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Antisecretory and serum gastrin lowering effect of enprostil in patients with duodenal ulcer disease.

This study was designed to compare the effects of enprostil, a synthetic dehydro-prostaglandin E2, on 24-h intragastric pH and serum gastrin profile in patients with duodenal ulcer disease. The dosing regimen included 3 enprostil groups: 35 microgram h.s. (at bedtime), 70 micrograms h.s., and 35 micrograms b.i.d., compared with cimetidine 600 mg b.i.d., and with placebo. Ten patients with inactive duodenal ulcer disease were randomly assigned to all five treatment regimens for 1 wk each according to a Latin Square design. There was a 1-wk washout period between each treatment. Intragastric pH and serum gastrin measurements were carried out on the last day of each treatment week. In placebo-treated patients, intragastric pH rose after each meal and fluctuated between 1.5 and 3.5. Enprostil 35 micrograms b.i.d. and cimetidine elevated pH after breakfast and during the night (p less than 0.05). The single nighttime dose of enprostil had a marked effect on pH only when given in the dose of 70 micrograms and this effect lasted over 13.5 h. The pH values during the night were similar in the groups treated with enprostil 35 micrograms b.i.d. and 70 micrograms h.s. During the daytime, the readings at or above pH 4 were placebo, 5%; cimetidine, 21%; enprostil 35 micrograms b.i.d., 34%. During the nighttime, the readings greater than or equal to 4 were placebo, 12%; cimetidine, 29%; enprostil 35 micrograms b.i.d., 39%; 35 micrograms h.s., 19%, and 70 micrograms h.s., 38%. The postprandial rise in serum gastrin was greatly enhanced by cimetidine, but the change after breakfast was dramatically blunted by enprostil 35 micrograms b.i.d. Gastrin concentration was increased with cimetidine during the night but there was no difference in gastrin concentration overnight between all regimens of enprostil and placebo. This study suggests that (a) enprostil 35 micrograms b.i.d. is as effective as cimetidine 600 mg b.i.d. in suppressing postprandial and nocturnal intragastric acidity; (b) enprostil 35 micrograms b.i.d. and 70 micrograms at night are similarly potent in suppressing nocturnal acidity; and (c) in addition to its cytoprotective effect, enprostil has potent antisecretory and antigastrin properties.

Adult↗

Gastric somatostatin content and binding in children with hypertrophic pyloric stenosis: a long-term follow-up study.

Because somatostatin (SS) inhibits basal and stimulated gastric acid secretion and gastrin release, it is conceivable that decreased gastric SS concentration may be one of the factors responsible for hypergastrinemia found in patients formerly operated on for hypertrophic pyloric stenosis (HPS). To investigate this issue, the SS-like immunoreactivity (SLI) concentration was estimated in antral and fundic mucosal samples from control and HPS children. In addition, SS binding to cytosol from gastric mucosa (fundus and antrum), fasting serum gastrin levels, and serum gastrin response to a standard breakfast were studied. The mean fundic and antral SLI concentrations were significantly lower in HPS children than in controls. The depletion of fundic and antral SLI content was associated with an increase in the number of gastric SS binding sites. The fasting serum gastrin levels and serum gastrin responses to the standard breakfast (after 60 minutes) of HPS children were significantly higher than those of controls. Since, together with the increase of SS binding to gastric mucosa, there is an increase in the gastrin serum levels, despite the inhibitor effect of SS on gastrin release, the binding capacity cannot be the main factor determining the response to SS in children with HPS. The present results suggest that both SS and gastrin have a role in the pathogenesis of HPS.

Adolescent↗

Fasting and cognitive function.

The effects of short-term fasting (skipping breakfast) on the problem-solving performance of 9 to 11 yr old children were studied under the controlled conditions of a metabolic ward. The behavioral test battery included an assessment of IQ, the Matching Familiar Figure Test and Hagen Central Incidental Test. Glucose and insulin levels were measured in blood. All assessments were made under fasting and non-fasting conditions. Skipping breakfast was found to have adverse effects on the children's late morning problem-solving performance. These findings support observations that the timing and nutrient composition of meals have acute and demonstrable effects on behavior.

Blood Glucose↗

Dietary effects on mood and performance.

Of 20 young students recruited at a college for nutrition, 10 followed a diet for a period of 3 weeks and 10 were assigned to a control condition. One subject in the control group dropped out. The diet consisted of approximately 70 g protein and 25 g carbohydrate at breakfast and 10 g protein and 100 g carbohydrate at dinner. In between, a protein luncheon was consumed. On the last day of the 3-week period repeated measurements of mood and performance were made, i.e. after breakfast and after dinner. Consequently, the same measurements were made 2 months later to serve as covariates in the analyses to control for base-line differences of the two groups. It was predicted that, in the morning, the performance and the vigour of the diet group would improve whereas, in the evening, performance would become worse and subjects would feel more sleepy. However, the diet group was found to have a higher anger score in the morning (probably due to the unattractive nature of the diet) and a tendency to have a higher fatigue score in the evening compared with the controls. In addition, the diet group performed better in the morning on finger tapping, compared with the control group. With respect to memory scanning, the diet group performed more slowly in the morning in comparison with the control group. From these conflicting results, it was concluded that dietary composition had no effect on mood and behaviour.

Adult↗

Serum gastrin level and gastric somatostatin content and binding in long-term pyloromyotomized children.

Since somatostatin inhibits basal and stimulated gastric acid secretion and gastrin release, it is conceivable that decreased gastric somatostatin concentration may be one of the factors responsible for gastric hypersecretion found in patients who have undergone long-term pylorotomy for hypertrophic pyloric stenosis. To investigate this proposal the somatostatin-like immunoreactivity concentration was determined in antral and fundic mucosa samples from control and long-term pyloromyotomized children. In addition, somatostatin binding to cytosol from gastric (fundus and antrum) mucosa and fasting serum gastrin levels and serum gastrin response to a standard breakfast were also studied. The mean fundic and antral somatostatin-like immunoreactivity concentrations were significantly lower in long-term pyloromyotomized children than in control children. The depletion of fundic and antral somatostatin-like immunoreactivity content was associated with an increase in the number of gastric somatostatin binding sites. The fasting serum gastrin levels and serum gastrin response to a standard breakfast (after 60 min) in long-term pyloromyotomized children was significantly higher than those in control children. Since, together with the increase of somatostatin binding to gastric mucosa, there is an increase in the gastrin serum levels, despite the inhibitory effect of somatostatin on gastrin release, the binding capacity cannot be the main factor determining the response to somatostatin in long-term pyloromyotomized children. The present results suggest that both somatostatin and gastrin have some pathophysiologic importance in long-term pyloromyotomized children.

Adolescent↗

Immunoreactive pancreatic polypeptide components in plasma from normal subjects and patients with chronic renal failure in basal and postprandial conditions.

Gel filtration of plasma from normal subjects and patients with chronic renal failure (CRF) yielded four immunoreactive human pancreatic polypeptide (IRhPP) peaks of approximately greater than 20,000, 10,000, 4200, and 2000 daltons. In normal subjects, the basal plasma distribution was 36 +/- 2%, 16 +/- 3%, 25 +/- 1% and 23 +/- 2%, respectively. In the CRF patients, the total plasma IRhPP was close to ten times higher than in the normal group. This difference was due to an increase in IRhPP10000 and IRhPP4200 plasma levels. After a standard breakfast, plasma IRhPP10000 and IRhPP4200 levels increased in the normal subjects and in the CRF patients, while the levels of the other two plasma components were not affected by the meal. In a patient with multiple endocrine adenomatosis type 1, the basal plasma levels of IRhPP10000 and IRhPP4200 were, respectively, 41 and 44 times higher than the mean value in the normal subjects; these fractions appeared to be further increased after breakfast. In trying to characterize the IRhPP10000, it was found that treatment with urea, guanadium hydrochloride, and acetic acid (pH 2.2) did not alter its molecular size, whereas limited trypsin treatment was able to destroy part of the immunoreactivity and to produce greater than 20,000-dalton and 4200-dalton immunoreactive materials. Plasma IRhPP10000 seems to be a co-secretory product of the PP cell, and the kidney plays a role in its catabolism as well as in that of the IRhPP4200 component. The IRhPP10000 component may correspond to a PP precursor.

Adult↗

Inhibitory effect of enkephalin on insulin secretion in healthy subjects and in non insulin-dependent diabetic subjects.

The administration of the long-acting met-enkephalin analogue (FK 33-824, Sandoz; Basel Switzerland) inhibits insulin secretion induced by glucose (oral and intravenous) and nonglucose (arginine and breakfast) secretagogues in both normal subjects and in patients with noninsulin-dependent diabetes mellitus. The plasma glucose rise triggered by oral glucose and breakfast is reduced by FK in both groups of subjects, suggesting for the opioid peptide an effect in delaying glucose absorption. The data suggest a negative role for enkephalin in the regulation of insulin secretion in both normal and noninsulin-dependent diabetic subjects.

Adult↗

Comparison of intraperitoneal and subcutaneous insulin administration on lipids, apolipoproteins, fuel metabolites, and hormones in type I diabetes mellitus.

The relative biologic efficacy of intraperitoneal (IP) insulin administration over peripheral routes of insulin infusion for artificial delivery devices is still poorly documented. Thus, the effects of IP insulin administration have been compared with the effects of subcutaneous (SC) insulin administration upon circulating fuel metabolites, hormones and lipoproteins. In a longitudinal study, seven type I diabetic patients, aged 33 +/- 3 years, duration 16 +/- 4 years, were studied. SC intensive insulin therapy was used for 3 months, then insulin was infused IP via an implantable pump for 6 months with a similar good blood glucose control. Lipids including high density lipoprotein (HDL) cholesterol and low density lipoprotein (LDL) cholesterol, apolipoproteins A-I, A-II, and B were measured every 3 months. Although all values remained in the normal range, significant changes occurred in plasma triglycerides (63 +/- 9 SC v 88 +/- 12 mg/dL IP, P less than .05) and HDL-cholesterol (57 +/- 4 SC v 42 +/- 4 mg/dL IP, P less than .05) without concomitant changes in apolipoprotein levels. In another cross-sectional study, six of the patients consumed a standardized 400 kcal breakfast after 0.15 U/kg insulin. Eight SC insulin infused age-, glucose control- and weight-matched diabetic patients also underwent the same test using SC insulin. Six normal subjects consumed the same breakfast and served as controls. Plasma glucose, B-hydroxybutyrate, lactate, alanine, free fatty acids, free insulin and glucagon were measured for five hours after the meal. All measured parameters were comparable in both groups except free insulin and lactate.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Influence of dietary fat polyunsaturated to saturated ratio on energy substrate utilization in obesity.

The effect of the polyunsaturated to saturated (P:S) ratio of dietary fat on preprandial and postprandial macronutrient oxidation was studied in normal-weight and obese individuals. Total thermogenic response and fat and carbohydrate oxidation rates were determined by duplicate respiratory gas exchange measurements after test breakfasts, in seven normal and eight overweight subjects who consumed self-selected diets containing fat of high or low P:S ratio. Dietary intake records and erythrocyte linoleic to oleic (L:O) acid ratio changes were used as indicators of dietary compliance. No diet- or weight-related differences were observed in resting fat or carbohydrate oxidation rates, or in protein-free basal energy expenditure. Obese subjects consuming low P:S ratio diets exhibited reduced (P less than .05) contribution of fat oxidation to the thermogenic response, compared with lean individuals consuming high or low P:S ratio diets. However, total calories associated with the thermogenic response, and total fat and carbohydrate oxidation after the test breakfasts, did not differ significantly across groups. These findings suggest that, in obesity, whole-body postprandial disposal of dietary fat is influenced by the long-chain fatty acid composition.

Adult↗

Carbohydrate/protein selection in a single meal correlated with plasma tryptophan and tyrosine ratios to neutral amino acids in fasting individuals.

Plasma ratios of tryptophan (Trp) and tyrosine (Tyr) to their respective competing large neutral amino acids (LNAA) for brain uptake, serum insulin and plasma glucose concentrations were determined in 31 fasting healthy female subjects, and in two smaller groups of smokers and oral contraceptive users, who were subsequently allowed to compose individual breakfast meals from a selection of 25 dietary products. Additional blood samples were collected at 2 hr after the meal. Smokers consumed less carbohydrate (-22%) and total calories (-23%) and showed decreased basal serum insulin level, when compared to controls on the same age. Females on oral contraceptives consumed significantly more carbohydrate (+54%) and total calories (+32%) than comparable controls. In the 31 females there was no significant correlation between any of the biological variables and the intake of fat or total calories. The ratio of carbohydrate/protein eaten was significantly and directly correlated with age and with the sum of plasma ratios Trp/LNAA and Tyr/LNAA, and these independent variables associated with 37% of the variance in the ratio carbohydrate/protein consumed, as evaluated by multiple regression analysis. After the meal, the plasma ratio Tyr/LNAA was increased, whereas the ratio Trp/LNAA was decreased in subjects whose ratio carbohydrate/protein consumed was below the mean of the full sample, whereas subjects who consumed meals with a high ratio carbohydrate/protein showed an increase in plasma ratio Trp/LNAA. It is concluded that biological variables in man are significantly associated with the choice between nutrients with different carbohydrate and protein contents for breakfast. The changes in the plasma ratios Trp/LNAA and Tyr/LNAA after consumption were generally moderate.

Amino Acids↗

Effects of aspartame and sucrose on hunger and energy intake in humans.

Physiological and behavioral responses to high intensity sweeteners have been poorly characterized, leading to questions regarding their utility in weight management regimens. To address this issue, studies must independently control attributes such as the taste properties, chemical composition and energy contribution of a given sweetener, as well as subject expectations of its effects. In the present study, 24 adults of normal weight consumed breakfasts including unsweetened or sweetened (sucrose or aspartame) cereal for 5 days, during which hunger and energy intake were monitored. The cereals were rated as equally sweet and pleasant and were equicaloric. Half of the subjects were aware of the cereal composition. Neither sweet taste nor aspartame alone significantly affected reported hunger, daily energy intake or subsequent selection of foods with varying taste qualities. Energy intake tended to be more strongly influenced by perceptions of the energy value of the experimental breakfast. Thus, this study failed to find an appetite stimulating effect of either sweetness or sweetener (aspartame or sucrose).

Adult↗

Restrained and nonrestrained eaters' orienting responses to food and nonfood odors.

Dietary restraint was assessed by Stunkard and Messick's (1985) three-factor eating questionnaire, using the restraint subfactor score only in normal-weight college students (n = 41). The subjects were than assessed for skin conductance orienting responses (ORs) to food and nonfood odors when hungry and sated (after a standard breakfast and after an overnight fast). Subjects also rated their hunger and each odorant for pleasantness on separate 7-point scales. Results indicated that restrained eaters oriented less to odors than did nonrestrained subjects. Food deprivation did not differentially affect the ORs in restrained and nonrestrained eaters. The ORs, however, tended to be decreased in all of subjects who had had breakfast. Finally, nonrestrained subjects rated food and nonfood odors approximately equal in pleasantness, while the restrained eaters rated food odors as more pleasant than the nonfood odors. These results suggest that restrained eaters must certainly process odor stimuli related to foods, but also suggests that orienting to these salient (informative) cues is restricted. Perhaps in defense of the diet, restrained eaters learn methods/responses (cognitive strategies, instructional sets) to block orienting to food related cues such as odors.

Adolescent↗

Taste and smell sensations enhance the satiating effect of both a high-carbohydrate and a high-fat meal in humans.

The effects of meal sensory properties (tasty vs. bland) and nutrient composition [high-CHO (carbohydrate) vs. high-FAT] on hunger ratings, blood glucose and free fatty acids (FFA), taste perception, and subsequent food intake, were studied in human subjects. Aspartame and vanilla were used to augment meal palatability, yielding four isocaloric liquid meals: bland-FAT, tasty-FAT, bland-CHO, tasty-CHO. Normal-weight, nondieting young adults consumed each of the meals for breakfast on separate days. The main finding was that tasty versions of high-FAT and high-CHO meals were more satiating than nutritionally identical bland meals, as indicated by a greater decrease in hunger ratings following the tasty meals. Changes in blood glucose and FFA were related to meal nutrient composition, but not to meal sensory properties. High-CHO meals tended to be more satiating than high-FAT meals. Consumption of each of the meals produced a similar decrease in pleasantness ratings of food-related tastes. Intake of carbohydrates was significantly higher at a self-selected lunch 5.25 h following a tasty breakfast. These findings indicate that hunger is decreased to a greater extent by meals flavored with aspartame and vanilla relative to nutritionally identical, unflavored meals. The satiety-enhancing effect of oral stimulation was found for both high-FAT and high-CHO meals.

Adult↗

Psychosocial and behavioral factors associated with serum lipids in university students.

The impact of psychosocial and behavioral factors on serum lipids was examined in 46 male and 47 female students with a mean age of 23 years. Subjects were recruited from the University of Stockholm and the study was performed with the Student Health Care Organization in order to have a basis for intervention programs. Significant associations between serum lipids and parental education, regularity of breakfast habits, nourishing eating, social support, depressive feelings and quality of life are found. However, there is no consistent pattern for these associations in men and women. Thus, some associations are significant for men and some for women. Women with parents having higher levels of education had lower values of cholesterol, triglycerides and apo B, and higher values of apo A-1 (representing the 'good' cholesterol) than women whose parents were not highly educated. When controlling the associations for confounding factors such as age, body mass index, physical activity, coffee, alcohol, smoking habits, nourishing eating and quality of life, the associations were strongly confirmed. No similar associations were found in men. Men who reported low social support or social integration and a low perceived quality of life showed a tendency to higher levels of lipids compared to those who reported high integration and quality of life. Regularity of dietary habits was found to be associated to serum lipids in men, the greater the regularity, the lower the lipid levels. The strongest association was found for regularity of breakfast habits. This association was also strongly significant in the regression analysis after controlling for the described confounding factors.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Effect of diet and vitamin C on DNA strand breakage in freshly-isolated human white blood cells.

We have measured DNA strand breaks induced by ionising radiation in nucleated cells from freshly isolated whole blood from normal human subjects. Samples were taken after subjects had fasted overnight and again 1 h after they had eaten breakfast in combination with approximately 35 mg/kg vitamin C. Damage was measured by single cell gel electrophoresis (the 'comet' assay), in which DNA single strand breaks generate a comet tail streaming from the nucleus. In repeat experiments on 6 subjects a reduction in DNA damage, as indicated by a highly significant decrease in overall comet length, was observed following vitamin C ingestion, both in the unirradiated control blood samples and in the dose response to ionising radiation damage. In addition, consistent differences in dose response between individual subjects were found. The peak effect was 4 h after intake of food and vitamin C. An effect was also seen with vitamin C alone and after breakfast without additional vitamin C. Protection against strand breakage was also seen in Ficoll-separated mononuclear cells but evidence was not obtained for protection of separated, mitogen stimulated T-lymphocytes either against ionising radiation cell killing in a clonal assay, or against clastogenicity assessed by micronucleus formation following one cell division. Exposure of separated lymphocytes in vitro to vitamin C, at doses greater than 200 microM, did not offer protection but induced strand breakage. Our results raise the possibility that variation in normal diet may not only affect susceptibility to endogenous oxidative damage, but may affect some responses of the individual to radiation.

Artifacts↗

Influence of food and antacid administration on fluoride bioavailability from enteric-coated sodium fluoride tablets.

The relative bioavailability of enteric-coated sodium fluoride (NaF) tablets (10 mg F-) has been assessed following administration with a standard calcium-rich breakfast or calcium-poor lunch, and 2 h before or simultaneously with antacid administration (2.4 g aluminum-magnesium hydroxide), versus intake on an empty stomach. Twelve volunteers were studied 3 times according to an open, three-way crossover design over a 24 h period at weekly intervals. Meals were found to decrease the peak serum concentration of NaF from 122 micrograms/L during fasting (after baseline subtraction) to 71 and 88 micrograms/L with breakfast and lunch respectively, and to slow its absorption rate with Tmax increasing from 3.3 to 7.3 and 11.2 hours, without altering its bioavailability. Antacid impaired the bioavailability of NaF by 80% when administered simultaneously, with AUC decreasing from 987 to 155 micrograms.h/L, but had no significant effect when taken 2 h before NaF. In conclusion, the enteric-coated NaF tablets used in this study can be administered with food or after a 2-hour delay following antacid administration, but should not be taken simultaneously with antacid.

Adult↗

Electromyography as a measure of peak and cumulative workload in intermediate care and its relationship to musculoskeletal injury: an exploratory ergonomic study.

Injury rates in Intermediate Care (IC) facilities are high and the factors related to these injuries are unclear. The objectives of this exploratory sub-study, which is part of a large multi-faceted study in 8 IC facilities are to: (1) evaluate EMG measured over a full-shift in the back and shoulders of 32 care aides (CAs) as an indicator of peak and cumulative workload (n = 4 x 8 facilities); investigate the relationship between EMG measures and injury indicators; and explore the relationship between EMG measures and other workload measurements. Lumbar EMG was converted to predicted cumulative spinal compression and ranged in CAs from 11.7 to 22.8 MNs with a mean of 16.4 MNs. Average compression was significantly different during different periods of the day (p < 0.001) with highest compression during pre-breakfast when CAs assist most with activities of daily living. Significant differences were found in average compression between low and high injury facilities for 3 of 5 periods of the day (p < 0.010). Peak compressions exceeding 3400 N occurred for very little of the workday (e.g. 11.25s during the 75 min period pre-breakfast). Peak neck/shoulder muscle activity is low (99% APDF ranged from 8.33% to 28% MVC). Peak and cumulative spinal compression were significantly correlated with lost-time and musculoskeletal injury rates as well as with total tasks observed in the CAs (p < 0.01). Perceived exertion was only correlated with peak compressions (p < 0.01). Facilities with low injury rates provided significantly more CAs (p < 0.01) to meet resident needs, and subsequently CAs performed fewer tasks, resulting in less peak and cumulative spinal loading over the day.

Back↗

Satiety from rice-based, wheat-based and rice-pulse combination preparations.

The satiety values of six breakfast items commonly consumed in India were determined on the basis of area under the curve. A repeated measures design was used wherein energy intake, hunger, and satiety scores were assessed for one rice-based, three wheat-based and a rice-pulse fermented preparation, using white bread as the reference. Subjects were provided equi-caloric portions of the six breakfast items on separate occasions, and satiety ratings were recorded every 15 min over a 120 min period, after which time they were free to consume whatever they desired. Satiety scores were in the order of fermented cereal-pulse preparation> savoury broken wheat preparation>whole wheat flour flat bread>savoury semolina preparation> savoury rice flakes preparation>white bread standard. Among the various factors examined for their influence on satiety scores, fibre content, energy density and cooked weight of the food items positively influenced satiety scores. Neither fat nor carbohydrate content showed any correlation with satiety scores. These data indicate that isoenergetic portions of various foods influence satiety to different extents. Thus results suggest that consumption of high protein, high fibre and foods with greater water/volume leading to low energy density may be effective in delaying the return of hunger.

Adult↗