[Alcohol consumption in relation to energy intake in 50-59 year old Danish men from a rural and an urban community].
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Premature infants are at risk for malnutrition and essential fatty acid deficiency. The authors administered 0.5 g of lipids by parenteral route as an adjuvant to enteral feeding, in 30 healthy premature infants aged 14 days to 6 weeks, with a body weight at birth of 1,879 +/- 325 g, presenting a slow rate of weight gain. This led to a long term improvement of the body weight gain preventing malnutrition. The serum level of total triglycerides, cholesterol, phospholipids and glycemia remained within normal limits.
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The increase in childhood obesity over the past several decades, together with the associated health problems and costs, is raising grave concern among health care professionals, policy experts, children's advocates, and parents. Patricia Anderson and Kristin Butcher document trends in children's obesity and examine the possible underlying causes of the obesity epidemic. They begin by reviewing research on energy intake, energy expenditure, and "energy balance," noting that children who eat more "empty calories" and expend fewer calories through physical activity are more likely to be obese than other children. Next they ask what has changed in children's environment over the past three decades to upset this energy balance equation. In particular, they examine changes in the food market, in the built environment, in schools and child care settings, and in the role of parents-paying attention to the timing of these changes. Among the changes that affect children's energy intake are the increasing availability of energy-dense, high-calorie foods and drinks through schools. Changes in the family, particularly an increase in dual-career or single-parent working families, may also have increased demand for food away from home or pre-prepared foods. A host of factors have also contributed to reductions in energy expenditure. In particular, children today seem less likely to walk to school and to be traveling more in cars than they were during the early 1970s, perhaps because of changes in the built environment. Finally, children spend more time viewing television and using computers. Anderson and Butcher find no one factor that has led to increases in children's obesity. Rather, many complementary changes have simultaneously increased children's energy intake and decreased their energy expenditure. The challenge in formulating policies to address children's obesity is to learn how best to change the environment that affects children's energy balance.
This study was undertaken to assess the recent data on Malaysian adult body weights and associations of ethnic differences in overweight and obesity with comorbid risk factors, and to examine measures of energy intake, energy expenditure, basal metabolic rate (BMR) and physical activity changes in urban and rural populations of normal weight. Three studies were included (1) a summary of a national health morbidity survey conducted in 1996 on nearly 29 000 adults > or =20 years of age; (2) a study comparing energy intake, BMR and physical activity levels (PALs) in 409 ethnically diverse, healthy adults drawn from a population of 1165 rural and urban subjects 18-60 years of age; and (3) an examination of the prevalence of obesity and comorbid risk factors that predict coronary heart disease and type 2 diabetes in 609 rural Malaysians aged 30-65 years. Overweight and obesity were calculated using body mass index (BMI) measures and World Health Organization (WHO) criteria. Energy intake was assessed using 3-d food records, BMR and PALs were assessed with Douglas bags and activity diaries, while hypertension, hyperlipidaemia and glucose intolerance were specified using standard criteria. The National Health Morbidity Survey data revealed that in adults, 20.7% were overweight and 5.8% obese (0.3% of whom had BMI values of >40.0 kg m(-2)); the prevalence of obesity was clearly greater in women than in men. In women, obesity rates were higher in Indian and Malay women than in Chinese women, while in men the Chinese recorded the highest obesity prevalences followed by the Malay and Indians. Studies on normal healthy subjects indicated that the energy intake of Indians was significantly lower than that of other ethnic groups. In women, Malays recorded a significantly higher energy intake than the other groups. Urban male subjects consumed significantly more energy than their rural counterparts, but this was not the case in women. In both men and women, fat intakes (%) were significantly higher in Chinese and urban subjects. Men were moderately active with the exception of the Dayaks. Chinese women were considerably less active than Chinese men. Chinese and Dayak women were less active than Malay and Indian women. In both men and women, Indians recorded the highest PALs. Hence, current nutrition and health surveys reveal that Malaysians are already affected by western health problems. The escalation of obesity, once thought to be an urban phenomenon, has now spread to the rural population at an alarming rate. As Malaysia proceeds rapidly towards a developed economy status, the health of its population will probably continue to deteriorate. Therefore, a national strategy needs to be developed to tackle both dietary and activity contributors to the excess weight gain of the Malaysian population.
This paper identifies determinants of women's postpartum weight and weight change in a large group of Filipino women followed for 24 mo. Longitudinal, multivariate models focused on the effects of lactation, while controlling for energy intake, energy expenditure, reproductive history and seasonality. Lactation was found to have a significant negative effect on weight of urban women. The negative effects of lactation increased with the intensity and duration of breast-feeding. Among rural women negative effects of lactation on weight were observed only after 10-14 mo. Models of net postpartum weight change (from 2 to 24 mo) among nonpregnant women confirmed an important role for lactation. The likelihood of weight loss was significantly increased by lactation of more than 12-mo duration, by greater maternal age and by low dietary energy intake. The effects of lactation on maternal energy reserves can be mitigated substantially be increasing maternal dietary energy intakes.
Six male children, aged 8-28 months, were studied for three consecutive periods of 1 week each. They were given diets that provided 1.7 g protein/kg per d and supplements of minerals and vitamins, with a metabolizable energy intake during the 1st, 2nd and 3rd week of 419, 293 and 335 kJ (100, 70 and 80 kcal)/kg per d, diets 1, 2 and 3 respectively. All the food offered was consumed. Each child was weighed at the same time each day on an electronic balance. On the 6th and 7th day of each study period urine and stool were collected for 24 h to assess nitrogen balance. Using linear regression analysis it was shown that all children gained weight on diet 1, 2.3 (SD 1.3) g/kg per d, and five of six children gained weight on diet 3, the mean for the whole group being 2.7 (SD 2.3) g/kg per d, not significantly different. On diet 2 all children lost weight, -5.4 (SD 1.3) g/kg per d, highly significantly different from each of the other dietary periods. Using asymptotic regression analysis it could be shown that the rate of weight loss during the first part of the week on diet 2, -11 g/kg per d, was greater than at the end of the week, -2 g/kg per d, with a tendency towards a steady weight by day 7. Apparent N retention (mg/kg per d) was positive at the end of each of the three dietary periods: diet 1, 112 (SD 25); diet 2, 54 (SD 34); diet 3, 82 (SD 20). In five of the six children there was a marked reduction in stool frequency on diet 2 compared with diet 1, that was maintained to the period on diet 3. The findings suggest that during the period on diet 2 there was a saving of energy of the order of 105 kJ (25 kcal)/kg per d, which lasted through into the period on diet 3.
The fatty acid composition of subcutaneous tissue has been determined in a population sample of apparently healthy middle aged men from Southern Italy. Dietary appraisal has been carried out by evaluating the usual pattern of food consumption during the year preceding the interview. The whole population sample was subdivided into three tertiles on the basis of the energy intake by the different individuals. The proportion of adipose tissue polyunsaturated fatty acids was relatively low in the high energy tertile III and high in the low energy tertile reflecting parallel differences in the intake of polyunsaturated fatty acids. The percentage of monounsaturated fatty acids (mainly oleic acid) was relatively high (p less than 0.01) and that of saturated fatty acids (mainly palmitic acid) relatively low (p less than 0.05) in the high energy tertile (III) as compared to the low energy tertile (I); these differences were independent of the amount and type of dietary fatty acids. Total energy was positively correlated (r = .87, p less than 0.01) to carbohydrate intake (g/day). Dietary carbohydrates (g/day) were inversely related to adipose tissue saturated fatty acids (r = -.40, p less than 0.001) and directly correlated to adipose tissue monounsaturated fatty acids (p = .40, p less than 0.001). Carbohydrate intake was related to adipose tissue monounsaturated and saturated fatty acids independently of daily energy intake. On the other hand when the influence of dietary carbohydrates was eliminated, no correlation was detectable any longer between energy intake and adipose tissue fatty acids.(ABSTRACT TRUNCATED AT 250 WORDS)
The doubly labeled water method was compared with indirect calorimetry and a nutrient-balance study for simultaneous determination of rates of CO2 production, energy expenditure, and water intake over 5 days in four preterm infants. Additionally, metabolizable energy (ME) intake estimated using the isotope procedure (as energy expenditure plus an estimate for energy deposition based on weight gain), was compared to ME intake measured in the balance study. Compared to values obtained by traditional methods, calculated CO2 production, energy expenditure, and water intake differed by -1.4 +/- 4.8% (SD), +0.3 +/- 2.6%, and +5.7 +/- 1.4%, respectively; the difference in water intake was significant (p less than 0.05). Calculated ME intakes were 5.3 +/- 19.3% less than measured intakes, but the difference was not significant. These findings indicate that the doubly labeled water method can provide accurate information on rates of CO2 production, energy expenditure, and water intake in preterm infants, but individual estimates of ME intake may be subject to substantial error.
The sympatho-adrenal system is involved in the regulation of energy metabolism and responds to changes in energy intake. Energy restriction diminishes the sympathetic drive while overfeeding increases it. Chronically energy deficient subjects show an enhanced alpha and beta receptor responsiveness, which may be of a denervation type, associated with the reduced sympathetic activity that results from the decrease in dietary energy intake. The reduced basal metabolism of energy restricted subjects is partly attributable to the decrease in sympathetic activity. Chronically energy deficient individuals also show a suppressed thermogenic response to infusions of adrenergic agonists such as noradrenaline. Although sympathetic activity plays a modulating role in the energy homeostasis of the chronically energy deficient, it is not possible to explain seasonal fluctuations in energy balance.
OBJECTIVES: Low-fat high-carbohydrate diets are recommended to prevent weight gain in normal weight subjects and reduce body weight in overweight and obese. However, their efficacy is controversial. We evaluated the efficacy of ad libitum low-fat diets in reducing body weight in non-diabetic individuals from the results of intervention trials. DESIGN: Studies were identified from a computerized search of the Medline database from January 1966 to July 1999 and other sources. Inclusion criteria were: controlled trials lasting more than 2 months comparing ad libitum low-fat diets as the sole intervention with a control group consuming habitual diet or a medium-fat diet ad libitum. MAIN OUTCOME MEASURES: Differences in changes in dietary fat intake, energy intake and body weight. Weighted mean differences for continuous data and 95% confidence intervals (CIs) were calculated. RESULTS: Two authors independently selected the studies meeting the inclusion criteria and extracted data from 16 trials (duration of 2-12 months) with 19 intervention groups, enrolling 1910 individuals. Fourteen were randomized. Weight loss was not the primary aim in 11 studies. Before the interventions the mean proportions of dietary energy from fat in the studies were 37.7% (95% CI, 36.9-38.5) in the low-fat groups, and 37.4% (36.4-38.4) in the control groups. The low-fat intervention produced a mean fat reduction of 10.2% (8.1-12.3). Low-fat intervention groups showed a greater weight loss than control groups (3.2 kg, 95% confidence interval 1.9-4.5 kg; P < 0.0001), and a greater reduction in energy intake (1 138 kJ/day, 95% confidence interval 564-1712 kJ/day, P = 0.002). Having a body weight 10 kg higher than the average pre-treatment body weight was associated with a 2.6 +/- 0.8 kg (P = 0.011) greater difference in weight loss. CONCLUSION: A reduction in dietary fat without intentional restriction of energy intake causes weight loss, which is more substantial in heavier subjects.
The coupling among energy intake, storage, and expenditure was examined in male Siberian hamsters (Phodopus sungorus sungorus) given access to running wheels for 14 weeks. Half of the hamsters were injected with melatonin in a schedule that mimics the effects of short photoperiods by decreasing body weight, carcass lipid content, and testis weight. The exercise-induced body weight increases which are seen in Syrian hamsters (Mesocricetus auratus) were not found in Siberian hamsters. Instead, the Siberian hamsters maintained their body weights, compensating for the increased energy demands of exercise by increasing their food intakes. Exercise did not affect carcass composition. Melatonin treatment decreased food intake and carcass lipid stores but did not affect voluntary exercise. The previously reported decrease in testis weight was seen in all melatonin-treated hamsters, but the stimulation of brown adipose tissue growth was not. Thus, exercising Siberian hamsters, unlike exercising Syrian hamsters, appear to exhibit a tight coupling among energy intake, storage, and expenditure.
The large deficit in energy intake in relation to energy requirements during the transition and early lactation periods means that high-producing cows need energy-dense rations. High-starch diets are intensively fermented by the microbial ecosystem in the rumen, giving rise to a high production of VFAs and resulting in a drop in pH and the accumulation of lactic acid, which exacerbates the decline in pH and is considered as the major cause of rumen acidosis. This rumen dysfunction affects rumen microbes and results in less efficient digestion, thereby decreasing feed intake and exacerbating the energy deficit in the cows. The main way to limit the risk of acidosis is by diet management. Thus, animals must be progressively adapted to grain ingredients during the 3-week period before calving. Furthermore, the diet management strategy will be to privilege low-degradable starch and include enough fiber in the diet to stimulate rumination and salivation. Chemical additives can be used to prevent rumen acidosis. Rumen pH can be controlled by direct addition of chemical buffers at doses of 1-2% of DM intake. Metabolic hydrogen can be mobilized through specific metabolic pathways such as propionogenesis to compete with the synthesis of lactic acid. This can be achieved by adding propionate precursors such as aspartate, malate or fumarate. However, these additives are not economically viable, and will not easily be accepted by consumers. Probiotics, which are mainly supplied as live yeasts, have to be regarded as a solution for preventing subacute acidosis but they are not considered as an efficient cure for acute acidosis. Although the mechanisms of action of probiotics are not fully understood, this paper proposes a plausible model of their mode of action. Recently, additives based on plant extracts have been proposed as a solution for optimizing rumen functions, but further efficacy studies and safety trials are required before these additives can be marketed. The addition of fibrolytic enzymes has been suggested to improve the digestion of the dietary fiber fraction during acidosis. Although the results obtained so far are encouraging, more ruminant-specific research needs to be carried out on these enzymes. Some antibiotics are potential inhibitors of Gram-positive bacteria, which are involved in rumen acidosis, but their use as feed additives has been banned from 01/01/2006 in the EU.
Distance running in humans has been associated with both positive and negative effects on the balance of bone remodelling. There is evidence to suggest that the negative effects may be linked to a failure to balance energy expenditure with an adequate energy intake. Energy restriction is known to reduce the synthesis and serum concentration of insulin-like growth factor 1 (IGF-1), which plays an important role in bone formation. The purpose of the present study was to compare the effects of repeated periods of prolonged treadmill running, under conditions of either energy balance or energy restriction, on markers of bone turnover and serum IGF-1 concentration in trained distance runners. Eight male distance runners [mean age 25.1 (SD 5.9) years, maximal oxygen uptake 61.8 (SD 4.9) ml x kg(-1) x min(-1)] undertook an exercise and diet regime on two separate occasions, 2 weeks apart. On each occasion they performed an intensive, 60 min treadmill run on 3 consecutive days. On one occasion their energy intake was restricted to approximately 50% of their estimated energy requirement (RES), whereas on the other occasion they remained in energy balance (BAL). The N-terminal pro-peptide of type 1 collagen (P1NP), osteocalcin and IGF-1 were measured in serum collected between 0800 and 0900 hours, when fasted and rested, on the day before and the day after each regime. The cross-linked N-telopeptides of type 1 collagen and deoxypyridinoline were measured from 24 h urine collections made on the day before and the final day of each regime and adjusted for creatinine excretion. The results showed that the serum concentration of both P1NP and IGF-1 declined by 15% (P = 0.008) and 17% (P = 0.007) respectively in response to RES, but did not change in response to BAL (P > 0.05). A strong relationship was observed between the magnitude of the reduction in the serum concentration of P1NP and IGF-1 after RES (r = 0.97; P < 0.001). There were no changes in the other bone markers in response to either regime. The results suggested that in trained distance runners, repeated periods of prolonged running do not affect the balance of bone turnover unless energy balance is simultaneously altered. These findings support the link between a negative energy balance, a reduced synthesis or serum level of IGF-1 and reduced collagen synthesis. They may also help to explain the bone remodelling imbalance that has been observed in some male and female distance runners.
It is controversial whether food intake in humans is under day-to-day regulation to maintain constant body glycogen stores. In eight white males with a mean (+/-SD) age of 30 +/- 4 y, body weight of 82 +/- 20 kg, and percentage body fat of 22 +/- 5%, exercise and diets were used to produce either high (HG) or low glycogen (LG) stores in a randomized crossover design. After each treatment a vastus lateralis muscle biopsy was obtained. Subsequent ad libitum food intake was measured with an automated food-selection system during 2 d in a respiratory chamber. Despite a 46 +/- 21% difference in muscle glycogen between the two treatments, ad libitum 2-d food intakes (energy, weight, or macronutrients) were similar between treatments (HG: 23.80 +/- 4.67 MJ/d; LG: 21.20 +/- 6.73 MJ/d). However, energy intake on the second day of ad libitum feeding was negatively correlated with carbohydrate balance on the first day, adjusted for the effect of total energy intake and treatment. Adjusted carbohydrate balance on day 1 only explained 9% of the variance in energy intake on day 2. The 24-h respiratory quotient on the first day after treatment was higher after the HG than after the LG treatment: 0.94 +/- 0.04 and 0.88 +/- 0.07 (P < 0.001). The findings suggest that 1) body glycogen stores play at most a minor role in short-term food intake regulation, and 2) in the short term, imbalances in glycogen stores are corrected by adjustments of macronutrient oxidation rates.
Family resemblance in fatness has been studied in 481 individuals from 114 families of French descent living in the greater Quebec city area. Subjects were measured for the following fatness indicators: triceps, biceps, subscapular, suprailiac, abdominal and medial calf skinfolds. The sum of these six skinfolds as well as a prediction of percent body fat (Durnin and Rahaman 1967) were also considered. Data were standardized for appropriate age and sex classes yielding SS scores. The influence of relevant lifestyle variables (energy intake, energy expenditure and socioeconomic status) were statistically removed from SS yeilding residual scores (RS) that were then submitted to familial analyses. Analyses of variance indicate that there is a larger between family variation than within (P less than or equal to 0.01) for SS when considering either the whole nuclear family or sibships; in these instances, the intra-class correlation ranges from 0.15 to 0.26. There was, however, no significant resemblance among spouses for the SS fatness indicators. Similar values were essentially found for RS fatness indicators. Furthermore, husband-wife inter-class correlations were not significant with the exception of subscapular and calf skinfold RS. Covariations between biological relatives are however significant (0.16 less than or equal to r less than or equal to 0.24, P less than or equal to 0.01) for SS and remain essentially unchanged after statistical control over the lifestyle variables (0.16 less than or equal to r less than or equal to 0.40, P less than or equal to 0.01). The findings that spouses do not covary significantly in fatness, while biological relatives of traditional nuclear families exhibit a significant degree of resemblance even after statistical control over daily energy intake, daily energy expenditure and socioeconomic status provide evidence supporting the hypothesis that there is a substantial genetic effect in human fatness.
Male Wistar rats rendered obese by a cafeteria diet were subjected to three successive cycles alternating food restriction with ad libitum cafeteria-diet feeding (WC rats). Body composition, energy intake, energy required for maintenance, and oxygen consumption were studied. Results were compared with those for rats fed a standard stock diet (CON rats) or a cafeteria diet (CAF rats). The rate of weight loss or regain was independent of the number of cycles. WC rats were fatter than CON rats and as fat as CAF rats after the third cycle. Cost of maintenance of WC rats decreased; their oxygen consumption decreased in the lean state, increased again in the fat state, but remained lower than that of CON and CAF rats. We conclude that the practice of successive restriction and refeeding did not result in resistance to weight loss, but rather in a defect in the utilization of energy intake, facilitating the development of obesity.
A cross-sectional study of 58 infants (age range 2-53 weeks) was carried out in a rural area of northern Thailand. Total dietary intake (energy and protein from breastmilk and supplementary food) was measured directly during continuous observation over 48 h of randomly selected study subjects in their homes. Associations between infant weight and total energy intake, total protein intake and morbidity were analysed by multiple regression analysis. Up to 6 months of age, heavier infants had larger energy intakes, when age and birthweight were taken into account. In the 7-12 months age group, heavier infants consumed more protein and had fewer respiratory infections. Weaned infants older than 6 months were significantly heavier and consumed more protein than infants of similar age who were still receiving breastmilk. The lower protein intakes of the latter infants were due to the low protein concentration of breastmilk compared with supplementary food.