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Energy expenditures & physical activity in rats with chronic suboptimal nutrition
Russell Rising, Fima Lifshitz
Nutrition & Metabolism , 2006, DOI: 10.1186/1743-7075-3-11
Abstract: Body weight gain was diminished (76.7 ± 12.0 and 61.6 ± 11.0 g) in rats fed 70 and 60% of the ad-libitum fed controls which gained more weight (148.5 ± 32.3 g). The rats fed 80% gained weight similarly to controls (136.3 ± 10.5 g). Percent Fat-free body mass was reduced (143.8 ± 8.7 and 142.0 ± 7.6 g) in rats fed 70 and 60% of ad-libitum, but not in those fed 80% (200.8 ± 17.5 g) as compared with controls (201.6 ± 33.4 g). Body fat (g) decreased in rats fed 80% (19.7 ± 5.3), 70% (15.3 ± 3.5) and 60% (9.6 ± 2.7) of ad-libitum in comparison to controls (26.0 ± 6.7). EE and PA were also altered by CSN. The control rats increased their EE and PA during the dark periods by 1.4 ± 0.8 and 1.7 ± 1.1 respectively, as compared with light the period; whereas CSN rats fed 80 and 70% of ad-libitum energy intake had reduced EE and PA during the dark periods as compared with the light period EE(7.5 ± 1.4 and 7.8 ± 0.6 vs. 9.0 ± 1.2 and 9.7 ± 0.8; p < 0.05, respectively), PA(3.1 ± 0.8 and 1.6 ± 0.4 vs. 4.1 ± 0.9 and 2.4 ± 0.4; p < 0.05) and RQ (0.87 ± 0.04 and 0.85 ± 0.5; vs. 0.95 ± 0.03 and 0.91 ± 0.05 p < 0.05). In contrast, both light (7.1 ± 1.4) and dark period (6.2 ± 1.0) EE and PA (3.4 ± 0.9 and 2.5 ± 0.5 respectively) were reduced in rats fed 60% of ad-libitum energy intake.CSN rats adapt to mild energy restriction by reducing body fat, EE and PA mainly during the dark period while growth proceeds and lean body mass is preserved. At higher levels of energy restrictions there is decreased growth, body fat and lean mass. Moreover EE and PA are also reduced during both light and dark periods.Suboptimal nutrition in children, due to a chronic reduction of energy/nutrient intake over a long period of time, causes a deceleration of growth accompanied by inadequate weight gain [1]. The deceleration of growth may be an adaptation mechanism to suboptimal nutrient intake that results in short stature [2,3]. Nutritional growth retardation is a hallmark of insufficient nutrient intake w
Endoscopist’s approach to nutrition in the patient with pancreatitis  [cached]
Shahzad Iqbal,Jay P Babich,James H Grendell,David M Friedel
World Journal of Gastrointestinal Endoscopy , 2012, DOI: 10.4253/wjge.v4.i12.526
Abstract: Nutritional therapy has an important role in the management of patient with severe acute pancreatitis. This article reviews the endoscopist’s approach to manage nutrition in such cases. Enteral feeding has been clearly validated as the preferred route of feeding, and should be started early on admission. Parenteral nutrition should be reserved for patients with contraindications to enteral feeding such as small bowel obstruction. Moreover, nasogastric feeding is safe and as effective as nasojejunal feeding. If a prolonged course of enteral feeding (> 30 d) is required, endoscopic placement of feeding gastrostomy or jejunostomy tubes should be considered.
Total Parenteral Nutrition : A Review  [cached]
Mrs. Rupali A. Patil,Dr. Parakh S.R.,Jagdale Swati C.
Pharmaceutical Reviews , 2005,
Abstract: "Parenteral" means administered any other way except by the mouth."Nutrition" means feeding."Parenteral nutrition" means feeding someone via their blood stream, "intravenously"."Total parenteral nutrition" ("TPN"), means feeding a patient solely rather than partly intravenously .Total parenteral nutrition (TPN), also called hyperalimentation, is the practice of feeding a person without using the gut. It is normally used during surgicalrecoveries. It has been used for patients in coma, although enteric (tube) feeding is usually adequate, and less prone to complications. Chronic TPN is occasionally used treat people suffering the extended consequences of an accident or surgery. Most controversially, TPN has extended the life of a small number of children born with nonexistent or severely birth-deformed guts. The oldest were eight years old in 2003.In TPN's simplest form, a bag of nutrients is added to a patient's intravenous drip.The preferred method of performing TPN is with a medical infusion pump. A sterile bag of nutrient solution, between 500ml and 4l is provided. The pump infuses a small amount (0.1 to 10ml/hr) continuously in order to keep the vein open. Feeding schedules vary, but one common regimen ramps up the nutrition over a few hours, levels off the rate for a few hours, and then ramps it down over a few more hours, in order to simulate a normal set of meal times .
Formation of Stylet Sheaths in āere (in air) from Eight Species of Phytophagous Hemipterans from Six Families (Suborders: Auchenorrhyncha and Sternorrhyncha)  [PDF]
J. Kent Morgan, Gary A. Luzio, El-Desouky Ammar, Wayne B. Hunter, David G. Hall, Robert G. Shatters Jr
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0062444
Abstract: Stylet sheath formation is a common feature among phytophagous hemipterans. These sheaths are considered essential to promote a successful feeding event. Stylet sheath compositions are largely unknown and their mode of solidification remains to be elucidated. This report demonstrates the formation and solidification of in āere (in air) produced stylet sheaths by six hemipteran families: Diaphorina citri (Psyllidae, Asian citrus psyllid), Aphis nerii (Aphididae, oleander/milkweed aphid), Toxoptera citricida (Aphididae, brown citrus aphid), Aphis gossypii (Aphididae, cotton melon aphid), Bemisia tabaci biotype B (Aleyrodidae, whitefly), Homalodisca vitripennis (Cicadellidae, glassy-winged sharpshooter), Ferrisia virgata (Pseudococcidae, striped mealybug), and Protopulvinaria pyriformis (Coccidae, pyriform scale). Examination of in āere produced stylet sheaths by confocal and scanning electron microscopy shows a common morphology of an initial flange laid down on the surface of the membrane followed by continuous hollow core structures with sequentially stacked hardened bulbous droplets. Single and multi-branched sheaths were common, whereas mealybug and scale insects typically produced multi-branched sheaths. Micrographs of the in āere formed flanges indicate flange sealing upon stylet bundle extraction in D. citri and the aphids, while the B. tabaci whitefly and H. vitripennis glassy-winged sharpshooter flanges remain unsealed. Structural similarity of in āere sheaths are apparent in stylet sheaths formed in planta, in artificial diets, or in water. The use of ‘Solvy’, a dissolvable membrane, for intact stylet sheath isolation is reported. These observations illustrate for the first time this mode of stylet sheath synthesis adding to the understanding of stylet sheath formation in phytophagous hemipterans and providing tools for future use in structural and compositional analysis.
Nutrition support to patients undergoing gastrointestinal surgery
Nicola Ward
Nutrition Journal , 2003, DOI: 10.1186/1475-2891-2-18
Abstract: Fears of postoperative ileus and the integrity of the newly constructed anastomosis have led to treatment typically entailing starvation with administration of intravenous fluids until the passage of flatus. However, it has since been shown that prompt postoperative enteral feeding is both effective and well tolerated. Enteral feeding is also associated with specific clinical benefits such as reduced incidence of postoperative infectious complications and an improved wound healing response. Further research is required to determine whether enteral nutrition is also associated with modulation of gut function.Studies have indicated that significant reductions in morbidity and mortality associated with perioperative Total Parenteral Nutrition (TPN) are limited to severely malnourished patients with gastrointestinal malignancy. Meta-analyses have shown that enteral nutrition is associated with fewer septic complications compared with parenteral feeding, reduced costs and a shorter hospital stay, so should be the preferred option whenever possible.Evidence to support pre-operative nutrition support is limited, but suggests that if malnourished individuals are adequately fed for at least 7–10 days preoperatively then surgical outcome can be improved.Ongoing research continues to explore the potential benefits of the action of glutamine on the gut and immune system for gastrointestinal surgery patients. To date it has been demonstrated that glutamine-enriched parenteral nutrition results in reduced length of stay and reduced costs in elective abdominal surgery patients. Further research is required to determine whether the routine supplementation of glutamine is warranted.A limitation for targeted nutritional support is the lack of a standardised, validated definition of nutritional depletion. This would enable nutrition support to be more readily targeted to those surgical patients most likely to derive significant clinical benefit in terms of improved post-operative outc
Nutrition-Related Practices and Attitudes of Kansas Skipped-Generation(s) Caregivers and Their Grandchildren  [PDF]
Mary Meck Higgins,Bethany J. Murray
Nutrients , 2010, DOI: 10.3390/nu2121188
Abstract: Despite growing numbers, the nutrition practices and attitudes of skipped?generation(s) kinship caregivers regarding feeding the dependent children in their care have not been examined. In this qualitative study, transcriptions of semi-structured interviews with 19 female and four male skipped-generation(s) Kansas caregivers (ages 47 to 80, 92% non-Hispanic whites, 83% female, 78% grandparents and 22% great-aunt or great?grandparent caregivers; caring for a range of one to four children, ages three to 18, for an average of nine years) were content analyzed for how their nutrition-related practices and attitudes had changed since parenting the first time. Sub-themes regarding practices included: being more nutrition and food safety conscious now, and shifting their child feeding style. The children seemed to be adversely affected by an on-the-go lifestyle and the use of more electronics. Caregivers described their sources for child feeding advice as being based mostly on information from their mothers, physicians, and their past parenting experiences. Sub-themes for attitudes included opinions that nutrition and safe food handling are important and that nutritious food is expensive. They preferred printed or video nutrition education materials and wanted to receive information through organizations they trusted. This population could benefit from education on: infant, child, adolescent, and sports nutrition; feeding “picky eaters”; healthful recipes, “fast foods” and packaged foods; quick, inexpensive meals and snacks low in fat, sugar, and salt; limiting sedentary time; family meals; using food thermometers; and intergenerational gardening and cooking.
Enteral Nutrition and Acute Pancreatitis: A Review  [PDF]
B. W. M. Spanier,M. J. Bruno,E. M. H. Mathus-Vliegen
Gastroenterology Research and Practice , 2011, DOI: 10.1155/2011/857949
Abstract: Introduction. In patients with acute pancreatitis (AP), nutritional support is required if normal food cannot be tolerated within several days. Enteral nutrition is preferred over parenteral nutrition. We reviewed the literature about enteral nutrition in AP. Methods. A MEDLINE search of the English language literature between 1999–2009. Results. Nasogastric tube feeding appears to be safe and well tolerated in the majority of patients with severe AP, rendering the concept of pancreatic rest less probable. Enteral nutrition has a beneficial influence on the outcome of AP and should probably be initiated as early as possible (within 48 hours). Supplementation of enteral formulas with glutamine or prebiotics and probiotics cannot routinely be recommended. Conclusions. Nutrition therapy in patients with AP emerged from supportive adjunctive therapy to a proactive primary intervention. Large multicentre studies are needed to confirm the safety and effectiveness of nasogastric feeding and to investigate the role of early nutrition support. 1. Introduction Acute pancreatitis (AP) ranges from a mild and self-limiting disease (80%), which usually resolves spontaneously within days, to a rapidly progressive fulminant illness with significant morbidity and mortality [1, 2]. The two most common etiological factors, representing more than 80% of cases, are gallstones and alcohol abuse [1, 3]. The clinical course of an attack of AP varies from a short period of hospitalization with supportive care to prolonged hospitalization and admittance to an Intensive Care Unit (ICU) because of the development of systemic inflammatory response syndrome (SIRS), multiorgan failure (MOF), and septic complications. Overall, in about 15% to 20% of patients, AP progresses to a severe illness with a prolonged disease course. These severely ill patients may develop organ failure and/or local complications such as pancreatic necrosis. In patients with necrotizing pancreatitis, the mortality is close to 17%, with a mortality of 12% in the case of sterile necrosis and up to 30% in infected necrosis [1]. Usually, the initial treatment of AP consists of a nil per os (NPO) regimen and the administration of analgesics and ample intravenous fluids [1, 2, 4]. The rationale for a period without food intake is the assumption that pancreatic stimulation by enteral feeding may aggravate pancreatic inflammation. The validity of this concept of “pancreatic rest” is heavily debated [5–7]. Moreover, many patients are anorectic and may suffer increasing pain sensations when eating and ileus-related
Nutrition education to improve dietary intake and micronutrient nutriture among children in less-resourced areas: a randomised controlled intervention in Kabarole district, western Uganda
M Kabahenda, RM Mullis, JG Erhardt, C Northrop-Clewes, SY Nickols
South African Journal of Clinical Nutrition , 2011,
Abstract: Objective: To determine whether nutrition education targeting the child-feeding practices of low-income rural caregivers will reduce anaemia and improve vitamin A nutriture of the young children in their care. Design: A controlled intervention trial, based on experiential learning theory. Forty-six women completed a nine-session nutrition education programme, while controls (n = 43) concurrently engaged in sewing classes. Setting: Two rural farming communities in the Kabarole district, western Uganda. Subjects: Less literate, low-income rural female caregivers and the children in their care (6-48 months). Outcome measures: Caregivers’ child-feeding practices and the children’s nutritional status were assessed at baseline, one month after intervention (Follow-up 1) and one year from baseline (Follow-up 2). Results: Caregivers in the intervention group reported improved child snacking patterns, food-selection practices, meal adequacy, and food variety. Children in the intervention group recorded lower haemoglobin levels at baseline (9.86 vs. 10.70 g/dl) and caught up with controls at Follow-up 1 (10.06 vs. 10.78 g/dl). However, changes were not sustained. Mean retinol-binding protein improved from 0.68 ìmol/l (95% CI: 0.57-0.78) to 0.91 ìmol/l (95% CI: 0.78-1.03) among intervention children, but remained approximately the same in controls. Vitamin A nutriture was influenced by infections. Conclusion: Nutrition education significantly improved feeding practices and children’s nutritional status. The effectiveness and sustainability of this programme can be enhanced if nutrition education is integrated into other food-production and public health programmes
Enteral Nutrition for Feeding Severely Underfed Patients with Anorexia Nervosa  [PDF]
Maria Gabriella Gentile
Nutrients , 2012, DOI: 10.3390/nu4091293
Abstract: Severe undernutrition nearly always leads to marked changes in body spaces (e.g., alterations of intra-extracellular water) and in body masses and composition (e.g., overall and compartmental stores of phosphate, potassium, and magnesium). In patients with severe undernutrition it is almost always necessary to use oral nutrition support and/or artificial nutrition, besides ordinary food; enteral nutrition should be a preferred route of feeding if there is a functional accessible gastrointestinal tract. Refeeding of severely malnourished patients represents two very complex and conflicting tasks: (1) to avoid “refeeding syndrome” caused by a too fast correction of malnutrition; (2) to avoid “underfeeding” caused by a too cautious rate of refeeding. The aim of this paper is to discuss the modality of refeeding severely underfed patients and to present our experience with the use of enteral tube feeding for gradual correction of very severe undernutrition whilst avoiding refeeding syndrome, in 10 patients aged 22 ± 11.4 years and with mean initial body mass index (BMI) of 11.2 ± 0.7 kg/m 2. The mean BMI increased from 11.2 ± 0.7 kg/m 2 to 17.3 ± 1.6 kg/m 2 and the mean body weight from 27.9 ± 3.3 to 43.0 ± 5.7 kg after 90 days of intensive in-patient treatment ( p < 0.0001). Caloric intake levels were established after measuring resting energy expenditure by indirect calorimetry, and nutritional support was performed with enteral feeding. Vitamins, phosphate, and potassium supplements were administered during refeeding. All patients achieved a significant modification of BMI; none developed refeeding syndrome. In conclusion, our findings show that, even in cases of extreme undernutrition, enteral feeding may be a well-tolerated way of feeding.
Enteral nutrition and surgical patient  [PDF]
Stamenkovi? Du?ica M.,Ba?i? Marica,Palibrk I.,Jankovi? Zorica
Acta Chirurgica Iugoslavica , 2003, DOI: 10.2298/aci0304109s
Abstract: Enterai nutrition can be applicated alone or in combination with, parenteral nutrition. Enterai feeding should be applicated as early as possible in preoperative preparation or in postoperative period in respect of contraindications and everyday evaluation of patients. Immunomodulatory substances like arginin, 3-o-fat acids, ribonucleic acid and glutamine are incorporated in "ready to use" solution for enterai feeding. Enterai feedings oral or via tubes are safe if some precautions are taken: like sitting position and control of feeding tubes position. Use of jejunostomy and promotility agents improved enterai feeding after major abdominal surgery and acute pancreatitis. Enterai feeding and immunonutrition improved postoperative course in reduction of hospital stay, incidence of postoperative complications especially infections. The aim of this review article is to validate pro and con for enterai nutrition in preoperative and postoperative course.
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