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Modulation of chemical toxicity by modification of caloric intake.

Caloric restriction increases maximum achievable lifespan and offsets the time to development of degenerative disease. Part of these desirable effects may result from positive modulation of toxic events. We have shown that when rodents are placed on a diet that is reduced in total calories by 40%, several beneficial changes on biochemical systems which impact on toxicologic processes are positively enhanced. Lipid metabolism is reduced and, therefore, the potential for lipoperoxidation is reduced. Additionally, activity of enzymes that produce free radicals as byproducts (cytochrome P4502C11) are also reduced. Concurrently, we have shown that the "effective" activity of catalase and the activity of superoxide dismutase (which are required for the detoxification of toxic oxygen radicals) are significantly increased by caloric restriction. The activities of enzymes of drug and xenobiotic metabolism are also altered by caloric restriction. The effect upon activity may be to either decrease or increase activity, dependent upon whether the enzyme activates compounds to intermediates which may be more toxic or whether the enzyme acts to reduce toxicity. We have also shown that caloric restriction may affect the initiation stage of carcinogenesis. Aflatoxin B1 binding to hepatic nuclear DNA was reduced by caloric restriction (caloric restriction reduced both major adducts that are formed upon exposure to aflatoxin B1). caloric restriction also reduced cytochrome P4502C11 which converts aflatoxin B1 to its toxic epoxide, and may partly explain the reduction in binding. These results suggest that caloric restriction may, in part, extend the time to development of degenerative disease by altering basic biochemical mechanisms of toxicity.

Animals

Caloric intake necessary for weight maintenance in anorexia nervosa: nonbulimics require greater caloric intake than bulimics.

In the past decade, patients with anorexia nervosa have been subdivided by the presence or absence of binging-and-purging behavior. Psychologic, physiologic, and premorbid weight differences have also been discovered between these subgroups. We now report that nonbulimic anorectics required 30-50% more caloric intake than bulimic anorectics to maintain a stable weight. This difference in caloric intake was independent of phase of illness; it was present at low weight and at intervals after weight restoration. Subjects were closely supervised on an inpatient hospital ward so that they could not binge or purge. Motor activity did not appear to explain these alterations in caloric requirements. Such differences in caloric intake could be trait related or a consequence of many years of starving or binging behavior. These findings are clinically relevant for advising eating disorder patients of caloric requirements necessary to maintain a normal weight.

Adult

Diagnosis of Gilbert's syndrome: role of reduced caloric intake test.

Reduction in caloric intake to 400 a day for 72 hours resulted in a significant increase in the plasma bilirubin concentration in patients with Gilbert's syndrome and in normal subjects. This was due to an increase in unconjugated pigment. There was no significant increase in the bilirubin concentration in patients with liver disease or haemolytic anaemia.The increase in unconjugated bilirubin was signficantly greater in Gilbert's syndrome than in normals but only when the initial bilirubin concentration was raised. It was usually seen within 24 hours of reducing the caloric intake. An increase of 100% or more suggests that unconjugated hyperbilirubinaemia is due to Gilbert's syndrome. In the normal subjects the unconjugated bilirubin level did not exceed 1.0 mg/100 ml.The increase in unconjugated bilirubin concentration on reducing the caloric intake may be due to decreased hepatic bilirubin uridine diphosphate glucuronyl transferase activity, which was shown to be present in seven rats starved for 72 hours. The effect of a 400 calorie diet for 24 hours on the unconjugated bilirubin level may distinguish Gilbert's syndrome from other causes of unconjugated hyperbilirubinaemia.

Anemia, Hemolytic

An assessment of caloric intake as an indicator of physical activity.

Caloric intake has been suggested as a surrogate measure of physical activity, provided that energy balance is maintained. In this study we assessed caloric intake in relation to other measures of physical activity in a free-living population by a single 24-hr recall in white adult males, ages 22-79 years, examined in 1957-1960 as part of the U.S. Railroad Study. Intake was positively related to leisure time and occupational activity. Men with higher levels of caloric intake had lower exercise test heart rates indicating that they were probably more fit. Caloric intake was also significantly and inversely related to body mass index, the sum of the triceps and subscapular skinfold thickness measurements, blood pressure, and total serum cholesterol. These results suggest that caloric intake, even as measured in a 24-hr dietary recall, is an indicator of physical activity level. Therefore, caloric intake may be a useful indicator of physical activity in some population-based epidemiologic studies.

Adult

Metabolic effects of increased caloric intake in man.

In order to determine if increased caloric intake could be responsible for the insulin resistance and elevated plasma glucose, insulin, and triglyceride levels commonly associated with obesity, hypercaloric diets were fed for 3 wk to eight normal subjects, and the metabolic consequences of this diet were assessed before significant weight gain had occurred. One wk of increased caloric intake led to statistically significant increases in fasting plasma insulin (22 per cent), glucose (5 per cent), and triglyceride (30 per cent) levels, as well as an increased insulin response (20 per cent) to oral glucose. Since the average weight gain during this period was only 1.6 kg, the observed changes appear to be secondary to increased caloric consumption, not obesity. Most of these changes returned toward baseline values during the succeeding 2 wk of increased caloric intake, but statistically significant elevations of fasting plasma glucose (10 per cent), insulin (8 per cent) and cholesterol (15 per cent) levels were still seen at the end of the hypercaloric dietary period. On the other hand, insulin resistance, as estimated by direct measurement of insulin responsiveness, did not change as a result of 3 wk of increased caloric intake. These results indicate that acute increases in caloric intake can lead to elevated plasma glucose, insulin, cholesterol, and triglyceride levels. These changes occurred before significant weight gain had taken place, and raised the possibility that at least some of the abnormalities of carbohydrate and lipid metabolism attributed to obesity may be due to increased caloric intake. However, this conclusion would not seem to apply to the insulin resistance associated with obesity, as 3 wk of increased caloric intake did not produce any change in the responsiveness of these subjects to insulin's action.

Adult

Effects of marihuana use on body weight and caloric intake in humans.

Body weight and caloric intake were measured in a group of heavy and casual marihuana users prior to, during and following 21 days of marihuana smoking under research ward conditions. A group of control subjects were studied under identical conditions, but they did not smoke marihuana. Both heavy and casual marihuana users had a significant increase in caloric intake and gained weight during the marihuana smoking period. Heavy and casual users gained an average of 3.7 and 2.8 lbs respectively during the first 5 days of marihuana smoking. In contrast, control subjects gained only a small amount of weight (0.2 lbs) during the same time interval. Water retention did not appear to be a major factor in weight gain by the marihuana users. These findings are in agreement with both anecdotal reports and previous experimental data that marihuana use is associated with increased caloric intake and weight gain.

Body Weight

Caloric intake, body weight, and cancer: a review.

The literature is reviewed for evidence concerning the relation between caloric intake, body weight, and cancer. Convincing experimental data regarding caloric intake and benign and malignant tumor incidence have been available since the 1940s and demonstrate that caloric restriction significantly reduces tumor incidence for a variety of tumor types in several animal models. Some epidemiological investigations provide evidence for a positive calorie-cancer association in humans, although it is difficult (in these studies) to separate the effects of calories per se from those of dietary fat. A larger number of investigations have evaluated body weight alone, and high relative body weight or high caloric intake has been associated with increased risk of cancer of the breast, colon, rectum, prostate, endometrium, kidney, cervix, ovary, thyroid, and gallbladder. In contrast, lung, bladder, and stomach cancers appear to be inversely associated with body weight, and some prospective studies of men demonstrate greater total cancer mortality among lean individuals. However, in their analyses, few of these latter investigations considered the effects of cigarette smoking, antecedent illness, or competing causes of death. While the relations between caloric intake, other dietary macronutrients (e.g., fat), and body weight are complex and require further investigation, a complete review of the data suggests that reducing caloric intake and relative body weight may lead to a considerable decrease in cancer risk in humans.

Animals

Nicotine's effects on female rats' body weight: caloric intake and physical activity.

Caloric intake and physical activity contribute to the inverse relationship between nicotine and body weight in male rats. In contrast, the relative contribution of these behavioral variables to the nicotine/body weight relationship in female rats has has not been investigated. Recent research indicates that males and females respond differently to nicotine. The present study was designed to determine the role of physical activity and food consumption in body weight changes associated with nicotine administration in female rats. Nicotine or saline was administered chronically to 24 female rats for 19 days. Body weight, food consumption, water consumption, and physical activity were measured before, during, and after nicotine administration. Body weight and food consumption decreased during and increased after nicotine administration. However, there were no changes in physical activity that could account for these changes in body weight. These results corroborate the report that males and females respond differently to nicotine.

Animals

Effects of smoking cessation on caloric intake and weight gain in an inpatient unit.

The present research was designed to assess the amount of weight gain that would occur when male smokers in an inpatient setting were deprived of cigarettes for 10 days, and to evaluate factors that could contribute to that weight gain, such as caloric intake and activity level. Subjects were 17 healthy male smokers who either smoked ad libitum (n = 8) or quit smoking (n = 9) for 10 days after a 3 day smoking baseline. Caloric intake, activity levels, and body weight were assessed daily. Abstainers gained more weight than did smokers and ate more over time. There were no group differences in activity level. An analysis of energy needs versus actual energy intake suggests that caloric intake accounted for a large percentage of the post-cessation weight gain. However, considerable individual variability exists in caloric intake after smoking cessation. In addition, the study found post-cessation increases in caloric intake that were quite similar to those found in studies with females, suggesting that gender may have little to do with overall post-cessation caloric intake. Further research assessing dietary and metabolic changes after smoking cessation in a larger sample of both males and females is needed so that the reasons for and implications of dietary variability can be evaluated.

Adolescent

Small intestine of artificially reared rat pups: effect of caloric intake and dietary composition on growth and disaccharidase activities.

When rats were fed a cow milk formula (CMF) from 12 to 16 days of age at a caloric intake sufficient to support a body weight gain equal to mother-fed (MF) rats, their small intestine outweighed that of MF rats by 40%. If the caloric intake was reduced by approximately 40%, artificially reared (AR) rats exhibited intestinal weights similar to MF rats, but their body weight was lower than MF rats. Sucrase specific activity was precociously increased in all AR rats; this increase was higher in rats with low caloric intake than rats with high caloric intake. Conversely, lactase specific activity was significantly decreased in the ileum of all AR rats. As compared to MF rats, the total lactase activity was significantly lower only in rats with low caloric intake. When AR rats were fed a modified Ross Carbohydrate-Free formula (RCF) containing the same caloric density of protein, fat, and carbohydrate as rat milk, the intestinal growth and disaccharidase activities were the same as those of AR rats fed CMF. It is concluded that the weight gain of small intestine depends on the caloric intake of AR rats and both CMF and RCF are nutritionally equal in supporting intestinal growth. Changes in sucrase and lactase activities in AR rats appear to have no relation to compositional differences in CMF and RCF.

Animals

Study of daily caloric intake of patients in the coronary intensive care unit.

A retrospective analysis of the caloric intake of patients in the coronary intensive care unit was undertaken after discovery of two cases of severe hypoglycemia. An unsuspected number of extremely low daily caloric intakes were found after careful analyses. The surviving group (50 patients) had less than 600 calories on 19.5% of the patient days and under 800 calories on 28.8% of patient days. In the nonsurviving group (29 patients) caloric intake was under 600 calories on 48.8% of patient days and under 200 calories on 22.7% of patient days. This study indicates the importance of monitoring actual caloric intake to avoid unrecognized extreme caloric deprivation and its possible complications.

Coronary Care Units

Caloric intake and activity levels are related in young children.

In this study the relationship between caloric intake and activity levels was examined in forty-three 18-month-old children. Caloric consumption was measured during a laboratory meal, and activity levels were assessed using an ambulatory monitor over a 24-hour period. Caloric intake was found to be significantly correlated with activity levels, such that children with a high caloric intake tended to have lower activity levels. This finding suggests that two risk factors influencing the development of obesity, caloric intake and physical activity levels, are likely to occur together in a subset of young children. A possible mechanism underlying this association is discussed.

Child Behavior

Resting energy expenditure, caloric intake, and short-term weight change in human immunodeficiency virus infection and the acquired immunodeficiency syndrome.

To assess the causes of short-term weight loss in patients with acquired immunodeficiency syndrome (AIDS), we measured resting energy expenditure (REE), caloric intake, and the 28-d weight trend in control subjects, human immunodeficiency virus (HIV)+ subjects, AIDS patients, and AIDS patients during secondary infection (AIDS-SI). REE was increased in HIV+ (11%), AIDS (25%), and AIDS-SI (29%). Caloric intake was similar in control subjects, HIV+, and AIDS but reduced 36% in AIDS-SI, who consumed 17% fewer calories than their REE. Average short-term weight was stable for HIV+ and AIDS but decreased 5% in AIDS-SI. Weight trend correlated with caloric intake but not with REE. Thus HIV+ and AIDS are able to partially compensate for increased REE because they do not show short-term weight loss. Decreased caloric intake is critical for short-term weight loss and is seen during secondary infection. Inability of decreased caloric intake to decrease REE during infection accelerates short-term weight loss. Rapid weight loss with anorexia may be a harbinger of secondary infection in AIDS.

Acquired Immunodeficiency Syndrome

Teaching self-management skills to cystic fibrosis patients and its effect on their caloric intake.

This study was undertaken to examine whether cystic fibrosis patients who received nutrition counseling based on self-management skills had an increased caloric intake and enhanced body mass index (kg/m2) values. Thirty-seven patients, aged 4 to 29 years, were placed on a nonrestricted nutrition program for a study period of 4 years. Bandura's self-management principles were applied in counseling patients to meet their nutrition needs. The results showed significant increases in energy intake and body mass index values (p less than .001). The mean energy intake increased from 93.6 +/- 16.9% of the Recommended Dietary Allowance to 125.8 +/- 24.1% of the RDA, and mean body mass index value increased from 16.9 +/- 2.3 to 18.8 +/- 2.5. Pulmonary functions remained unchanged during the counseling period. Four to six counseling sessions were required before the mean caloric intake of the patients increased to the desired goal of 115% of the RDA. During the remainder of the study period, the mean caloric intake rose to 125% of the RDA. The results of this study suggest that cystic fibrosis patients are able to increase their caloric intake significantly with counseling.

Adolescent

Obesity and caloric intake: the National Health and Nutrition Examination Survey of 1971-1975 (HANES I).

Most published studies have failed to show a greater food intake in obese subjects than in nonobese. However, the sample sizes in most of these studies are small and the methodologies open to question. HANES I is based on a probability sample of 20,749 people, representative of the civilian noninstitutional population of the U.S. We analyzed a subsample of 6219 nonpregnant adults whose diet was not influenced by illness or drugs and who stated that their intake, estimated by dietary interview, represented their usual pattern. Neither the caloric intake nor the caloric intake adjusted for physical activity level and age was higher in the obese subjects. This suggests that, unless estimates of food intake differ in accuracy between obese and nonobese subjects, factors other than overeating should be given increased consideration in the etiology of obesity.

Adult

[Caloric intake and weight gain according to the shift schedule of shift workers].

Survey involved 84 workers matched for age, socio-occupational and families status and divided into 3 groups : A : 27 shift workers on 3 days rotating shift, B : 47 shift workers on 5 days rotating shift, C : 20 days workers. Each subject was submitted to dietary survey by means of 24 hours recall, realised 3 times for shift workers and once for control. All workers were interviewed about caloric intake of the preceding day off caloric intake. Annual weight gain was studied through the use of occupational health service records. There was no significant difference between the 3 groups for working day caloric intake. Day-off intake was lower (p less than 0.05) in group A (day-off any day of the week). Annual weight gain was not different between the 3 groups. Shift workers with faster weight gain had a higher caloric intake on day-off and after evening meal.

Adult

Quantitative therapeutic plan for the treatment of obesity and a simple method for estimating appropriate caloric intake by using previous rate of weight loss.

We have formulated an equation for the calculation of the caloric intake in a reducing diet that is suited to individual obese patients. We have designed a system in which the weight loss achieved after the intake of a fixed number of calories over a given period is used as a basis for the next weight-reducing plan for a given patient. We devised the formula Y = X - 1000 (b2/a2-b1/a1) for calculating the daily caloric intake (Y). X is the previous caloric intake; b1 is achieved weight loss (kg) in the previous period (a1 weeks); and b2 is the planned reduction in weight in the subsequent target period (a2 weeks).

Energy Intake