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Preoperative fasting for preventing perioperative complications in children.

BACKGROUND: Children, like adults, are required to fast before general anaesthesia with the aim of reducing the volume and acidity of their stomach contents. It is thought that fasting reduces the risk of regurgitation and aspiration of gastric contents during surgery. Recent developments have encouraged a shift from the standard 'nil-by-mouth-from-midnight' fasting policy to more relaxed regimens. Practice has been slow to change due to questions relating to the duration of a total fast, the type and amount of intake permitted. OBJECTIVES: To systematically assess the effects of different fasting regimens (duration, type and volume of permitted intake) and the impact on perioperative complications and patient wellbeing (aspiration, regurgitation, related morbidity, thirst, hunger, pain, comfort, behaviour, nausea and vomiting) in children. SEARCH STRATEGY: We searched Cochrane Wounds Group Specialised Register, the Cochrane Central Register of Controlled Trials, MEDLINE, CINAHL, the National Research Register, relevant conference proceedings and article reference lists and contacted experts. SELECTION CRITERIA: Randomised and quasi randomised controlled trials of preoperative fasting regimens for children were identified. DATA COLLECTION AND ANALYSIS: Data extraction and trial quality assessment was conducted independently by two authors. Trial authors were contacted for additional information including adverse events. MAIN RESULTS: Forty-three randomised controlled comparisons (from 23 trials) involving 2350 children considered to be at normal risk of regurgitation or aspiration during anaesthesia. Only one incidence of aspiration and regurgitation was reported. Children permitted fluids up to 120 minutes preoperatively were not found to experience higher gastric volumes or lower gastric pH values than those who fasted. The children permitted fluids were also less thirsty and hungry, better behaved and more comfortable than those who fasted. Clear fluids preoperatively did not result in a clinically important difference in the children's gastric volume or pH. Evidence relating to the preoperative intake of milk was sparse. The volume of fluid permitted during the preoperative period did not appear to impact on children's intraoperative gastric volume or pH contents. AUTHORS' CONCLUSIONS: There is no evidence that children who are not permitted oral fluids for more than six hours preoperatively benefit in terms of intraoperative gastric volume and pH over children permitted unlimited fluids up to two hours preoperatively. Children permitted fluids have a more comfortable preoperative experience in terms of thirst and hunger. This evidence applies only to children who are considered to be at normal risk of aspiration/regurgitation during anaesthesia.

Adolescent↗

Energy restriction early in life and colon carcinoma risk: results of The Netherlands Cohort Study after 7.3 years of follow-up.

BACKGROUND: This study evaluated the effects of severe undernutrition during adolescence and subsequent colon carcinoma risk. METHODS: The authors evaluated The Netherlands Cohort Study on Diet and Cancer (NLCS) among 62,573 women and 58,279 men aged 55-69 years at baseline. Information on diet and risk factors was collected by questionnaire in 1986. Additional information was collected concerning residence during the hunger winter (1944-1945), the World War II years (1940-1944), and father's employment status during the economic depression of 1932-1940, which were used as indicators of exposure. After 7.3 years of follow-up, 807 colon carcinoma cases (388 females and 419 males) were available for analysis. RESULTS: Multivariate analysis showed that both men and women who had lived in a western city in 1944-1945 had a decreased colon carcinoma risk (men: relative risk [RR] = 0.85, 95% confidence interval [CI] = 0.62-1.16; women: RR = 0.80, 95% CI = 0.59-1.09). No association between colon carcinoma risk and urban versus rural residence was found during the war years (1940-1944). Having an unemployed father during the economic depression (1932-1940) was also associated with a small decrease in colon carcinoma risk for men (RR = 0.90, 95% CI =0.62-1.31) and women (RR = 0.75, 95% CI 0.49-1.14). In subgroup analyses, a decreased colon carcinoma risk for men and women who were in their adolescent growth spurt and living in a western city during the hunger winter of 1944-1945 was noted (men: RR = 0.72, 95% CI = 0.31-1.65; women: RR = 0.88, 95% CI = 0.40-1.96). No associations were statistically significant because of the limited study size. CONCLUSIONS: In the current study, a weak inverse relation was found between energy restriction early in life and subsequent colon carcinoma risk for men and women. However, these findings need replication in a larger study.

Adolescent↗

Neuroanatomic deficits in congenital central hypoventilation syndrome.

Congenital Central Hypoventilation Syndrome (CCHS) patients exhibit compromised autonomic regulation, reduced breathing drive during sleep, diminished ventilatory responses to chemoreceptor stimulation, and diminished air hunger perception. The syndrome provides an opportunity to partition neural processes regulating breathing and cardiovascular action. No obvious lesions appear with conventional magnetic resonance imaging; however, T2 relaxometry procedures can detect reduced cell or fiber density or diminished myelination not found with routine evaluation. High-resolution T1, proton density, and T2-weighted brain images were collected from 12 patients and 28 age- and gender-matched controls. Voxel-by-voxel T2 maps were generated from the proton density and T2-weighted images and evaluated by voxel-based-relaxometry procedures. Normalized and smoothed T2 maps were compared between groups using analysis of covariance at each voxel, with age and ventricle size included as covariates. Patients showed damaged or maldeveloped tissue, principally right-sided, including white matter from the level of the anterior cingulate cortex caudally to the level of the posterior cingulate and laterally to the posterior superior temporal cortex. Portions of the posterior, mid, and anterior cingulate, as well as the internal capsule, putamen, and globus pallidus and basal forebrain extending to the anterior and medial thalamus were affected. Deficits in the cingulum bundle and mid-hippocampus and ventral prefrontal cortex appeared, as well as the right cerebellar cortex and deep nuclei. Neuroanatomic deficiencies in limbic structures suggest a structural basis for reduced air hunger perception, thermoregulatory and autonomic deficiencies in the syndrome, while cerebellar deficits may also contribute to breathing and cardiovascular dysregulation.

Adolescent↗

Heightened arousal in the 2-week-old rat: the importance of starvation.

The 2-week-old rat has frequently been reported to be hyperactive; however, the causes of this are disputed. In 3 experiments, with split-litter designs, the following possibilities were eliminated as causative factors: (a) body temperature; (b) nest seeking; and (c) maturation of peripheral sensory, motor, and endocrine systems. In contrast, the isolated 2-week-old rat, in a novel environment, was shown to be very reactive to hunger, however mild. Further, this was true whether the hunger was self-generated during a forced switch in diet or external origin due to food deprivation. These data are consistent with and supportive of the hypothesis that the 2-week-old rat does not have functionally-mature forebrain inhibitory structures with which to modulate arousal. Thus, even a mild arousal stimulus results in extreme hyperactivity. Further, these results, together with previously published results, suggest that the concurrence of isolation, starvation, and novelty of environment are necessary, but none of these alone is sufficient, for the 2-week-old rat to become hyperactive.

Age Factors↗

The effect of fasting on attentional biases for food and body shape/weight words in high and low Eating Disorder Inventory scorers.

OBJECTIVE: To assess attentional biases associated with food and body shape/weight words in fasted and nonfasted high and low Eating Disorder Inventory-2 (EDI-2) scorers. METHOD: Subjects were 56 female first-year undergraduate psychology students, aged 17-24 years, participating for course credit. High and low scorers on the Drive for Thinness and Body Dissatisfaction subscales of the EDI-2 completed alternative modified dot probe tasks containing food words, body shape/weight words, and control words, under fasted and nonfasted conditions. RESULTS: Fasting increased attentional bias toward high-calorie food words across all subjects. High EDI-2 scorers also showed an attentional bias toward low-calorie words, but only when nonfasted. DISCUSSION: Food-related attentional biases, commonly observed in eating disorder patients, may reflect a pervasive concern with food-related stimuli as opposed to being simply a product of chronic hunger. That is, with increasing hunger, high EDI-2 scorers shift their focus away from low-calorie foods to high-calorie foods. This result suggests an attentional bias basis for the cycle of high-calorie binging when hungry and low-calorie food selections when less hungry.

Adolescent↗

Associations among aspects of impulsivity and eating factors in a nonclinical sample.

OBJECTIVE: Impulsivity has been well documented as a factor in the behavior of eating-disordered populations and is likely to influence normal eating patterns as well. The current study attempted to clarify the relationship between the three elements of impulsivity (nonplanning, attentional, and motor) and the three factors of eating (cognitive restraint, disinhibition, and hunger) in a nonclinical sample. METHOD: Data were collected from a sample (N = 112) of volunteer participants from the community who answered two self-report instruments related to impulsivity (the Barratt Impulsiveness Scale, Version 11) and eating (the Eating Inventory). Partial correlations were performed on the data to control for age, sex, and education. Cognitive restraint did not correlate with any element of impulsivity. Disinhibition was positively correlated with both attentional impulsivity (r = .40, p < .001) and motor impulsivity (r = .32, p < .01). Attentional impulsivity was also positively correlated with hunger (r = .24, p < .05). DISCUSSION: The lack of association between cognitive restraint and impulsivity suggests that they are functionally distinct. Disinhibition is most closely associated with impulsivity, consistent with findings from clinical samples. Further clarification of the relationship between impulsivity and eating in nonclinical populations could facilitate a better understanding of the relationship between personality variables and normal eating behavior.

Adolescent↗

Predictors of weight maintenance.

OBJECTIVE: To obtain predictors of weight maintenance after a weight-loss intervention. RESEARCH METHODS AND PROCEDURES: An overall analysis of data from two-long intervention studies [n=67 women; age: 37.9+/-1.0 years; body weight (BW): 87.0+/-1.2 kg; body mass index: 32.1+/-0.5 kg.m(-2); % body fat: 42.4+/-0.5%]. Subjects were measured before a very low energy diet (month 0), after the very low energy diet of 2 months (month 2) and after a 14-month follow-up phase (at 16 months), in which fiber or a carbohydrate-containing food supplement was supplied. The baseline measurements and the changes in parameters induced by the diet intervention were used to predict the changes in BW in the follow-up phase [deltaBW(2-16)]. RESULTS: Multiple regression analysis revealed that 50% (p<0.001) of the variability in weight regain could be explained by physiological and behavioral factors. These were: frequency of previous dieting (r2=0.27, p<0.05), hunger score (measured with the three-factor eating behavior questionnaire), and change in 24-hour resting metabolic rate (RMR). Frequent dieters showed significantly more weight regain than less frequent dieters (8.8+/-1.0 kg vs. 5.1+/-0.8 kg, p<0.01). Subjects having parents with obesity regained almost significantly more weight than subjects with lean parents (8.5+/-0.2 kg vs. 5.1+/-1.5 kg, respectively; p = 0.06). DISCUSSION: Physiological (deltaRMR-24 hours) and behavioral factors (previous frequency of dieting and hunger score) predicted failure of weight maintenance and, as such, can be used to identify women who are at risk for weight regain.

Adult↗

Differences in begging behaviour between barn swallow, Hirundo rustica, nestlings.

Recent models of parent-offspring communication suggest that nestling begging reliably reflects food requirements, and therefore should increase with nestling need. Need may be affected by short-term variations in hunger, as well as by long-term factors such as relative size, growth rate and body condition. In the present study, the brood sizes of barn swallows were manipulated to create differences in nestling growth rate and body condition. The extent to which begging behaviour reflects these differences was tested. I measured begging behaviour by removing nestlings from the nest for three laboratory tests in which temporal variations in hunger were controlled, and four target nestlings (small and large, from small and large broods) were tested simultaneously. Small nestlings and nestlings from large broods had lower growth rates and poorer body condition than large nestlings and nestlings from small broods, respectively. Begging was positively correlated with both short- and long-term determinants of need. However, when nestlings grew older (second test), the trend was mixed, mainly because begging levels dropped in the neediest nestling category (small nestlings from large broods). After nestlings had been exchanged between broods for 24 h, small nestlings from large broods improved their growth rate and body condition, but still begged less than expected from their long-term need. The results suggest that nestling begging strategies vary with brood size and with nestling rank. However, these variations may reflect not only long-term need, but also nestling response to past experience or to variations in the cost and effectiveness of their begging efforts. Copyright 1998 The Association for the Study of Animal Behaviour. Copyright 1998 The Association for the Study of Animal Behaviour.

Journal Article↗

Effect of exercise and dietary restraint on energy intake of reduced-obese women.

Self-selected food intake of 15 reduced-obese women living in a metabolic ward was studied for 14 consecutive days to determine the effect of exercise and other metabolic and behavioral variables on energy intake. A choice of prepared food items were offered at breakfast, lunch and dinner, and a variety of additional food items were available continuously 24 h/day. Subjects performed either moderate intensity aerobic exercise (A-EX) (n = 8) expending 354 +/- 76 kcal/session or low intensity resistance weight training (R-EX)(n =7) expending 96 +/- kcal/session, 5 days/week. Mean energy intakes (kcal/day, +/- SEM) of the exercise groups were similar: 1867 +/- 275 for A-EX, 1889 +/- 294 for R-EX. Mean energy intakes of individuals ranged from 49 to 157% of the predetermined level required for weight maintenance. Resting metabolic rate per kg 0.75 and the Eating Inventory hunger score contributed significantly to the between subject variance in energy intake, whereas exercise energy expenditure did not. Regardless of exercise, eight women consistently restricted their energy intake (undereaters), and seven other consumed excess energy (overeaters). Overeaters were distinguished by higher Eating Inventory disinhibition (P = 0.023) and hunger (p = 0.004) scores. The overeaters' diet had a higher fat content 34 +/- 1% (p = 0.007). Also, overeaters took a larger percentage of their daily energy, than that of undereaters, 27 +/- 1 energy intake in the evening, 13 +/- 2%, compared to undereaters, 7 +/- 1% (p = 0.005). We conclude that the Eating Inventory is useful for identifying reduced-obese women at risk of overeating, and these individuals may benefit from dietary counseling aimed at reducing fat intake and evening snacking.

Adult↗

Effects of intragastric infusions of fat and carbohydrate on appetite ratings and food intake from a test meal.

Previous studies using meal preloads have indicated that carbohydrate has a greater satiating power than fat. To investigate the effects of macronutrients on ingestion and satiety, without the influence of meal design and orosensory factors, two groups of ten healthy, fasted male volunteers took part in two separate experiments involving rapid direct intragastric infusions of macronutrients. In the first experiment volunteers received isocaloric infusions of either Intralipid, or 1:1 Intralipid and glucose mixture or saline over 15 min on three separate occasions. In a second experiment volunteers received isocaloric infusions of either Intralipid or glucose. For both studies, appetite ratings were recorded for the first two hours of the study and energy and macronutrient intakes were evaluated from a test meal given 1.5 h after the infusion. Food diaries were used to monitor food intake for the remainder of the study day. In the first experiment, both Intralipid and the Intralipid/glucose mixture suppressed appetite ratings and reduced energy intake at lunch compared with saline but had no effect on energy intake during the remainder of the study day. No differences were found between nutrient conditions in suppressing appetite ratings or energy intake. In the second experiment there were no differences between the effects of Intralipid and glucose on hunger, fullness or on energy intake from the test meal or intake over the remainder of the day. Taken together, these results suggest that intragastric infusions of either Intralipid, glucose or a mixture of the two, reduced hunger and increased fullness, but they failed to confirm the hypothesis that different macronutrients have different satiating capacities.

Adolescent↗

Characteristics of eating in anger, fear, sadness and joy.

The influences of emotions on eating were investigated. One-hundred and seven female and 103 male subjects were asked to report how various characteristics of eating could change during the emotions of anger, fear, sadness and joy. Subjects completed a questionnaire of 33 items for each emotion and a food deprivation condition. A factor analysis of the items answered with respect to food deprivation yielded four factors which were labelled hunger, impulsive eating, sensory eating and hedonic eating. ANCOVAs showed main effects of emotions upon each factor. Single comparisons showed that: (1) subjects reported to experience higher levels of hunger during anger and joy than during fear and sadness; (2) impulsive eating and sensory eating were rated higher during anger than during the other emotions; and (3) hedonic eating was rated higher during joy than during the other emotions. Results did not indicate any differential influences upon eating between fear and sadness. Women reported to experience higher tendencies of impulsive eating and sensory eating than men during anger and sadness. Eating scores of negative emotions correlated low and positive with body mass index, low and negative with dietary restraint. The differential effects of emotions on characteristics of eating may be due to differences of the examined emotions in frequency of occurrence, physiological correlates and motivational properties.

Adult↗

A prospective controlled trial of early postoperative oral intake following major abdominal gynecologic surgery.

OBJECTIVE: The objective was to determine whether, when compared with traditional dietary advancement, early oral intake following major gynecologic surgery leads to a reduction in the length of hospitalization. METHODS: Patients undergoing major abdominal gynecologic surgery were invited to participate in this study. After informed consent was obtained, they were randomized to one of two groups. The control group (group 1) was treated traditionally. Oral intake was initiated only after documentation of bowel function, which was defined by two of the following three criteria: (1) bowel sounds; (2) flatus or bowel movement; and (3) subjective hunger. Those assigned to the study group (group 2) were given a clear liquid diet on postoperative day 1. Once 500 cc was tolerated, a regular diet was given. Patients were evaluated on a daily basis for bowel sounds, flatus, bowel movement, hunger, nausea, vomiting, and need for nasogastric tube decompression. The groups were compared with regard to length of hospital stay, length of postoperative ileus, and incidence of adverse effects including nausea, vomiting, and postoperative complications. Statistical analyses were performed with the Student t and chi 2 tests. RESULTS: The demographic characteristics of the control (N = 47) and study groups (N = 49) were similar, with no significant differences in underlying medical conditions, prior abdominal surgery, or diagnosis of a malignancy. The groups did not vary statistically in the number of subjects who required postoperative antiemetics or postoperative biscodyl suppository. There was a statistically significant reduction in the length of hospitalization for those patients on the early feeding regimen. The average length of stay for group 1 was 4.02 days +/- 0.30 (SEM), while that for group 2 was 3.12 days +/- 0.16 (P = 0.008). While there was a significantly higher incidence of emesis in the study population, this was not associated with any untoward outcome, and this group actually tolerated a solid diet nearly one full day earlier (2.72 days +/- 0.14 vs 1.88 days +/- 0.14, P < 0.0001). CONCLUSIONS: Early postoperative oral intake results in a decreased length of hospitalization and is well tolerated when compared with traditional dietary management in patients undergoing abdominal surgery on a university gynecologic oncology service.

Enteral Nutrition↗

Pharmacology of appetite suppression.

Despite a rising worldwide epidemic of obesity there is currently only a very small number of anti-obesity drugs available to manage the problem. Large numbers of differing pharmacological agents reliably produce a reduction in food intake when administered acutely to animals, and when administered chronically they result in a significant decrease in body mass. Behavioural analysis of drug-induced anorexia in animals demonstrates that various compounds profoundly effect feeding behaviour in differing ways. This indicates the variety of mechanisms by which pharmacological agents can induce changes in food intake, body weight and eventually body composition. Some of the same drugs produce decreases in food intake and weight loss in humans. Some of these drugs do so by modifying the functioning of the appetite system as measured by subjective changes in feelings of hunger and fullness (indices of satiety). Such drugs can be considered as "appetite suppressants" with clinical potential as anti-obesity agents. Other drugs induce changes in food intake and body weight through various physiological mechanisms inducing feelings of nausea or even by side effect related malaise. Of the drugs considered suitable candidates for appetite suppressants are agents which act via peripherally satiety peptide systems (such as CCK, Bombesin/GRP, Enterostatin and GLP-1), or alter the CNS levels of various hypothalamic neuropeptides (NPY, Galanin, Orexin and Melanocortins) or levels of the key CNS appetite monoamine neurotransmitters such as serotonin (5-HT) and noradrenaline (NA). Recently, the hormone leptin has been regarded as a hormonal signal linking adipose tissue status with a number of key central nervous system circuits. The peptide itself stimulates leptin receptors and it links with POMC and MC-4 receptors. These receptors may also provide drug targets for the control of appetite. Any changes induced by a potential appetite suppressant should be considered in terms of the (i) psychological experience and behavioural expression of appetite, (ii) metabolism and peripheral physiology, and (iii) functioning of CNS neural pathways. In humans, modulation of appetite may involve changes in total caloric consumption, subjective changes in feelings of hunger and fullness, preferences for specific food items, and general macronutrient preferences. These may be expressed behaviourally as changes in meal patterns, snacking behaviour and food choice. Within the next 20 years it is certain that clinicians will have a new range of anti-obesity compounds available to choose from. Such novel compounds may act on a single component of the appetite system or target a combination of these components detailed in this review. Such compounds used in combination with lifestyle changes and dietary intervention may be useful in dealing with the rising world epidemic of obesity.

Animals↗

Interaction effects of d-amphetamine treatment and ambient temperature on rat's food intake.

The "thermoregulatory theory of hunger" posits that rats placed in a cold environment should increase the amount of food intake, while rats placed in a hot environment should decrease their food intake. d-Amphetamine causes hyperthermia among rats kept at warm ambient temperature, and results in hypothermia among animals kept in a cold environment. d-Amphetamine-caused-hyperthermia should therefore result in decreased eating behavior, and d-amphetamine-caused hypothermia should result in increased eating behavior. One must take into account the fact that d-amphetamine is an anorexic drug. The interaction between (a) ambient temperature, (b) body temperature and (c) food intake were tested on groups of rats injected with various doses of d-amphetamine (1.5-15 mg/kg) and placed in ambient temperatures ranging from 4-37 degrees C. No increase in food intake was revealed under any dosage or temperature condition. The decrease in food intake found with d-amphetamine treated animals could not be explained in the "thermoregulatory theory of hunger". Our data indicate that d-amphetamine anorexic effects and thermal effects are mediated by different mechanisms.

Animals↗

Nicotine replacement: ten-week effects on tobacco withdrawal symptoms.

This study examined the long-term effects of nicotine replacement on tobacco withdrawal symptoms. Smokers (N = 40 community volunteers) maintained biologically validated smoking abstinence under closely monitored conditions while chewing 2 mg nicotine gum (Nicorette; average of 6.9 pieces per day) or placebo gum during the first 10 weeks following smoking cessation. During the first postcessation week symptoms of irritability, anxiety, impatience, restlessness, excessive hunger, difficulty concentrating, drowsiness, sleep disturbance and tobacco craving intensity were significantly lower in active as compared with placebo nicotine gum subjects. Symptoms of psychological distress including irritability, anxiety and impatience declined over time in placebo subjects and were suppressed by replacement therapy below placebo treatment levels only during the first 4-5 weeks after smoking cessation. On other items, most notably increased appetite and excessive eating, stable between-group differences persisted over the entire 10-week trial. The data suggest that use of active gum beyond the first 5 weeks post-cessation may be inconsequential as far as suppression of certain key symptoms of psychological disturbance is concerned, but more prolonged use of active gum would be advisable if the long-term nicotine replacement effects observed (e.g. decreased hunger) are relevant to smoking relapse prevention.

Adolescent↗

Time course of cigarette withdrawal symptoms while using nicotine gum.

Ratings of withdrawal symptoms were provided at weekly intervals by 147 smokers clinic clients who managed complete abstinence for 4 weeks. The ratings followed a similar temporal pattern regardless of amount of nicotine gum used. Irritability, depression, difficulty concentrating and restlessness peaked in the 1st week or two and returned to baseline by week 4. Hunger was more persistent. Craving was reported to be the most troublesome withdrawal symptom at first, although by the 4th week hunger was cited almost as often. Across all subjects, evenings were cited most often as the worst time of day for craving but among heavier smokers and those who used more nicotine gum mornings were considered worst.

Female↗

Changes in blood pressure, body weight and urinary catecholamines during austerities.

More than one hundred monks belonging to Nichirenshu, a major Buddhist sect in Japan, participated in the annual hundred days austerities during the winter. Cold water bathing, insufficient sleep, hunger and emotional impact are considered to be the major stressors experienced by the monks subjected to these austere regimes. This study was conducted to evaluate the endocrinological and physiological changes in twenty newcomer monks during the first four weeks of the austerities. The urinary concentration of noradrenaline (NOR) increased significantly during the first four weeks but not that of adrenaline (ADR). The changes in urinary concentration of ADR and NOR indicated the main stressors possibly to be low ambient temperature and hunger. NOR is thus probably a better indicator than ADR for evaluating stress under austere conditions. Blood pressure (BP) did not rise but the concentration of NOR was noted to increase. NOR may possibly be excreted in excessive amounts to maintain normal BP against hypotensive factors such as loss of body weight due to low calorie intake.

Adult↗

Biometeorology and animal protein production: the case of arid lands.

To meet the food demands of the ever-increasing world population, man's only major future land bank is the arid lands. However, their exploitation has been limited and constitutes a major challenge to many scientific disciplines. Under the present conditions of hunger and/or malnutrition, a large-scale expansion in food production is not to be expected. Hence, it is imperative that in any development programme for arid lands, malnutrition, in general, and a deficiency of animal proteins, in particular, should be considered. Major advancements have been made, but much remains to be learned and implemented. Improvement of native farm animals should be the first step in increasing the availability of animal proteins. This may be achieved by an educational programme to enhance management, housing, food intake, etc. Then a breeding programme selecting for high productivity can be pursued. After eliciting the maximum return from the present livestock, attention should be directed to domesticating wild ungulates and/or introducing highly productive temperature-zone breeds for upgrading the local animals. Additionally, new potential and unconventional sources of animal proteins must be explored. Aquaculture, in particular, has the potential of producing large quantities of lower-cost protein-rich food. Available evidence in arid regions of the developed countries, i.e. USA and Australia, promises favourable results in our efforts toward increasing the production of animal protein. By innovative methods and long-term planning, such successes can be adapted and transferred to other regions of the world, with the aim of gradually lessening the present state of malnutrition and hunger.

Animal Husbandry↗