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PubMed1992

Achievable guidelines for food consumption to reach a balanced fat and nutrient intake in childhood and adolescence.

In many highly industrialized countries a reduction in the high average intake of fat, especially saturated fatty acids and cholesterol, has been recommended for the prevention of cardiovascular diseases for the general population, including children. However, it has not yet been shown that such a diet is generally achievable in childhood and that it meets the Recommended Dietary Allowances (RDA) for essential nutrients. Based on results of a nutrition survey using a 3-day weighing method for 350 German children and adolescents (1-14 years of age), achievable dietary modifications have been proposed to improve the observed nutrient intake (percentages of energy intake from protein:fat/saturated fatty acids:carbohydrates 13:39/18:48%). Age-related average daily quantities are given for 11 main food groups (e.g., milk, lean meat, visible fats, grain products, vegetables). The main proposals for food consuption are: avoidance of fatty meat and fatty meat products, reduction of fatty foodstuffs commonly consumed with bread and of foodstuffs with a high sucrose content and an increase in whole grain cereal products, potatoes and vegetables. The food consumption proposals are compatible with the typical meal patterns of German children and adolescents. Nutrient content of the proposed diet is presented. The proportions of protein:fat/saturated fatty acids:carbohydrates are 13:35/12:52% of total energy intake. It is shown that the US RDA for most of the calculated minerals, trace elements and vitamins can be met by the proposed balanced mixed diet without using special dietary products or products with added nutrients.

Adolescent↗

PubMed2006

[AMPK, an active player in the control of metabolism].

Impairment in the regulation of energy homeostasis and imbalance between energy intake and energy expenditure lead to many metabolic disorders and diseases such as obesity and type 2 diabetes. AMP-activated protein kinase (AMPK) is considered as a "fuel-gauge" in the cell and plays a key role in the regulation of energy metabolism. Activated by an increase in the AMP/ATP ratio, AMPK switches on catabolic pathways such as fatty acid oxidation and switches off anabolic pathways such as lipogenesis or gluconeogenesis. Insulin-sensitizing adipokines (leptin and adiponectin) and anti-diabetic drugs (thiazolidinediones and biguanides) are acting in part through the activation of AMPK. More recent findings indicate that AMPK plays also a major role in the control of whole body energy homeostasis by integrating, at the hypothalamus level, nutrient and hormonal signals that regulate food intake and energy expenditure. AMPK provides therefore a potential target for the treatment of metabolic diseases such as obesity and type II diabetes.

Adenylate Kinase↗

PubMed2002

A cost-analysis of adopting a healthful diet in a family-based obesity treatment program.

OBJECTIVE: To assess dietary costs during a family-based pediatric obesity intervention. DESIGN: Families were randomized to one of two groups. Dietary and cost data were collected from a parent or child using three 24-hour recalls: at baseline, 6 months, and 12 months. SUBJECTS: Thirty-one families with an obese 8- to 12-year-old child entered treatment, with complete dietary data provided from 20 families. INTERVENTION: The 20-week behavior modification intervention emphasized increasing diet nutrient-density. Families attended group and individual sessions or group sessions. MAIN OUTCOME MEASURES: Energy intake; percent of energy from protein, fat, and carbohydrate; servings and percent servings from food groups classified by nutrient density; and daily food costs. STATISTICAL ANALYSES PERFORMED: Mixed analyses of variance, with group as the between-subject factor, and time as the within-subject factor. RESULTS: No significant effect of group was found in any analyses. Significant decreases in percent overweight were observed at 6 and 12 months for children (-10.0+/-8.7 and -8.0+/-10.3, respectively) (mean+/-standard deviation) and parents (-6.7+/-10.3 and -5.3+/-14.1). Energy intake for parents and children combined significantly decreased from baseline (1,881+/-462) to 6 months (1,412+/-284), and 1 year (1,338+/-444). Servings from low-nutrient-dense foods significantly decreased from baseline (34.7+/-16.2) to 6 months (16.0+/-8.6) and 1 year (18.6+/-9.2), causing a significant increase in diet nutrient density. Dietary cost did not change at 6 months, but significantly decreased from baseline to 1 year ($6.77+/-2.41 to $5.04+/-1.80). Cost per 1,000 kcal did not significantly change. APPLICATIONS/CONCLUSIONS: Adopting a lower-energy, nutrient-dense diet did not increase dietary costs over time. Consequently, cost should not be a barrier in the adoption of a healthful diet.

Anthropometry↗

PubMed2003

Interaction of body mass index and attempt to lose weight in a national sample of US adults: association with reported food and nutrient intake, and biomarkers.

OBJECTIVE: This study examined the interaction between body mass index (BMI) and attempting to lose weight for reporting of: (1) macro- and micronutrient intake; (2) intake of low-nutrient-density foods; and (3) serum biomarkers of dietary exposure and cardiovascular disease risk. METHODS: Dietary, anthropometric and biochemical data were from the third National Health and Nutrition Examination Survey (1988-1994), n=13 095. Multiple regression methods were used to examine the independent associations of BMI, trying to lose weight, or the interaction of BMI-trying to lose weight with reported intakes of energy, nutrients, percentage energy from low-nutrient-density foods (sweeteners, baked and dairy desserts, visible fats and salty snacks), and serum concentrations of vitamins, carotenoids and lipids. RESULTS: BMI was an independent positive predictor (P<0.05) of percentage of energy from fat, saturated fat, but a negative predictor of the ratio of reported energy intake to estimated expenditure for basal needs (EI/BEE), percentage of energy from carbohydrate and alcohol (men only), and serum concentrations of folate, vitamin C, vitamin E and most carotenoids in both men and women. Trying to lose weight was a negative predictor (P<0.05) of EI/BEE, intake of energy, and energy density, but not micronutrient intake. Higher mean serum ascorbate, vitamin E, lutein/zeaxanthin, and other carotenoids (men only) concentrations were associated with trying to lose weight (P<0.05) in both men and women. Few adverse BMI-trying to lose weight interaction effects were noted. CONCLUSIONS: There was little evidence of increased nutritional risk in those reportedly trying to lose weight irrespective of weight status.

Adult↗

PubMed1989

[Nutrition survey of adults using a 7-day protocol--a pilot study in the Augsburg MONICA project].

During the MONICA-project nutrition as one factor for the development of coronary heart disease is examinated. The individual intake of total energy, of fat-including saturated and unsaturated fatty acids-and of alcohol should be determined. This pilot study was done before the first cohort study within the MONICA-project Augsburg. The nutritional data were collected from february to march 1984 with the 7-day-dairy-record-method. 65 of totally 112 received records were suitable for evaluation by the computer program KALI (version 2.1.4). The 35 male persons had an average energy intake of 2.677 kcal/day. The average daily energy intake of the 30 female persons decreased with age. The main energy source for all persons is fat. Five women and eight men have an average intake of more than 500 mg cholesterol/day. Estimations of the intake of fatty acids were not possible, because of the specification of the computer program. Carbohydrates supply about 36% in men and 40% in women of the total energy, protein about 13% and 16% respectively. Men are drinking about 44 g alcohol/day. This is distinctly more than women do. Womens daily intake of vitamin B1, vitamin B6 and iron was lower than the recommendations of the German Nutrition Society. It's the same with vitamin B6 for men.

Adult↗

PubMed2002

Nutritional status in the HEMO Study cohort at baseline. Hemodialysis.

The nutritional status of the first 1,000 patients randomized into the Hemodialysis (HEMO) Study was analyzed at baseline when they received their typical dialysis dose (equilibrated Kt/V = 1.30 +/- 0.22) and dialysis membrane. This is the largest study to date of the nutritional status of chronic hemodialysis patients. The mean (+/- SD) values for these parameters included a serum albumin level of 3.65 +/- 0.38 g/dL, a dietary energy intake of 22.9 +/- 8.4 kcal/kg/day, a dietary protein intake of 0.93 +/- 0.36 g/kg/day, and a double pool normalized protein catabolic rate (enPCR) of 1.00 +/- 0.25 g/kg/day. The percentage of patients below HEMO Study nutritional standards of care included 29% of patients with a serum albumin level less than 3.5 g/dL, 76% of patients with a dietary energy intake less than 28 kcal/kg/day, 61% of patients with a dietary protein intake less than 1.0 g/kg/day, and 52% of patients with an enPCR of less than 1.0 g/kg/day. There was a strong correlation between dietary protein intake and dietary energy intake (r = 0.74, P < 0.0001). Significant correlations were also evident between serum albumin and double pool PCR and between dietary protein intake and double-pool PCR. Kt/V and membrane flux were not predictive of baseline dietary protein intake, dietary energy intake, or serum albumin level. Thus, a majority of patients in the HEMO Study had protein and energy intake levels and enPCR levels that were below National Kidney Foundation Kidney Dialysis Outcome Quality Improvement (NKF-K/DOQI) guidelines.

Aged↗

PubMed2002

Dietary correlates of plasma insulin-like growth factor I and insulin-like growth factor binding protein 3 concentrations.

Plasma levels of insulin-like growth factor I (IGF-I) have been associated with risk of several cancers. Although protein-calorie malnutrition is known to decrease IGF-I levels, few published studies have related diet to IGF-I levels in well-nourished humans. We examined the cross-sectional association of plasma IGF-I and IGF-binding protein 3 (IGFBP-3) levels with intakes of alcohol, energy, macronutrients, micronutrients, and specific foods in 1037 healthy women. Adjusted mean hormone levels across categories of dietary variables were calculated by linear regression. Results were adjusted for non-dietary factors found to be associated with IGF levels. Total energy intake was positively associated with IGF-I levels when adjusted for covariates. Adjusted mean levels of IGF-I (ng/ml) across increasing quintiles of energy intake were 181, 185, 191, 199, and 195 (P for the linear trend = 0.006). In other multivariate analyses, energy-adjusted fat and carbohydrate intake had no association with IGF-I levels. The most consistent finding was a positive association between protein intake with circulating IGF-I concentration (174, 188, 201, 192, and 196 ng/ml across quintiles of protein intake; P = 0.002), which was largely attributable to milk intake. Adjusted mean levels of IGF-I (ng/ml) across increasing quartiles of milk intake were 183, 189, 188, and 200 (P = 0.01). Higher fat intake, in particular saturated fat, was associated with lower levels of IGFBP-3. We conclude that higher energy, protein, and milk intakes were associated with higher levels of IGF-I. These associations raise the possibility that diet could affect cancer risk through influencing IGF-I level.

Aged↗

PubMed2002

Effects of manipulating sedentary behavior on physical activity and food intake.

OBJECTIVES: Sedentary behaviors have been correlated with obesity. We investigated whether changes in sedentary behaviors relate to changes in energy intake and/or physical activity. STUDY DESIGN: Experimental within-subject crossover design in which children participated in three 3-week phases: baseline and increased and decreased targeted sedentary behaviors. PARTICIPANTS: Thirteen 8- to 12-year-old, nonobese children. MEASUREMENTS: Sedentary behaviors were measured through the use of daily activity logs, physical activity measured with accelerometers, and energy intake measured by means of repeated 24-hour recalls collected during each phase. Energy intake, energy expenditure, and energy balance per day were calculated. RESULTS: Children showed significant (P <.001) increases of 50% and decreases of 53% in targeted sedentary behaviors from baseline during the increase and decrease phases, respectively. There was a significant (P =.05) increase in energy balance per day (+350.7 kcal) when sedentary behaviors were increased, as the result of an increase in energy intake per day (+250.9 kcal) and a decrease in energy expenditure (-99.8 kcal). No significant changes in energy balance were observed when sedentary behaviors were decreased. CONCLUSIONS: Increasing sedentary behaviors had a greater influence on physical activity and energy intake than reducing sedentary behavior in nonobese youth. In some children, changes in sedentary behaviors may be important to modify energy balance and prevent obesity.

Child↗

PubMed2002

Cardiovascular risk factors in an Iranian urban population: Tehran lipid and glucose study (phase 1).

OBJECTIVES: Coronary artery disease is becoming more prevalent in developing countries, particularly in urban areas. This study was conducted to determine the prevalence of cardiovascular risk factors among Tehran urban population. METHODS: The prevalence and distribution of high blood pressure, cigarette smoking, dyslipoproteinemia, diabetes mellitus, and obesity was determined in 15,005 subjects, aged three years and over, selected by cluster random sampling in Tehran urban district-13 between February 1999 to August 2001. Total energy intake, percent of energy derived from protein, carbohydrate, and fat were assessed in a subsidiary of 1,474 persons by means of two 24-hour dietary recalls. RESULTS: In adults, 78% of men and 80% of women presented at least one CVD risk factor. The percentage of adult women with two or more risk factors was significantly greater than the one for men. Prevalence of DM, hypertension, obesity, high TC, low HDL, high TGs, and smoking was 9.8, 20.4, 14.4, 19.3, 32, 5.3, and 22.3%, respectively. In children and adolescents, two or more CVD risk factors were found in 9% of boys and 7% of girls. Prevalence of hypertension, obesity, high TC, low HDL, and high TGs, was 12.7, 5.2, 5.1, 10.2, and 5%, respectively. The mean percentage values of energy intake derived from carbohydrate, protein, and fat were 57.8 +/- 6.9, 11.1 +/- 1.8, and 30.9 +/- 7.2, respectively. CONCLUSION: The prevalence of cardiovascular risk factors among Tehran urban population is high; particularly of high total cholesterol, low HDL cholesterol levels, and high waist to hip ratio. An effective strategy for life style modification is a cornerstone of a population approach to the cardiovascular risk factors. Moreover, these results will serve as a baseline for assessment of future trends in the risk factors studied.

Adolescent↗

PubMed2006

Body mass regulation at altitude.

Altitude exposure decreases energy intake and thus induces an energy deficit resulting in the loss of body mass. The energy deficit is worsened when energy expenditure is increased by exercise because the increase is not matched by an increased energy intake. The indicated fuel for the optimal use of the rarefied oxygen at altitude is carbohydrate. For optimal taste and maximizing energy intake, fat is the best. Protein should rather be limited because of its high thermic effect. Intestinal malabsorption probably does not play a role in the energy deficit. Even though the sensation of exertion during climbing at high altitude is intense, the actual energy expenditure is not high.

Altitude↗

PubMed1985

[Thermogenesis induced by nutrients in man: its role in weight regulation].

The maintenance of body weight at a stable level for an adult man requires the involvement of mechanisms which should adapt energy intake to energy expenditure (or vice versa). Energy balance is thus maintained near equilibrium. However, the nature of these mechanisms is poorly understood. The control of food intake has been studied often and will not be discussed in this presentation. This paper concerns the control of energy expenditure, particularly the control of nutrient-induced thermogenesis. The recent interest in this field has arisen following the demonstration of the role of nutrient-induced thermogenesis in rats and mice having free access to the "cafeteria diet". Under these conditions, these animals overeat, but the major part of the excess energy intake above maintenance, is dissipated as heat through the sympathetic activation of brown adipose tissue. By contrast, a thermogenic defect in brown adipose tissue is involved in the development of genetic or hypothalamic obesity in rats and mice. In man, diet-induced thermogenesis seems to play a smaller role in the control of energy balance than in small mammals. This is probably related to the partial atrophy of brown adipose tissue in adult man. Studies on thermogenesis induced by the intravenous infusion of glucose and insulin (euglycemic hyperinsulinemic clamp technique) in man have allowed us to identify two components: the first, the obligatory thermogenesis is due to the energetic cost of glucose storage (which mainly occurs as glycogen); the second has been called facultative thermogenesis, and is dependent upon stimulation of the sympathetic nervous system. Facultative thermogenesis can be suppressed by propranolol, a drug which blocks the beta-receptors of the sympathetic nervous system. The effector tissue which is responsible for the facultative thermogenesis in man is unknown. Overfeeding studies with carbohydrates in man have also shown the occurrence of facultative thermogenesis. The contribution of a thermogenesis defect to the development of obesity in predisposed individuals is shown by studies using the technique of the respiration chamber. About one third of obese subjects who have been studied in the chamber have shown a decreased postprandial thermogenic response. A thermogenic defect could explain a weight gain of about 10 kg. Other mechanisms which include eating behaviour and low physical activity are needed to explain weight gains greater than 10 kg.(ABSTRACT TRUNCATED AT 400 WORDS)

Adipose Tissue, Brown↗

PubMed1988

Exercise and food intake. What is the relationship?

Understanding the effects of exercise on food intake is complicated by limitations of methodology. One primary limitation with human subjects is food intake assessment. Highly accurate techniques may not represent usual eating patterns. Present techniques representative of usual eating habits lack accuracy. Several independent variables also affect the results of exercise-food intake studies, even with laboratory rats where food intake measurements can be quite accurate. These variables include exercise protocols, subject characteristics, types and amounts of food available for consumption, environmental conditions, and sociocultural factors. Most investigations have focused on the effects of exercise training protocols on energy intake. When forced to run on treadmills, energy intake of laboratory rats usually decreases in males and increases in females. In response to forced swimming protocols, energy intake in male rats is usually unchanged and increased by female rats. In contrast, voluntary running (in running wheels) usually results in an increase in energy intake in both male and female rats. However, energy intake may also be unaffected or reduced in male rats given access to running wheels. These gender differences may be related to much lower levels of voluntary wheel running observed in male rats. The gender difference observed with rats is not apparent in humans. Energy intake of humans is usually increased or unchanged in response to exercise training programmes. However, when energy intake is increased, it is usually below the increased expenditure, resulting in negative energy balance. Highly trained athletes and lean individuals usually increase energy intake in response to increased physical activity, whereas, obese untrained subjects commonly do not change energy intake when exposed to exercise training. Few studies have investigated the effects of exercise on changes in food selection in laboratory animals; the results of studies with humans also have been inconsistent. Research results range from increased carbohydrate, fat, or protein consumption to no change in diet composition. Rats respond to detraining (cessation of exercise) with increased or unchanged energy intake. Men who detrain after 9 months of training regain bodyweight and body fat lost during training despite a reduction of energy intake and the percentage of calories from dietary fat. The relationship between exercise and food intake is complex. These often inconsistent or conflicting results reflect this complexity. Further understanding awaits additional research to clarify confounding variables.

Animals↗

PubMed2002

An appropriate tool for appetite testing and evaluation in young children in Benin.

Appetite measurements were performed in 109 Beninese children aged 18-30 months to develop a tool for appetite evaluation in young children in nutritional intervention programmes. Two test foods were identified as appropriate for these children: a maize porridge (aklui) and rice (riz-au-gras). Ad libitum intakes of the foods served after an overnight fast according to a standardized offering procedure were measured on 3 days. The children's habitual intakes were measured during 3 consecutive days not overlapping with the days when the test meals were provided. Energy intake from the test foods was comparable to breakfast energy intake which was 0.8-1.0 MJ, representing 21% of total daily energy intake. Energy intake from aklui was significantly correlated with daily intake (r=0.41, n=38, p<0.05) and with energy intake from breakfast (r=0.52, p<0.01). Correlations concerning riz-au-gras were less pronounced and non-significant. Reproducibility (as coefficient of variation) of the appetite test as calculated from the triplicate measurements was 40% for aklui and 25% for riz-au-gras. This reproducibility is better than that of the habitual breakfast intake (43-45%). In conclusion, the appetite test used in our studies can be considered as an appropriate tool in appetite evaluations.

Appetite↗

PubMed2000

No energy compensation at the meal following exercise in dietary restrained and unrestrained women.

The objective of this investigation was to compare the acute effects of exercise and diet manipulations on energy intake, between dietary restrained and unrestrained females. Comparisons of two studies using an identical 2 x 2 repeated-measures design (level of activity (rest or exercise) and lunch type (high-fat or low-fat)) including thirteen dietary unrestrained and twelve restrained females were performed. Energy expenditure during the rest session was estimated and the energy cost of exercise was measured by indirect calorimetry. Relative energy intake was calculated by subtracting the energy expenditure of the exercise session from the energy intake of the test meal. Post-meal hedonic ratings were completed after lunch. Energy intake and relative energy intake increased during high-fat conditions compared with the low-fat, independently of exercise (P < 0.001). There was a positive relationship between dietary restraint scores and energy intake or relative energy intake in the rest conditions only (r 0.54, P < 0.01). The decrease of relative energy intake between the rest and exercise conditions was higher in restrained than in unrestrained eaters (P < 0.01). These results confirm that a high-fat diet reversed the energy deficit due to exercise. There was no energy compensation in response to an acute bout of exercise during the following meal. In restrained eaters, exercise was more effective in creating an energy deficit than in unrestrained eaters. Exercise may help restrained eaters to maintain control over appetite.

Adult↗

PubMed2001

[Physiopathology of obesity].

Obesity results from an imbalance between energy intake and energy expenditure. Human studies indicate that obese individuals have an increased basal metabolic rate secondary to an increased fat-free mass. A blunted dietary thermogenesis is observed but is not of sufficient magnitude to lead to a major weight gain. Indirect evidence suggests that physical activity may be low in obese individuals. In healthy lean subjects, overfeeding leads to a stimulation of spontaneous physical activity. The ensuing increase in energy expenditure may play a role in the prevention of weight gain. This response, however, shows a high interindividual variability. There is overall little evidence that major alterations of energy expenditure are present in obese individuals. It is likely that an alteration of mechanisms of food intake control plays a prominent role in the pathogenesis of this disease.

Energy Intake↗

PubMed2002

Obesity therapy: altering the energy intake-and-expenditure balance sheet.

Obesity is associated with numerous health complications, which range from non-fatal debilitating conditions such as osteoarthritis, to life-threatening chronic diseases such as coronary heart disease, diabetes and certain cancers. The psychological consequences of obesity can range from lowered self-esteem to clinical depression. Despite the high prevalence of obesity and the many advances in our understanding of how it develops, current therapies have persistently failed to achieve long-term success. This review focuses on how fat mass can be reduced by altering the balance between energy intake and expenditure.

Adipose Tissue, Brown↗

PubMed1995

Nutrient Intake following Vertical Banded Gastroplasty or Gastric Bypass.

BACKGROUND: This study explored eating habits, nutrient intake, and blood vitamin and mineral levels to determine whether severely obese subjects (BMI 40-50kg m(2)) post-vertical banded gastroplasty (VBG) or gastric bypass Roux-en-Y (GBR) are at risk of developing compounded under-nutrition. METHODS: A dietary follow-up of 36 VBG and. 19 GBR was maintained for 18 months via 7-day food intake diaries and 24-h recalls. Food intake was analyzed for energy and nutrient composition and for its relative amount to recommended dietary allowances (RDA). RESULTS: Weight loss was greatest during the first 6 months, continued at a slower rate for the next 6 months, nearly ceasing thereafter. The results following GBR were not substantially different from those following VBG 18 months postoperatively. The median weight loss at 1 year postoperatively was 48, 46, 48 and 36 kg; expressed as residual excess body weight: 0.2, 16, 13 and 22% for GBR Men, Women, VBG Men, Women, respectively. According to the classification proposed by Reinhold, all subjects achieved excellent treatment outcomes 18 months postoperatively. Despite the relatively low reported energy intake (2050% below RDA), no correlation was found between rate of weight loss and energy intake at 6 months postoperatively. The intake of most vitamins and minerals was below 50% of RDA during the 18 months follow-up. The increase in energy intake did not improve the level of the nonenergy-contributing nutrients. Compliance to multivitamin and mineral supplement intake deteriorated with time. CONCLUSION: The low to within-normal range of blood vitamin and mineral levels 12 months postoperatively suggests the slow development of subclinical nutritional deficiency which could jeopardize the subjects' long-term health status.

Journal Article↗

PubMed1997

Molecular approaches to the discovery of new treatments for obesity.

The treatment of obesity requires modulation of both energy intake and energy expenditure, and pharmaceutical treatments are being developed to complement the traditional means of dietary restriction and exercise. The recent discovery of the protein leptin, which modulates both food intake and energy expenditure, has provided a new tool with which to define and analyze potential pathways for pharmacological intervention. Neurotransmitters, such as neuropeptide Y (NPY) and norepinephrine, act downstream of leptin to modulate energy homeostasis. Specific subtypes of the receptors for these neurotransmitters represent promising molecular targets for the discovery of new drugs for the treatment of obesity.

Anti-Obesity Agents↗