Human nutrition. Clinical nutrition最新文献

We have studied the within-person variability in the excretion of sodium, potassium, calcium, magnesium and creatinine in 20-60-year old men and women from 8 European centres. Only the data from people who reported that their collections were complete were entered in the analysis. The within-person coefficients of variation for the electrolytes ranged from 28 to 38 and that for creatinine from 21 to 24. The corresponding number of days required to estimate the excretion of electrolytes and creatinine to within 20 per cent of the habitual excretion (95 per cent confidence interval) varied between 4 for creatinine in men to 14 for magnesium in both men and women. The results of this study demonstrate once more that creatinine is unsuitable as a marker of completeness of urine collection for the individual.

Serum concentrations of 25(OH)D, 24,25(OH)2D, 1,25(OH)2D, total calcium, protein, phosphorus, magnesium and alkaline phosphatase were measured in two groups of Finnish women throughout pregnancy and in cord serum at delivery. The autumn group delivered in August-September and the spring group in February-March. There was strong seasonal variation in the 25(OH)D concentrations in both groups. Maternal values (mean +/- s.d.) at delivery were 44.3 +/- 20.8 nmol/l in autumn and 26.0 +/- 13.0 nmol/l in spring. Fetal concentrations were 28.8 +/- 14.3 and 18.3 +/- 11.3 nmol/l, respectively. In both mothers and infants low 25(OH)D values were measured in winter. In the autumn group 7 out of 21 mothers (33 per cent) and in the spring group 17 out of 36 mothers (47 per cent) had values below 17 nmol/l, which is the lowest winter reference value recorded in our laboratory. No significant seasonal variation was observed in dihydroxylated vitamin D metabolites, although 24,25(OH)2D values were a little higher in summer than in winter. Concentrations of 1,25(OH)2D tended to rise towards delivery. Corrected calcium, magnesium and phosphorus concentrations did not change during pregnancy. Fetal calcium and phosphorus concentrations were significantly (P less than 0.001) higher than maternal ones. The data indicate that many mothers and infants have poor vitamin D status in the latitude of Finland. Our results support the concept that vitamin D supplementation should be considered in Finland for pregnant women at least in winter.

Forty-eight children, aged 2-5 years, presenting with watery diarrhoea of less than 48 h duration at home prior to hospitalization, were admitted into a randomized controlled clinical trial, 24 children being treated during the first 24 h of admission with oral rehydration solution (ORS) alone and 24 children being given 'ORS plus boiled-rice feeding'. The latter group received boiled-rice to supply at least 55 kcal/kg/d (about 150 g boiled-rice per feed, given four times daily). Vibrio cholerae were isolated by stool culture on admission from all children. No antibiotics were given. Clinical characteristics of children in the two treatment groups were comparable. Among children given 'ORS plus boiled rice', there was a significant increase in volume of diarrhoea stools (P less than 0.05), duration of diarrhoea in hospital (P less than 0.01), and more frequent diarrhoea motions (not significant statistically). However, the children fed boiled rice absorbed and retained 176 ml more fluid, and had gain in body weight comparable to that observed in children who were not fed during the first 24 h of hospitalization.

Use of a 3 mm skin-biopsy punch results in skin plus an additional core of subcutaneous fat which is adequate for gas chromatographic analysis of fatty acids. This technique is quicker, cheaper and less traumatic than other methods of fat biopsy and is recommended for population surveys of diet where the pattern of fat intake is being investigated. It has been used in a survey for cardiovascular risk factors on some 3 000 subjects and has proved to be safe and acceptable.

Sixteen young non-obese men, seven of whom had an obese parent, were studied under standardized conditions in a respiration chamber to assess their metabolic rate during sleep, at rest, in response to food and during a variety of exercises. The men from obese families were already fatter than the 'normal' group from non-obese families but reported equivalent intakes of energy, had a normal pattern of energy expenditure and could not be distinguished as a group from the men of normal-weight parents. Only the three men of lighter weight of obese parents had a lower energy expenditure per kg fat-free mass and a lower thermic response to food than the normal group; those who were already overweight did not differ from the normal group in their energy expenditure.

An indirect calorimeter is described with which it is possible to make recordings of oxygen uptake, carbon dioxide production and respiratory quotient in one or two subjects simultaneously. The gas analysers sample expired air from the two patients and room air in a continuous cycle which lasts 15 min; a microcomputer is used to switch solenoid valves, read the gas analysers and output the results to a printer. A butane lamp is described which is made from components of a camping cooker. This can be used to simulate two patients, and enables the operator to check the function of the calorimeter quickly and inexpensively. If there is an error in the system the printout indicates whether the fault is likely to be a leak or an error in a gas analyser.

It has been suggested that patients with cystic fibrosis have abnormal immune responses to foods. We have measured IgE antibodies to inhalants and foods (by RAST) in 105 patients with cystic fibrosis aged between 8 months and 28 years. Serum IgE was elevated (greater than 180 kU/l) in 21 patients. In 43, IgE antibodies were detected in serum. The majority of positive results were with house-dust mite, grass pollen or Aspergillus. Only four of the patients had a positive RAST to a food--one to milk, one to wheat and two to egg. On the basis of high serum IgE or positive RAST results, 44.8 per cent of the patients were atopic and the frequency of atopy was age-related, being higher in patients aged 4 years or more. However, the presence of food antibodies was unrelated to age. This study confirms the high prevalence of atopy in patients with cystic fibrosis but unequivocally demonstrates that the presence of IgE antibodies to foods in their serum is rare.

The gastric emptying, expressed as the half-emptying time (T1/2) and mean transit time (MTT90), in 31 obese and 21 control women was studied using a radionuclide technique. No correlation between body weight and body surface area and gastric emptying rates could be found. T1/2 was slightly shorter and MTT90 faster in the obese women than in the controls. There is little chance that a subtle difference in gastric emptying is of any importance in the pathogenesis of obesity.

Food intake and nutritional status was studied in 67 patients, who had had a gastrectomy 2-30 years earlier, and in a randomly selected, matched group of healthy persons. The gastrectomized patients weighed less than the control persons (women 56.4 +/- 9.5 vs 61.4 +/- 6.9 kg; P less than 0.05; men 72.4 +/- 12.5 vs 77.7 +/- 9.2 kg; P less than 0.02). Compared to the controls the gastrectomized women had a significantly lower fat-free mass (37.8 +/- 4.1 vs 40.7 +/- 4.3 kg; P less than 0.02), whereas the gastrectomized men had a lower fat mass (17.0 +/- 7.8 vs 21.2 +/- 6.0 kg; P less than 0.01). The serum concentration of alkaline phosphatase was raised and the concentration of calcium, phosphorus and 25-hydroxycholecalciferol reduced in the gastrectomized group. None of these results could be explained from the nutritional study as both the intake of energy and protein and the intake of calcium and vitamin D was about the same in the operated and the healthy controls. The serum concentration of 25-hydroxycholecalciferol was significantly higher in the gastrectomized persons taking supplementary vitamin D (21.9 +/- 12.0 vs 11.7 +/- 6.5 ng/ml). A daily supplement of 10 micrograms of vitamin D secured normal serum values. As the serum level of 25-hydroxycholecalciferol is correlated to the degree of osteomalacia, all gastrectomized patients should have at least 10 micrograms vitamin D as a supplement once a day.

A randomized trial was carried out to test the effectiveness of nutrition education as a rehabilitation measure for childhood protein-energy malnutrition. The intervention comprised a series of home-based nutrition counselling sessions for the mothers/caretakers of 65 children (hospital outpatients) aged 7-36 months, who were suffering from mild to moderate protein-energy malnutrition. Both the intervention and control groups of children and their caretakers were assessed over a 12-month period: the children on admission and at 3-monthly intervals for weight-for-age, weight-for-height, height-for-age, triceps skinfold-for-age and clinical features; the caretakers on admission and at the final follow-up for nutrition knowledge. Although the nutrition knowledge score of the caretakers in the intervention group improved significantly, no significant differences developed between the two groups of children regarding any of the nutritional status measures assessed. Thus, nutrition education per se was not found to be a major factor in promoting recovery from malnutrition. Nevertheless, both groups of children showed highly significant improvements in all age-adjusted anthropometric assessments except height-for-age.