On the recommended nutrient and energy intakes for the European Community.
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AIM: To measure the nutritive value of pasture in terms of digestible energy (DE) intake (DEI) and dry matter (DM) digestibility, and to determine the apparent absorption of macroelements in lactating Thoroughbred mares grazed on pasture. METHODS: DM intake (DMI) and DEI were determined from daily faecal DM output measured in grazing mares, divided by the DM indigestible fraction (1-digestible DM), measured in a digestibility trial using pasture-fed mares. Eight lactating mares and their foals, that had a mean age of 40 days, were grazed separately on 50x100 m areas of pasture and daily faecal DM outputs were recorded for 8 days. Five mares and their foals were then placed in individual bare 20x20 m corrals containing custom-made feeding stations for 14 days to determine the indigestible DM fraction. DM, gross energy content, crude protein (CP), soluble carbohydrate, acid detergent fibre (ADF), neutral detergent fibre (NDF), lipid, and macroelement composition of the pasture offered and faeces were determined and their digestibility and/or apparent absorption calculated. RESULTS: DM digestibility of the pasture was 0.6 and the DMI and DEI of a grazing 560 kg mare in early lactation nursing a foal growing at 1.34 kg/day was 13.6 (SE 0.8) kg/day and 146.9 (SE 8.4) MJ DE/day, respectively. Apparent absorptions of the macroelements measured were: Ca 0.75, P 0.43, Mg 0.63, Na 0.78, and K 0.72. CONCLUSIONS: Good quality ryegrass-white clover pasture that had a DE content of 10.8 MJ/kg DM, and a macroelement composition (g/kg) of Ca 3.33, P 3.0, Mg 1.67, Na 1.67, and K 24.2, will provide adequate DMI, DEI, and macroelement intake to lactating Thoroughbred mares.
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Resting metabolic rate is modulated by the amount of calories consumed in the diet relative to energy expenditure. Excessive consumption of energy appears to increase resting metabolic rate while fasting and very low calorie dieting causes resting metabolic rate to decrease. Since the metabolic rate at rest is the primary component of daily energy expenditure, its reduction with caloric restriction makes it difficult for obese individuals to lose weight and to maintain weight that is lost. Whether exercise has a carry-over effect on resting metabolic rate remains controversial, even though this question has been studied extensively during the last 90 years. Reasons for contradictory results include variations in control of prior diet and exercise patterns, inadequate exercise frequency, intensity and duration, and the possibility of response to exercise varying between individuals. Several lines of evidence suggest exercise may modulate resting metabolic rate. Bed rest in sedentary individuals leads to a reduction in resting metabolic rate. Similarly, in highly trained runners, cessation of daily exercise training lowers resting metabolic rate by about 7 to 10%. Resting metabolic rate is depressed in previously sedentary obese individuals on a very low calorie diet, but it quickly returns to the predieting level when exercise of sufficient frequency, intensity and duration is undertaken while dieting. These findings suggest caloric intake and daily exercise can modulate resting metabolic rate. Exercise of adequate intensity and duration may also enhance resting metabolic rate.
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Sugars and fat play a unique role in the human diet. The selective choice of sugars and fat as chief energy sources seems to be influenced less by the body's energy needs than by the sensory appeal of sweet and fat-rich foods. This appeal typically holds not only across individuals but across cultures. Although many behavioral, social, and cultural factors play major roles in diet selection, people respond primarily to the sensory qualities of food. Some clinical studies have reported that individual food choices and therefore the macronutrient composition of the diet are influenced directly by the central nervous system. However, broader population-based studies point to the central role of taste in determining food selection. Survey studies have shown that the global consumption of sugars and fat is further determined by such variables as income, socioeconomic status, and the availability of sugars and fat in the food supply. Nutrition intervention strategies aimed at promoting dietary change in communities ought therefore to consider not only physical health, but also the sensory pleasure response, and a wide range of demographic, economic, and sociocultural variables.
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BACKGROUND: Thus far, there have been no controlled studies to examine optimal levels of energy provision in critically ill patients with acute renal failure (ARF) receiving artificial nutrition. METHODS: After a 24 h nitrogen-free regimen (20% dextrose), we assigned during an open-label, AB/BA-crossover-trial, 10 ARF patients receiving both total parenteral nutrition (TPN) and renal replacement therapy (seven males; mean age 72 years, range 60-83; mean APACHE II score 27.1, range 23-34, mechanical ventilation 8/10) to a lower calorie-TPN regimen (30 kcal/kg/day) and to a higher calorie-TPN regimen (40 kcal/kg/day), each for 3 days. Nitrogen intake was 0.25 g/kg/day for both regimens. We estimated nitrogen balance, protein catabolic rate and urea generation rate by urea kinetic methods based on both timed blood samples of serum urea and direct urea quantification from dialysis fluid. RESULTS: Two patients were excluded from the analysis (due to death and serum triglycerides above 5.1 mmol/l, respectively). Compared with the lower calorie-TPN, the higher calorie-TPN regimen did not improve estimated nitrogen balance [+1.55 g/day (95% confidence interval: -0.95 to +4.05, P = 0.18)], protein catabolic rate [-0.10 g/kg/day (-0.33 to +0.14, P = 0.35)], or urea generation rate [-1.3 mg/min (-5.2 to +2.7, P = 0.46)], whereas it increased serum triglycerides [+1.36 mmol/l (+0.53 to +2.19, P = 0.007)], glucose [+1.15 mmol/l (+0.07 to +2.24, P = 0.041)], insulin need [+20.4 U/day (+8.3 to +32.6, P = 0.006)] and nutritional fluid administration [+468 ml/day (+370 to +566, P<0.001)]. CONCLUSIONS: The present study, conducted in a small group of subjects, shows that in critically ill patients with ARF on a nitrogen intake of 0.25 g/kg/day, an energy provision of 40 kcal/kg/day does not improve nitrogen balance estimates compared with a 30 kcal/kg/day intake; instead, it may increase the risk of artificial nutrition-related side-effects.