PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “nutrient adequacy”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 145 records · Page 8Linked to original sources

Total parenteral nutrition in the mouse: development of a technique.

A method for total parenteral nutrition in the mouse was developed using commercially available supplies and equipment. The mouse's inferior vena cava was catheterized and the catheter was exteriorized from the tail. Mice (average body weight 22.5 g) were not tethered but instead were partially restrained by immobilizing the tail to protect the infusion tubing. A solution was formulated to contain 40% dextrose and 4.3% amino acids plus vitamins, electrolytes, and trace elements. It was administered via pump in graded fashion for the first 3 days to allow the mice to adapt, and then at a rate of 8 ml/day thereafter. This volume provided approximately 12 kcal and 54 mg nitrogen per day and was calculated to meet the needs of the mouse fed per os according to guidelines of the National Research Council. During the adaptation period mice lost weight but they were in positive N balance thereafter. At the end of 12 days body weight was not different than at the start, indicating the adequacy of nutrient input. Further, there were no differences in nitrogen balance or body weight in total parenteral nutrition fed mice in comparison with tail-restrained mice given the same solution per os. All mice appeared to tolerate the partial restraint without incidence and showed no untoward side effects. The rationale and validity of this technique is discussed in detail.

Animals↗

Evaluation of nutritional status in children with refractory epilepsy.

BACKGROUND: children affected by refractory epilepsy could be at risk of malnutrition because of feeding difficulties (anorexia, chewing, swallowing difficulties or vomiting) and chronic use of anticonvulsants, which may affect food intake and energy metabolism. Moreover, their energy requirement may be changed as their disabilities would impede normal daily activities. The aim of the present study was to evaluate nutritional status, energy metabolism and food intake in children with refractory epilepsy. METHODS: 17 children with refractory epilepsy (13 boys and 4 girls; mean age 9 +/- 3,2 years; Body Mass Index 15,7 +/- 3,6) underwent an anthropometric assessment, body composition evaluation by dual-energy X-ray absorptiometry, detailed dietetic survey and measurement of resting energy expenditure by indirect calorimetry. Weight-for-age, height-for-age (stunting) and weight-for-height (wasting) were estimated compared to those of a reference population of the same age. RESULTS: 40% of children were malnourished and 24% were wasted. The nutritional status was worse in the more disabled children. Dietary intake resulted unbalanced (18%, 39%, 43% of total daily energy intake derived respectively from protein, lipid and carbohydrate). Adequacy index [nutrient daily intake/recommended allowance (RDA) x 100] was < 60% for calcium iron and zinc. CONCLUSION: many children with refractory epilepsy would benefit from individual nutritional assessment and management as part of their overall care.

Absorptiometry, Photon↗

Gastric vs small-bowel feeding in critically ill children receiving mechanical ventilation: a randomized controlled trial.

STUDY OBJECTIVES: To determine the effect of feeding tube position (gastric vs small bowel) on adequacy of nutrient delivery and feeding complications, including microaspiration, in critically ill children. DESIGN: Randomized controlled trial. SETTING: Pediatric ICU in a university teaching hospital. PATIENTS: Seventy-four critically ill patients < 18 years of age receiving mechanical ventilation were randomized to receive gastric or small-bowel feeding. INTERVENTIONS: All feeding tubes were inserted at the bedside. Color, pH, and bilirubin concentration of the feeding tube aspirates were used to guide placement. Final tube position was confirmed radiographically. Continuous feedings were advanced to achieve a caloric goal based on age and body weight. Tracheal secretions were collected daily and tested for gastric pepsin by immunoassay. MEASUREMENTS AND RESULTS: Thirty-two patients were randomized to the gastric group, and 42 patients were randomized to the small-bowel group. Twelve patients exited the study because a small-bowel tube could not be placed at the bedside, leaving 30 patients in the small-bowel group. Gastric and small-bowel groups were similar at baseline in age, sex, percentage of ideal body weight, serum prealbumin concentration, and pediatric risk of mortality score. The percentage of daily caloric goal achieved was less in the gastric group compared to the small-bowel group (30 +/- 23% vs 47 +/- 22%, p < 0.01). No difference was found in the proportion of tracheal aspirates positive for pepsin between the gastric and small-bowel groups (50 of 146 aspirates vs 50 of 172 aspirates, respectively; p = 0.3). No differences were found in the frequency of feeding tube displacement, abdominal distension, vomiting, or diarrhea between groups. CONCLUSIONS: Small-bowel feeds allow a greater amount of nutrition to be successfully delivered to critically ill children. Small-bowel feeds do not prevent aspiration of gastric contents.

Adolescent↗

Nutritional evaluation of children with phenylketonuria.

CONTEXT: Dietary phenylalanine (PA) restriction is the most effective form for reducing its excess in the blood and is the only efficient method for treating phenylketonuria. The diet is complex and should be adapted to combine the patients' eating habits, growth and development. It depends basically on the use of industrialized products as substitutes free of PA for proteins that are not fully supplied. OBJECTIVE: To evaluate the nutritional status of children with phenylketonuria (PKU) by anthropometric measurements and food intake. DESIGN: Cross-sectional study. SETTING: Children with PKU attending the Association of Parents and Friends of Handicapped Children (Associação de Pais e Amigos dos Excepcionais - APAE) and normal children attending at municipal day care centers in São Paulo. PARTICIPANTS: 42 children with PKU and 31 normal children aged 1 to 12 of both sexes were assessed in two groups, under and over 7 years of age. MAIN MEASUREMENTS: Weight and height measurements. RESULTS: Children with PKU ingested calories, calcium, iron, zinc, and copper below the recommended values, whereas the protein intake was within the normal range. Food intake in the group of normal children was within normality rates. The height/weight Z-score means for children with PKU were 0.47 for those under 7 years and 1.86 for 7 year-olds and over; in normal children the means were 0.97 <7 years and 1.54 >/=7 years, with no statistically significant difference. The height/age Z-score means were significantly lower in the PKU children <7 years (-1.23) than in the normal controls (0.91). CONCLUSIONS: The data presented demonstrate the importance of nutritional surveillance in patients with PKU so as to support adequacy of nutrient intake and to guarantee growth within the relevant standards.

Calcium, Dietary↗

Dietary adequacy of the rotary diversified diet as a treatment for "Environmental Illness".

The rotary diversified diet, used in the management of environmental illness, consists of eliminating prohibited foods from the diet and rotating remaining non-prohibited foods and their "food families" within a regular cycle. We assessed the adequacy of nutrient intakes in 22 women prescribed the diet, described the nature of supplement use, and assessed the relationship between adherence and nutrient intake levels. Except for calcium and folacin intakes, mean nutrient intakes met or exceeded recommended levels. No subjects had calcium intakes above the adequate intake for calcium; 72.7% had folate intakes below the estimated average requirement. Intakes of other nutrients, except thiamin and magnesium, were below the estimated average requirement in less than 25% of the sample; 31.8% and 45.5% of subjects, respectively, had thiamin and magnesium intakes at this level. Those who adhered more closely to the rotary diversified diet had higher intakes of vitamin C, vitamin B6, folate, and fibre than did those who followed the diet less closely. Supplements conferred some nutritional benefits; however, supplemental niacin and magnesium intakes exceeded tolerable upper intake levels. Those prescribed the rotary diversified diet require nutrition counselling from dietitians to cope with the complexity and restrictiveness of the diet.

Adult↗

Dietary practices of women diagnosed with environmental sensitivity.

PURPOSE: Food avoidance is central to the treatment of environmental sensitivity (ES), a chronic, often debilitating, multisystem disorder characterized by adverse reactions to non-noxious levels of environmental substances. Because prolonged food avoidance could impact nutritional health, the purpose of this research was to assess adequacy and quality of diets consumed by women diagnosed with ES. METHODS: Twelve women aged 37 to 50 recruited from the Nova Scotia Environmental Health Clinic completed a four-day food record during the spring and summer of 1998. RESULTS: When adequacy of nutrient intake was assessed by comparison to the Estimated Average Requirement, the most limited nutrients in the diet were folate, vitamin B6, vitamin B12, and magnesium. Only one woman exceeded the Adequate Intake for calcium. When diet quality was assessed using the Healthy Eating Index, the majority of women (75%) scored in the "needs improvement" category; intake of milk and dietary variety scored the lowest. Women consumed very few servings from "other foods", defined in the food guide as foods containing mostly sugar and mostly fat. CONCLUSIONS: The results of this study suggest that women diagnosed with ES would benefit from counselling on ways to increase dietary variety, which would lead to improved nutrient intake, and ways to increase calcium intake.

Adult↗

Breastfeeding the low birth weight preterm infant.

The recent increase in the use of human milk in feeding low birth weight (LBW) preterm infants has stimulated new research questions in infant nutrition, especially in regards to the nutritional adequacy and nutrient composition of milk from mothers of mature and preterm infants. The current state of knowledge on the effect of feeding human milk with or without nutritional supplements on growth of the low birth weight infant is summarized. Recommendations and guidelines for feeding human milk and/or supplementing human milk in LBW infants are discussed and appropriate handling of human milk and feeding schedules are outlined.

Breast Feeding↗

Dietary considerations in designing nutrition intervention programmes in rural areas of Kenya.

A comparative study was carried out in three localities in Kenya: Kwale, Mbooni and Lwak in an attempt to identify dietary factors important in designing community based nutrition interventions. The data indicate geographical differences in age at weaning, reasons for termination of breastfeeding, the variety in the diets consumed and the nutrient intake adequacy. However, there was no difference in the duration in breastfeeding and, for children above 6 months (a period when weaning is recommended) rarely was there any food termed as "baby food" but children consumed bits and portions of the family food. In all the localities, there was no statistical difference between households with malnourished children and those without in most of the factors. Households with children admitted in the nutritional rehabilitation centres in the localities were, however, different in most of the characteristics examined. It is concluded that dietary interventions should be targeted to households and not children, mothers' care and nutrition are of paramount importance if the nutrition condition of their children is to be improved and, planning of nutritional interventions should be specific to the districts.

Adult↗

Schoolchildren have similar predicted prevalences of inadequate intakes as toddlers in village populations in Egypt, Kenya, and Mexico.

OBJECTIVES: To examine the probability of inadequacy of schoolchild nutrient intakes; to compare the predicted adequacy of schoolchild diets to previously published data for toddler diets and to examine the relative adequacy of the diets of sibling pairs. DESIGN: Food consumption data were measured 2 days per month across approximately one year. Mean nutrient intakes were calculated and compared to international standards using a probability approach. SETTING: Villages in Egypt, Kenya, and Mexico. SUBJECTS: 285 school-age children (7-9 years of age) and 255 toddlers (18-30 months of age) including 94 sibling pairs. RESULTS: Within a country, there was a striking similarity between the nutrients predicted to be inadequate in schoolchild and toddler diets across all nutrients except vitamin B12, which was more likely to be inadequate among schoolchildren. Nutrients of concern for both ages in one or more countries included iron, zinc, calcium, riboflavin, and vitamins B12, D, E, and A. For 94 toddler-schoolchild pairs, siblings at high risk of nutrient inadequacy could be identified from an indicator child with a sensitivity of 43-100% and a specificity of 59-100%. CONCLUSIONS: Nutrient adequacy tends to be a household characteristic for these two ages of children. Nutritional interventions that target the household have a high probability of benefitting multiple age groups of children.

Child↗

Salad and raw vegetable consumption and nutritional status in the adult US population: results from the Third National Health and Nutrition Examination Survey.

OBJECTIVE: To examine the relationship between reported salad consumption and serum nutrient levels as well as dietary adequacy, as defined by nutrient intakes, in relation to the National Academy of Science Food and Nutrition Board Guidelines, in pre- and postmenopausal women and in men of comparable ages. DESIGN: Analyses of 24-hour recalls were conducted to determine dietary intake using the Third National Health and Nutrition Examination Survey data. Salad consumption was assessed based on intakes of salad, raw vegetables, and salad dressing. SUBJECTS: Nine thousand four hundred-six women and 8,282 men aged 18 to 45 years and older than 55 years were examined between 1988 and 1994. STATISTICAL ANALYSES: Regressions were used to model associations between salad and raw vegetable consumption and selected serum nutrient outcomes. Usual nutrient intake distributions were estimated using the Iowa State University method for adjustment of the distribution. The Estimated Average Requirement method was used to determine the proportion of subjects with inadequate intake for each nutrient. RESULTS: The consumption of salads, raw vegetables, and salad dressing was positively associated with above-median serum micronutrient levels of folic acid, vitamins C and E, lycopene, and alpha- and beta-carotene. Each serving of salad consumed was associated with a 165% higher likelihood to meet the recommended Dietary Allowance for vitamin C in women and 119% greater likelihood in men. CONCLUSIONS: Salad consumers tended to have more favorable intakes of vitamins C and E, folic acid, and carotenoids, after adjustment for other differences. The significant and consistently higher serum values of these vitamins among salad consumers suggest that they are being well absorbed from salad. Salad, salad dressing, and raw vegetable consumption can be an effective strategy for enhancing nutritional adequacy and increasing vegetable consumption in the population at large.

Adolescent↗

Eating habits of young children with Down syndrome in The Netherlands: adequate nutrient intakes but delayed introduction of solid food.

OBJECTIVES: To investigate nutritional status, pattern of being breast-fed, age at introduction of solid food, and adequacy of energy and nutrient intakes in children with Down syndrome in The Netherlands. DESIGN: Nutritional status was assessed by height and weight measurements. The dietary history method was used to collect information on the diet. Data obtained from children with Down syndrome were compared with data from control subjects and from the general population of Dutch children. Adequacy of energy and nutrient intakes was assessed by comparison to US recommendations. SUBJECTS: Forty-four Dutch children with Down syndrome (newborns to 4-year-olds) and 37 healthy control subjects without this syndrome. STATISTICAL ANALYSES: The prevalence of breast-feeding of children with and without Down syndrome was compared using the chi 2 test. To compare ages at which solid food was introduced, the log-rank test and Kaplan-Meier curves were used. Anthropometric data and mean dietary intake were compared between the groups using 2-way analysis of variance. Comparison to recommended levels of dietary intake was performed using 95% confidence intervals. RESULTS: Heights and weights of the children with Down syndrome were in the normal range. Down syndrome does not affect the prevalence of breast-feeding of children or the adequacy of their energy and nutrient intakes, but it does significantly delay the age at which solid food is introduced, which can be deleterious to oral-motor development. APPLICATION: If late introduction of solid food is observed in children with Down syndrome, pre-speech therapy should be considered.

Age Factors↗

Dietary reference intakes: concepts and approaches underlying protein and energy requirements.

Nutrient reference values provide guidance for maintaining and enhancing health via standard setting and development of nutritionally improved products to decrease the risk of disease. Since 1941, the Food and Nutrition Board (FNB) of the National Academy of Sciences in the United States has developed and periodically revised recommendations for nutrients; the last (10th) edition of the Recommended Dietary Allowances (RDA) was released in 1989. In 1994 the FNB initiated an expanded approach to develop dietary reference intakes (DRI), quantitative nutrient intakes that include concepts of chronic disease risk and multiple reference values more specifically suited to various applications. In concert with Canadian scientists, 10 DRI reports have been completed since 1997 and are available for review at www.nap.edu. The DRI reports explicitly review possible functional endpoints considered in determining the adequacy of each nutrient, and differentiate between the statistical basis for assessing the adequacy of intakes for individuals and groups and providing recommended intakes, as well as levels of nutrient intake that should not be exceeded. Recommended intakes for infants are based on average volumes of intake by healthy, full-term, exclusively breast-fed infants and nutrient analysis of human milk; the recommended intake also includes nutrients contributed by complementary foods consumed during the second 6-month period of life.

Age Factors↗

[Food consumption patterns of children 4 to 14 years old in Valencia, Venezuela].

Results from a nutritional assessment are presented to establish the usual food consumption pattern of 438 children between 4-14 years of age, from a low income urban community in Valencia, Venezuela. Food intake data were collected through multiple 24 hours recalls and converted to individual food item weight in grams. Amounts of energy, macronutrients, iron, calcium, vitamin A, and vitamin C were estimated to compare them to national references. The food pattern was established according to intake frequency per food item and per food groups. Arepa was the most commonly consumed food item, and a main source of kilocalories, protein, carbohydrates, iron, and vitamin A. Unlike coffee, fruits were not among the most commonly consumed foods. Black beans were the main source of protein. Cookies and sodas were among the major sources of energy. Energy and nutrient intake were adequate, except for calcium (67% in preschoolers y 43% in school-aged children). Preschoolers' diet showed a better adequacy for all nutrients (p < 0.005), except for iron which was significantly higher in school-aged children. Since children below 15 years old are still forming food behaviors and habits, they are an ideal group to develop nutritional education strategies to modify harmful patterns such as high intake of sodas, and low intakes of calcium rich foods.

Adolescent↗

[The dietary score as a simplified methodology in processing and analyzing food consumption data].

The purpose of this investigation was to evaluate the dietary score as a valid and rapid alternative procedure for the processing and analysis of food consumption data in Guatemala. The dietary score consists in assigning points to a diet based upon the number of servings the diet provides of each one of the eight groups in which food has been classified. The size of the serving for each food receiving points was estimated based on available data describing the food pattern of Guatemala. The caloric contribution of each of the eight groups to the total caloric intake was also calculated, and information on the caloric and nutrient needs of the Guatemalan population is discussed. In this communication, the dietary score was compared to the percentage of adequacy for energy and nutrients in 392 diets of women, and children between the ages of 24 and 60 months. Half of the dietaries were collected using the 24-hour recall method, while in the other half, the direct weighing method was used. Nutritional adequacy was estimated from food composition tables and based on the recommended energy and nutrient intake figures. In addition, by utilizing the adequacy indices for energy and nutrients, a binary variable was developed to describe the overall adequacy of the diet. This variable describes the probability a diet has of being adequate, given the dietary score obtained. In conclusion, the dietary score was found to be a valid, rapid and efficient alternative for the processing and evaluation of food consumption information, collected by means of either the direct weighing of foods or the 24-hour recall methods.

Adult↗

[Food based approaches to improve vitamin and mineral nutrition adequacy].

This paper, using the nutrient density concept and the development of Food-Based Dietary Guidelines (FBDG), explores the nutritional adequacy of food patterns based on the main staples around the world--maize, wheat, rice and potato. The nutritional adequacy of the vitamins A, C, folates and the minerals iron, zinc and calcium in diets composed by these staples is analyzed. Projected diets modified by the addition of foods high in vitamins and minerals, based on food table composition information, are analyzed for changes in nutritional adequacy, in order to cover the nutritional requirements of all family members. This theoretical exercise shows that diets diversified by the addition of relatively small quantities (27-70 g) of foods like fruits, vegetables, legumes and meat improve substantially the nutritional adequacy of the vitamins A, C, folates, iron and zinc. In the case of calcium, the addition of a dairy source becomes essential. From the practical point of view, the implementation of the food based approach requires a national effort in order to support the production of nutrient rich foods and to promote consciousness of nutrient bioavailability, so that people may obtain all nutrient potential from foods. Simultaneously, the need of fortification programs at the national level is recognized. This is the case for critical nutrients, where requirements might be above the potential in available foods. A similar situation occurs in the case of vulnerable groups like pregnant women and infants, who need supplementation to ensure nutritional adequacy of their diets. In conclusion, the use of FBDG is a good alternative for improving the nutritional adequacy of diets based predominantly on staple foods. However, food fortification and supplementation programs directed to vulnerable groups are necessary and complementary practices to the FBDG implementation.

Ascorbic Acid↗

Independent effects of residual renal function and dialysis adequacy on actual dietary protein, calorie, and other nutrient intake in patients on continuous ambulatory peritoneal dialysis.

Previous studies have suggested that the cross-sectional relationship observed between total solute clearance (Kt/V) and dietary protein intake (DPI) in patients undergoing dialysis is possibly mathematical in origin. A cross-sectional study on 242 patients undergoing continuous ambulatory peritoneal dialysis (CAPD) was performed to determine the differential effects of dialysis adequacy and residual renal function (RRF) on actual dietary intake. All patients underwent a 7-d food frequency questionnaire to quantify daily dietary protein, calorie (DCI), and other nutrient intake, subjective global assessment (SGA), and collection of 24-h dialysate and urine for total (PD and renal) Kt/V and RRF. Patients were categorized into three groups: I (n = 94), total Kt/V >/=1.7 and GFR >0.5 ml/min per 1.73 m(2); II (n = 58), total Kt/V >/=1.7 but GFR <0.5 ml/min per 1.73 m(2); and III (n = 90), total Kt/V <1.7. Sixty-nine percent versus 62% versus 42% of group I versus II versus III patients were well nourished according to SGA (P = 0.004). DPI (1.23 [0.47] versus 1.12 [0.49] versus 0.99 [0.40] g/kg per d; P = 0.002) and DCI (27.3 [8.9] versus 23.8 [8.6] versus 23.0 [8.2] kcal/kg per d; P = 0.002) showed significant decline across the three groups. Intake of other nutrients, including carbohydrate, fat, fatty acids, and cholesterol was higher for group I compared with groups II and III. Adjusting for age, gender, weight, and diabetes, every 1 ml/min per 1.73 m(2) increase in GFR was associated with a 0.838-fold increase in DCI (95% confidence interval to interval, 0.279 to 1.397; P = 0.003) and a 0.041-fold increase in DPI (95% confidence interval, 0.009 to 0.072; P = 0.012), whereas every 0.25-unit increase in total (PD and renal) Kt/V was associated with a 0.570-fold increase in DCI (95% confidence interval, 0.049 to 1.092; P = 0.032) and a 0.052-fold increase in DPI (95% confidence interval, 0.023 to 0.081; P = 0.001). Greater small-solute clearances are associated with better dietary intake and better nutrition. The study confirmed significant and independent effect of RRF, but not PD solute clearance, on actual DPI, DCI, and other nutrient intake in patients on CAPD.

Adult↗

Calcium, vitamin D, and nutrition in elderly adults.

The nutritional needs for optimizing bone health easily can be met by a diet that is high in fruits and vegetables (five or more servings/day), adequate in protein but moderate in animal protein, and with adequate calcium and vitamin D intakes through the consumption of low fat dairy or calcium-fortified foods. Foods are a preferred source to maintaining calcium balance because there are other essential nutrients that are found in high-calcium foods. For those individuals in whom there is inadequate calcium intake from diet, supplemental calcium can be used. Supplemental or dietary calcium should be spread out throughout the day, with 500 mg or less being consumed at each meal to optimize absorption. In all individuals older than 70 years, vitamin D intakes of at least 600 IU per day (up to 1000 IU/day) are recommended, in addition to the calcium requirement of 1200 mg per day. Vitamin D from foods, supplements, and/or multivitamins can be used to meet the vitamin D requirement. In frail elderly individuals with malabsorption and alcoholics, there may be a need to supplement magnesium. Some elderly individuals with indications of poor nutritional status (low albumin levels) or after hip fracture might benefit from protein supplementation and a multivitamin to ensure adequacy of other nutrients.

Aged↗

Recommended Dietary Allowances should be used to set Daily Values for nutrition labeling.

Guiding principles were recently suggested for revising the Daily Values (DVs) used for nutrition labels on foods and dietary supplements. These principles incorporate the new Dietary Reference Intakes, which are nutrient standards issued between 1997 and 2005 by the Institute of Medicine. Most of the principles are likely to lead to a more accurate basis for the DVs. However, the recommendation to use the Estimated Average Requirement (EAR) rather than the Recommended Dietary Allowance (RDA) should be reconsidered. Traditional public health messages to American and Canadian consumers have focused on nutrient intake levels with a high probability of being adequate. The RDA, with a 98% probability of adequacy, is designed to be the target nutrient intake for individuals; in contrast, the EAR has only a 50% probability of adequacy. Three considerations should lead to a preference for using the RDA rather than the EAR for the DVs: 1) consumers are likely to expect that a product (or a diet) with 100% of the DV has a high probability of nutrient adequacy; 2) use of the RDA for the DV will be consistent with other types of dietary guidance, such as the Dietary Guidelines for Americans 2005 and US food guides; and 3) use of the RDA as a standard for nutrient intake, rather than the EAR, has a potential benefit (a higher prevalence of adequate intakes) that exceeds potential risk (a higher prevalence of excessive intakes).

Food Labeling↗