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PubMed1989

Nationwide survey on nutritional habits in elite athletes. Part II. Mineral and vitamin intake.

The nutritional habits of elite athletes competing at a national and international top level were determined. Groups of endurance strength, and team sport athletes participated. All athletes trained at least 1-2 h daily. The purpose of the study was to quantify the mineral and vitamin intake and to identify the magnitude of the nutrient supplementation use. Information on food intake was obtained by a 4- or 7-day food diary. It was found that calcium and iron intake was positively related to energy intake. In low energy intakes (less than 10 MJ) iron intake might be insufficient. In general, vitamin intake with food was in agreement with the Dutch recommendations. However, if energy intake is high (greater than 20 MJ) the amount of refined carbohydrate is increased. Consequently, the nutrient density for vitamin B1 drops. Therefore, under these conditions, supplementation for vitamin B1 must be considered. The low vitamin intake found in lower energy intakes can be improved by proper nutritional advice. In body building and in professional cycling, high dosages of vitamins are used. The other groups of athletes used only moderate quantities of vitamin supplements. It is concluded that vitamin and mineral intake is sufficient, when energy intake ranges between 10 and 20 MJ/day.

Diet↗

PubMed1985

What sort of teenager has low intakes of energy nutrients?

An alternative statistical technique, based on analysis of the 25th percentile, was used to examine teenagers' diets. The technique was developed to identify personal characteristics that affected the prevalence of low energy and nutrient intakes. It provided useful information not obtainable from methods based on average intakes. The study sample was a representative sample of 1055 high-school students in Tasmania, Australia, aged 11-16 years. Among girls, different characteristics had the greatest influence on the prevalence of low intakes ('low' being defined as below the 25th percentile for girls). Fatness had the greatest influence for several dietary components. Fatter girls were more likely to have low intakes of energy, carbohydrate, iron, calcium and niacin-equivalent, and also of 'empty-energy' foods. School type had the greatest influence for fat, riboflavin and vitamin A. Exercise had the greatest influence for protein, low intakes being more usual among the least active girls. Among boys, height and age generally had the greatest influence on the prevalence of low intakes ('low' being defined as below the 25th percentile for boys). Taller and older boys were less likely to have low intakes. This was attributed partly to increased physiological needs, but peer-group influences appeared more important in relation to food choices. Thiamin was unusual, in that recent use of analgesics had the greatest influence on the prevalence of low intakes.

Adipose Tissue↗

PubMed2000

Perioperative nutrition and metabolism in pediatric patients.

A developing child, with a high metabolic rate and low body stores of nutrients, is susceptible to metabolic disturbances due to surgical stress. For perioperative nutritional care of infants, the distinct physiologic features of their body fluids must be carefully considered. The postoperative metabolic response is the same as that in adults, but in children this response is more rapid. Based on the urinary excretion of 3-methylhistidine in infants, the postoperative degradation of muscle protein is thought to be twice the preoperative level. This transient increase during the early postoperative period was not suppressed by increased amino acid intake, and energy intake was sufficient. To prevent postoperative metabolic complications, the energy intake of glucose or fat should correspond to the patient's requirements, and excess carbohydrate should be avoided. The quantity and quality of the amino acid formula used must be carefully evaluated.

Amino Acids↗

PubMed1998

Dietary protein and energy requirements in ESRD patients.

The published reports of dietary protein and energy intake and protein and energy requirements for maintenance hemodialysis (MHD) patients and chronic peritoneal dialysis (CPD) patients are reviewed. Evidence indicates that the dietary energy intake of patients undergoing MHD or continuous ambulatory peritoneal dialysis (CAPD) is less than normal. Dietary protein intake in various surveys averages approximately 1.0 g/kg/d. The energy expenditure of MHD patients appears to be normal or slightly increased during resting and normal during various other daily activities. Energy expenditure in CAPD patients appears normal. Nitrogen balance and anthropometric studies in MHD or CAPD patients ingesting controlled diets in a metabolic unit research ward also indicate that dietary energy requirements are normal and are approximately 35 to 38 kcal/kg/d in MHD patients. For CAPD patients, total energy requirements (from diet and dialysate) also appear to be 35 to 38 kcal/kg/d. These recommended energy intakes are for adult patients aged approximately 60 years or younger. Thus, the low dietary energy intakes of MHD and CPD patients are maladaptive. Nitrogen balance studies indicate that a safe dietary allowance for protein is approximately 1.2 g/kg/d for MHD patients and 1.2 to 1.3 g/kg/d for CAPD patients. Because the nutritional status of patients at the onset of chronic dialysis therapy is a strong predictor of both their nutritional status during the course of chronic dialysis treatment and their subsequent morbidity and mortality, it is important to maintain good nutritional status in patients with chronic renal failure before their development of end-stage renal disease (ESRD) and establishment on chronic dialysis. Evidence indicates that there is a reduction in dietary protein and energy intake and a gradual deterioration of nutritional status in patients with chronic renal insufficiency as the glomerular filtration rate (GFR) decreases progressively to less than 50 to 60 mL/min/1.73 m2. More studies are needed to assess dietary protein and energy requirements both for MHD and CPD patients who are clinically stable and for those who have sustained comorbid conditions that increase energy expenditure or protein nitrogen appearance.

Dietary Proteins↗

PubMed1996

[Food, energy and nutrient intake at breakfast in a group of elderly persons. Most common problems and differences related to body mass index].

A study was made of the dietary habits and intake of energy and nutrients of 127 elderly people aged between 65 and 95 (60 men and 67 women). The method employed involved the recording of food consumption over a period of five days. Subjects were divided into two groups according to body mass index: those who were overweight or obese (0) (BMI > or = 25 Kg/m2), who made up 60% of the experimental population, and those with normal bodyweight (NW) (BMI < 25 Kg/m2) (40%). The percentage of subjects who took no breakfast was somewhat higher amongst members of group 0 (5.6% compared to 3.9% of NW subjects). Further, the breakfast of 0 subjects was less varied, smaller and contributed less to daily energy intake and the covering of theoretical energy expenditure than did the breakfasts of NW subjects. 0 subjects also took less time over their breakfasts. More than half (58.8%) of NW subjects took what might be considered a satisfactory breakfast, i.e. this meal provided more than 20% of the total energy intake. Only 29.6% of 0 subjects took breakfasts of similar energetic value. NW subjects consumed greater quantities of sugars and fruits at breakfasts and also more carbohydrates, fibre, vitamin E and iron than did 0 subjects. The shorter length of time spent at breakfast by 0 subjects, their consumption of smaller and less varied breakfasts and the composition of the same, could indicate the existence of less healthy breakfast habits amongst the overweight and obese. This could be the reflection of inadequate food habits all round, or be a conditioning factor prompting 0 subjects to make poorer food choices for the rest of the day. Though some people omit breakfast in an attempt to control their weight, this is probably an inadvisable practice. The control of bodyweight might be more efficiently accomplished by taking an adequate breakfast and better distributing total calorie intake across the day, avoiding its concentration into one or two meals.

Aged↗

PubMed1998

Obesity and nutrition in children. The Belgian Luxembourg Child Study IV.

OBJECTIVE: To analyse the association between nutritional and familial factors and obesity in boys and girls. DESIGN: Randomized, cross-sectional population study. SETTING: Province de Luxembourg, Belgium. SUBJECTS: One thousand and twenty-eight boys and girls in age strata 6-8, 8-10 and 10-12 y, comprising 70.3% of primary cohort. METHODS: Examinations included anthropometric measurements and questionnaires covering familial, socioeconomic and psychosocial factors. A three day dietary record was obtained in 955 children. This was analysed in relation to the anthropometric data. RESULTS: In comparison with similar studies from other regions and recommended allowances, the intakes of total energy, fat, particularly saturated fat and cholesterol, were high, while consumption of carbohydrate and fiber was low, as well as the polyunsaturated/saturated ratio of fat. Total energy intake showed no or weakly significant correlations with anthropometric factors. However, total fat (P=0.045) and saturated fat (P=0.0005) intake showed consistent positive correlations with body mass index (BMI, kg/m2) and skinfold thickness, with corresponding negative relationships to carbohydrate intake (P=0.034) in boys. Such relationships were also found when calculated as energy density. These associations were not statistically significant in girls. The high fat, low carbohydrate pattern of the nutritional status seemed to be more pronounced in families where the father had a low level of education (lipids, boys, P=0.0007), and where both parents were obese (saturated fat, boys, P=0.023), suggesting involvement of socioeconomic and familial factors. CONCLUSION: The lack of correlation between factors indicating obesity and total energy intake suggests that the positive energy balance causing obesity is due mainly to a low energy output. However, since energy intake measurements are imprecise, overeating can not be excluded, particularly since elevated consumption of food with high contents of fat, found in these children seems to be poorly regulated.

Belgium↗

PubMed1990

Diet intervention methods to reduce fat intake: nutrient and food group composition of self-selected low-fat diets.

A multicentered pilot study was conducted to test an intervention protocol designed to reduce fat intake to 15% of energy intake. Eligible subjects were postmenopausal women with stage II breast cancer whose baseline fat intake was more than 30% of energy intake. The low-fat diet intervention protocol consisted of bi-weekly individual counseling sessions with emphasis on substitution of lower-fat foods for high-fat foods and maintenance of nutritional adequacy. Nutrient intakes were calculated from 4-day food records collected at baseline and after 3 months of diet intervention. Mean daily fat intake for the 17 patients on the low-fat diet dropped significantly from 38.4 +/- 4.3% of energy intake at baseline to 22.8 +/- 7.8% at 3 months (p less than .001). A 25% reduction in mean energy intake, from 1,840 +/- 419 kcal at baseline to 1,365 +/- 291 kcal at 3 months, was accompanied by significant increases in protein and carbohydrate as percent of energy intake. A mean weight loss of 2.8 kg and a 7.7% reduction in serum cholesterol were observed; both changes were significant at the p less than .01 level. Absolute intakes of zinc and magnesium were significantly reduced. However, mean intake on the low-fat diet for 14 vitamins and minerals, including zinc and magnesium, exceeded two-thirds of the 1989 Recommended Dietary Allowances (RDAs). When expressed as nutrient density (i.e., amount of nutrient per 1,000 kcal), increases were observed for all micronutrients. These results support the hypothesis that a nutritionally adequate low-fat diet can be successfully implemented in a highly motivated, free-living population.

Aged↗

PubMed1998

Reduced energy expenditure in preobese children treated for acute lymphoblastic leukemia.

Children with acute lymphoblastic leukaemia (ALL) typically gain weight at excessive rates during and after therapy, and a high proportion of young adult survivors are obese. Previous studies have failed to identify the abnormalities in energy balance that predispose these children to obesity. The aim of this study was to determine the cause of excess weight gain in children treated for ALL by testing the hypothesis that energy expenditure is reduced in these patients. Twenty children [9 boys, 11 girls; mean age 10.9 (3.2) y] treated for ALL who had shown excess weight gain, but were not obese [mean body mass index SD score 0.70 (1.04)], were closely and individually matched with 20 healthy control children [9 boys, 11 girls; mean age 10.7 (3.0) y; mean body mass index SD score 0.27 (0.91)]. In each child we measured total energy expenditure by doubly-labeled water method, resting energy expenditure, energy expended on habitual physical activity, and energy intake. Total energy expenditure was significantly higher in control subjects than in patients: mean paired difference 1185 kJ/d (282 kcal/d), 95% confidence interval (CI) 218-2152. This difference was largely due to reduced energy expended on habitual physical activity in the patients. Resting energy expenditure was lower in the patients: mean paired difference 321 kJ/d (76 kcal/d), 95% CI 100-541. Energy intake was also lower in the patients: mean paired difference 1001 kJ/d (238 kcal/d), 95% CI 93-1909. Children treated for ALL are predisposed to excess weight gain, and subsequently obesity, by reduced total energy expenditure secondary to reduced habitual physical activity. Prevention of obesity in ALL should focus on modest increases in habitual physical activity, modest restriction of dietary intake, and monitoring of excess weight gain.

Adult↗

PubMed2001

Dietary energy density and weight regulation.

Dietary energy density (ED) has been suggested as an important determinant of energy intake and, therefore, energy regulation. This review summarizes published studies on the effects of dietary ED on hunger, satiety, energy intake, and body weight in healthy individuals, and compares the relative effects of ED manipulated by dietary fat only, fat and fiber, water, and type of sweetener. In short-term studies, consumption of low-ED foods promotes satiety, reduces hunger, and decreases energy intake with no marked differences between different dietary manipulations used to change ED. In addition, low-ED diets promote moderate weight loss in long-term studies. In studies lasting longer than 6 months, weight loss was more than three times as great in individuals consuming diets both low in fat and high in fiber compared with diets only low in fat (-3.4 kg versus -1.0 kg). Combined, these studies suggest that diets low in fat and high in fiber may be the most effective low-ED diets for promoting weight loss. Further research is needed on the effects of dietary ED by changing water or sweetener content.

Body Composition↗

PubMed2003

Nutritional status of Japanese-Brazilian subjects: comparison across gender and generation.

The present paper describes a nutritional survey carried out among Japanese-Brazilian subjects living in Bauru, south-eastern Brazil. Data were from a cross-sectional population-based study of 1283 first-generation Japanese-Brazilian subjects (Japan-born; 127 men and 121 women) and second-generation Japanese-Brazilian subjects (Brazil-born; 456 men and 573 women) aged 30-90 years. Anthropometric measurements and % body fat were measured and BMI and waist:hip ratio calculated. Dietary assessment was performed using a validated food-frequency questionnaire. A considerable proportion of men (51 %) and women (47 %) had excess weight (BMI>24.9 kg/m2). A greater waist circumference in men and women (age-adjusted by covariance analysis) was observed among Brazil-born participants. In general, only 10 % of the participants reported current practice of sports or other vigorous physical activity. Age-adjusted mean energy intakes and % energy from macronutrients were found to be similar across generations. The age-adjusted mean daily % energy intake from fat were similar across generations: among Japan-born participants, they were 31.5 (95 % CI 30.6, 32.4) % for men and 32.6 (95 % CI 31.7, 33.5) % for women. The respective figures for Brazil-born subjects were 32.1 (95 % CI 31.6, 32.6) % and 33.2 (95 % CI 32.7, 33.5) %. These values are quite different from the usual intakes reported in Japan during the last decades (about 25 %). Taking into account the traditional Japanese diet, a high energy density diet and a sedentary lifestyle may be implicated in the high prevalence of central obesity and metabolic syndrome observed among Japanese-Brazilian subjects across gender and generations.

Adult↗

PubMed1985

The effect of catabolic doses of corticosterone on heat production in the growing rat.

The effect of corticosterone treatment on energy balance and heat production was investigated in growing rats. Animals were treated with daily subcutaneous injections of a vehicle containing 0, 50 or 100 mg corticosterone/kg for 5 d. Measurements of digestible energy intake and urinary energy losses showed that corticosterone treatment resulted in a depression of metabolizable energy intake due to elevated urinary energy losses resulting from massive glucosuria. Measurements of the metabolizable energy intake and the change in carcass energy indicated that at 50 mg/kg energy deposition and heat production were reduced, whilst at 100 mg/kg energy deposition was completely abolished with heat production increased. Postprandial oxygen consumption was unchanged at 50 mg/kg and increased at 100 mg/kg. Factorial analysis of these results based on reported values for the energy cost of protein and fat deposition indicated that (a) the depression of total heat production at 50 mg/kg could be entirely accounted for by the concomitant suppression of growth, and (b) the elevation of total and postprandial heat production at 100 mg/kg reflected a specific influence of corticosterone on thermogenesis. The significance of these findings is discussed in the light of reports that corticosterone in low doses suppresses heat production.

Adipose Tissue, Brown↗

PubMed1993

Induction and prevention of low-T3 syndrome in exercising women.

To investigate the influence of exercise on thyroid metabolism, 46 healthy young regularly menstruating sedentary women were randomly assigned to a 3 x 2 experimental design of aerobic exercise and energy availability treatments. Energy availability was defined as dietary energy intake minus energy expenditure during exercise. After 4 days of treatments, low energy availability (8 vs. 30 kcal.kg body wt-1.day-1) had reduced 3,5,3'-triiodothyronine (T3) by 15% and free T3 (fT3) by 18% and had increased thyroxine (T4) by 7% and reverse T3 (rT3) by 24% (all P < 0.01), whereas free T4 (fT4) was unchanged (P = 0.08). Exercise quantity (0 vs. 1,300 kcal/day) and intensity (40 vs. 70% of aerobic capacity) did not affect any thyroid hormone (all P > 0.10). That is, low-T3 syndrome was induced by the energy cost of exercise and was prevented in exercising women by increasing dietary energy intake. Selective observation of low-T3 syndrome in amenorrheic and not in regularly menstruating athletes suggests that exercise may compromise the availability of energy for reproductive function in humans. If so, athletic amenorrhea might be prevented or reversed through dietary reform without reducing exercise quantity or intensity.

Adult↗

PubMed1999

Effect of dietary intake and lifestyle factors on in vivo mutant frequency at the HPRT gene locus in healthy human subjects.

This paper describes the results of a study designed to assess the effects of a variety of dietary and lifestyle factors on background levels of mutant frequency (MF) at the hypoxanthine-guanine phosphoribosyltransferase (HPRT) gene locus in humans. Eighty-three healthy and free-living subjects (aged 20-80 yr; 61 males and 22 females; mean age of 63.07 +/- 14.71 yr) were recruited. Background levels of MF were determined for each subject using a cloning assay. The mean MF/10(6) clonable cells (MF) for the study subjects was 4.63 +/- 2.20. An interview-administered questionnaire was completed by each study subject in order to assess details of dietary history, physical activity, health and potential genotoxin exposure history. A 7-day estimated dietary record method with a food frequency questionnaire was used to determine average intakes of energy and macronutrients (including alcohol), and a range of micronutrients (including vitamin and mineral supplement usage). The relationships between individual dietary and lifestyle factors and HPRT MF were investigated by univariate and multivariate analysis (data was adjusted for age, lymphocyte plating efficiency [PE] and energy intake [EI]). Univariate analysis revealed a significant positive correlation between EI and MF and multivariate analysis revealed significant positive correlations between, body mass index (BMI), % energy intake from total carbohydrate, starch, fat and MF. These findings suggest that a reduction in EI may be a useful preventative measure against the onset of carcinogenesis in humans. No correlations were found between alcohol intake and MF or between estimated antioxidant intake and MF. Thus, estimated intakes of antioxidants may not reflect their bioavailability and functional capacity in vivo and it may be more useful to examine actual plasma/cell levels vs. MF to establish if any significant relationship exists.

Adult↗

PubMed2001

Peripheral signals conveying metabolic information to the brain: short-term and long-term regulation of food intake and energy homeostasis.

Numerous peripheral signals contribute to the regulation of food intake and energy homeostasis. Mechano- and chemoreceptors signaling the presence and energy density of food in the gastrointestinal (GI) tract contribute to satiety in the immediate postprandial period. Changes in circulating glucose concentrations appear to elicit meal initiation and termination by regulating activity of specific hypothalamic neurons that respond to glucose. Other nutrients (e.g., amino acids and fatty acids) and GI peptide hormones, most notably cholecystokinin, are also involved in short-term regulation of food intake. However, the energy density of food and short-term hormonal signals by themselves are insufficient to produce sustained changes in energy balance and body adiposity. Rather, these signals interact with long-term regulators (i.e., insulin, leptin, and possibly the orexigenic gastric peptide, ghrelin) to maintain energy homeostasis. Insulin and leptin are transported into the brain where they modulate expression of hypothalamic neuropeptides known to regulate feeding behavior and body weight. Circulating insulin and leptin concentrations are proportional to body fat content; however, their secretion and circulating levels are also influenced by recent energy intake and dietary macronutrient content. Insulin and leptin concentrations decrease during fasting and energy-restricted diets, independent of body fat changes, ensuring that feeding is triggered before body energy stores become depleted. Dietary fat and fructose do not stimulate insulin secretion and leptin production. Therefore, attenuated production of insulin and leptin could lead to increased energy intake and contribute to weight gain and obesity during long-term consumption of diets high in fat and/or fructose. Transcription of the leptin gene and leptin secretion are regulated by insulin-mediated increases of glucose utilization and appear to require aerobic metabolism of glucose beyond pyruvate. Other adipocyte-derived hormones and proteins that regulate adipocyte metabolism, including acylation stimulating protein, adiponectin, diacylglycerol acyltransferase, and perilipin, are likely to have significant roles in energy homeostasis.

Adipocytes↗

PubMed2002

Energy balance in Alzheimer's disease.

Alzheimer s disease is the most frequent cause of dementia in elderly people and it is one of the leading causes of death among older individuals. Weight loss is a frequent clinical finding in Alzheimer s disease patients, and it is actually listed as a symptom consistent with the diagnosis of Alzheimer s disease, but its significance has not been clearly understood until now. This review examines the role of the components of energy balance in determining weight loss in AD patients, on the basis of data collected from the literature. We also considered the possible causes of anorexia in AD patients. In the last years many researchers investigated the possible role of abnormally high energy expenditure, or low energy intakes, or both, to explain weight loss in these patients. Studies on energy intake, energy expenditure and body composition in AD patients have been reviewed. The results of published studies do not seem to support the hypothesis of an hypermetabolic state or inadequate energy intake in AD patients, but further studies, with greater samples are necessary in the future to investigate weight loss in AD patients. A better understanding of this finding could be important to obtain the maximal lifespan of demented patients.

Aged↗

PubMed1992

Total energy expenditure of healthy Swedish women during pregnancy and lactation.

Total energy expenditure (TEE) was estimated in healthy Swedish women by the doubly labeled water method in a longitudinal study during pregnancy and lactation. Measurements were made before pregnancy (A); in gestational weeks 16-18 (B), 30 (C), and 36 (D); as well as 2 (F) and 6 (G) mo after delivery. When the results were interpreted, earlier published data regarding resting metabolic rate (RMR), energy intake, and energy in breast milk were also considered. TEE (MJ/d) and TEE/RMR were 10.5 +/- 2.2 (mean +/- SD) and 1.87 +/- 0.42 (n = 28), 9.6 +/- 2.8 and 1.65 +/- 0.67 (n = 22), 12.5 +/- 3.4 and 1.82 +/- 0.45 (n = 22), 12.2 +/- 4.1 and 1.66 +/- 0.52 (n = 19), 10.6 +/- 2.0 and 1.82 +/- 0.41 (n = 23), and 10.8 +/- 2.7 and 1.79 +/- 0.42 (n = 23) at A, B, C, D, F, and G, respectively. The results indicated that physical activity tended to be decreased during early pregnancy. Taking changes in body energy stores into consideration, it was estimated that subjects recorded 86% and 77% of their energy intakes at A and F respectively.

Adipose Tissue↗

PubMed2002

Beneficial effects of adenosine triphosphate on nutritional status in advanced lung cancer patients: a randomized clinical trial.

PURPOSE: In a randomized clinical trial in patients with advanced non-small-cell lung cancer (NSCLC), infusion with adenosine 5'-triphosphate (ATP) inhibited loss of body weight and quality of life. In the present article, the effects of ATP on body composition, energy intake, and energy expenditure as secondary outcome measures in the same patients are reported. PATIENTS AND METHODS: Patients with NSCLC, stage IIIB or IV, were randomized to receive either 10 intravenous, 30-hour ATP infusions every 2 to 4 weeks or no ATP. Fat mass (FM), fat-free mass (FFM), and arm muscle area were assessed at 4-week intervals for 28 weeks. Food intake, body cell mass (BCM), and resting energy expenditure (REE) were assessed at 8-week intervals for 16 weeks. Between-group differences were tested for statistical significance by repeated-measures analysis of covariance. RESULTS: Fifty-eight patients were randomized (28 ATP, 30 control). No change in body composition over the 28-week follow-up period was found in the ATP group, whereas, per 4 weeks, the control group lost 0.6 kg of FM (P =.004), 0.5 kg of FFM (P =.02), 1.8% of arm muscle area (P =.02), and 0.6% of BCM/kg body weight (P =.054) and decreased 568 KJ/d in energy intake (P =.0001). Appetite also remained stable in the ATP group but decreased significantly in the control group (P =.0004). No significant differences in REE between the ATP and control groups were observed. CONCLUSION: The inhibition of weight loss by ATP infusions in patients with advanced NSCLC is attributed to counteracting the loss of both metabolically active and inactive tissues. These effects are partly ascribed to maintenance of energy intake.

Adenosine Triphosphate↗

PubMed1996

Megestrol acetate therapy for anorexia and weight loss in children with malignant solid tumours.

BACKGROUND: Malnutrition is very frequent in childhood cancer. Its main cause is inadequate intake for energy demands owing to lack of appetite. Megestrol acetate is a synthetic progestin that has been used for reversing anorexia in adult cancer. OBJECTIVE: To assess megestrol acetate efficacy and side-effects in treating anorexia in childhood cancer. METHODS: Thirty-five children with solid tumours were receiving antitumour therapy. Nutritional assessment was by anthropometry. Megestrol acetate efficacy was assessed by evaluating grade of appetite, energy intake and well-being. Side-effects were evaluated by means of clinical history, physical examination, lipid profile, coagulation tests and cortisol rhythm. RESULTS: When compared to baseline all the anthropometric measurements increased (P < 0.05) from the first month of megestrol acetate therapy, as well as appetite and energy intake. No significant side-effects were found. CONCLUSION: Megestrol acetate therapy is a powerful appetite stimulant which led to weight gain, composed of both fat mass and fat-free mass. Megestrol acetate is well tolerated, with few and mild side-effects. If megestrol acetate therapy is started at the onset of anorexia, the use of more expensive, invasive and complicated techniques of nutritional support may be avoided.

Adolescent↗