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PubMed2003

Obesity in patients with craniopharyngioma: assessment of food intake and movement counts indicating physical activity.

Patients with childhood-onset craniopharyngioma (CP) often suffer from obesity. We evaluated two important etiological factors of obesity development, energy intake and physical activity. Energy intake was supposed to be high due to a disturbed hypothalamic regulation of appetite. We used a validated nutritional diary to determine the 1-wk food intake in 27 CP patients (12 with intrasellar tumors and 15 with hypothalamic tumors) and 1027 controls who were a representative sample of the 7- to 16-yr-old German population. In 2 accelerometry settings, we determined movement counts indicating physical activity. Nineteen CP patients were comparable to 26 controls for age and body mass index. One setting was a clinical one during weight reduction; the other was an out-patient setting. Daily energy intake was 1916 +/- 677 kcal (mean +/- SD) in intrasellar CP patients, 2075 +/- 877 kcal in hypothalamic CP patients, and 2476 +/- 815 kcal in non-CP controls. Patients suffering from CP showed fewer movement registrations [clinical setting, 228 vs. 298 cpm for obese controls (P = 0.01); out-patient setting, 228 vs. 282 cpm for controls (P = 0.08)]. Differences were most pronounced during leisure time (382 cpm in CP patients vs. 546 cpm in obese controls; P = 0.002; clinical setting). Our findings suggest that reduced physical activity, rather than increased energy intake, in CP patients is responsible for the obesity development noted in these subjects.

Adolescent↗

PubMed2002

Similarities and differences between Alzheimer's disease and vascular dementia from the viewpoint of nutrition.

Dietary habits were compared in patients with Alzheimer's disease (AD) and those with vascular dementia (VaD). Twenty-seven patients with AD, 15 patients with VaD, and 49 age-matched controls were enrolled. Nutritional status was assessed using a semiquantified food-frequency questionnaire. Dietary habits were very similar in male patients with AD and VaD. Both groups had significantly higher energy intake than their energy demands: +25% for AD and +35% for VaD, respectively. However, major sources of energy were different: grains and animal fats for AD versus only grains for VaD. Calculation of nutrients revealed excess intake of n-6 polyunsaturated fatty acids (PUFA) and relative deficiencies of multiple vitamins including antioxidants, vitamin C and carotene, and the vitamin B group. In contrast, dietary habits in female patients with AD differed significantly from those of male patients. Female patients consumed significantly lower amounts of fish and green vegetables. Calculation of nutrients showed absolute deficiencies of n-3 PUFA, multiple vitamins, and minerals. Our results show that AD and VaD are similar from the viewpoint of nutrition, except for the higher consumption of animal fats for AD patients, probably reflecting Westernization of dietary habits in recent years. Nutrition may be relevant to the pathogenesis of dementia through many processes. Higher intake of energy and lower intake of antioxidants may exaggerate the process of dementia through oxidative stress. Excessive amounts of n-6 PUFA or deficiency of n-3 PUFA may cause chronic inflammation, platelet aggregation, or endothelial dysfunction of microvasculature. Nutrition may be useful for preventing dementia, although gender-specific differences must be taken into account.

Aged↗

PubMed1983

The effect of wheat bran on the intake of energy and nutrients and on serum mineral levels in constipated geriatric patients.

The total intake of energy and nutrients was recorded during 5 consecutive d in ten constipated patients in a geriatric ward. Twenty grams of ordinary or low-phytate wheat bran was then added to their diet and the 5-d food intake was recorded after 6 and 12 weeks, respectively. The intake was generally satisfactory and decreased in only two women on bran treatment. The hospital diet had a high mineral content and calcium, magnesium, zinc and iron levels in serum did not decrease when wheat bran was added to the diet. Consequently no difference was found in serum mineral levels, when ordinary wheat bran was replaced by a low-phytate bran.

Aged↗

PubMed1985

Effect of dietary protein concentration and ambient temperature on the energy, protein and water metabolism of the rat.

Groups of rats (n 8) were offered, to appetite, diets containing 10 (LP), 25 (MP) and 45 (HP)% of gross energy as protein energy from 45 d of age to slaughter 50 d later. At 53 d of age, half the rats on each diet were left at 22 degrees while the other half were transferred to 6 degrees. Water balances were measured daily, and digestibilities of energy and nitrogen and the metabolizability of the diets were measured for each rat over a 7 d period at some stage between the age of 74 and 95 d. The rats were slaughtered at day 95 and their carcasses were analysed for protein, lipid, energy and ash contents. Energy expenditure was calculated as the difference between metabolizable energy intake and energy retained. Growth performance was best on the MP diet at both temperatures. At 22 degrees the rate of gain of body-weight and of energy retention, although not of protein, were slightly reduced on the HP diet while overall performance was markedly inferior on the LP diet. At 6 degrees the LP diet, while not so good as the MP diet, led to significantly better all-round growth performance than did the HP diet. Cold increased the energy expenditure of the rats by 50% (109-138 kJ/d); the increase was greater for the LP group than for the HP group. Intrascapular brown adipose tissue hypertrophied in response to cold and to the LP diet. Adrenal gland size was significantly increased by cold exposure and by increasing level of dietary protein concentration. Urine volume was more closely related to the intake of protein than to that of energy. Urinary N concentration for the HP rats was approximately double that for those on the LP diet. Cold-exposed rats had a high water content in their fat-free carcasses, but there were no differences between the dietary treatments.

Adipose Tissue, Brown↗

PubMed2003

Genetic regulation of feed intake and energy balance in poultry.

Intensive selection by poultry breeders over many generations for economically important production traits such as growth rate and meat production has been accompanied by significant changes in feed intake and energy balance. For example, the modern commercial broiler, selected for rapid growth and enhanced muscle mass, does not adequately regulate voluntary feed intake to achieve energy balance. When given unrestricted access to feed, broilers exhibit hyperphagia leading to an excessive accumulation of energy (fat) stores, making these birds prone to obesity and other health-related problems. Humoral and neural pathways have been identified and studied in mammals that link appetite and energy balance. A series of highly integrated regulatory mechanisms exists for both of these processes involving complex interactions between peripheral tissues and the central nervous system. Within the central nervous system, the brainstem and the hypothalamus play critical roles in the regulation of feed intake and energy balance. Genes encoding key regulatory factors such as hormones, neuropeptides, receptors, enzymes, transcription factors, and binding/transport proteins constitute the molecular basis for regulatory systems that derive from integrated sensing, signaling, and metabolic pathways. However, we do not yet have a complete understanding of the genetic basis for this regulation in poultry. This review examines what is currently known about the regulation of feed intake and energy balance in poultry. A better understanding of the genes associated with controlling feed intake and energy balance and how their expression is regulated by nutritional and hormonal stimuli will offer new insights into current poultry breeding and management practices.

Animal Husbandry↗

PubMed2000

Dietary approaches to the treatment of obesity.

According to the National Institute of Health guidelines for the treatment of overweight and obesity, the most important element in a weight loss program is the reduction in energy intake. Reducing the fat content of the diet and increasing physical activity without restricting energy intake are relatively inefficient methods of weight loss. Because individuals tend to consume a constant weight of food, the decrease in energy intake on a reduced-fat diet is likely related to the lower energy density of the diet. Diets of low energy density, which are typically low in fat and rich in complex carbohydrates, allow individuals to consume satisfying portions of food while reducing their energy intake. Because a wide variety of foods can be included in a diet that is low in energy density, this type of diet encourages the adoption of life-long eating habits that are integral to the maintenance of weight loss and the prevention of weight gain.

Adult↗

PubMed2000

Aetiology of overweight and obesity in children and adolescents.

UNLABELLED: The epidemic diffusion of obesity in industrialised countries has promoted research on the aetiopathogenesis of this disorder. The purpose of this review is to focus mainly on the contribution that European research has made to this field. Available evidence suggests that obesity results from multiple interactions between genes and environment. Parents obesity is the most important risk factor for childhood obesity. Twin, adoption, and family studies indicated that inheritance is able to account for 25% to 40% of inter-individual difference in adiposity. Single gene defects leading to obesity have been discovered in animals and, in some cases, confirmed in humans as congenital leptin deficiency or congenital leptin receptor deficiency. However, in most cases, genes involved in weight gain do not directly cause obesity but they increase the susceptibility to fat gain in subjects exposed to a specific environment. Both genetic and environmental factors promote a positive energy balance which cause obesity. The relative inefficiency of self-adapting energy intake to energy requirements is responsible for fat gain in predisposed individuals. The role of the environment in the development of obesity is suggested by the rapid increase of the prevalence of obesity accompanying the rapid changes in the lifestyle of the population in the second half of this century. Early experiences with food, feeding practices and family food choices affect children's nutritional habits. In particular, the parents are responsible for food availability and accessibility in the home and they affect food preferences of their children. Diet composition, in particular fat intake, influences the development of obesity. The high energy density and palatability of fatty foods as well as their less satiating properties promotes food consumption. TV viewing, an inactivity and food intake promoter, was identified as a relevant risk factor for obesity in children. Sedentarity, i.e. a low physical activity level, is accompanied by a low fat oxidation rate in muscle and a low fat oxidation rate is a risk factor of fat gain or fat re-gain after weight loss. CONCLUSION: Further research is needed to identify new risk factors of childhood obesity, both in the genetic and environmental areas, which may help to develop more effective strategies for the prevention and treatment of obesity.

Adolescent↗

PubMed2006

Oligofructose promotes satiety in healthy human: a pilot study.

OBJECTIVE: The administration of a fermentable dietary fibre (oligofructose) in rats increases satietogenic gut peptides and lowered spontaneous energy intake. The aim of the study was to assess the relevance of those effects of oligofructose on satiety and energy intake in humans. DESIGN: Single-blinded, crossover, placebo-controlled design, pilot study. SUBJECTS: Volunteers included five men and five women aged 21-39 years, BMI ranging from 18.5 to 27.4 kg/m(2), were randomly assigned as described below. INTERVENTIONS: Subjects were included in two 2-week experimental phases during which they received either fibre (oligofructose (OFS)) or placebo (dextrine maltose (DM)); a 2-week washout period was included between crossover phases. In total, 8 g OFS or 8 g DM were ingested twice daily (16 g/day in total). Energy intake, hunger, satiety, fullness and prospective food consumption were assessed with analogue scales at the end of each experimental phase. RESULTS: During breakfast, OFS significantly increases the satiety (P=0.04) without any difference on other sensations as compared to DM treatment periods. After lunch, no significant differences are observed between treatment period. At dinner, OFS significantly increases satiety (P=0.04), reduces hunger (P=0.04) and prospective food consumption (P=0.05). The energy intake at breakfast and lunch are significantly lower (P=0.01, 0.03, respectively) after OFS treatment than after DM treatment. Total energy intake per day is 5% lower during OFS than in DM period. CONCLUSION: Oligofructose treatment increases satiety following breakfast and dinner, reduces hunger and prospective food consumption following dinner. This pilot study presents a rationale to propose oligofructose supplements in the management of food intake in overweight and obese patients.

Adult↗

PubMed1985

Why does congenital heart disease cause failure to thrive?

Metabolisable energy intake, determined by bomb calorimetry of food, vomit, stool and urine, and resting metabolism, assessed by respiratory gas exchange, were studied in 21 infants with congenital heart disease and nine control infants. Weight for age, growth rates, and daily metabolisable energy intake per kg tended to be lower in infants with heart disease than in control infants. Resting oxygen consumption was high in those infants with pulmonary hypertension and persistent cardiac failure. Energy intake, as a percentage of that recommended for age, correlated with weight gain, and resting oxygen consumption correlated inversely with both percentage body mass index and relative fatness. Failure to thrive in infants with congenital heart disease may be due to a combination of low energy intakes and, in some cases, high energy requirements allowing insufficient energy for normal growth. Increasing the energy intakes of infants with congenital heart disease may be a way of improving their growth.

Body Weight↗

PubMedDate not supplied

Impact of caloric intake on parenteral nutrition-associated intestinal morphology and mucosal barrier function.

BACKGROUND: Parenteral nutrition (PN) is known to induce villus atrophy, epithelial cell (EC) apoptosis, and increase mucosal permeability. The study hypothesized that increasing amounts of energy delivery to mice would result in the best outcome, with the least effects on the mucosa. METHODS: Mice were randomized to enteral controls (saline infusion with ad libitum enteral food) or to 1 of 3 PN groups (with no enteral nutrition): full (100% of daily average energy intake for the mouse), reduced (75% of energy intake) or very low (50% of energy intake). Mice received PN for 7 days. Mucosal morphology, EC apoptosis, and bacterial translocation were assessed. RESULTS: Villus height decreased significantly with decreasing levels of caloric intake and was significantly lower in all PN groups compared with controls. Body weight loss was significantly greater in PN groups vs controls and was greatest in mice with the lowest caloric delivery. A consistent trend toward a higher EC apoptotic index with decreasing caloric intake was observed, and apoptosis in all PN groups exceeded controls (2-fold). All PN groups demonstrated greater bacterial translocation than controls. CONCLUSIONS: PN induces intestinal EC apoptosis and villus and crypt atrophy, even at 100% of predicted energy needs, and such changes increased with greater reduction of energy intake. This study supports a concept that lack of enteral nutrition, rather than absolute caloric levels, is responsible for many of the adverse effects of PN. The study also allows the investigators to better optimize a mouse model of PN delivery.

Animals↗

PubMed1988

Voluntary food intake of lean and obese Zucker rats in relation to dietary energy and nitrogen content.

Genetically obese (fa/fa) Zucker rats maintain a normal lean body size but deposit excessive amounts of body fat. Preferential use of substrates for lipid synthesis results in inefficient use of dietary nitrogen for protein deposition. Three studies were carried out to determine whether an increased protein requirement caused hyperphagia and whether young Zucker rats preferentially regulated protein or energy intake. Rats were offered isoenergetic diets with nitrogen contents ranging from 4.5 to 53.2 mg/g, or isonitrogenous diets with energy contents of 2.2, 3.3 or 4.2 kcal/g. In both situations obese rats had significantly higher food intakes than lean rats. Within phenotype the rats maintained an almost constant energy intake so that nitrogen intake was proportional to dietary nitrogen concentration. In a third experiment lean and obese rats were given different proportions of their control protein intake by stomach tube. Energy intake was determined by voluntary consumption of a protein-free diet. Within phenotype energy intake was the same for all levels of protein intake. It appears that obese Zucker rats regulate energy intake at an elevated level and that protein intake is determined by dietary nitrogen content. Hyperphagia does not appear to result from a desire to obtain protein.

Animals↗

PubMed1982

Interaction of dietary protein with cellulose in the adaptation of caloric dilution by weaning rats.

The adaptive response of food intake to increasing levels of dietary cellulose was studied in weanling rats fed limiting amounts of dietary protein of different qualities. At low levels of dietary cellulose, the food intake depends on protein quality. As the cellulose levels were increased, the diet and gross energy digestibilities diminished, yielding diets with lower digestible energy contents. The rats fed the higher quality protein were able to compensate for this caloric dilution, increasing their food consumption enough to keep constant their digestible energy intake. The animals fed a lower quality protein, however, were unable to make this adaptive increase in food intake. As a result, although gross food intake remained stable, cellulose constituted an increasing proportion of it and the digestible energy consumption of these animals diminished. Water consumption in this trial appears to reflect the animal's digestible energy intake rather than cellulose consumption. The above observations may be considered as an indication that a smooth regulation of the energy intake occurs only with a complete or non-deficient diet and that deficient, abnormal or unusual diets upset this process. In the present experimental situation, when dietary protein is inadequate, the animal can no longer make appropriate compensatory increases in its food consumption to keep its digestible energy intake constant.

Adaptation, Physiological↗

PubMed1992

Effect of bolus fluid intake on energy expenditure values as determined by the doubly labeled water method.

The doubly labeled water (DLW, 2H(2)18O) method is a highly accurate method for measuring energy expenditure (EE). A possible source of error is bolus fluid intake before body water sampling. If there is bolus fluid intake immediately before body water sampling, the saliva may reflect the ingested water disproportionately, because the ingested water may not have had time to mix fully with the body water pool. To ascertain the magnitude of this problem, EE was measured over a 5-day period by the DLW method. Six subjects were dosed with 2H2(18)O. After the reference salivas for the two-point determination were obtained, subjects drank water (700-1,000 ml), and serial saliva samples were collected for the next 3 h. Expressing the postbolus saliva enrichments as a percentage of the prebolus value, we found 1) a minimum in the saliva isotopic enrichments were reached at approximately 30 min with the minimum for 2H (95.48 +/- 0.43%) being significantly lower than the minimum for 18O (97.55 +/- 0.44, P less than 0.05) and 2) EE values calculated using the postbolus isotopic enrichments are appreciably higher (19.9 +/- 7.5%) than the prebolus reference values. In conclusion, it is not advisable to collect saliva samples for DLW measurements within approximately 1 h of bolus fluid intake.

Body Water↗

PubMed2005

Milk, dairy fat, dietary calcium, and weight gain: a longitudinal study of adolescents.

BACKGROUND: Milk is promoted as a healthy beverage for children, but some researchers believe that estrone and whey protein in dairy products may cause weight gain. Others claim that dairy calcium promotes weight loss. OBJECTIVE: To assess the associations between milk, calcium from foods and beverages, dairy fat, and weight change over time.Design, Subjects, and Outcome Measure We followed a cohort of 12 829 US children, aged 9 to 14 years in 1996, who returned questionnaires by mail through 1999. Children annually reported their height and weight and completed food frequency questionnaires regarding typical past-year intakes. We estimated associations between annual change in body mass index (BMI) (calculated as weight in kilograms divided by height in meters squared) and our dietary factors, adjusted for adolescent growth and development, race, physical activity, inactivity, and (in some models) total energy intake. RESULTS: Children who drank more than 3 servings a day of milk gained more in BMI than those who drank smaller amounts (boys: beta +/- SE, 0.076 +/- 0.038 [P = .04] more than those who drank 1 to 2 glasses a day; girls: beta +/- SE, 0.093 +/- 0.034 [P = .007] more than those who drank 0 to 0.5 glass a day). For boys, milk intake was associated with small BMI increases during the year (beta +/- SE, 0.019 +/- 0.009 per serving a day; P = .03); results were similar for girls (beta +/- SE, 0.015 +/- 0.007 per serving a day; P = .04). Quantities of 1% milk (boys) and skim milk (girls) were significantly associated with BMI gain, as was total dietary calcium intake. Multivariate analyses of milk, dairy fat, calcium, and total energy intake suggested that energy was the most important predictor of weight gain. Analyses of year-to-year changes in milk, calcium, dairy fat, and total energy intakes provided generally similar conclusions; an increase in energy intake from the prior year predicted BMI gain in boys (P = .003) and girls (P = .03). CONCLUSIONS: Children who drank the most milk gained more weight, but the added calories appeared responsible. Contrary to our hypotheses, dietary calcium and skim and 1% milk were associated with weight gain, but dairy fat was not. Drinking large amounts of milk may provide excess energy to some children.

Adolescent↗

PubMed1990

Accuracy of weighed dietary records in studies of diet and health.

OBJECTIVE: To provide an independent evaluation of seven day weighed dietary records, which are currently accepted as the most accurate technique for assessing habitual dietary intake in studies investigating the links between diet and health. DESIGN: Subjects who had previously participated in the Northern Ireland diet and health study were reselected by stratified random sampling to represent the range of energy intakes in the study as assessed by the seven day weighed dietary record. SETTING: Northern Ireland. SUBJECTS: 31 Free living adults (16 men and 15 women). MAIN OUTCOME MEASURES: Energy intake as measured by the seven day weighed dietary record and total energy expenditure estimated concurrently by the doubly labelled water technique. RESULTS: Average recorded energy intakes were significantly lower than measured expenditure in the group overall (9.66 MJ/day v 12.15 MJ/day, 95% confidence interval 1.45 to 3.53 MJ/day). Among those in the upper third of energy intakes the mean (SE) ratio of intake to expenditure was close to 1.0, indicating accurate records (men 1.01 (0.11), women 0.96 (0.08]. In the middle and lower thirds the ratios for men were only 0.74 (0.05) and 0.70 (0.07) respectively and for women 0.89 (0.07) and 0.61 (0.07). CONCLUSIONS: These results show a serious bias in reporting habitual energy intake. If substantiated they may have wide implications for the interpretation of many nutritional studies.

Adolescent↗

PubMed2004

Prenatal exposure to a maternal low-protein diet programmes a preference for high-fat foods in the young adult rat.

Nutrient restriction in pregnancy has been shown to programme adult obesity. Modulation of feeding behaviour may provide a mechanism through which obesity may be programmed. Pregnant Wistar rats were fed either a control diet or a low-protein (LP) diet throughout gestation. Their offspring were allocated to a self-selected-diet protocol to assess appetite and food preferences at 12 and at 30 weeks of age. Self-selection of high-fat, high-protein or high-carbohydrate foods by 12-week-old rats indicated that the prenatal environment influenced feeding behaviour. Both male and female offspring of LP-fed mothers consumed significantly more of the high-fat (P<0.001) and significantly less (P<0.02) of the high-carbohydrate food than the control animals. Female, but not male, offspring of LP-fed rats failed to adjust food intake to maintain a constant energy intake and had higher fat (P<0.005) and energy intakes (P<0.05) than control female rats. At 30 weeks of age there were no differences in the pattern of food selection between the two groups of animals. Male offspring of LP-fed rats had significantly more gonadal fat than control animals (P<0.05), but analysis of total body fat content indicated that there was no significant difference in overall adiposity. The present study suggests that in young adults at least, early life exposure to undernutrition determines a preference for fatty foods. Maternal nutrition may thus promote changes in systems that are involved in control of appetite or the perception of palatability.

Animal Feed↗

PubMed1998

Volume of food consumed affects satiety in men.

This study tested the hypothesis that the amount (weight or volume) of food consumed affects the satiating potency of a food, independent of its energy content. Normal-weight young men (n = 20) were tested in a within-subjects design. Subjects were served a milk-based drink or no drink (control), followed 30 min later by a self-selected lunch and > 4 h later by a self-selected dinner. Milk drinks were equal in energy content (2088 kJ, or 499 kcal) and had similar proportions of fat (30.3%), carbohydrate (54.7%), and protein (15%) across three volumes: 300, 450, and 600 mL. Ratings of palatability, sensory properties, and energy content of the drinks and of hunger completed before consumption of the preloads were not significantly different among conditions. The results showed that preload volume affected energy intake at lunch (P < or = 0.009) such that energy intake was less after the 600-mL preload than after the 300-mL preload. This effect was still present when energy intake at dinner was included (P < or = 0.022). At lunch, including energy from the preload, subjects overate relative to the control condition (4323 +/- 322 kJ) after the 300- (5263 +/- 321 kJ) and 450-mL (5011 +/- 300 kJ) preloads but not after the 600-mL (4703 +/- 353 kJ) preload. Thus, the best adjustment for the energy in the preloads was with the largest, least energy-dense drink. Consistent with the effects on intake, the volume of the drinks affected ratings of hunger and fullness. These results indicate that the volume consumed is an important determinant of satiety after milk drinks under these conditions.

Adult↗

PubMed1990

[Assessment of the diet of malnourished outpatients with chronic obstructive respiratory insufficiency].

We investigated the daily diets of malnourished patients with chronic obstructive ventilatory insufficiency. A total of 28 patients with body weights of less than 80% of ideal body weight were included. The patients were all ambulatory and in a stable phase of their illness. Their diets were assessed by dietary registration covering seven days. Basal energy expenditure was calculated using the Harris-Benedict equation. On an average these patients had a daily energy intake of 205% of their total energy expenditure, which is significantly higher than the value of 150% of basal energy expenditure considered sufficient for normal daily activity (p less than 0.0001). We conclude that low energy intake is not the cause of low body weight in these patients. They seem to be in a hypermetabolic state which may be due to the increased energy demand of the exertion of breathing.

Diet Records↗