[Nutritional status and energy intake in patients admitted to internal medicine units].
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Energy Intake↗
Biomedical subjects
B Sandström
Publications and source records attributed to B Sandström.
Disposition of the adrenergic blocker metoprolol and its metabolite OH-metoprolol in maternal plasma, amniotic fluid and capillary blood of the neonate.
Seven women were treated with metoprolol 50-100 mg twice daily for hypertension in pregnancy. The disposition of metoprolol and one of its metabolites alfa-OH-metoprolol was studied in venous plasma and amniotic fluid during labour, in mixed cord plasma and in capillary blood of the newborn. Peak concentrations of metoprolol and alfa-OH-metoprolol were reached 60 to 120 min after dosing in maternal plasma while the amniotic fluid levels of these compounds continued to increase from 60 to 180 min to the end of the study and were substantially higher than in the plasma after 4 to 5 h. It is postulated that a major fraction of metoprolol and alfa-OH-metoprolol reaches the amniotic fluid via the fetal urine and that the elimination from the amniotic fluid mainly proceeds via diffusion across fetal membranes and transfer across the fetal capillary bed. No measurable concentrations of metoprolol were found in two of the newborns 2 h after delivery. In the remaining four neonates the 2-h concentrations exceeded the corresponding cord plasma levels. In all neonates the alfa-OH-metoprolol levels in the capillary blood were higher 2 h after birth than in cord blood. In two newborns the metabolite levels continued to increase for 5 h and in one the highest blood concentrations of this metabolite was found 20 h after birth. Redistribution of metoprolol from tissue stores followed by metabolism might be the cause of these temporary elevations of the blood levels of metoprolol and alfa-OH-metoprolol.
Amniotic Fluid↗
The evaluation of maternal anti-D concentrations during pregnancy.
Anti-D quantitation by the AutoAnalyzer technique has been shown to be a helpful aid in assessing the severity of D alloimmunization during pregnancy. In this study, the technique has been used both to detect antibody boosting after amniocentesis and to differentiate active D immunization from the presence of passive antibodies. The AutoAnalyzer technique and the more generally used indirect antiglobulin test titration method showed good agreement at titre levels of 32 or lower. A titre of 32 was found to be a good discriminative level to separate the mildly affected from the more severely affected newborns suffering from Rh haemolytic disease. At higher titre levels, however, the AutoAnalyzer technique was the method of choice for correct clinical assessment of the severity of D alloimmunization.
Amniocentesis↗
The effect of vegetables and beet fibre on the absorption of zinc in humans from composite meals.
1. The absorption of zinc in humans from composite meals, was determined by extrinsic labelling of the meals with 65Zn and measurement of the whole-body retention of the radioisotope. 2. Low-Zn (mean 25 mumol) chicken meals with 150 g white bread or 225 g potatoes, carrots, turnips, cabbage or green peas were studied. The effect of a beet-pulp-fibre preparation used as a breakfast cereal, in bread and as a meat extender on Zn absorption was also studied. 3. The mean percentage absorption from the chicken meals with white bread, carrots and cabbage was significantly different from the meals with potatoes, turnips and green peas. When the amount of Zn in the meals was taken into account a slightly higher absorption was observed from the white-bread meal compared with the meals with potatoes and cabbage, while no differences were seen between the vegetable meals. 4. The beet-pulp-fibre preparation did not affect the extent of Zn absorption when used as a meat extender. The absorption of Zn was higher when the beet fibre was included in bread than when used as müesli. 5. The results obtained suggest that, besides the low-Zn content in vegetables, a large intake of vegetables or a pure-vegetable-fibre preparation has no significant effect on Zn availability from animal-protein-based meals.
Adult↗
Zinc absorption in humans from meals based on rye, barley, oatmeal, triticale and whole wheat.
The absorption of zinc from meals based on 60 g of rye, barley, oatmeal, triticale or whole wheat was studied by use of extrinsic labelling with 65Zn and measurement of the whole-body retention of the radionuclide. The cereals were prepared in the form of bread or porridge and were served with 200 mL of milk. The oatmeal flakes were also served without further preparation. The absorption of zinc was negatively correlated to the phytic acid content of the meal with the highest absorption, 26.8 +/- 7.4%, from the rye bread meal containing 100 mumol of phytic acid and the lowest, 8.4 +/- 1.0%, from oatmeal porridge with a phytic acid content of 600 mumol. It is concluded that food preparation that decreases the phytic acid content improves zinc absorption.
Absorption↗
Degradation products of bran phytate formed during digestion in the human small intestine: effect of extrusion cooking on digestibility.
To investigate the digestion of phytate in the stomach and small intestine in humans, studies were performed in subjects with established ileostomy. A recently developed high performance liquid chromatography method made it possible to analyze phytate and its degradation products in food and digesta. The digestibility of phytate in raw bran and extruded bran was investigated in seven ileostomy patients. Each subject was studied for two 4-d periods while consuming a constant low fiber diet with the addition of either 54 g/d of a bran-gluten-starch mixture or the corresponding extruded product. During passage through the subject's stomach and small intestine 58%, on average, of the phytate in unprocessed bran was hydrolyzed to inositol penta-, tetra- and triphosphates. When bran was subjected to extrusion cooking, 25% of the inositol hexaphosphate was hydrolyzed to penta- and tetraphosphate and the phytase activity ceased. Essentially no phytate digestion occurred when the ileostomy subjects consumed the extruded product. The reduced digestibility might be due to the lost phytase activity or to formation of indigestible phytate complexes during extrusion cooking.
Cooking↗
Absorption of zinc from soy protein meals in humans.
The absorption of zinc from soy protein-containing meals was studied in healthy human subjects by means of extrinsic labelling with 65Zn and whole body counting. Three types of soy protein, a soy flour, a soy concentrate and a soy isolate, were used in two types of meals: one consisting of rice and meat sauce and the other of white or whole-meal bread. Thirty and 100% of the protein of the meat sauce and 50% of the protein of bread was replaced with the soy protein products. Replacement of 30% of the protein in meat sauce had a marginal effect on the percentage absorption of zinc, whereas the absolute amount of zinc absorbed was lower due to the lower zinc content in soy products than in meat. After total replacement of the meat protein, a significantly lower percentage and absolute absorption of zinc was observed. A lower absorption of zinc was observed when soy protein was added to white bread. The absorption of zinc from the whole-meal bread was low and did not change when 50% of the flour protein was replaced by soy protein. We conclude that the effect of soy protein on zinc absorption depends on the degree of replacement, the phytic acid and zinc content of the soy product and the protein content of the meal.
Absorption↗
The effect of different prosthetic restorations on the dietary selection in edentulous patients. A longitudinal study of patients initially treated with optimal complete dentures and finally with tissue-integrated prostheses.
The effect of prosthetic restoration of masticatory ability on dietary selection was evaluated in 23 edentulous patients with denture adaptation problems. The patients were first given optimal complete dentures and then a fixed prosthesis on tissue-integrated implants in the lower jaw. Changes in dietary selection were evaluated from 4-day records obtained before prosthetic treatment and on six occasions up to 78 months after treatment. With the method used, no significant changes in food selection were recorded during the rehabilitation period, except for a slight increase in intake of crisp bread and fresh fruit after treatment with fixed tissue-integrated prostheses in the mandibular jaw. It is concluded that an improved oral function will not in itself lead to a change in dietary selection and that dietary changes probably require professional and individually given dietary advice by a trained dietitian.
Adult↗
Retention of selenium (75Se), Zinc (65Zn) and manganese (54Mn) in humans after intake of a labelled vitamin and mineral supplement.
The whole body retention of 75Se, 65Zn, and 54Mn after intake of a labelled vitamin and mineral supplement was followed in 12 healthy volunteers. The supplement had a vitamin and mineral content according to recommended dietary allowances or the so-called "safe and adequate levels" for trace elements, including 15 mg of zinc as zinc citrate, 50 micrograms of selenium as sodium selenite and 2.5 mg of manganese as manganese sulphate. The supplement was taken either in the fasting state or together with a light meal. Retention day 14 was 48 +/- 6%, 33 +/- 6% and 5 +/- 2% (mean +/- SD) for selenium, zinc and manganese, respectively, when the supplement was taken fasting and 45 +/- 3%, 8 +/- 1% and 1.0 +/- 0.2% when it was taken with food. During day 1-14, 27%, 1% and less than 0.01% of the administered selenium, zinc and manganese radionuclides, respectively, were excreted in the urine. Based on the rate of turnover of the radionuclides and the urinary losses of 75Se, the absorption of selenium, zinc and manganese from the supplement was estimated to be 89 +/- 5%, 38 +/- 7%, 9 +/- 3% (mean +/- SD) in the fasting state and 87 +/- 4%, 10 +/- 2% and 2 +/- 1% with food. These results indicate that when a supplement is taken with food the minerals are absorbed and metabolized in the same way as are native minerals in food. When the supplement is taken in the fasting state, the absorption of zinc and manganese can be substantially higher.
Absorption↗
Effect of ascorbic acid on the absorption of zinc and calcium in man.
The effect of ascorbic acid on the absorption of zinc and calcium, was studied in healthy subjects by a radionuclide technique with 65Zn and 47Ca and whole body retention measurements. Addition of 100 mg of ascorbic acid to a water solution of 40 or 200 mumol zinc and 1 g of ascorbic acid to a high phytate meal with wholemeal bread had no effect on zinc absorption. Neither did 1 g of ascorbic acid added to 6.4 mmol of calcium influence the retention and calculated absorption of calcium. The results suggest that ascorbic acid does not affect the absorption of normal dietary levels of zinc and calcium.
Absorption↗
Zinc status and dark adaptation in patients subjected to total gastrectomy: effect of zinc supplementation.
Totally gastrectomized patients could be regarded at risk for development of nutritional deficiencies including trace elements. Sensitive indices for early detection of these deficiencies are lacking. In order to evaluate the nutritional status of trace elements in patients previously subjected to a total gastrectomy we studied the zinc status in 10 patients by determining serum zinc, urinary zinc excretion and also, by a simplified dark adaptation test, the effect on these parameters of 4 weeks of zinc supplementation. The serum zinc level but not the 24-h urinary zinc excretion was lower in gastrectomized patients compared to age-matched controls. A slower dark adaptation was observed in the former patients when measured in the non-fasting state but not when fasted. Dark adaptation was slower in the patients as well as the age-matched controls compared to younger healthy subjects. Zinc supplementation increased the serum zinc levels and the urinary zinc excretion in the gastrectomized patients but had no effect on dark adaptation.
Aged↗
Extrusion cooking of a high-fibre cereal product. 1. Effects on digestibility and absorption of protein, fat, starch, dietary fibre and phytate in the small intestine.
1. The effect of extrusion cooking of a high-fibre cereal product on digestibility of starch, fibre components and phytate in the stomach and small intestine was studied by in vivo digestion in ileostomy subjects, as well as its effect on ileostomy losses of fat, nitrogen, sodium and potassium. 2. Seven ileostomy subjects were studied during two periods (each of 4 d) while on a constant low-fibre diet supplemented with 54 g/d of a bran-gluten-starch mixture (period A) or the corresponding extruded product (period B). 3. Extrusion cooking, using mild conditions, did not change the content of starch, dietary fibre components or phytate of the bran product, but the phytase (EC 3.1.3.26) activity was lost. During the period using the extruded bran product, there was a significant increase in recovery of phytate-phosphorus (period A, 44% of intake; period B, 73% of intake). The amount of fibre components, fat, fatty acids, N, Na, K, water and the ash weight of the ileostomy contents did not differ between the two periods. Only 0.6 and 0.7% respectively of ingested starch was recovered in ileostomy contents in periods A and B, while the fibre components were almost completely recovered. 4. Extrusion cooking, using even mild conditions, may lead to a considerable impairment in the digestion of phytate, probably due to a qualitative change in phytate and a loss of phytase activity. Starch, before and after extrusion cooking, is almost completely digested in the stomach and small intestine while fibre components are digested to a very small extent.
Absorption↗
Extrusion cooking of a high-fibre cereal product. 2. Effects on apparent absorption of zinc, iron, calcium, magnesium and phosphorus in humans.
1. The effect of extrusion cooking, using mild conditions, of a high-fibre cereal product on apparent small bowel absorption of zinc, iron, calcium, magnesium and phosphorus was studied. 2. Seven ileostomy subjects were studied during two periods (each of 4 d), on a constant low-fibre diet supplemented with either 54 g/d of a bran-gluten-starch mixture or the corresponding extruded product. 3. The apparent absorption of Zn, Mg and P was significantly decreased (P less than 0.05) during the period with extruded product compared with the period with bran-gluten-starch. No difference was found for Fe and Ca. 4. The negative effect of extrusion cooking of a product containing phytic acid on availability of Zn, Mg and P was small but could be of nutritional relevance in foodstuffs that are consumed frequently and in infant formulas.
Absorption↗
Retention of zinc and calcium from the human colon.
Colonic retention of zinc and calcium was studied after installation during colonoscopy of 30 mumol of zinc and 6.4 mmol of calcium labeled with 65Zn and 47Ca, and measurement of the whole-body retention of the radionuclides. After cecal installation in nine patients, retention (day 13) of zinc was 3.5 +/- 2.1% (mean +/- SD) and of calcium 3.5 +/- 2.7%. The calculated mean absorption was 4.1% for zinc and 14.1% for calcium. Application at the hepatic flexure in four patients resulted in a mean retention (day 13) of 1.2% for zinc and 0.6% for calcium. Under prevailing conditions, colonic absorption of zinc is relatively small, compared to the uptake after oral administration. Colonic absorption of calcium could, however, account for a substantial part of the total calcium uptake.
Aged↗
Apparent small intestinal absorption of nitrogen and minerals from soy and meat-protein-based diets. A study on human ileostomy subjects.
The apparent absorption of nitrogen and minerals was studied in 8 ileostomy subjects. Four different test diets containing 60 g of meat, rice and bread protein, or a 25% replacement of the protein with soy flour, soy concentrate or soy isolate, were randomly assigned to the subjects in 2-d periods. All animal protein was replaced by soy isolate for a fifth 2-d period in two of the subjects. Ileostomy contents were collected in 2-h intervals during the day and in one portion during night and immediately deep-frozen. The fiber components and the phytic acid in the diet were almost completely recovered in the ileostomy contents, whereas unabsorbed starch was less than 2% of the intake. A significantly lower protein digestibility was observed when the diets containing soy protein were fed. No difference in protein digestibility was found between the different soy protein products. A 25% replacement by soy protein had no obvious effect on apparent mineral absorption. A low protein digestibility was also observed when soy was the main source of protein, and a negative apparent absorption of zinc was found in both subjects. Although 25% of soy protein in the diet does not seem to impair mineral absorption significantly, small intestinal net absorption of nitrogen is less from the soy diets than from the meat diet.
Adult↗
Manganese absorption and metabolism in man.
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Administration, Oral↗
[Malnutrition in the hospital: the physician should increase his interest for patients' nutritive condition and food habits].
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Feeding Behavior↗