Increasing energy intake in hospital food.
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Dietetics↗
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Dietary fiber, energy intake and nutritional status during the treatment of children with chronic constipation.
The present prospective study was carried out to determine dietary fiber and energy intake and nutritional status of children during the treatment of chronic constipation. Twenty-five patients aged 2 to 12 years with chronic constipation were submitted to clinical evaluation, assessment of dietary patterns, and anthropometry before and after 45 and 90 days of treatment. The treatment of chronic constipation included rectal disimpaction, ingestion of mineral oil and diet therapy. The standardized diet prescribed consisted of regular food without a fiber supplement and met the nutrient requirements according to the recommended daily allowance. The fiber content was 9.0 to 11.9 g for patients aged less than 6 years and 12.0 to 18.0 g for patients older than 6 years. Sixteen patients completed the 90-day follow-up and all presented clinical improvement. The anthropometric variables did not change, except midarm circumference and triceps skinfold thickness which were significantly increased. Statistically significant increases were also found in percent calorie intake adequacy in terms of recommended daily allowance (55.5 to 76.5% on day 45 and to 68.5% on day 90; P = 0.047). Percent adequacy of minimum recommended daily intake of dietary fiber (age + 5 g) increased during treatment (from 46.8 to 52.8% on day 45 and to 56.3% on day 90; P = 0.009). Food and dietary fiber intake and triceps skinfold thickness increased during follow-up. We conclude that the therapeutic program provided a good clinical outcome.
Body Composition↗
The effect of a Plantago ovata seed containing preparation on appetite variables, nutrient and energy intake.
OBJECTIVES: Investigation of a Plantago ovata seed containing supplement (Plantaginis ovatae semen and testa) to determine its effect on appetite variables, nutrient and energy intake in normal subjects. DESIGN: Triple blind (subjects, investigators and statisticians) cross-over design. Three, 3-day study periods when subjects were given the following treatments in randomised order: Plantago ovata preparation (20 g granules with 200 ml water), placebo (20 g granules with 200 ml water), or water (200 ml) 3 hs pre-meal and the same dose immediately pre-meal. A set meal was given at lunch time after the supplement to subjects who had fasted overnight. SETTING: Metabolic unit of King's College London. SUBJECTS: Seventeen female subjects, all classified as non-restrained eaters. MAIN OUTCOME MEASURES: Visual analogue scales were completely premeal, postmeal and at hourly intervals for 3 hs after the meal. All food consumed on the meal day, and the following day was weighed. RESULTS: There was a significant difference in fullness at 1 h post-meal between Plantago and placebo, and also Plantago and water. Total fat intake was significantly lower in g/d and as a percentage of energy on the day of the meal after Plantago compared with water. CONCLUSIONS: This plantago ovata containing product, which is already taken by many people world-wide to control bowel function, may be a useful supplement in weight control diets as it affects fat intake, and may have some effect on the subjective feeling of fullness.
Adult↗
Dietary underreporting: validity of dietary measurements of energy intake using a 7-day dietary record and a diet history in non-obese subjects.
Substantial dietary underreporting questions the validity of dietary measurements of energy intake (EI). The present study compares the value of a 7-day prospective dietary record (7dDR) with a computer program-based diet history (DH). 7dDR and DH were performed in 50 non-obese subjects (33 females, 17 males, mean age 26.1 years, BMI 18.9-29.6 kg/m2) using total energy expenditure (EE = sum of resting metabolic rate as measured by indirect calorimetry plus energy expenditure derived from an activity protocol) as standard for the validity of data on EI. EI was 2,206 (728-3,646) kcal/day for 7dDR and 2,398 (566-4,764) kcal/day for DH. There was an association between EI for 7dDR and EI for DH (r = 0.6, p < 0.0001). Underreporting [i.e. a difference between EI and EE (delta E = EI - EE)] of 20% or more was seen in 48% (7dDR, mean -1,047 kcal/day, range -616 to -1,895, or -38.8% of EE) or 48% (DH, -1,151 kcal/day, -594 to -2,057 kcal/day, or -42.3% of EE). Considerable differences were found between delta E for 7dDR and delta E for DH (mean 603, range 26-2,033 kcal/day), and only 34% of underreporting subjects were identified by both dietary measurements. It is concluded that at the individual level dietary underreporting is influenced by the dietary assessment tool.
Adult↗
Childhood energy intake and cancer mortality in adulthood.
A retrospective mortality follow-up of a British survey of family diet and health (1937-1939) identified significant associations between childhood energy intake and mortality from cancer, particularly those cancers not thought to be associated with smoking. This is the first large-scale epidemiologic study to suggest that the observed reduction in tumor incidence in energy-restricted rodents has relevance for humans.
Adolescent↗
Energy intake required to maintain body weight is not affected by wide variation in diet composition.
Diets rich in fat may promote obesity by leading to a greater deposition of adipose-tissue triglycerides than do isoenergetic diets with less fat. This possibility was examined by a retrospective analysis of the energy needs of 16 human subjects (13 adults, 3 children) fed liquid diets of precisely known composition with widely varied fat content, for 15-56 d (33 +/- 2 d, mean +/- SE). Subjects lived in a metabolic ward and received fluid formulas with different fat and carbohydrate content, physical activity was kept constant, and precise data were available on energy intake and daily body weight. Isoenergetic formulas contained various percentages of carbohydrate as cerelose (low, 15%; intermediate, 40% or 45%; high, 75%, 80%, or 85%), a constant 15% of energy as protein (as milk protein), and the balance of energy as fat (as corn oil). Even with extreme changes in the fat-carbohydrate ratio (fat energy varied from 0% to 70% of total intake), there was no detectable evidence of significant variation in energy need as a function of percentage fat intake.
Adult↗
Nitrogen balance in relation to energy intake in entire male pigs weighing 75 kg.
1. Nitrogen balance (NB) was determined in entire male pigs weighing 75.6 (SE 0.56) kg and given 1.43 MJ metabolizable energy (ME)/kg live weight (LW)0.75 per d of semi-synthetic liquid diets which varied in crude protein (N x 6.38):ME from 2.5 to 14.5 g/MJ. Maximum NB of 20.8 g/d was reached with diets containing at least 6.2 g protein/MJ ME. 2. The relation between energy intake and NB was then examined in pigs of comparable live weight (mean 73.8 (SE 0.39) kg) and receiving a liquid diet not limiting in protein. The diet, containing 10.0 g protein/MJ ME, was given at eight rates from 0.24 MJ ME/kg LW0.75 per d to ad lib. by approximately equal increments. Two animals were allocated to each level and two animals were fasted during the balance period. 3. The animals fed ad lib. achieved a mean intake of 1.84 MJ ME/kg LW0.75 per d. NB increased linearly as ME intake increased up to 27.6 MJ/d (1.096 MJ/kg LW0.75 per d) but thereafter remained constant at 22.8 g N/d.
Age Factors↗
Digesta kinetics, energy intake, grazing behavior, and body temperature of grazing beef cattle differing in adaptation to heat.
The objective of this study was to determine whether digesta kinetics, energy intake (EI, kcal ME intake x kg(-.75) x d(-1)), grazing behavior, or body temperature differed by breed, lactational state, or season of the year among cattle presumed to vary in adaptability to the subtropics. Two-year-old lactating and nonlactating Brahman x Angus (BA; n = 5, n = 5), Tuli x Angus (TA; n = 5, n = 4), and Angus (A; n = 4, n = 4) cows were used. During both early (ES) and late summer (LS), lactating cattle vs nonlactating cattle had greater gastrointestinal tract load (CM2) and EI (P < .01), although passage rate did not differ (P > .48). During LS, lactating cattle had decreased early morning rectal temperatures (P < .05) and spent more time grazing during the day compared with nonlactating cattle (P < .001). Among breeds, A had the largest CM2 (P < .01 compared with BA and P = .068 compared with TA) and accumulated the greatest heat during the day (P < .05). Due to greater daytime shading (P < .01) and less daytime grazing (P < .05), A had lower (P < .05) early morning and comparable (P > .26) late afternoon rectal temperatures compared with BA and TA. With data pooled over both grazing trials, BA cattle had the smallest CM2 (P < .01), and in ES they spent the least amount of time in the shade (P < .001). The TA spent more time in the shade than did BA (P < .001) during ES and less during LS (P < .001) and had similar (P > .28) early morning rectal temperatures compared with BA during ES and LS. During LS, TA spent more time in the sun and less time in the shade than did either A or BA (P < .001). During ES, EI did not differ among breeds (P > .50). During LS, EI for lactating A was greater than for BA and TA (P < .05), and EI for nonlactating BA was less than for A and TA (P < .05). Bite rate per minute for lactating cattle during ES was reduced (P < .03) by increased body condition score. Tuli x Angus cattle appear to be comparable to BA with respect to heat adaptation. It appears that EI demands are greater in a hot environment.
Adaptation, Physiological↗
Excess energy intake promotes the development of hypoalbuminaemia in rats fed on low-protein diets.
1. A group of rats were given ad lib, a diet with a protein-energy: total energy (P:E) value of 0 . 03. Other animals received the same protein intake (g/kg body-weight per d) as this group, but had their energy consumption reduced to either 90, 80, 70, 60 or 50% of the ad lib. value. 2. The restricted growth rate of rats fed on the P:E--0 . 03 diet ad lib. has been shown to be due entirely to their insufficient protein consumption. In contrast, energy intake was far in excess of that required for maintenance and the limited amount of growth. 3. Carcass analysis demonstrated that some of the excess energy intake was stored as fat, but a greater part had been dissipated, presumably by diet-induced thermogenesis. 4. The plasma concentration of triiodothyronine (T3) was elevated in all animals consuming excess energy and was significantly related to both the total surplus and the amount of energy dissipated. 5. In the group of animals restricted to 50% of the ad lib. intake, energy rather than protein appeared to be the factor limiting growth. Energy intake was below estimated requirements for maintenance and was associated with values for plasma T3 that were lower than those found in well-fed control rats. 6. Although all the animals had similar protein intakes, plasma albumin concentration differed between the groups and was found to be inversely proportional to the energy intake. Thus it was lowest in animals receiving food ad lib. and rose to near normal values in the most-severely-restricted rats. 7. It is suggested that hypoalbuminaemia, and perhaps other features of protein deficiency, seen in animals fed on low-P:E diets may occur as an undesirable consequence of the metabolic response required to deal with excess energy consumption.
Adipose Tissue↗
Interrelationship between circulating leptin concentrations, hunger, and energy intake in healthy subjects receiving tube feeding.
BACKGROUND: Tube feeding is an unphysiological route of nutrient delivery, and yet there is a lack of controlled trials examining its effects on appetite, food intake, and factors involved in their control. This study aimed to investigate the relationship between diurnal tube feeding, hunger, food intake, and circulating concentrations of leptin (a putative satiety factor). METHODS: Six healthy lean men received a continuous nasogastric infusion (9:00 AM to 9:00 PM) of colored water (2 days), liquid feeding (4.2 kJ/mL, energy provision 1 x the initial predicted basal metabolic rate; 3 days), and colored water (2 days). Measurements of hunger (visual analog scales), weighed food intake, and fasting circulating leptin concentrations were made while the subjects were allowed free access to isoenergetically dense food items. RESULTS: Three days of diurnal nasogastric feeding (mean, 6.9 MJ/d) significantly increased total energy intake (to 19.4 MJ/d; p < .001; analysis of variance [ANOVA]), suppressing oral energy intake by only 17%, with no significant effect on mean daily hunger. Higher levels of energy intake led to a universal rise in circulating leptin concentrations (2.82 to 4.23 ng/mL; p < .004; ANOVA) that was not significantly related to subsequent breakfast energy intake, first rated hunger of the day, timing of morning food consumption, or subsequent mean daily oral energy intake or hunger. CONCLUSIONS: This study suggests that 3 days of diurnal tube feeding (equivalent to basal metabolic rate) failed to suppress hunger and reduced food intake by only 17%. The rise in circulating leptin concentrations, associated with tube feeding and the increase in total energy intake, failed to predict subsequent hunger or oral energy intake.
Adult↗
Underreporting of energy intake in an elderly German population.
OBJECTIVES: Within the longitudinal study on nutrition and health status in an aging population in Giessen, Germany (GISELA), the underreporters of energy intake (EI) were identified and characterized. METHODS: EI was assessed in 238 female and 105 male participants of the GISELA study (age range = 60-89 y) by means of a 3-day estimated dietary record developed especially for this study. Resting metabolic rate (RMR) was measured by indirect calorimetry after an overnight fast. EI was expressed as a multiple of RMR and subjects with an EI:RMR ratio below 1.073 were classified as underreporters. RESULTS: Mean EI:RMR was 1.62 +/- 0.46 in females and 1.53 +/- 0.46 in males; 7.6% of the females and 16.2% of the males were identified as underreporters. They showed lower levels of education and significantly greater body weight, body mass index, and fat mass than the adequate reporters. Further, underreporters stated more often than adequate reporters that they want to lose weight. Except for beta-carotene in males, reported nutrient intakes were significantly lower in underreporters than in adequate reporters. Carbohydrate and fat intake in both sexes, protein intake in females calculated as a percentage of EI, and vitamin and mineral densities were not affected by underreporting. CONCLUSIONS: The results indicate that underreporting of EI is related to a low educational level and greater body weight, body mass index, and fat mass and affects all nutrients. These findings should be considered when the association between nutrition and health status is investigated in the elderly.
Aged↗
Nutritional survey of children and adolescents with myelomeningocele (MMC): overweight associated with reduced energy intake.
UNLABELLED: In patients affected by MMC both neurological and systemic dysfunctions may cause obesity and malnutrition. The aim of this study is a nutritional survey, with anthropometric assessment and dietary evaluation, of patients affected by MMC. CLINICAL MATERIALS AND METHODS: Anthropometric assessment, dietary evaluation, and a comprehensive assessment of motor impairment degree (MID) were performed in 100 patients (54 males, 46 females) affected by MMC aged from 6 to 228 months (median 91 months). RESULTS: Fifty-five/100 children and adolescents with MMC were classified as normal or wellnourished and 5 at risk of malnutrition or malnourished, while another 40/100 patients were classified as marked overweight (weight-for-height or BMI above the 95th percentile). Deficit in height-for-age was observed in 34/100 patients; 12 of these patients presented with obesity. Dietary assessment evidenced that the majority of wellnourished patients (48/55) were consuming less than 80% or between 80% to 100% of recommended daily allowances (RDA) of energy. Overweight patients had an energy intake lower than their own RDA: 5 below 80%, 25 between 80% to 100%, and only 10 over 100% of RDA of energy for age and sex. No statistical correlation was found between nutritional status and MID, while there was a statistically significant difference between nutritional status and dietary intake (p = 0.005). DISCUSSION: Overweight is the most frequent nutritional disease in patients affected by MMC. Since in our experience on correlation with MID was found, we can speculate that childhood and adolescent obesity in patients with MMC occurs as a result of complex interactive factors, not strictly related to energy intake and MID. Nutritional surveillance and specific treatment programs for overweight MMC patients are essential to enhance their quality of life.
Adolescent↗
Adaptation of energy metabolism of overweight women to low-energy intake, studied with whole-body calorimeters.
In 14 overweight women, 24-h energy expenditure (EE) was measured in a whole-body indirect calorimeter: before weight reduction (100% diet), after 1 wk on a 4.2-MJ diet, after 8 wk on 4.2-MJ diet, after weight reduction on 100% diet. Data of two subjects were excluded. Mean body weight declined from 93.3 +/- 7.4 (mean +/- SD) to 83.4 +/- 7.7 kg; 24-hEE decreased from 10.52 +/- 0.83 MJ on the 100% diet to 9.58 +/- 0.75 MJ on the 4.2-MJ diet. After 8 wk, 24-hEE had decreased by 15% of the initial 24-hEE to 8.92 +/- 0.65 MJ. After refeeding (1 wk), it increased to 9.45 +/- 0.75 MJ. Calculated energy requirement before weight reduction was 10.62 +/- 0.88 MJ/day; after weight reduction, 9.39 +/- 0.79 MJ/day. The decrease was more than that predicted from the change in body weight and body composition. An adaptation probably occurs, which may be metabolic.
Adaptation, Biological↗
Limits to sustained energy intake. V. Effect of cold-exposure during lactation in Mus musculus.
We have previously observed that female MF1 mice appeared to reach a limit in their food intake and milk production during late lactation, reaching a plateau between days 13 and 16 of lactation and between litter sizes of 9 and 15. These mice did not increase their food intake when forced to raise more offspring or when manipulated to be concurrently pregnant during late lactation, yet they did eat significantly more food at the peak of their second sequential lactation or when challenged with food of reduced energy content. These data suggest that apparent limits on sustained energy intake in this strain may not reflect central limitations but rather peripheral constraints at the mammary glands. In this study, we aimed to determine whether these were indeed limits by increasing the demands on the females during late lactation by cold-exposure (8 degrees C). Females responded to this manipulation by significantly increasing their food intake (F1,73=77.53, P<0.001) above that of lactating females kept in warmer conditions (21 degrees C). In addition, there was a significant reduction in the number of pups raised in the cold (t=2.36, d.f.=18, P=0.03), with the majority of the mortality occurring within the first 2 days of cold-exposure. The mean mass of the pups raised in the cold was significantly lower (F1,74=13.8, P<0.001) than that of those raised in the warm. Despite the cold-exposure and the increased food intake, there was no difference in the resting metabolic rates of the two groups of mothers or in the lengths of their small intestine. The greater food intake of lactating mice during cold-exposure supported our previous observations that they were capable of eating more food than the previously suggested limit of 23.1 g x day(-1). However, the milk energy output of females in the cold was also significantly higher than in the warm (F1,15=11.99, P=0.003), indicating that the asymptotic food intake of females in the warm was not mediated by limitations in their milk production. Sustained energy intake in these mice does not appear to be centrally or peripherally limited. Rather, the mice may restrain their use of energy during their first lactation because of life-history consequences for future reproductive attempts.
Acclimatization↗
Energy intake and glycemia in lactating women with type 1 diabetes.
OBJECTIVE: To describe glycemia and insulin administration in lactating women with type 1 diabetes and compare their energy intake, lactation onset, and postpartum weight to lactating women without diabetes. DESIGN: A prospective observational study conducted at 2, 3, 6, 14, 42, and 84 days postpartum. Insulin dosage and glucose levels after fasting and at 80 and 110 minutes after eating (by measuring capillary blood glucose concentrations and glycated hemoglobin [HbA1c] values) are described for women with type 1 diabetes. Dietary intake, weight, and lactation onset for women with type 1 diabetes are compared with those without the disease. SUBJECTS/SETTING: Fourteen lactating women with type 1 diabetes and 25 women without diabetes (control subjects) were recruited from private obstetrician offices and high-risk prenatal clinics at 3 major medical centers. STATISTICAL ANALYSES: A repeated-measures 2-factor analysis of variance was used to determine group, time, and interaction effects between women with type 1 diabetes and the control group at 2, 3, 7, 14, 42, and 84 days postpartum. RESULTS: Seven women with type 1 diabetes breast-fed through 84 days postpartum, although they perceived later onset of milk and had fasting and postprandial hyperglycemia. Their HbA1c levels increased by 20%, confirming relative hyperglycemia. After adjustment for prepregnancy weight, women with type 1 diabetes consumed 7 kcal fewer per kilogram per day than control subjects. Average insulin dose was returned to prepregnancy levels of 45.3 +/- 3.6 U/d (least square means +/- standard error of the mean) by 1 week. APPLICATION: Achieving desired metabolic control during the establishment of lactation is difficult. A better understanding of energy and insulin needs and their relationship to lactation in women with type 1 diabetes is needed.
Adult↗
Energy intake and physical activity during short-term smoking cessation in postmenopausal women.
This study assessed the effect of short-term (2-week) smoking abstinence on weight gain, energy intake, and physical activity in 60 postmenopausal women. Participants were stratified by their use of hormone replacement therapy (HRT; currently taking/not taking) and then randomized to abstinence or continued smoking for 2 weeks. The 30 abstainers gained a mean of 1.28 kg, compared with a 0.54 kg loss for the 30 continued smokers (P=.002). The abstainers also reported a significantly greater increase than did the smokers in total kilocalorie and in carbohydrate consumption for both weeks. There were no changes in physical activity and HRT effect. These are the first published findings on caloric intake and weight gain during smoking abstinence in postmenopausal women-an understudied population in the smoking cessation literature.
Adult↗
Effects of recombinant DNA-derived somatotropin and dietary energy intake on development of beef heifers: I. Growth and puberty.
The effects of dietary energy intake and somatotropin (STH) on growth and puberty were studied in 40 Angus heifers. At an average age of 7 mo (208 +/- 8 d), heifers were assigned to four treatment groups: 1) vehicle (V) + high energy (HE; 2.68 Mcal ME/kg DM), 2) recombinant DNA-derived STH (20.6 mg/d; s.c.) + HE, 3) V + low energy (LE; 2.22 Mcal ME/kg DM) or 4) STH + LE. Animals remained on treatments until 15.5 mo of age. Body weights (BW), hip heights (HH) and areas of pelvic openings (PA) were measured every 28 d and backfat thicknesses (BF) were measured every 56 d. Plasma progesterone was measured in blood samples taken three times per week beginning at 9 mo of age to determine age at first ovulation. Heifers fed HE were heavier (P less than .01), gained faster (P less than .01) and had greater BF (P less than .01) than those fed LE. Animals treated with STH gained faster (P less than .01) and were heavier (P less than .05) between 12 and 15 mo of age than V-treated heifers. Heifers treated with STH also had less BF (P less than .05) and a tendency for a greater (P = .08) increase in HH than in V-treated heifers. Somatotropin interacted with energy (P less than .05) and age (P less than .01) to influence PA. Somatotropin increased (P less than .01) PA in heifers fed the HE diet but not in those fed the LE diet.(ABSTRACT TRUNCATED AT 250 WORDS)
Analysis of Variance↗
Nutritional status of women in Bangladesh: comparison of energy intake and nutritional status of a low income rural group with a high income urban group.
This study evaluated the influence of socio-economic status on energy intake (EI), anthropometric characteristics and body composition (BC) of premenopausal Bangladeshi women in two socio-economic groups. This cross-sectional study measured height, weight, biceps and triceps skinfolds by standard procedures. A three-day dietary record was used to estimate EI. The biceps and triceps skinfolds were used to calculate total body fat (TBF), fat-free mass (FFM) and body fat percentage (BF%) according to Durnin and Womersley. FAO/WHO/UNU equations were used to calculate basal metabolic rates (BMR). Two locations in Bangladesh were studied; the Dhaka city area and the west region of the subdistrict Nandail (Betagair Union) in the district of Mymensingh. Study subjects were premenopausal women (N =191) aged 16(40 years. The high socio-economic group (group H, N =90) consisted of women with high income and educational level. The low socio-economic group (group L, N =101) consisted of rural, low income, illiterate women. Both groups contained three subgroups (non-pregnant, non-lactating =1, pregnant =2, lactating =3). Socio-economic status had a significant effect on body weight, height, biceps and triceps skinfolds, BMI, TBF, FFM and BF% (P<0.001). These variables were significantly higher (P<0.001) in all subgroups of group H than in the corresponding subgroups of group L. The influence of physiological status on most of these variables was not significant. EI was, however, influenced by both socio-economic (P<0.001) and physiological(P<0.05) status. The mean EI was significantly lower (P<0.001) in all subgroups of group L than in the corresponding subgroups of group H. The contributory sources were different in high and low income groups. In both groups, EI was lower than the recommended level. Based on the dietary and anthropometric results, we conclude that malnutrition is a common feature among low income rural women. This contradicts findings in western countries, where obesity is prevalent in low income groups.
Adolescent↗