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PubMed1988

Body composition and nutrient intakes of college men and women basketball players.

Computer analysis of diet records was used to compare adequacy of nutrient intake for 16 male and 10 female intercollegiate basketball players. Significant differences (p less than .05) between men and women were observed for the provision of nutrients from food alone; mean percent RDAs of all nutrients except vitamins A and D was greater for men. This was due primarily to caloric intakes by the men, which averaged twice those of the women. Nutrient supplements had a significant effect on the women's total intake. With the exceptions of energy, protein, and vitamin C, differences between men and women in percent RDAs were eliminated when the contribution of nutrient supplements was included. The data made apparent the need for dietitians familiar with sports nutrition to counsel female athletes on means of obtaining nutrients via an adequate diet.

Adolescent↗

PubMed2005

A nutrient density standard for vegetables and fruits: nutrients per calorie and nutrients per unit cost.

OBJECTIVES: The Dietary Guidelines for Americans 2005 recommended that consumers give priority to nutrient-dense foods, those that contain substantial amounts of key nutrients in relation to the dietary energy they provide. This study developed a scoring system to estimate the nutritional adequacy of vegetables and fruits, on a per weight, per calorie, and per unit cost basis. DATA: We used a French national food composition database for 637 foods, including 129 vegetables and fruits. Mean national retail prices were obtained for each food. METHODS: The nutrient adequacy score was defined as the mean of percent daily values for 16 nutrients, based on 100 g of food. The nutrient density score and the nutrient-to-price ratio were the mean of percent daily values for 16 nutrients, expressed per 100 kcal and per 1 euro of food, respectively. Relationships between energy density of vegetables and fruits, nutrient adequacy score, nutrient density score, and nutrient-to-price ratio were tested using linear regression. RESULTS: Energy density and nutrient density score were negatively correlated, confirming the widely accepted notion that energy-dense foods tend to be nutrient-poor. As expected, fruits and vegetables had the highest nutrient density score because they were nutrient-rich in relation to their low energy content. They also had a relatively high nutrient-to-price ratio, showing that they provided nutrients at a reasonable cost when compared with other foods. CONCLUSIONS: Foods ranked differently when nutritional adequacy was calculated per weight (nutrient adequacy score), per calorie (nutrient density score), or per unit cost (nutrient-to-price ratio). The present results showed that although fruits and vegetables are an expensive source of dietary energy, they provide key nutrients at a reasonable cost.

Biological Availability↗

PubMed2005

Low nutrient intakes among infants in rural Bangladesh are attributable to low intake and micronutrient density of complementary foods.

We assessed the adequacy of nutrient intakes of 135 rural Bangladeshi breast-fed infants 6-12 mo of age and examined nutritional trade-offs due to possible displacement of breast milk by complementary foods. Observers completed 12-h daytime measurements of breast milk and complementary food intakes; data for the previous 12 h were obtained from maternal recall, yielding estimates of total 24-h intakes. On average, infants were mildly wasted (mean +/- SD weight-for-length Z-score = -0.92 +/- 0.88) and moderately stunted (length-for-age Z-score = -1.49 +/- 0.96). Total energy intakes at 6-8 and 9-12 mo were 88 and 86% of absolute energy requirements (kJ/d), 106 and 105% of requirements per kg body weight, and 97 and 94% of requirements per kg median weight-for-length, respectively. Breast milk contributed 78% of energy intake at 6-8 mo and 75% at 9-12 mo. Mean meal frequency and energy density of complementary foods were generally consistent with recommendations, but only small amounts of food were offered. Nevertheless, only 72% of the food energy offered was consumed. Total energy intake was positively correlated with meal frequency, quantity consumed per meal, and energy intake from breast milk, but not with energy density of complementary foods. Energy intake from complementary foods was inversely related to energy intake from breast milk. The diets fell short of recommended intakes for numerous vitamins and minerals. We conclude that although greater intakes of complementary foods were associated with higher total energy intake, micronutrient intake remained low due to the low micronutrient density of the complementary foods consumed and the partial displacement of breast milk.

Bangladesh↗

PubMedDate not supplied

Survey of nutritional problems encountered in children with neuromotor disorders.

A survey of 200 patients ranging in age from 5-21 yr was undertaken in 3 facilities in central Pennsylvania: state- (100), county- (13), and privately-operated (66), together with 21 children being cared for at home. Their diagnoses included chromosomal, metabolic, and anatomic abnormalities, and other encephalopathies. The following nutritional problems were identified: 1) inadequate nutrient intake due to feeding technique, swallowing difficulties, or regurgitation; 2) obesity and low activity level; 3) constipation; 4) nutrient-drug interactions and allergies; and 5) inadequate standards with which to compare growth and adequacy of nutrient intake. The nutritional problems encountered in these pediatric patients with neuromotor disorders warrant management by a physician-nutritionist team skilled in nutritional assessment and techniques of providing nutritional support.

Adolescent↗

PubMed2001

Fruit and vegetable consumption is lower and saturated fat intake is higher among Canadians reporting smoking.

Understanding differences in dietary patterns by smoking status is important for nutritionists and health educators involved in helping individuals to make healthy dietary and lifestyle choices. Although smokers have a poor quality diet compared with nonsmokers, no study has examined nutritional adequacy and variability in the nutrient intake of smokers. The aim of this study was to compare dietary habits of smokers with nonsmokers in terms of nutrient intake, food groups contributing to nutrient intake, nutritional adequacy and day-to-day variation in nutrient intake. Noninstitutionalized adults aged 18--65 y (n = 1543) who participated in the Food Habits of Canadians Survey (1997--1998) were studied. Subjects, selected from across Canada using a multistage, random-sampling strategy, completed an in-home 24-h dietary recall. Repeat interviews were conducted in a subsample to estimate variability in nutrient intake. Smokers had higher intakes of total and saturated fat, and lower intakes of folate, vitamin C and fiber than nonsmokers. There were no significant differences in calcium, zinc and vitamin A intakes or day-to-day variation in nutrient intake by smoking status. Smokers consumed significantly fewer fruits and vegetables than nonsmokers, leading to lower intakes of folate and vitamin C. In conclusion, smokers have a less healthy diet than nonsmokers, placing them at higher risk for chronic disease as a result of both dietary and smoking habits. Diet may act as a confounder in smoking-disease relationships.

Adolescent↗

PubMed1994

The Association of American Feed Control Officials Dog and Cat Food Nutrient Profiles: substantiation of nutritional adequacy of complete and balanced pet foods in the United States.

The Association of American Feed Control Official (AAFCO) formed the Canine (1990-1991) and Feline (1991-1992) Nutrition Expert Subcommittees to update the requirements for substantiation of "complete and balanced" claims for pet foods sold in the United States. There are two means by which a company may substantiate nutritional adequacy for a dog or cat food. The first means is by formulating the food so that nutrient levels fall within the ranges as established in the AAFCO Dog and Cat Food Nutrient Profiles. These profiles replace the National Research Council recommendations as the recognized authority in the United States as that term is applied to AAFCO regulations. Levels of nutrients are based on practical formulations of pet foods with adjustments to account for bioavailability of nutrients in commonly used ingredients. Separate profiles for adult maintenance and growth and reproduction are set, and maximum levels of some nutrients are also established. The second means of substantiation is through the conduct of feeding trials following AAFCO protocols.

Animal Feed↗

PubMed1999

Protein-energy undernutrition among elderly hospitalized patients: a prospective study.

CONTEXT: Numerous studies have identified strong correlations between the severity of nutritional deficits and an increased risk of subsequent morbid events among the hospitalized elderly, but whether inadequate nutrient intake during hospitalization contributes to such nutritional deficits or the risk of adverse outcomes is not known. OBJECTIVES: To identify the distribution of average daily nutrient intake among the nonterminally ill hospitalized elderly, ascertain what factors contribute to persistently low intakes, and determine whether the adequacy of nutrient intake correlates with the risk of mortality. DESIGN: Prospective cohort study conducted from 1994 to 1997. SETTING: University-affiliated Department of Veterans Affairs hospital. PATIENTS: A total of 497 patients 65 years or older (mean [SD] age, 74 [6] years; 97% male; 86% white) with a length of stay of 4 days or more. MAIN OUTCOME MEASURES: Daily in-hospital nutrient intake, in-hospital mortality, and 90-day mortality. RESULTS: A total of 102 patients (21%) had an average daily in-hospital nutrient intake of less than 50% of their calculated maintenance energy requirements. Admission illness severity, average length of stay, and admission albumin and prealbumin levels for this low nutrient group did not differ significantly from those of the remaining patients. However, the low nutrient group had lower mean (SD) discharge serum total cholesterol (154 [44] mg/dL [4 [1.1] mmol/L] vs 173 [42] mg/dL [4.5 [1.1] mmol/L]; P=.001), albumin (29.1 [6.7] vs 33.2 [6.1] g/L, P=.001), and prealbumin (162 [69] vs 205 [68] mg/L; P=.001) concentrations and a higher rate of in-hospital mortality (relative risk, 8.0; 95% confidence interval, 2.8-22.6) and 90-day mortality (relative risk, 2.9; 95% confidence interval, 1.4-6.1). Contributing to the problem of inadequate nutrient intake, patients were frequently ordered to have nothing by mouth and were not fed by another route. Neither canned supplements nor nutritional support were used effectively. CONCLUSIONS: Throughout their hospitalization, many elderly patients were maintained on nutrient intakes far less than their estimated maintenance energy requirements, which may contribute to an increased risk of mortality. Given the difficulties reversing established nutritional deficits in the elderly, greater efforts should be made to prevent the development of such deficits during hospitalization.

Aged↗

PubMed2003

Nutrient intake and iron status of urban poor and rural poor without access to rice fields are affected by the emerging economic crisis: the case of pregnant Indonesian women.

OBJECTIVE: We evaluated the adequacy of nutrient intake in comparison with the Indonesian Estimated Average Requirement (EARs) among pregnant Indonesian women and explain the short-term effect of economic crisis on nutrient intake and iron status. DESIGN: Cross-sectional study. SETTING: Purworejo District, Central Java, located 60 km west of Yogyakarta Province, Indonesia. SUBJECTS: During the period from 1996 to 1998, up to six 24 h recalls were performed during the second trimester of pregnancy among 450 women. Nutrient intake and iron status was evaluated in relation to date of data collection relative to the economic crisis that emerged in August 1997. A computer program (Inafood) was developed to calculate nutrient intake. RESULTS: : Forty percent of the pregnant women were at risk of inadequate intake of energy and protein, and 70% were at risk of inadequate intake of vitamin A, calcium and iron even before the crisis. Our results also demonstrate an effect of short-term economic crisis on nutrient intake and iron status. When the crisis emerged, urban poor experienced a decrease in intake of most nutrients. During the crisis, rich women experienced a significant decrease in fat (P<0.05). Negative changes in fat density during crisis were experienced by the rich and the rural, poor, and access to rice field subgroups (P<0.01). A significant increase in carbohydrate densities was seen for the rich and rural, poor, and access to rice fields groups (P<0.05). Urban poor experienced decreased serum ferritin concentration (P<0.05), whereas rich women experienced a significant increase (P<0.05). CONCLUSIONS: Urban poor and rural poor landless women were most directly affected by the emerging economic crisis.

Adipose Tissue↗

PubMed2004

Dietary adequacy of Indian rural preschool children--influencing factors.

The dietary adequacy (qualitative and quantitative) of preschool children residing in rural areas near Mysore (a district in south India) was assessed by the 'Food frequency method' and '24-h recall method'. Food intake assessed in three different seasons revealed that their diets were predominantly cereal based with negligible quantity of protective foods. The overall nutrient intake was found to be inadequate, irrespective of the seasons. The adequacy level of the nutrients (cereal dependence) was found to be comparatively better in monsoon and winter seasons because of better labour opportunities and availability. Food consumption pattern showed no gender differences. The nutrient adequacy also varied by the age of the children. The influence of 'food expenditure' on the nutrient adequacy was not statistically significant. Nutritional status was found to be a factor influencing nutrient intake. Apart from age, nutritional status and food availability, feeding practices may also influence the nutrient intake of the preschool children.

Age Factors↗

PubMed1979

Nutrient intake of low-income, black families in southwestern Mississippi.

A dietary intake study for 250 low-income households in Claiborne County in southwestern Mississippi was conducted from June through August 1974. Data were obtained during daily home visits for seven days by trained college students. The adequacy of nutrient intake for individuals was evaluated by comparing the data with the 1974 Recommended Dietary Allowances by age and sex. The data was also compared with those of the Ten-State Nutrition Survey and HANES. Mean intakes of protein, vitamin A, thiamin, riboflavin, and ascorbic acid for all subjects were above the RDAS; those of energy, calcium, iron, and preformed niacin were below the allowances. Whereas calcium was the nutrient least adequately consumed by all persons, protein was most adequately consumed. Sixty per cent of children had calcium intakes below two-thirds of the allowance. By sex, 66.7 per cent of all males and 73.3 per cent of all females had calcium intakes below two-thirds of the standard. None of children received less than two-thirds of the allowance for protein. Nutrient intake was low for a substantial number of the subjects. Adolescents, ages eleven to eighteen years, of both sexes had the poorest diets for all nutrients. Regarding the sex difference, females had better nutrient intakes than did males for all nutrients except calcium and iron.

Adolescent↗

PubMed2000

The incidence of ventilator-associated pneumonia and success in nutrient delivery with gastric versus small intestinal feeding: a randomized clinical trial.

BACKGROUND: Enteral feeding provides nutrients for patients who require endotracheal tubes and mechanical ventilation. There is a presumed increase in the risk of ventilator-associated pneumonia (VAP) with tube feeding. This has stimulated the development of procedures for duodenal intubation and small intestinal (SI) feeding as primary prophylaxes to prevent VAP. OBJECTIVE: To investigate the rate of VAP and adequacy of nutrient delivery with gastric (G) vs. SI feeding. DESIGN: A prospective, randomized, controlled trial. SETTING: A medical intensive care unit of a county hospital. PATIENTS: A total of 44 endotracheally intubated, mechanically ventilated patients requiring enteral nutrition. INTERVENTION: Subjects were randomized to receive enteral nutrition via G or SI feeding. Protocols directed the placement of the feeding tube and the infusion of enteral nutrition and defined the radiographic and clinical criteria for a diagnosis of VAP. MEASUREMENTS AND OUTCOMES: The incidence of VAP and the adequacy of nutritional supplementation were prospectively followed. The relative risk of VAP with SI was 1.1 (95% confidence interval 0.96-2.44) compared with G. The SI group received a greater percentage of their caloric requirements (SI 69 +/- 7% vs. G 47 +/- 7%, mean +/- SEM, p < .05). Mortality did not differ between G (26 +/- 9%) and SI (24 +/- 10, p = .86). CONCLUSIONS: There is no clear difference in the incidence of VAP in SI compared with G enteral nutrition. Patients given feeding into the SI do receive higher calorie and protein intakes.

Enteral Nutrition↗

PubMed2026

Low-burden metrics for monitoring healthy diets among nonpregnant females aged 15 to 49 years: a multicountry validation analysis using quantitative 24-hour dietary intake data.

BACKGROUND: Limited nationally representative quantitative dietary intake data and a lack of consensus on lower-burden tools and metrics hinder high-frequency monitoring of healthy diets globally. OBJECTIVES: This study aimed to evaluate the comparative construct validity and potential complementarity of low-burden metrics of a healthy diet among nonpregnant females aged 15 to 49 y. METHODS: Quantitative 24-h dietary intake data collected from 77,118 adolescent and adult females across 27 countries were used to construct low-burden metrics and reference metrics of dietary intake. Associations between mean-standardized low-burden measures or indicators and reference metrics were assessed using linear and logistic mixed-effect models, with Spearman's ρ used for survey-level rank correlations. Test characteristics identified low-burden indicators best differentiated adherence to reference indicators. RESULTS: An indicator reflecting nonconsumption of sweet foods and/or sweet beverages was most robustly associated with greater adherence to <10% energy from free sugars in upper-middle-income countries {odds ratio [OR] [95% confidence interval (CI)]: 5.35 [5.05, 5.66]}. Food group diversity score (FGDS) was most strongly associated with and differentiated higher mean adequacy ratio of micronutrients [β of 1-standard deviation (SD) change: ∼11 percentage points (9, 12); ρ: 0.79], whereas noncommunicable disease-Protect score best reflected consumption of ≥400 g/d of fruits and vegetables [range OR of 1-SD changes (95% CI): 2.56-3.01 (2.40, 3.13) in lower-middle and high-income countries, respectively; ρ: 0.56]. FGDS and Global Diet Quality Score Positive were most consistently associated with achieving ≥25 g/d of fiber and ≥3510 mg/d of potassium across contexts. CONCLUSIONS: Low-burden data collection tools yield valid metrics, enabling high-frequency monitoring of healthy diets across contexts. Specifically, avoiding sweet foods and/or sweet beverages is an indicator for adherence to WHO free sugar guidelines among nonpregnant females in upper-middle-income countries, whereas metrics reflecting nutritious food group diversity strongly reflect better micronutrient adequacy and adherence to WHO guidelines for fruits and vegetables, fiber, and potassium intakes within and across contexts.

Humans↗

PubMed1999

Nutritional consequences of modified vertical gastroplasty in obese subjects.

BACKGROUND: Gastroplasty results in a considerable reduction in food intake and dramatic weight loss. This is likely to have a nutritional impact, although it is expected that this may be minimised by good advice and supplement use. METHODS: Twenty six obese subjects were studied in detail before and after modified long vertical gastroplasty (MLVG), in a setting where comprehensive nutritional advice on symptom avoidance was readily available and multivitamin supplements advised. Nutritional intake and anthropometry were measured preoperatively and at 2, 5 (n = 22) and 12 months (n = 11) postoperatively. RESULTS: Mean weight loss was 13%, 22% and 31% of initial body weight at the respective time points. Energy intake (EI) was significantly reduced postoperatively, with the mean protein intake being only 40 g/d. At 2 months, mean intakes of iron, calcium and zinc from food were 40%, 71% and 39%, respectively, of the Australian recommended dietary intake (RDI), and iron and zinc intake remained below half the RDI at 5 months. Only regular adherence to the vitamin/mineral supplement, brought iron and calcium intakes close to RDI, but zinc remained low. Haemoglobin and serum ferritin concentrations did not alter significantly and remained within the reference range, but serum folate fell significantly between 5 months and 12 months. By 5 months, 60% of subjects never regurgitated or regurgitated less than once a week. Fresh bread was the least tolerated food. Frequency of regurgitation was not correlated with adequacy of nutrient intake. CONCLUSIONS: The results emphasise the need for regular follow-up of MLVG patients, and nutritional advice which includes diet quality as well as symptom management, and regular intake of the vitamin/mineral supplement for at least a year postoperatively. Low protein intakes, however, remain of potential long-term concern.

Adult↗

PubMed2002

Complexities in ETS-domain transcription factor function and regulation: lessons from the TCF (ternary complex factor) subfamily. The Colworth Medal Lecture.

The ETS-domain transcription factor family can be divided into a series of subfamilies. Elk-1 represents the founding member of the ternary complex factor (TCF) subfamily. By focusing on the TCF subfamily, we can demonstrate the complexities that exist in the function and regulation of ETS-domain transcription factors. This article focuses on Elk-1 in detail and summarizes the functions of other TCFs. The key themes covered include the domain structure of the TCFs, the mechanisms of complex formation with serum response factor, regulation of TCFs by mitogen-activated protein kinase cascades, and transcriptional regulatory properties of the TCFs. Finally, the emerging role of the TCFs in vivo is discussed. A picture is developing indicating that, while these proteins exhibit significant sequence and functional conservation, key differences in their structure and regulation are being identified which may relate to unique functions of these proteins in vivo.

Amino Acid Sequence↗

PubMed1982

The functional vascular anatomy of rib.

The adequacy of nutrient blood supply to ribs based on the intercostal-periosteal system versus the medullary nutrient artery was investigated in six dogs containing ribs of each type. Free grafts with periosteum and without periosteum were also included. Vascularity was monitored by bone scanning and tetracycline double labeling. A preliminary study with RES scanning using sulfur colloid was also preformed. The results of this study showed (1) that no demonstrable difference in blood supply exists between rib supplied by the anterior intercostal-periosteal system versus the nutrient artery (this was seen with bone scans, tetracycline double labels, and RES scans); (2) that bone scans can differentiate between vascularized rib grafts and free rib grafts for at least the first 7 days (after 7 days, some free grafts begin to take up label); and (3) that by using bone scan, no difference in the rate of revascularization is detected between free grafts with the periosteum stripped or the periosteum intact (RES scans and tetracycline labeling were not given late enough after surgery to be incorporated in either type of nonvascularized graft).

Animals↗

PubMed1997

Infant nutrition: implication for somatic growth, adult onset diseases, and oral health.

The gold standard for assessing the adequacy of nutrient intake in pediatrics is that diet which promotes optimal growth and development. Thus, it is crucial that our methods for measuring these outcomes be valid, reliable, and widely accepted. A review of the recent medical literature in the field of clinical nutrition indicates that both growth data and dietary standards continue to evolve as more data accrue concerning their applicability in both health and disease. In addition, oral nutrition is clearly a determinant of perhaps the most prevalent infectious disease in pediatrics: dental caries. Research in this field stresses the importance of oral fluoride intake in the prevention of caries, as well as the fact that current efforts at reducing milk-bottle tooth decay are inadequate.

Adult↗

PubMed2004

Enteral nutrition in patients with acute renal failure.

BACKGROUND: Systematic studies on safety and efficacy of enteral nutrition in patients with acute renal failure (ARF) are lacking. METHODS: We studied enteral nutrition-related complications and adequacy of nutrient administration during 2525 days of artificial nutrition in 247 consecutive patients fed exclusively by the enteral route: 65 had normal renal function, 68 had ARF not requiring renal replacement therapy, and 114 required renal replacement therapy. RESULTS: No difference was found in gastrointestinal or mechanical complications between ARF patients and patients with normal renal function, except for high gastric residual volumes, which occurred in 3.1% of patients with normal renal function, 7.3% of patients with ARF not requiring renal replacement therapy, 13.2% of patients with ARF on renal replacement therapy (P= 0.02 for trend), and for nasogastric tube obstruction: 0.0%, 5.9%, 14%, respectively (P < 0.001). Gastrointestinal complications were the most frequent cause of suboptimal delivery; the ratio of administered to prescribed daily volume was well above 90% in all the three groups. Definitive withdrawal of enteral nutrition due to complications was documented in 6.1%, 13.2%. and 14.9% of patients, respectively (P= 0.09 for trend). At regimen, mean delivered nonprotein calories were 19.8 kcal/kg (SD 4.6), 22.6 kcal/kg (8.4), 23.4 kcal/kg (6.5); protein intake was 0.92 g/kg (0.21), 0.87 g/kg (0.25), and 0.92 g/kg (0.21), the latter value being below that currently recommended for ARF patients on renal replacement therapy. Median fluid intake with enteral nutrition was 1440 mL (range 720 to 1960), 1200 (720 to 2400), and 960 (360 to 1920). CONCLUSION: Enteral nutrition is a safe and effective nutritional technique to deliver artificial nutrition in ARF patients. Parenteral amino acid supplementation may be required, especially in patients with ARF needing renal replacement therapy.

APACHE↗

PubMed1993

Oral health problems and involuntary weight loss in a population of frail elderly.

OBJECTIVE: To evaluate whether poor oral health is a potentially reversible contributor to the development of significant involuntary weight loss in elderly rehabilitation patients. DESIGN: Survey (cross-sectional study). SETTING: Geriatric Rehabilitation Unit (GRU) of a Veterans Administration hospital. PATIENTS: One hundred ten consecutive admissions to the GRU, of whom 99% were male and 80% were white. The average age of the study patients was 77 years. MEASUREMENTS: At admission each patient completed a comprehensive medical, neuro-psychological, social, nutritional, and dental assessment. Previous weights were documented by review of old medical records. Involuntary weight loss was considered significant if it was greater than 5% of pre-weight-loss weight within 6 months or 10% of pre-weight-loss weight within 1 year. Of the 97 variables evaluated, the strongest predictors of significant involuntary weight loss prior to GRU admission were identified using univariate and multivariate (stepwise logistic regression) analyses. RESULTS: The number of general oral problems was the best predictor of significant involuntary weight loss within 1 year prior to GRU admission, followed by household income, age, smoking status, adequacy of nutrient intake prior to admission, and education. When all six of the variables were included in the stepwise logistical regression analysis, the model had a sensitivity of 63.2%, a specificity of 91.1%, and overall predictive accuracy of 86.2%. The number of general oral problems was also a strong predictor of significant weight loss within 6 months prior to GRU admission. CONCLUSIONS: Poor oral health may be an important contributing factor to the development of significant involuntary weight loss among the frail elderly. If this is true, it places even greater emphasis on the need for maintaining an optimal state of oral health in our elderly patients.

Aged↗