Dietary intake may improve mucosal immunity by accelerating SIgA secretion. This study investigated the effect of dietary intake of Agaricus bisporus white button mushroom (WBM) on salivary IgA (sIgA) secretion in healthy subjects.Methods: Twenty-four healthy volunteers were randomly assigned to a normal daily diet (control group) or a normal diet with WBM. The subjects in the active group (n = 12, 41.4 ± 11.3 y old) consumed 100 g of blanched WBM daily with their normal diet for 1 wk, whereas those in the control group consumed their normal diet (n = 12, 43.5 ± 12.5 y old) without WBM. Saliva was collected before and after commencement of the study and every week thereafter for 3 wk. Saliva flow rate, sIgA concentration, and osmolality were determined and the sIgA:osmolality ratio and the sIgA secretion rate were calculated.Results: There was no significant difference between pre- and postdietary mushroom intakes for all indices in the control group (P > 0.05). In contrast, the mean sIgA secretion rate increased significantly at weeks 1 and 2 by 53% and 56%, respectively, compared with that at week 0 (P < 0.0005) in the WBM intake group and then returned to a baseline level at week 3. Changes in sIgA secretion rate over the intervention period were greater in the WBM group than in the control group without WBM. In both groups, no significant changes in osmolality and saliva IgG were noted. There was, however, a significant increase in the sIgA:osmolality ratio (P < 0.0012), confirming the postdietary WBM-induced sIgA increase.Conclusion: The dietary intake of A. bisporus WBM significantly accelerates sIgA secretion, thereby indicating its potential health benefits for improving mucosal immunity.

Characteristics of under- and over-reporters of energy intake among Japanese children and adolescents: The Ryukyus Child Health Study - Corrected Proof

2011-11-24

Abstract: Objective: Evidence on factors associated with misreporting of energy intake in children and adolescents is sparse, particularly in non-Western countries. We examined the characteristics of under- and over-reporters of energy intake in Japanese children and adolescents.Methods: This study included 25 761 Japanese boys and girls 6 to 15 y old. Energy intake was assessed using a self-administered diet history questionnaire developed for Japanese children and adolescents. Estimated energy requirement was calculated from self-reported body weight with the use of equations from the Food and Agriculture Organization (FAO)/World Health Organization (WHO)/United Nations University (UNU) Expert Consultation Report on Human Energy Requirements. Under-reporters, acceptable reporters, and over-reporters of energy intake were identified based on the ratio of energy intake to estimated energy requirement (<0.76, 0.76 to 1.24, and >1.24, respectively). The risk of being an under- or over-reporter of energy intake compared with being an acceptable reporter was analyzed using logistic regression.Results: The percentages of under-, acceptable, and over-reporters of energy intake were 31.6%, 53.2%, and 15.2%, respectively. Under-reporting was associated with female sex, older age, overweight and obesity, low parental education, and completion of the dietary questionnaire without the cooperation of parent(s)/caregiver(s). Over-reporting was associated with younger age, normal weight, low parental education, and completion of the dietary questionnaire by the child/adolescent alone (compared with completion by the child/adolescent and parent[s]/caregiver[s]).Conclusions: Although under- and over-reporting of energy intake were common and differential in this study of Japanese children and adolescents, the cooperation of parent(s)/caregiver(s) in answering the dietary questionnaire seemed to improve the quality of dietary intake data.

Coenzyme Q10 supplementation and exercise-induced oxidative stress in humans - Corrected Proof

Bengt Östman, Anders Sjödin, Karl Michaëlsson, Liisa Byberg — 2011-11-14

Abstract: Objective: The theoretically beneficial effects of coenzyme Q10 (Q10) on exercise-related oxidative stress and physical capacity have not been confirmed to our knowledge by interventional supplementation studies. Our aim was to investigate further whether Q10 supplementation at a dose recommended by manufacturers influences these factors.Methods: Using a randomized, double-blind, controlled design, we investigated the effect on physical capacity of 8 wk of treatment with a daily dose of 90 mg of Q10 (n = 12) compared with placebo (n = 11) in moderately trained healthy men 19 to 44 y old. Two days of individualized performance tests to physical exhaustion were performed before and after the intervention. Primary outcomes were maximal oxygen uptake, workload, and heart rate at the lactate threshold. Secondary outcomes were creatine kinase, hypoxanthine, and uric acid.Results: No significant differences between the groups were discerned after the intervention for maximal oxygen uptake (−0.11 L/min, 95% confidence interval −0.31 to 0.08, P = 0.44), workload at lactate threshold (6.3 W, −13.4 to 25.9, P = 0.36), or heart rate at lactate threshold (2.0 beats/min, −4.9 to 8.9, P = 0.41). No differences between the groups were detected for hypoxanthine or uric acid (serum markers of oxidative stress) or creatine kinase (a marker of skeletal muscle damage).Conclusion: Although in theory Q10 could be beneficial for exercise capacity and in decreasing oxidative stress, the present study could not demonstrate that such effects exist after supplementation with a recommended dose.

Oral administration of docosahexaenoic acid attenuates interleukin-1β response and clinical course of septic neonates - Corrected Proof

2011-11-14

Abstract: Objective: To analyze cytokine responses and the clinical course of septic neonates orally supplemented with docosahexaenoic acid as well as to evaluate fatty acid incorporation into leukocytes.Methods: A quasiexperimental study was conducted in neonates who developed sepsis following a surgical procedure. Selected neonates were randomly assigned to receive 100 mg docosahexaenoic acid (G-DHA) daily or olive oil (G-OO) as placebo for 14 d throughout a sepsis episode. At selection (baseline), blood samples were obtained to determine interleukin-1 (IL-1)β, interleukin-6 (IL-6), and tumor necrosis factor-α as well as the leucocyte fatty acid profile. Measurements were repeated at 7 (D7) and 14 d (D14) of follow-up. Within- and between-group comparisons were conducted with parametric statistics after logarithmic transformation. Repeated measurement analyses with a general linear model procedure were used, adjusting according to human milk intake, use of anti-inflammatory drugs, and nutritional status.Results: Sixty-three neonates were included: 29 in G-DHA group and 34 in G-OO group. Although decreases of cytokines during hospitalization were similar in both groups, there was a greater decrease of IL-1β in the G-DHA group than in the G-OO group after adjusting by confounders (P = 0.028). Leukocyte docosahexaenoic acid increased from 4.96 ± 2.96 at baseline to 5.52 ± 3.05 and 5.92 ± 2.8 at D7 and D14, respectively, in the G-DHA group (P = 0.044). Illness severity was inversely associated with the proportion of docosahexaenoic acid in leukocytes throughout follow-up (P = 0.034).Conclusions: Oral supplementation with docosahexaenoic acid to neonates attenuates IL-1β response and the clinical course of sepsis. This may be an additional strategy to further benefit ill neonates even if they are not candidates for parenteral nutrition.

Impact of barbecued meat consumed in pregnancy on birth outcomes accounting for personal prenatal exposure to airborne polycyclic aromatic hydrocarbons: Birth cohort study in Poland - Corrected Proof

2011-11-14

Abstract: Objective: We previously reported an association between prenatal exposure to airborne polycyclic aromatic hydrocarbons (PAH) and lower birth weight, birth length, and head circumference. The main goal of the present analysis was to assess the possible impact of coexposure to PAH-containing barbecued meat consumed during pregnancy on birth outcomes.Materials and Methods: The birth cohort consisted of 432 pregnant women who gave birth at term (>36 wk of gestation). Only non-smoking women with singleton pregnancies, 18–35 y of age, and who were free from chronic diseases such as diabetes and hypertension, were included in the study. Detailed information on diet over pregnancy was collected through interviews and the measurement of exposure to airborne PAHs was carried out by personal air monitoring during the second trimester of pregnancy. The effect of barbecued meat consumption on birth outcomes (birth weight, length, and head circumference at birth) was adjusted in multiple linear regression models for potential confounding factors such as prenatal exposure to airborne PAHs, child's sex, gestational age, parity, size of mother (maternal prepregnancy weight, weight gain in pregnancy), and prenatal environmental tobacco smoke.Results: The multivariable regression model showed a significant deficit in birth weight associated with barbecued meat consumption in pregnancy (coeff = −106.0 g; 95%CI: −293.3, −35.8). The effect of exposure to airborne PAHs was about the same magnitude order (coeff. = −164.6 g; 95%CI: −172.3, −34.7). Combined effect of both sources of exposure amounted to birth weight deficit of 214.3 g (95%CI: −419.0, −9.6). Regression models performed for birth length and head circumference showed similar trends but the estimated effects were of borderline significance level. As the intake of barbecued meat did not affect the duration of pregnancy, the reduced birth weight could not have been mediated by a shortened gestation period.Conclusion: In conclusion, the study results provided epidemiologic evidence that prenatal PAH exposure from diet including grilled meat might be hazardous for fetal development.

Coenzyme Q10, vitamin E, selenium, and methionine in the treatment of chronic recurrent viral mucocutaneous infections - Corrected Proof

2011-11-14

Abstract: Objective: Host defense and latency determinants in viral recurrent dermatologic infections are not entirely understood, as conventional protocols are inadequate to achieve fast healing and relapse prevention. Endogenously produced oxygen/nitrogen reactive species (ROS/RNS) are essential for antiviral immune defense, while their excess may aggravate skin inflammation. Here, we sought a nutritional approach capable of controlling ROS/RNS balance to accelerate recovery and inhibit recurrences of two mucocutaneous chronic DNA-virus infections.Methods: Two controlled clinical trials evaluated the feasibility of ROS/RNS-modulating nutriceutical dosages of coenzyme Q10, RRR-α-tocopherol, selenium aspartate, and L-methionine associated with established therapies. Clinical trial 1 evaluated 68 patients with relapsing human papillomavirus skin warts treated with cryotherapy followed by 180 d of nutriceutical/placebo administration. Clinical trial 2 compared the combination of acyclovir followed by 90 d of nutriceutical administration versus acyclovir alone in patients with recurrences of herpes simplex genitalis (n = 60) or herpes zoster (n = 29). Viral DNA levels were assessed by polymer chain reaction, biomarkers of antiviral defense (peroxynitrite and IFNα/γ) and antioxidant capacity (lipophilic antioxidants and glutathione) were assayed by biochemical/enzyme-linked immunosorbent assay techniques in blood fractions.Results: In both trials, the nutriceutical induced significantly faster healing (P < 0.01-0.05) with reduced incidence of relapses (P < 0.05) as compared to control groups, which was confirmed by decreased viral load and increased antiviral cytokine and peroxynitrite plasma levels. Plasma antioxidant capacity was higher (P < 0.01) in the experimental versus control groups.Conclusions: Results document positive clinical outcomes of the selected nutriceutical associated with conventional protocols in the management of relapsing mucocutaneous human papillomavirus and herpes infections.

Effects of leucine supplementation and resistance exercise on dexamethasone-induced muscle atrophy and insulin resistance in rats - Corrected Proof

2011-11-14

Abstract: Objective: We aimed to evaluate the effects of resistance exercise (RE) and leucine (LEU) supplementation on dexamethasone (DEXA)-induced muscle atrophy and insulin resistance.Methods: Male Wistar rats were randomly divided into DEXA (DEX), DEXA + RE (DEX-RE), DEXA + LEU (DEX-LEU), and DEXA + RE + LEU (DEX-RE-LEU) groups. Each group received DEXA 5 mg · kg−1 · d−1 for 7 d from drinking water and were pair-fed to the DEX group; LEU-supplemented groups received 0.135 g · kg−1 · d−1 through gavage for 7 d; the RE protocol was based on three sessions of squat-type exercise composed by three sets of 10 repetitions at 70% of maximal voluntary strength capacity.Results: The plantaris mass was significantly greater in both trained groups compared with the non-trained groups. Muscle cross-sectional area and fiber areas did not differ between groups. Both trained groups displayed significant increases in the number of intermediated fibers (IIa/IIx), a decreased number of fast-twitch fibers (IIb), an increased ratio of the proteins phosphoSer2448/total mammalian target of rapamycin and phosphoThr389/total 70-kDa ribosomal protein S6 kinase, and a decreased ratio of phosphoSer253/total Forkhead box protein-3a. Plasma glucose was significantly increased in the DEX-LEU group compared with the DEX group and RE significantly decreased hyperglycemia. The DEX-LEU group displayed decreased glucose transporter-4 translocation compared with the DEX group and RE restored this response. LEU supplementation worsened insulin sensitivity and did not attenuate muscle wasting in rats treated with DEXA. Conversely, RE modulated glucose homeostasis and fiber type transition in the plantaris muscle.Conclusion: Resistance exercise but not LEU supplementation promoted fiber type transition and improved glucose homeostasis in DEXA-treated rats.

Enteral nutrition supplemented with l-glutamine in patients with systemic inflammatory response syndrome due to pulmonary infection - Corrected Proof

2011-11-07

Abstract: Objective: To evaluate the effect of enteral nutrition (EN) supplemented with l-glutamine on glycolytic parameters, inflammation, immune function, and oxidative stress in moderately ill intensive care patients with sepsis.Methods: Thirty patients received EN. Fifteen patients received EN supplemented with glutamine (30 g; GLN group) for 2 d followed by EN supplemented with calcium caseinate (30 g, CAS group), also over 2 d. The other 15 patients received EN with calcium caseinate (30 g; CAS group) for 2 d followed by EN with glutamine (30 g; GLN group), also over 2 days. One washout day with only EN was provided between every 2-d period of EN plus supplementation to all patients. Blood samples were taken before and after supplementation.Results: There were no changes in glycolytic parameters in either group. Leukocytes decreased in the two groups (from 13 650 to 11 500 in the CAS group, P = 0.019; from 12.850 to 11.000 in the GLN group, P = 0.046). Lymphocytes increased in the GLN group (from 954 to 1916, P < 0.0001) and were more numerous after glutamine supplementation (from 1916 to 1085, P < 0.0001, GLN versus CAS). No significant changes were observed in interleukin levels, but urea levels were higher in the GLN compared with the CAS group (50.0–47.0, P = 0.030). Glutathione plasma concentrations did not differ significantly between the groups. No significant changes were observed in the plasma glutamine and glutamate concentrations.Conclusions: The EN supplemented with glutamine increased the lymphocyte count and helped to decrease lipid peroxidation but presented no effect on the antioxidant glutathione capacity and on cytokine concentrations or glycolytic parameters.

Daily vitamin supplementation and hypovitaminosis after obesity surgery - Corrected Proof

2011-11-07

Abstract: Objective: The objective of this study was to determine whether constant daily vitamin supplementation would be sufficient to prevent possible vitamin deficiencies in obese patients undergoing bariatric surgery.Methods: The study was conducted on 58 men and women (mean age 41 ± 10 y) who underwent Roux-en-Y gastric bypass RYGB and were assessed preoperatively and at 3, 6, and 12 mo after surgery. During the postoperative period, the patients received a multivitamin-mineral supplement on a daily basis.Results: Serum β-carotene and vitamin C were lower starting from the third postoperative month and continued to be low after 12 mo, and vitamin A was decreased by the sixth month and increased by 12 mo. Vitamin B12 levels were stable up to 6 mo but were decreased by 12 mo. Folic acid levels increased from the third month and remained higher throughout follow-up. One year after surgery there were 19% and 21% increases in the number of patients with vitamin A and vitamin C deficiency, respectively, and a 4% decreased of patients with folic acid deficiency.Conclusion: Weight loss and improvement in patients’ general condition followed surgery, but serum levels of some vitamins were decreased despite the use of a vitamin-mineral supplement. These patients need continuous follow-up and individualized prescription of supplementation after the surgical procedure to prevent and treat vitamin deficiencies.

Augmentation of cellular immunity and protection against influenza virus infection by bovine late colostrum in mice - Corrected Proof

2011-11-07

Abstract: Objective: We investigated whether oral administration of skimmed and concentrated bovine late colostrum (SCBLC) activates the immune system and protects against influenza virus (Flu) infection.Methods: Murine Peyer's patch (PP) cells (2.5 105) were cultured in 0.1 ml RPMI-1640 supplemented with SCBLC at a concentration of 0, 0.1 or 1.0 mg/ml. To determine the levels of IL-12 and IFN-, supernatants were collected on day 3. Mice were orally administered sterile saline solution (control group), or 400 g/g body weight (SCBLC 400 group) or 2,000 g/g body weight (SCBLC 2,000 group) of SCBLC for three weeks. These mice were measured for natural killer (NK) cells activity on PP cells, splenocytes and lung cells. Also, these mice in the control and SCBLC 2,000 groups were infected with Flu and were measured for the accumulated symptom rate.Results: In PP cells cultured with SCBLC, the levels of IL-12 and IFN- were significantly increased in vitro. Oral administration of SCBLC to mice significantly increased NK cell activity of PP cells, splenocytes and lung cells. The accumulated symptom rate of the SCBLC 2,000 group was significantly lower than that of the control group in a mouse model of Flu infection.Conclusion: These results indicate that oral administration of SCBLC activates not only systemic cellular immunity but also local cellular immunity, such as in the respiratory tract, and that activation of cellular immunity is one of the mechanisms of amelioration of Flu infection.

Nutritional and biochemical parameters associated with 6-year change in bone mineral density in community-dwelling Japanese women aged 69 years and older: The Muramatsu Study - Corrected Proof

2011-09-15

Abstract: Objective: Predictors of bone loss in elderly Asian women have been unclear. This cohort study aimed to assess lifestyle, nutritional, and biochemical predictors of bone loss in elderly Japanese women.Methods: Subjects included 389 community-dwelling women aged 69 y and older from the Muramatsu cohort initiated in 2003; follow-up ended in 2009. We obtained data on physical characteristics, osteoporosis treatment (with bisphosphonates or selective estrogen receptor modulators), physical activity, calcium intake, serum 25-hydroxyvitamin D, undercarboxylated osteocalcin, serum albumin, and bone turnover markers as predictors. The outcome was a 6-y change in forearm BMD (ΔBMD). Osteoporosis treatment was coded as 0 for none, 1 for sometimes, and 2 for always during the follow-up period. Stepwise multiple linear regression analysis was used to identify independent predictors of ΔBMD.Results: Mean age of the subjects was 73.3 y. Mean values of ΔBMD and Δweight were −0.019 g/cm2 (−5.8%) and −2.2 kg, respectively. Stepwise multiple linear regression analysis revealed baseline BMD (β = −0.137, P < 0.0001), osteoporosis treatment (β = 0.0068, P = 0.0105), serum albumin levels (β = 0.0122, P = 0.0319), and Δweight (β = 0.0015, P = 0.0009) as significant independent predictors of ΔBMD. However, none of the other nutritional or biochemical indices were found to be significant predictors of ΔBMD.Conclusions: Our findings indicate that adequate general nutrition and appropriate osteoporosis medication, rather than specific nutritional regimens, may be effective in preventing bone loss in elderly women.

Relation of visfatin to cardiovascular risk factors and adipocytokines in patients with impaired fasting glucose - Corrected Proof

2009-01-09

Abstract: Objective: The discovery of visfatin has great potential to significantly enhance our understanding of impaired fasting glucose and diabetes mellitus. The aim of the present study was to explore the relation of visfatin concentrations to cardiovascular risk factors and serum adipocytokine concentrations in patients with impaired fasting glucose.Methods: A sample of 55 patients with impaired fasting glucose was analyzed in a prospective way. All patients with a 2-wk weight-stabilization period before recruitment were enrolled. Weight, blood pressure, basal glucose, lipoprotein(a), C-reactive protein, insulin, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triacylglycerols, blood, and adipocytokines (visfatin, leptin, adiponectin, resistin, tumor necrosis factor-α [TNF-α], and interleukin-6) levels were measured. Tetrapolar impedancometry, indirect calorimetry, and prospective serial assessment of nutritional intake with 3-d written food records were performed.Results: Fourteen men (25.5%) and 41 women (74.5%), with a mean age of 57.3 ± 11.7 y and mean body mass index of 35.8 ± 3.6 kg/m2, were included. Patients were divided in two groups by median visfatin value (18.2 ng/mL): group I had low values and group II had high values. Patients in group I had greater weight, body mass index, fat mass, fat-free mass, and adiponectin than patients in group II. Patients in group II had higher total cholesterol, low-density lipoprotein cholesterol, resistin, and TNF-α levels than patients in group I. In the multivariate analysis with age- and sex-adjusted basal visfatin concentration as a dependent variable, only TNF-α remained an independent predictor in the model (F = 8.4, P < 0.05), with an inverse correlation. Visfatin concentration decreased 7.33 ng/mL (95% confidence interval 2.10–12.58) for each nanogram per milligram of TNF-α increase.Conclusion: Only TNF-α is related in an independent way to serum visfatin levels.