Biomedical subjects

J B Keogh

Publications and source records attributed to J B Keogh.

9 recordsLinked to original sources

PubMed2006

Effects of meals with high soluble fibre, high amylose barley variant on glucose, insulin, satiety and thermic effect of food in healthy lean women.

OBJECTIVE: To examine the effect of barley flour (barley cultivar, Hordeum Vulgare var Himalaya 292) incorporated into breakfast and lunch compared with otherwise identical meals containing white wheat flour on the thermic effect of food (TEF), subsequent food intake and metabolic parameters. DESIGN: Randomized single blinded crossover study. SETTING: Outpatient setting. SUBJECTS AND METHODS: Fourteen healthy women consumed a test breakfast at 0700 h. Energy expenditure, respiratory quotient (RQ), appetite ratings using a visual analogue scale (VAS), insulin and glucose levels were measured before and after a test lunch at 1330 h. Food intake was recorded for the remainder of the day. RESULTS: The TEF was 5% for both test lunches and meal type did not affect any variable measured by the VAS. There was an increase in post-prandial RQ above baseline (0.80) independent of treatment (0.88 and 0.90 for barley and wheat-containing meals, respectively, P<0.001). Mean area under the glycaemic response curve (AUC) for wheat-containing meals was 4.68+/-1.67 mmol/l/h, 22% higher than for the barley-containing meals (3.67+/-1.91 mmol/l/h), P=0.05. AUC of insulin in response to wheat-containing meals (78.1+/-35.3 mIU/l/h) was 32% greater than barley-containing meals (52.8+/-24.7 mU/l/h), P<0.02. Ad libitum food intake over the next 10 h was reduced by 23% (9.6 vs 11.0 MJ, P<0.05) after the wheat-containing meals compared to the barley-containing glycaemic index meals. CONCLUSION: Inclusion of an ingredient containing increased soluble fibre and amylose did not reduce spontaneous food intake but rather was associated with higher subsequent energy intakes despite its reduced glycaemic and insulinemic effects. SPONSORSHIP: CSIRO, Human Nutrition, Adelaide, Australia.

Adult↗

PubMed2005

Effect of weight loss on inflammatory and endothelial markers and FMD using two low-fat diets.

OBJECTIVE: Cardiovascular disease is strongly associated with obesity and there is evidence that weight loss has positive effects on cardiovascular disease risk. The aims of this study were to compare meal replacements (MR) with a conventional low-fat diet as weight loss strategies and to examine the effect of weight loss on flow-mediated dilatation (FMD) and other markers of endothelial function in overweight Australians with raised triglycerides (TG) (> 2 mmol/l). RESEARCH METHODS: Subjects matched for age, gender, fasting plasma TG and body mass index were randomized to two low- fat high- carbohydrate weight loss strategies (both < 6000 kJ), one using MR and the other a structured eating plan, control (C). Subjects followed both diets for 3 months. In total, 55 subjects completed the study. FMD, pulse wave velocity and blood pressure (BP) were measured at baseline and at 3 months, as were fasting blood samples for lipids, glucose, insulin, C reactive protein (CRP) and endothelium-derived factors. RESULTS: Mean weight loss was 6.3 +/- 3.7 kg (6.0 +/- 4.2 vs 6.63 +/- 3.35 kg, MR vs C) with no difference between diet groups. TG, insulin, CRP, plasminogen activator inhibitor 1 (PAI-1) and soluble intracellular adhesion molecule-1 (sICAM1) fell after weight loss, but FMD did not change. Systolic BP fell by 8 mmHg and pulse wave velocity improved. DISCUSSION: In subjects with elevated TG, weight loss resulted in significant improvements in cardiovascular risk markers, particularly endothelium-derived factors (PAI-1 and sICAM1). However, FMD did not improve with weight loss.

Adult↗

PubMed2005

The role of meal replacements in obesity treatment.

Effective weight loss strategies are needed to help overweight and obese people lose weight and maintain weight loss in the long term. Meal replacements for weight loss are available in the community; however, their efficacy in the longer term is not clear. This review summarizes recent evidence on the use of meal replacements as a weight loss strategy.

Body Mass Index↗

PubMed2004

Long-term effects of a high-protein, low-carbohydrate diet on weight control and cardiovascular risk markers in obese hyperinsulinemic subjects.

OBJECTIVE: To compare the long-term compliance and effects of two low-fat diets differing in carbohydrate to protein ratio on body composition and biomarkers of cardiovascular disease risk in obese subjects with hyperinsulinemia. DESIGN: Outpatient, parallel, clinical intervention study of two groups of subjects randomly assigned to either a standard protein (SP; 15% protein, 55% carbohydrate) or high-protein (HP; 30% protein, 40% carbohydrate) diet, during 12 weeks of energy restriction (approximately 6.5 MJ/day) and 4 weeks of energy balance (approximately 8.3 MJ/day). Subsequently, subjects were asked to maintain the same dietary pattern for the succeeding 52 weeks with minimal professional support. SUBJECTS: A total of 58 obese, nondietetic subjects with hyperinsulinemia (13 males/45 females, mean age 50.2 y, mean body mass index (BMI) 34.0 kg/m2, mean fasting insulin 17.8 mU/l) participated in the study. MEASUREMENTS: : Body composition, blood pressure, blood lipids, fasting glucose, insulin, CRP and sICAM-1 were measured at baseline and at weeks 16 and 68. Urinary urea/creatinine ratio was measured at baseline, week 16 and at 3 monthly intervals thereafter. RESULTS: In total, 43 subjects completed the study with similar dropouts in each group (P=0.76). At week 68, there was net weight loss (SP -2.9+/-3.6%, HP -4.1+/-5.8%; P<0.44) due entirely to fat loss (P<0.001) with no diet effect [corrected]. Both diets significantly increased HDL cholesterol concentrations (P<0.001) and decreased fasting insulin, insulin resistance, sICAM-1 and CRP levels (P<0.05). Protein intake was significantly greater in HP during the initial 16 weeks (P<0.001), but decreased in HP and increased in SP during 52-week follow-up, with no difference between groups at week 68, indicating poor long-term dietary adherence behaviour to both dietary patterns. CONCLUSION: Without active ongoing dietary advice, adherence to dietary intervention is poor. Nonetheless, both dietary patterns achieved net weight loss and improvements in cardiovascular risk factors.

Adult↗

PubMed1999

Bone loss at the proximal femur and reduced lean mass following liver transplantation: a longitudinal study.

The longevity of recipients of liver transplant may be compromised by spinal osteoporosis and vertebral fractures. However, femoral neck fractures are associated with a higher morbidity and mortality than spine fractures. As there is little information on bone loss at this clinically important site of fracture, the aim of this study was to determine whether accelerated bone loss occurs at the proximal femur following transplantation. Bone mineral density and body composition were measured at the femoral neck, lumbar spine and total body, using dual x-ray absorptiometry in 22 men and 19 women, age 46 +/- 1.4 y (mean +/- SEM) before and at a mean of 19 mo after surgery (range 3-44). Results were expressed in absolute terms (g/cm2) and as a z score. Before transplantation, z scores for bone mineral density were reduced at the femoral neck (-0.47 +/- 0.21 SD), trochanter (-0.56 +/- 0.19 SD), Ward's triangle (-0.35 +/- 0.14 SD), lumbar spine (-0.76 +/- 0.13 SD), and total body (-0.78 +/- 0.15 SD) (all P < 0.01 to < 0.001). Following transplantation, bone mineral density decreased by 8.0 +/- 1.7% at the femoral neck (P < or = 0.01) and by 2.0 +/- 1.2% at the lumbar spine (P < or = 0.05). Total weight increased by 12.2 +/- 2.3%, lean mass decreased by 5.7 +/- 1.4%, while fat mass increased from 24.1 +/- 2.0% to 35.1 +/- 1.8% (all P < or = 0.001). Patients with end-stage liver disease have reduced bone mineral density. Liver transplantation is associated with a rapid decrease in bone mineral density at the proximal femur, further increasing fracture risk and a reduction in lean (muscle) mass, which may also predispose to falls. Prophylactic therapy to prevent further bone loss should be considered in patients after liver transplantation.

Absorptiometry, Photon↗

PubMed1978

Renal clearance of pancreatic and salivary amylase relative to creatinine in patients with chronic renal insufficiency.

Pancreatic and salivary amylase/creatinine clearance ratios in patients with various degrees of renal impairment were compared with those obtained for control subjects. In chronic renal insufficiency (mean GFR 30 ml/min +/- 15 SD; n = 13) the clearance ratios for pancreatic (mean 3.5 +/- 1.85 SD) and salivary (mean 2.3 +/- 1.3 SD) amylase were significantly higher (P less than 0.05) than those in controls. Corresponding control values (n = 26) were 2.64 +/- 0.86 (pancreatic) and 1.64 +/- 0.95 (salivary). Three patients showed values above the normal limit. In the diabetic group (mean GFR 41 ml/min +/- 22 SD; n = 10) salivary amylase/creatinine clearance ratios (mean 2.36 +/- 1.55 SD) were significantly higher than in controls (P less than 0.05). Three patients showed raised values. Pancreatic amylase clearance was raised in only one of these patients. Three patients with terminal disease (mean GFR 10 ml/min) showed markedly raised (two- to threefold) clearance ratios for both salivary and pancreatic amylase. Of a total of 26 patients, eight had increased total amylase/creatinine clearance ratios. Pancreatic amylase/creatinine clearance was increased in seven patients, while nine patients showed raised salivary amylase/creatinine ratios. Patients with raised clearance ratios did not have clinical evidence of pancreatitis. We suggest that, in the presence of impaired renal function, a high amylase/creatinine clearance ratio need not be indicative of pancreatic disease.

Adult↗

PubMed1977

A new quantitative procedure for proteinuria.

Abnormalities of tubular cells were treated by administration of nephrotoxin and studied by specialized gel filtration methods to discern early quantitative and qualitative changes in proteinuria. Dogs given nephrotoxic doses of Diglycoaldehyde, alpha-(hydroxymethyl)-alpha1-(6-hydroxy-9H-purine-9-yl) 60 mg per kg per day intravenously, for 3 days showed a marked reduction in effective renal plasma flow from 264.91 +/- 90.05 ml per min to 125.0 +/- 19.0 ml per min as measured by 131I sodium iodohippurate, and corresponding decrease in total renal perfusion by 131I xenon wash-out from 222.2 +/- 8.6 to 124.0 +/- 28.38. However, after treating four dogs with 20 mg per kg, an increase in effective renal plasma flow was obtained. Histologic changes of glomerular and tubular damage were demonstrated. Urine from this same series of animals was examined on a daily basis by sucrose-acrylamide gradient gel centrifugation together with ultraviolet scanning. Specific patterns were also obtained using dialyzed urine which eliminated molecules greater than 3500 mol wt. The ultraviolet pattern data were digitized and analyzed on computers to augment pattern recognition. These techniques indicted that molecules (3500 mol wt or less) were excreted in response to a known nephrotoxic agent, establishing early distinctive changes in tubular cells and also relating to alteration in renal function.

Aldehydes↗

PubMed1975

Plasma amino acids and protein levels in chronic renal failure and changes caused by oral supplements of essential amino acids.

1. Plasma amino acids and six proteins have been measured in patients with chronic renal failure receiving low protein diets before and after oral supplementation with essential amino acids. 2. All the patients on low protein diets had a lower percentage of essential amino acids in their plasma than normal subjects but after supplementation, plasma levels increased significantly with minimal increase in non-essential amino acids or urea nitrogen. 3. Mean levels of plasma transferrin, complement C3 and globulin Gc were lower and plasma prealbumin higher in patients than in normal subjects. Plasma complement C4 and albumin were not different from normal. 4. Seven out of nine patients who tolerated the supplementation showed a significant increase in plasma transferrin, prealbumin and complement C3 but not in complement C4, globulin Gc or albumin. 5. Correlations between the percentage of essential amino acids and each of plasma transferrin, prealbumin and complement C3 and also between several of the plasma proteins further substantiate their value in the assessment of dietary intake in chronic renal failure. 6. The value of amino acid supplementation on low protein diets in chronic renal failure is discussed in relation to these observations.

Adult↗

PubMedDate not supplied

Hand grip dynamometry as a predictor of postoperative complications reappraisal using age standardized grip strengths.

A mechanical hand grip dynamometer was used to derive age- and sex-related standard grip strengths from 247 healthy volunteers between 16 and 95 yr old. Preoperative grip strength was measured in 90 patients and related to postoperative complication rates. A grip strength of 85% standard for age and sex was found to be the most effective cut-off for prediction of postoperative complications in terms of sensitivity and specificity, predicting 74% of the complications (p less than 0.05). Specificity is improved over previously published standards related to sex alone especially when assessing the elderly patient (50% vs 21%). A grip strength below the recommended cut-off for age and sex suggests that the patient is in a high-risk group and demands further investigation of nutritional status. Studies of pre-operative nutritional support for the at risk group need to be undertaken.

Adolescent↗