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PubMed1992

Broiler weight gain and carcass composition when fed diets varying in amino acid balance, dietary energy, and protein level.

Three experiments were conducted with broiler chicks where diet composition varied with respect to dietary protein, energy, and essential amino acid (EAA) balance. Birds fed diets varying widely in EAA balance and protein and energy levels performed differently with respect to percentage carcass fat and protein. The absolute carcass protein deposition remained relatively constant between treatments, but body fat content varied depending on level of energy intake. Although abdominal fat content varied with level of dietary protein and energy, these values did not correlate well with total carcass fat deposition. Carcass fat deposition correlated well with dietary energy intake, which in turn appeared to be influenced by birds eating to satisfy their EAA requirement. With diets of similar EAA balance, birds appeared to have similar EAA intakes rather than similar energy intakes. Birds fed diets with similar EAA levels, but varying widely in level of nonessential amino acids, energy, or both consumed similar amounts of feed and deposited similar amounts of carcass protein. The present data suggest that level and balance of EAA can have a significant effect on feed intake, thereby influencing weight gain and carcass composition.

Adipose Tissue↗

PubMed2005

The neuronal histamine H(1) and pro-opiomelanocortin-melanocortin 4 receptors: independent regulation of food intake and energy expenditure.

Hypothalamic neuronal histamine and its H(1) receptor (H(1)-R) form part of the leptin signaling pathway in the brain, and regulate body weight and adiposity by affecting food intake and energy expenditure. The pro-opiomelanocortin (POMC)-melanocortin 4 receptor (MC4-R) is also important for leptin signaling. We investigated whether and how these two neuronal pathways interact in regulating energy metabolism. From studies of agouti yellow (A(y)/a) obese mice, a model of a defect in POMC-MC4-R signaling, we concluded that the histamine H(1)-R signaling pathway is independent of the POMC-MC4-R complex in regulating food intake, energy metabolism, and adiposity.

Animals↗

PubMed2005

Secular trends in under-reporting in young people.

National survey data show that reported energy intake has decreased in recent decades despite a rise in the prevalence of obesity. This disparity may be due to a secular increase in under-reporting or a quantitatively greater decrease in energy expenditure. This study examines the extent of under-reporting of energy intake in the National Diet and Nutrition Survey (NDNS) in young people aged 4-18 years in 1997 using published equations to calculate estimated energy requirements. It explores secular changes by comparison with the Diets of British School Children (DBSC) survey in 10-11- and 14-15-year-olds in 1983. In the NDNS, under-reporting (estimated energy requirements--energy intake) represented 21 % of energy needs in girls and 20 % in boys. The magnitude of under-reporting increased significantly with age (P<0.001) and was higher in overweight than lean individuals over 7 years of age. To compare reported energy intake in DBSC and NDNS, the estimated physical activity level from dietary records (dPAL=reported energy intake/predicted BMR) was calculated. If there were no under-reporting, dPAL would represent the subject's true activity level. However, dPAL from the NDNS was significantly lower than that from the DBSC by 8 % and 9 % in boys and girls for those aged 10-11 years, and by 14 % and 11 % for 14-15-year-olds respectively, reaching physiologically implausible levels in the 14-15-year-old girls (dPAL=1.17). If activity levels have remained constant between the two surveys, under-reporting has increased by 8-14 %. The evidence supports a secular trend towards increased under-reporting between the two surveys, but the precise magnitude cannot be quantified in the absence of historical measures of energy expenditure.

Adolescent↗

PubMed2002

High-protein weight-loss diets: are they safe and do they work? A review of the experimental and epidemiologic data.

Recommendations for increased consumption of protein are among the most common approaches of popular or fad diets. This review summarizes the effects of dietary protein on satiety, energy intake, thermogenesis, and weight loss, as well as its effect on a variety of health outcomes in adults. In short-term studies, dietary protein modulates energy intake via the sensation of satiety and increases total energy expenditure by increasing the thermic effect of feeding. Whereas these effects did not contribute to weight and fat loss in those studies in which energy intake was fixed, one ad libitum study does suggest that a high-protein diet results in a greater decrease in energy intake, and therefore greater weight and fat loss. In terms of safety, there is little long-term information on the health effects of high-protein diets. From the available data, however, it is evident that the consumption of protein greater than two to three times the U.S. Recommended Daily Allowance contributes to urinary calcium loss and may, in the long term, predispose to bone loss. Caution with these diets is recommended in those individuals who may be predisposed to nephrolithiasis or kidney disease, and particularly in those with diabetes mellitus.

Diet, Reducing↗

PubMed1995

Diet and nutritional status in children with cow's milk allergy.

OBJECTIVE: The purpose of this study was to investigate the nutritional status and adequacy of the diet in the children with cow's milk allergy (CMA). DESIGN AND SUBJECTS: 18 children with challenge-proven CMA and 20 healthy children were investigated in the cross-sectional study. The mean (range) age of the children was 2.0 (1.0-3.5) years. The healthy children were matched by age and sex with the allergic children. Food consumption data were collected by the six-day food record method. The weight and height of both groups and laboratory indices of children with CMA were measured to study the nutritional status. RESULTS: Thirteen (72%) of the children with CMA used a formula based on soy or casein hydrolysate. The amounts of these formulas consumed by the allergic children were smaller (371 ml vs 559 ml; P < 0.01) than the amount of milk and milk products consumed by the healthy children. There was no difference in energy intake between the groups. Protein intake by the allergic children was lower (39 g vs 48 g; P < 0.05) and fat intake higher (47 g vs 39 g; P < 0.05) than that of the healthy children. The mean intakes of energy and zinc in both groups, and the intake of iron in the healthy children, were below the RDAs. The diet in the allergic children was supplemented with calcium and in 11 children with vitamins A and D. Fourteen healthy children had vitamin A and D supplement. The height-for-age was lower in the children with CMA (-0.6 vs +0.2 s.d. units; P < 0.05) as compared to healthy children. Serum biochemical measurements were within the reference range in the allergic children, and no nutritional problems were found. CONCLUSIONS: For the eliminated foods children with CMA substituted nutritionally corresponding food items which resulted in adequate mean intakes of nutrients. Specific formulas contributed substantially to the nutrient intake. Children with CMA need intensive nutritional counselling and regular monitoring of growth.

Body Height↗

PubMedDate not supplied

Fluoxetine in the treatment of obese type 2 diabetic patients.

In a 12-month randomly allocated double-blind trial in 19 obese Type 2 diabetic patients, fluoxetine 60 mg daily compared to placebo produced a significant fall in median body weight after 3 months (3.8 kg), 6 months (6.5 kg), 9 months (7.1 kg) and at 1 year (5.8 kg). Median fasting blood glucose and HbA1c levels fell significantly after 3 months (1.9 mmol l-1) and 1.7%, respectively) and 6 months (1.8 mmol l-1 and 1.7%) but neither showed a significant difference to placebo after 9 or 12 months therapy with fluoxetine. There were no significant changes in serum cholesterol levels in the year but patients on fluoxetine showed a significant fall in serum triglyceride level (0.5 mmol l-1) after 3 months therapy but not thereafter. Compared to placebo there was a significant fall in median energy intake on fluoxetine after 3 months (257 kcal day-1) and 6 months (199 kcal day-1) but this difference was not significant at 9 or 12 months. There was also a significant fall in carbohydrate intake after 3 months (30 g day-1) and 6 months (23 g day-1) on fluoxetine as well as a significant fall in carbohydrate intake expressed as a percentage of the total daily energy intake; 5.9% at 3 months, 6.1% at 6 months, and 4.0% at 9 months. There were no significant effects on protein or fat intake except a significant increase in the intake of fat expressed as a percentage of daily energy intake, 5.9% after 6 months. Two of the nine patients on fluoxetine dropped out of the study due to gastrointestinal side-effects. Fluoxetine might prove to be a useful adjunct therapy in obese Type 2 diabetic patients where short-term weight loss and fall in carbohydrate intake and an improvement in glycaemia are indicated.

Adult↗

PubMed2005

Dietary variety predicts low body mass index and inadequate macronutrient and micronutrient intakes in community-dwelling older adults.

BACKGROUND: Low body mass index (BMI) and micronutrient deficiencies are associated with increased morbidity and mortality rates in old age. Whether adverse patterns of dietary variety predict both low BMI and low micronutrient intakes in older adults was investigated. METHODS: A cross-sectional analysis of national survey data was conducted in 1174 healthy adult men and women (ages 21 to 90 years) who provided physiologically plausible dietary data in the 1994-1996 Continuing Survey of Food Intakes by Individuals. Measurements included reported energy intake, protein intake (percentage meeting Recommended Dietary Allowance), micronutrient intakes (percentage meeting Estimated Average Requirements for 14 micronutrients), and BMI. RESULTS: Adults who were 61 years or older consumed a greater total variety of foods, chose foods from a wider range of food groups, had a greater variety of micronutrient-dense foods and energy-weak foods, and had a lower variety of micronutrient-weak foods compared with adults ages 21 to 60 years (p < .05 to.001). However, older adults with low BMIs (< 22 kg/m2) consumed a lower variety of energy-dense foods compared with older adults with higher BMIs (p < .05). The variety of energy-dense foods predicted both energy intake and BMI at all ages in multiple regression models controlling for confounding variables (R2 = .124 for energy, R2 = .574 for BMI, p < .001). A higher percentage of older persons had inadequate micronutrient intakes compared with younger persons (p < .05), especially vitamin E, calcium, and magnesium, but consumption of a particularly wide variety of micronutrient-rich foods helped counterbalance these trends (p < .05). Older adults who had a low BMI and consumed a low variety of micronutrient-dense foods were particularly at nutritional risk, with only 65.4% consuming the Recommended Dietary Allowance for protein and none meeting the Estimated Average Requirements for all 14 micronutrients. CONCLUSIONS: In contrast to previous suggestions that older persons consume a monotonous diet, this study showed that adults who were 61 years or older consumed a greater total food variety, and a greater variety of micronutrient-dense and energy-weak foods, compared with adults who were 60 years or younger. Although consumption of a low variety of energy-dense foods may contribute to reduced energy intake and body weight at any age, the variety of micronutrient-dense foods consumed needs to increase in old age to prevent micronutrient deficiencies. These findings suggest that all adults need advice on the changing needs for dietary variety with aging to maintain health, and that older persons with low BMI are particularly vulnerable to dietary shortfalls.

Age Factors↗

PubMed1994

Recorded food intake of obese women with binge eating disorder before and after weight loss.

Because binge eating in obese individuals has been postulated to be a reaction to dietary restriction, we examined the recorded food intake of 17 obese women with and 16 obese women without binge eating disorder (BED) during 1-week periods before and 3 months after a very low calorie diet program in order to determine the effects of dietary restriction on binge eating frequency and severity. Before weight loss, rather than reporting severe caloric restriction, women with BED reported greater average energy intake than nonbinge eaters on both a total (2707 vs. 1869 k cal/day, p < .01) and weight-adjusted (25.1 vs. 18.1 kcal/kg, p < .01) basis, with both higher intake on nonbinge days and an increased frequency of binge days. After weight loss, there was no significant difference in energy intake, on either a total or weight-adjusted basis, between subjects with and without BED. Although average daily energy intake fell for both groups after weight loss, only subjects with BED reported significantly decreased energy intake when adjusted for change in body weight. This resulted from decreased intake on nonbinge days and a decreased frequency of binge days. Before weight loss, subjects with BED reported an average energy intake equivalent to 94% of their predicted energy expenditure. Whereas subjects without BED reported intake only 64% of predicted (p = .002). After weight loss, there was no significant difference between subjects with and without BED in the percentage of predicted energy expenditure reported as intake (64% vs. 58%). Restraint was similar in both groups before weight loss, but those with BED reported greater hunger and disinhibition. After weight loss treatment, restraint increased significantly, whereas disinhibition and hunger remained elevated in subjects with BED. Disinhibition, rather than restraint, appears to be a major contributor to the disordered eating of these individuals. Unlike normal-weight women with bulimia nervosa, dietary restriction does not appear to worsen symptoms of binge eating in obese women with BED. Over the short term, subjects with BED may respond to a standard weight loss treatment program with improvements in binge eating behaviors.

Adolescent↗

PubMed2004

Reduced ventromedial hypothalamic neuronal nitric oxide synthase and increased sensitivity to NOS inhibition in dietary obese rats: further evidence of a role for nitric oxide in the regulation of energy balance.

Inhibition of hypothalamic nitric oxide (NO) decreases energy intake, and changes in hypothalamic NO synthase (NOS) have been observed in genetically obese rodents, but it is not known if NO is involved in the development of diet-induced obesity (DIO). We therefore measured changes in hypothalamic neuronal NOS (nNOS) in DIO and investigated effects of peripheral and central inhibition of NOS in this model. Expression of nNOS in relation to changes in nutritional state was measured by immunohistochemistry, with radiochemical detection. The effect of chronic intraperitoneal (i.p.) administration of the NOS inhibitor N(G)-nitro-L-arginine methyl ester (L-NAME, 50 mg/kg/day) on energy intake, bodyweight and hypothalamic nitric oxide content was assessed in both chow-fed and DIO animals. Twenty-four hour energy intake after acute intracerebroventricular (i.c.v.) of L-NAME was also measured. Diet-induced obese animals had a statistically significant 32% reduction in the number of nNOS-immunolabelled cells in the ventromedial hypothalamus compared to chow-fed controls. Intraperitoneal administration of L-NAME decreased hypothalamic NO content in both chow-fed and DIO. Energy intake was reduced by 16% in DIO over 16 days, whereas energy intake was only reduced by 11% in chow-fed animals, although both were statistically significant. L-NAME significantly reduced body weight gain in DIO but not in chow-fed rats. L-NAME administered i.c.v. decreased 24 h energy intake to a greater extent in DIO rats, by 18%, compared with a 10% reduction in chow-fed rats. Ventromedial hypothalamic expression of nNOS is sensitive to changes in nutritional state. Despite having reduced nNOS, dietary obese rats were more sensitive to the effects of NOS inhibition than lean controls, suggesting a role for NO in the development of hyperphagia and obesity in rats fed a palatable diet.

Analysis of Variance↗

PubMed1995

Daily energy metabolism in patients with type 1 diabetes mellitus.

OBJECTIVE: We evaluated the daily energy balance and main substrate utilization in Type 1 insulin dependent diabetic patients and healthy volunteers. METHODS: Ten patients with Type 1 diabetes mellitus and eight healthy volunteers were studied. Diabetic patients were well controlled under intensive insulin treatment (0.6 UI/kg body weight, HbA1c = 5.5 +/- 0.7%). During the 30 hours each subject spent in the respiration chamber VO2, VCO2, respiratory quotient, daily energy intake, 24-hour, day-time, night-time and basal energy expenditure as well as energy expenditure during exercise (at 40% maximal exercise capacity), main substrate oxidation (carbohydrates, lipids and proteins) and overall diet-induced thermogenesis, were measured. The results were corrected for 24-hour urinary nitrogen loss. RESULTS: Diet-induced thermogenesis, expressed as percent of energy intake, was found to be significantly lower in diabetic patients than in control subjects (6.69 +/- 1.29% vs 11.8 +/- 4.71% of energy intake, p < 0.05). A negative correlation was found between diet-induced thermogenesis and daily average glycemia for diabetic patients (r = -0.65, p < 0.01). Energy expenditure during exercise, calculated in terms of net work efficiency, was not different between the two groups. CONCLUSIONS: In conclusion, since diet-induced thermogenesis is highly correlated with the theoretical cost of glucose storage and since no difference was found in carbohydrate oxidation, glucose storage in diabetic patients is probably reduced when hyperglycemia occurs. Diabetic patients in good metabolic control are able to perform mild exercise with a work efficiency very similar to that of control subjects.

Adult↗

PubMed1994

Energy requirements of adult female beagles.

The energy requirements of 19 intact adult female beagles were determined over a 60-wk period. The initial age of the dogs averaged 6.5 y (range 0.8-13.4) and the initial weight averaged 11.0 kg (range 8.7-13.7). Dogs were housed in groups of four in heated indoor-outdoor kennel runs. Dogs were fed daily a commercial dry dog food that contained 13.8 kJ/g. The amount offered was adjusted to maintain body weight. Daily energy intake ranged from 2227 to 3667 kJ/dog, with an average of 3061 kJ/dog. When adjusted for differences in body weight, average daily energy intake ranged from 482.6 to 803.1 kJ/kg body weight0.67 with a mean of 617.5 kJ/kg0.67. Energy intake (kJ/kg body weight0.67) declined with age and could be described by the nonlinear equation Y = 753 x age-0.1321; r = -0.802. When these data are combined with an earlier study, the energy intake (kJ/kg body weight0.67) of this group of 36 dogs could be described by the equation Y = 767 x age-0.1408; r = -0.777. These data demonstrate that canine energy requirements decline with age and that the National Research Council recommendations of 552 kJ/kg body weight0.75 overestimates the requirements of adult dogs 3 y of age and older.

Aging↗

PubMed1990

Sympathoadrenal activity and hypoglycemia in the hibernating garden dormouse.

The hibernating garden dormouse is spontaneously hypophagic during the prehibernating period at which time we found a low peripheral sympathetic activity (S.A.). The aim of this work was to investigate the link between dietary intake and S.A. The S.A. was evaluated by measurement of catecholamines in both plasma and adrenal glands by HPLC. Food intake, body weight, energy expenditure and plasma glucose were measured during the reentry phase of the hibernating period. The following results were obtained: the energy intake in pretorpid animals (55 to 83 kJ/24 h/100 g body weight) was less than energy expenditure which was between 145 and 97 kJ/24 h/100 g. The energy deficit induces marked hypoglycemia immediately before the onset of hypothermia (117 mg/dl vs. 76 mg/dl) and leads to a drastic drop in the peripheral sympathetic system. This, in turn, reduced energy production, causing the hypothermia.

Adrenal Glands↗

PubMed2005

Appetite sensations as a marker of overall intake.

The aim of this study was to evaluate the clinical utility of appetite sensations to characterize individual overall energy intake. A group of men (n 28) and women (n 23) was recruited to record their 'desire to eat', 'hunger', 'fullness' and 'prospective food consumption' (PFC) on visual analogue scales before a standardized meal test, immediately after and every 10 min for a period of 1 h after the meal. The 1 h post-meal area under the curve (1 h AUC) and the satiety quotient (SQ) were calculated for all appetite sensations. In a second visit, all participants were invited to eat three meals in order to measure total energy intake (TEI) and food preferences. Metabolic rate (MR) was also assessed to derive daily relative energy intake (REI) by subtracting this variable from TEI (TEI-MR=REI). The Three-Factor Eating Questionnaire scores were also calculated for all participants. One h AUC for fullness was the appetite sensation most strongly associated with TEI and REI (r-0.42, P< or =0.003 and r-0.32, P< or =0.05, respectively). SQ for fullness was the only predictor of TEI and REI (r-0.42, P< or =0.0003 and r-0.30, P< or =0.05, respectively). Restraint, disinhibition and hunger scores were not associated with appetite sensation variables. These results suggest that the fullness dimension seems to be a useful appetite sensation to predict long-term TEI and REI. Thus, assessment of appetite sensation such as fullness in response to a fixed load may be useful to evaluate individual overall energy intake.

Adult↗

PubMed2004

Quantitative analysis of the energy requirements for development of obesity.

OBJECTIVE: Obesity is typically developed over long time and reflected in an energy imbalance, which is too small to be measured and controlled. Our objective is to formulate a mathematical model for the relation between the change in body mass and the values of the energy intake and the energy expenditure, controlled by the physical activity factor PAF. DATA AND THEORY: The uncontrolled components of energy expenditure increases as result of body mass increase: expenditure of a larger mass and expenditure to convert matter in intake into tissue. Both contributions depend on the fraction of fat in the added tissue. Based on data from the literature, the fraction of fat in added tissue and the energy required to convert energy into tissue are estimated and included in the model. RESULTS: Application of the theory shows that an increase in body mass of 1 kg/year corresponds to an energy imbalance of 71 kJ/d for men. Of this imbalance, 82% are stored as new tissue, while 18% are used for energy conversion. If a man in steady state changes energy intake by 0.1 MJ/d, keeping the physical activity factor constant, then the corresponding increase in steady-state body mass is 1.77 kg/PAF, and it will take 320/PAF days before half the change of body mass has taken place. A typical value for PAF is 1.8. CONCLUSION: Energy-based theoretical relations between the various factors involved in energy balance help identifying and quantifying the components of the energy balance and understanding their relations during development of obesity. The inclusion of increased energy expenditure to convert food energy to tissue changes previous estimates of the energy imbalance by about 20 percent.

Animals↗

PubMed2003

Minireview: nutrient sensing and the regulation of insulin action and energy balance.

Obesity is the result of an imbalance between energy intake and energy expenditure. Under most circumstances, the increased availability of nutrients is tightly coupled with nutrient-sensing mechanisms that in turn activate appropriate behavioral and metabolic responses. The latter responses include decreases in food intake and the production of endogenous nutrients and increased expenditure of energy. The availability of nutrients can be sensed at central sites (mostly in the hypothalamus) or directly in peripheral tissues such as skeletal muscle and fat. The hypothalamus links the sensing of nutrients to the control of metabolism and feeding behavior. Here, we discuss how two central and peripheral nutrient-sensing mechanisms participate in this complex feedback system.

Animals↗

PubMed1999

The appetizing effect of an apéritif in overweight and normal-weight humans.

BACKGROUND: Epidemiologic studies have shown alcohol consumption to be inversely as well as positively related to body weight and body fat. Metabolic studies have shown an increase in energy intake as well as compensation after alcohol consumption. OBJECTIVE: Our objective was to assess the effects on energy intake of an apéritif compared with those of a water appetizer and 3 fruit juice appetizers. DESIGN: Fifty-two men and women aged 20-45 y with a body mass index (in kg/m2) between 20 and 32 were randomly given 1 MJ (340 mL) alcohol (wine or beer), fat (cream fruit juice), protein (protein fruit juice), carbohydrate (grape juice), or water, or no preload 30 min before an ad libitum lunch consumed from the universal eating monitor. RESULTS: Energy intake (3.5+/-0.3 MJ compared with 2.7+/-0.2 MJ, P < 0.001) and eating rate were higher (44+/-3 g/min compared with 38+/-3 g/min, P < 0.01), meal duration was longer (14 min compared with 12.0 min, P < 0.01), satiation started to increase later (3.5 min compared with 1.5 min, P < 0.01), and eating was prolonged after maximum satiation (2.5 min compared with 0.6 min, P < 0.01) after an apéritif than after a fat, protein, or carbohydrate appetizer,. Twenty-four-hour energy intake was higher on a day that an apéritif was consumed than after water or no preload. CONCLUSION: Twenty-four-hour energy intake was elevated with a 1-MJ apéritif but not with a 1-MJ liquid carbohydrate, fat, or protein appetizer.

Adult↗

PubMed1990

Formulas for older infants.

We explored the possibility that standard infant formulas designed as the sole source of nutrients for small, rapidly growing infants may not be equally suitable for older, larger, and less rapidly growing infants who obtain a portion of energy intake from beikost. Our approach was to consider the probable nutrient intakes of a 6-month-old hypothetic infant receiving 80% of energy intake from a standard formula and 20% from beikost, and nutrient intakes of a 10-month-old hypothetic infant receiving 50% of energy intake from a standard formula and 50% from beikost. The assortment of beikost items consumed by infants is moderately high in protein and low in fat. Calculated nutrient intakes of the 10-month-old hypothetic infant were compared with intakes of infants of similar age in two national surveys. We conclude that standard infant formulas designed for young infants are reasonably well suited to meeting the nutrient needs of infants during the latter half of the first year of life.

Aging↗

PubMed2002

Dietary intake, resting energy expenditure, weight loss and survival in cancer patients.

Anorexia, hypermetabolism and weight loss are common in advanced cancer. The progressive wasting may be due to diminished dietary intake as well as to increased energy expenditure mediated by metabolic alterations caused by the tumor. We studied dietary intake, resting energy expenditure and weight loss in 297 patients with generalized malignant disease and their relation to survival. Patients were examined cross-sectionally at entry into an outpatient palliative care program that included anti-inflammatory treatment and nutritional counseling. Survivors were studied longitudinally after 4 mo during palliative care. We found at entry that the patients' mean dietary intake was low. Weight loss of >10% was present in 43% of the patients, and hypermetabolism was present in 48%. Dietary intake did not differ between normometabolic and hypermetabolic patients, nor was tumor type or gender related to energy and protein intake. Weight loss could not be accounted for by diminished dietary intake alone. Increased resting energy expenditure was not compensated for by an increase in spontaneous food intake. These findings indicate that feedback regulation of dietary intake in relation to energy expenditure is frequently lost in patients with cancer. Hypermetabolism and weight loss were significant predictors of decreased survival. Mean survival time was about 8 mo; 189 patients survived 4 mo or more, and 153 could be reexamined. At the 4-mo follow-up during palliative care, group mean weight was nearly maintained, with large individual variations. Weight loss during follow-up predicted decreased survival. Energy intake increased slightly, also with great variation, and an increased energy intake predicted longer survival.

Cross-Sectional Studies↗