PubMed · 4714786
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A Ochoa Solano, O Dahl. 1973. [Fish for human consumption].. https://pubmed.ncbi.nlm.nih.gov/4714786/
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The extent of interdialytic weight gain (IDWG) in chronic hemodialysis patients is usually attributed to the level of compliance with fluid restriction. However, in view of the substantial water content of food (and caloric content of beverages), IDWG also may be a function of calorie and protein intake and may reflect the nutritional state of patients. To investigate this theory, the relationship between 2-day IDWG and body weight, normalized protein catabolic rate (nPCR), serum albumin, and delivered Kt/V urea was assessed in a prospective, randomized study of 860 chronic hemodialysis patients in 56 dialysis units. Compared with patients having < 2 kg IDWG (n = 378), patients with > 3 kg IDWG (n = 138) weighed more (dry weight, 76.8 v 61.7 kg), had higher nPCR (1.15 v 0.96 g/kg/d), and had higher serum albumin levels (3.96 vs 3.79 g/dL) (all P < 0.001) but did not have different levels of Kt/V (1.04 v 1.06). When IDWG was assessed as a function of dry weight, patients with IDWG > 4.5% of dry weight (n = 151) had higher nPCR (1.17 v 0.94 g/kg/d) but weighed less (60.1 v 70.0 kg) and had a higher Kt/V (1.14 v 1.01) than patients with IDWG < 3% of dry weight (n = 355) (all P < 0.001). Artifactual association between IDWG and nPCR attributable to an accentuated two-pool effect from differing ultrafiltration requirements was unlikely as assessed by the relationship between modeled Kt/V and prescribed Kt/V determined using an anthropometric urea volume.(ABSTRACT TRUNCATED AT 250 WORDS)
A previous study has shown that malnourished, clinically stable patients with liver cirrhosis are in protein and energy balance at their spontaneous dietary intake and that an improvement in nutritional status cannot be anticipated at this intake (Nielsen et al. 1993). In the present study we examined to what extent oral intake could be increased by nutritional support, and to what extent dietary protein would be retained with increased intake. The techniques used for balance studies were also validated since this information is not available for patients with liver cirrhosis. Fifteen malnourished patients with alcoholic liver cirrhosis were given increasing amounts of a balanced ordinary diet for 38 (SE 3) d. Intakes of protein and energy were recorded by weighing servings and leftovers on food trays. Protein intake was calculated from food tables. Total N disposal was calculated after measurement of urinary N excretion, and protein balance was calculated from the N balance. A validation study of protein balance in a subgroup of patients (analysis of N in food by the duplicate portion technique, correction for incomplete recovery of urine by measurement of urinary para-aminobenzoic acid (PABA) after administration of PABA tablets, and measurement of faecal N) did not change protein balance values. Protein intake increased from 1.0 (SE 0.1) g/kg per d to 1.8 (SE 0.1) g/kg per d. With increasing protein intake, 84 (SE 8)% of the increase in intake was retained. The rate of protein retention was not saturated at the intakes obtained in this study. Protein intolerance was only encountered in one patient. Available evidence indicates that the requirement for achieving N balance is increased in these patients but protein retention is highly efficient with increased intake. Protein retention is dependent on energy balance. Energy intake was calculated from food tables and total energy expenditure was calculated by the factorial method. A validation study was performed in a subgroup of patients. The energy contents of food sampled by the duplicate portion technique, and of urine and faeces were measured by bomb calorimetry. Resting energy expenditure (REE) was measured by indirect calorimetry before and at the end of the study, and O2 uptake during bicycle exercise was measured before and at the end of the study. The measured intake of metabolizable energy was on average 13% lower than the value given in food tables. Calculated energy expenditure was not changed by the validation study.(ABSTRACT TRUNCATED AT 250 WORDS)
Processing of cassava roots by the Alur tribe in Uganda includes a stage of solid substrate fermentation in heaps. Changes in cyanogen levels during the process, microflora involved, and protein levels, amino acid patterns and mycotoxin contamination of the final products were studied. Processing was monitored at six rural households and repeated at laboratory site, comparing it to sun-drying. Flour samples from rural households were analysed for residual cyanogens, mutagenicity, cytotoxicity and aflatoxins. Mean (+/- SD) total cyanogen levels in flours collected at rural households were 20.3 (+/- 16.8) mg CN equivalents kg-1 dry weight in 1990 (n = 23) and 65.7 (+/- 56.7) in 1992 (n = 21). Mean (+/- SD) levels of cyanohydrins plus HCN were 9.1 (+/- 8.7) in the 1992 flours. Total cyanogen levels in the village monitored batches were reduced considerably by heap-fermentation from 436.3 (+/- 140.7) to 20.4 (+/- 14.0) mg CN equivalents kg-1 dry weight cassava. Residual cyanogen levels were positively correlated with particle size of the resulting crumbs. Heap-fermentation was significantly more effective in reducing cyanogen levels than sun-drying alone, but did not always result in innocuous levels of of cyanogens. Dominant mycelial growth was from the fungi Neurospora sitophila, Geotrichum candidum and Rhizopus oryzae. No mutagenicity, cytotoxicity nor aflatoxins could be detected in the flours. Protein quantity and quality were not significantly reduced. Cassava gel viscosity pattern was modified to the consumers' preference by this method. As the removal of cyanogens was more efficient and we found no new obvious health risk, heap-fermentation can be regarded as an improvement compared to sun-drying alone in areas where cassava varieties with higher cyanogen levels prevail, but we recommend optimisation of the process for ensuring still safer products.