Showing papers in "European Journal of Clinical Nutrition in 1990"

The LMS method for constructing normalized growth standards

Abstract: It is now common practice to express child growth status in the form of SD scores. The LMS method provides a way of obtaining normalized growth centile standards which simplifies this assessment, and which deals quite generally with skewness which may be present in the distribution of the measurement (eg height, weight, circumferences or skinfolds). It assumes that the data can be normalized by using a power transformation, which stretches one tail of the distribution and shrinks the other, removing the skewness. The optimal power to obtain normality is calculated for each of a series of age groups and the trend summarized by a smooth (L) curve. Trends in the mean (M) and coefficient of variation (S) are similarly smoothed. The resulting L, M and S curves contain the information to draw any centile curve, and to convert measurements (even extreme values) into exact SD scores. A table giving approximate standard errors for the smoothed centiles is provided. The method, which is illustrated with US girls' weight data, should prove useful both for the construction and application of growth standards.

Effect of fenugreek seeds on blood glucose and serum lipids in type I diabetes.

Abstract: The effect of fenugreek seeds (Trigonella foenum graecum) on blood glucose and the serum lipid profile was evaluated in insulin-dependent (Type I) diabetic patients. Isocaloric diets with and without fenugreek were each given randomly for 10 d. Defatted fenugreek seed powder (100 g), divided into two equal doses, was incorporated into the diet and served during lunch and dinner. The fenugreek diet significantly reduced fasting blood sugar and improved the glucose tolerance test. There was a 54 per cent reduction in 24-h urinary glucose excretion. Serum total cholesterol, LDL and VLDL cholesterol and triglycerides were also significantly reduced. The HDL cholesterol fraction, however, remained unchanged. These results indicate the usefulness of fenugreek seeds in the management of diabetes.

Could saponins be a useful treatment for hypercholesterolaemia

Abstract: Body mass index (BMI) is used widely as an index of fatness (the proportion of the body as fat) but its application to the low weight and stature populations in developing countries has not been established. As BMI is an indicator of size (the amounts of fat and fat free masses) as well as fatness, its relation to fatness and interpretation as a measure of energy stores may vary in different groups. Very low BMI reflects low fat and fat free mass, a state for greater concern than low fat mass alone, and possibly more typical of chronic energy deficiency.

Gastric emptying in infants with or without gastro-oesophageal reflux according to the type of milk.

Abstract: The present study was designed to determine the effects of milk composition and the influence of gastro-oesophageal reflux (GOR) on gastric emptying. Cineoesogastrocintigraphy (COGS) was performed in 201 infants between 0-1 year of age in order to detect GOR, and provided a means of estimation of the gastric emptying (GE). Ninety infants appeared free from GOR and constituted the control group; 111 had GOR. There infants were fed human milk or various standard formulae. In addition, 20 infants fed a whey-hydrolysate formula were tested. An appropriate volume of milk was marked with sulfur-colloid Tc (200 microcuries). Measurements of gastric radioactivity were made 30 min and 120 min after ingestion. For the whole population, the infants with GOR had slightly more rapid GE after 30 min (P less than 0.05), but, for the same type of milk, there was no significant difference between GOR and controls. GE did not differ with age or sex, but differed mainly according to the type of milk. In the control group, gastric residual content (GRC) at 120 min was 18 +/- 11 per cent with human milk (n = 7), 16 +/- 21 per cent with whey-hydrolysate formula (n = 8), 25 +/- 17 per cent with acidified formula (n = 13), 26 +/- 19 per cent with whey-predominant formula (n = 22), 39 +/- 17 per cent with casein-predominant formulae (n = 20), 47 +/- 19 per cent with follow-up formulae (n = 16) and 55 +/- 19 per cent with cow's milk (n = 12).(ABSTRACT TRUNCATED AT 250 WORDS)

Assessment of body composition by bioelectrical impedance in children and young adults is strongly age-dependent.

Abstract: Body composition was measured in a group of 246 children and young adults, ranging in age from 7 to 25 years, by means of densitometry, body impedance (R) and anthropometry. Body fat percentage and fat-free mass (FFM) were calculated from body density using age-specific calculation formulas. From body impedance, FFM and body height, the specific impedance of the body (rho = R*FFM/height) was calculated in which body impedance is corrected for differences in the shape of the conductor. From age 10 onwards the specific impedance was positively related with age until age 13 in girls and age 16 in boys, after which it stabilized in boys at a significantly higher level than in girls. Based on the relationship of the specific impedance with age and sex, three age groups could be defined in which the relation between FFM and body impedance was analysed: age group I, boys and girls younger than 10 years; age group II, boys aged 10-15 years, girls aged 10-12 years; age group III, boys 16 years and older, girls 13 years and older. The regression equation in age group I had the same slope as the sex-specific regression equations in age group III. The regression equation in age group II had a steeper slope compared to the regression equations in age group I and III. Thus the relationship between FFM and body impedance was found to be slightly S-shaped, being identical for boys and girls until age 13, after which sex differences became apparent. For the different age categories the best prediction formula for the FFM from body impedance, sex, age and anthropometric variables was calculated. The prediction error of the age-specific regression equations was lower than the prediction error of the regression equation for the entire population.

Evaluation of body fat estimated from body mass index, skinfolds and impedance. A comparative study.

Abstract: The purpose of the study was to cross-validate three different methods used in field studies for estimating body fat in a group of Danes (n = 139) aged 35-65 years with a wide range in body fat. On the first two-thirds of the participants (n = 93) multiple regressions equations were developed for body fat by means of height, weight, sex and age and either BMI, or by sum of four skinfolds or electrical impedance. A four-compartment-model based on measurements of both total body water (TBW) and potassium (TBK) was used as reference. On the remaining one-third of the subjects (n = 46) cross-validation of the developed equations was carried out. The multiple regression equation for impedance had higher R-square (R2 = 0.89) and lower residual error (SEE = 3.32 kg) than the multiple regression equations for skinfolds (R2 = 0.81, SEE = 3.91 kg) or body mass index (R2 = 0.85, SEE = 3.94 kg). The cross-validation study showed that all three simple methods give reliable average body fat estimates. The difference in estimates of body fat between the reference method and impedance, BMI and skinfolds was 0.76 kg, -0.64 kg and -0.21 kg respectively, none of these differences being different from zero. However, the variance of body fat estimated from BMI (4.84 kg) was higher than body fat estimated from impedance (4.36 kg) (P = 0.013). The multiple regression analysis further showed that measurements of skinfold do not seem to add significantly to the prediction of body fat if height and weight are included.(ABSTRACT TRUNCATED AT 250 WORDS)

Plasma antioxidants and coronary heart disease: vitamins C and E, and selenium

Abstract: The possibility of a relation between plasma antioxidants such as vitamins C and E and selenium, and mortality from coronary heart disease (CHD) was examined. A cross-sectional survey was undertaken of random population samples of apparently healthy middle-aged men in four European regions with differing mortalities from CHD [rate/100,000 for men aged 40-49]: north Karelia (eastern Finland) (n = 99) [212/100,000]; south-west Finland (n = 85) [146/100,000]; Scotland (n = 131) [140/100,000]; and south Italy (n = 80) [43/100,000]. Median (5th-95th percentile) plasma vitamin C concentrations were lower in Scotland: 18.2 (5.7-61.3) microM than in other regions: north Karelia 28.4 (6.2-85.2); south-west Finland 33.5 (5.7-76.6); south Italy 38.0 (10.2-69.8) microM (P less than 0.001). The median levels in the four areas did not however reflect the regional CHD mortality rates. Regional differences in plasma vitamin E levels were also observed: Scottish levels were low 20.0 (12.1-29.3) microM (P less than 0.001) and did not differ between the other areas: 23.0 (16.7-35.1), 22.5 (13.7-31.6) and 23.9 (15.6-41.3) microM respectively. The vitamin E gradient could be explained in part by differences in serum cholesterol. However, cholesterol-adjusted vitamin E levels were low in the three high CHD areas: Scotland 3.41 (2.41-4.62); north Karelia 3.53 (2.67-5.18); south-west Finland 3.53 (2.58-4.92); Italy 4.81 (3.25-5.99) mumol/mmol cholesterol (P less than 0.001). Cholesterol-adjusted vitamin E was not lower in north Karelia, the higher CHD mortality area in Finland. Serum selenium values also varied with the area examined and reported low levels in Finland were confirmed. Nevertheless, selenium levels did not correlate with the reported mortality rates of CHD. Thus in our small cross-cultural study the evidence did not support our hypothesis that plasma antioxidants explain regional differences in CHD mortality.

Is diarrhoea a major cause of malnutrition among the under-fives in developing countries? A review of available evidence.

Abstract: To evaluate whether, at the community level, diarrhoea is a major cause of malnutrition or inversely whether the association between diarrhoea and growth retardation can be explained by a higher susceptibility of malnourished children to diarrhoea, all recent studies examining the relationship between diarrhoea and malnutrition in the community were reviewed. It was determined, for each of these two hypotheses, to what extent four standard causality criteria were met, viz., (i) lack of temporal ambiguity, (ii) consistency of findings, (iii) strength of association and (iv) biological plausibility. That malnutrition predisposes to diarrhoea seems likely: this is supported by a series of studies which adequately fulfil the examined causality criteria and seems biologically plausible. On the other hand, it is not clear whether diarrhoea is a major cause of malnutrition. Some studies examine the effect of diarrhoea on nutritional status over short time intervals and it cannot be determined whether diarrhoea-induced growth faltering is transient or sustained. Other studies examining this effect over longer periods do not show clearly that diarrhoea precedes malnutrition. Inconsistencies between studies and lack of evidence supporting a biologically plausible mechanism also question the importance of diarrhoea as a cause of malnutrition.

Growth suppression in the Trichuris dysentery syndrome.

Abstract: The Trichuris Dysentery Syndrome (Ramsey, 1962) is an insidious, chronic condition which has clinical features similar to Crohn's ileocolitis and ulcerative colitis, diseases similarly associated with growth retardation. The attained heights and weights of 19 children at the time of diagnosis of intens, -2.4 Standard Deviation (Z) scores from the Tanner-Whitehouse median with weight, adjusted for height-age, -1.3 Z. We present data on the growth velocities of 11 of the children in the half-year following worm expulsion by mebendazole. These children returned to their home environments without food supplementation or close follow-up, but showed an average height velocity of +5.5 Z and weight velocity (for height-age) of +2.4 Z. Of 8 children with unequivocal height spurts only 3 had any weight spurt. We suggest that the pattern of catch-up growth points to the existence of some specific link between allergy or inflammation in the lower intestinal tract and suppression of linear growth, rather than to stunting due to general deprivation and undernutrition.

Seasonal energy deficiency in Ethiopian rural women.

Abstract: The purpose of the study was to establish the existence of seasonal exposure to energy deficiency in rural areas of developing countries and to investigate the sequence of appearance and the nature of energy-sparing mechanisms utilized under real life conditions. The body weight of a group of 226 rural Ethiopian women was measured repeatedly over a one year period, at 45 day intervals. On a sub-group of 22 non-pregnant women total energy intake, TEI, total energy expenditure, TEE, and basal metabolic rate, BMR were also measured by the precise weighing method and by indirect calorimetry (Kofranyi-Michaelis respirometer or Douglas bag) and activity diaries. Body weight was found to have a moderate but statistically significant seasonal trend, with an overall loss of 1.6 kg. Women with higher BMI had larger seasonal swings of their body weight. Seasonal fluctuations were also found for TEI (maximum difference 420 kcal/d, not significant), and for BMR (maximum difference 200 kcal/day, P less than 0.000). TEE (mean yearly value of 1909 kcal/d, 42 kcal/kg) was very stable over the year and did not show any seasonal fluctuation. The present findings suggest that, under the study circumstances, seasonal exposure to fluctuation in food availability caused a moderate weight loss which was sufficient to induce metabolic adaptations, but not to cause any detectable change in physical activity.

Differences in dietary intake associated with smoking status.

Abstract: This study was designed to identify and describe smoking-related differences in dietary and nutritional factors that are potential independent predictors of cancer risk or effect modifiers or confounders of tobacco-cancer relationships. Data were obtained from a large hospital-based case-control study which was designed to estimate the cancer risk from various tobacco products and consisted of 465 male and 300 female incident lung cancer cases and 870 male and 556 female hospitalized patient controls matched on sex and age (+/- 5 years). Nutritional data were analysed as log-transformed frequencies of thirty food items, nine factor scores generated to describe overall patterns of dietary intake, and estimated daily nutrient scores for fat, vitamin A, fibre, and cholesterol. In general, the dietary habits of ex-smokers more closely resembled those of never-smokers than those of current smokers. We found that after controlling for case-control status, education, alcohol consumption, and age, there were many more significant differences in nutritional exposures by smoking status than could be explained merely by chance. For both sexes we observed significantly increased consumption of fruits and higher vitamin A and fibre scores in non-smokers compared to current smokers (for any smoking vs non-smoking comparison the P-value was always less than 0.002, 0.01, and 0.007, respectively). A similar but weaker relationship was observed for high-fat, sweet foods such as ice cream. An inverse association, also of smaller magnitude, was found for other high-fat foods items. Implications for further study and strengths and weaknesses of the current study are discussed.

Resting and sleeping energy expenditure in the elderly.

Abstract: An estimate of a patient's energy needs is usually derived from equations, which predict energy expenditure (EE) by considering sex, age and body weight. Due to the increasing number of elderly people in a hospital population, more data on energy requirements in this age-group are needed. In this study resting energy expenditure (REE) of 40 healthy men and women, aged 51-82 years, was measured using a ventilated hood system. The results showed that some commonly used prediction equations underestimated REE by approximately 6 per cent. REE was highly correlated with fat free mass (FFM) (r = 0.88; P less than 0.001) and body weight (r = 0.85; P less than 0.001). A stepwise multiple regression analysis showed that the combination of body weight, sex and age resulted in the best prediction for REE; REE (kcal) = 1641 + 10.7 weight (kg)--9.0 age (years)--203 sex (1 = male, 2 = female) (r = 0.92). However, REE of an individual may be over- or underestimated by +/- 225 kcal (10-20 per cent) due to large between-subject variations. We suggest therefore that the energy requirements of elderly people should be measured rather than predicted. Due to small within-subject variations (including measurement error) a single REE measurement would suffice. Sleeping energy expenditure (SEE) was 7 per cent lower than REE.

Rice and iron absorption in man

Abstract: Several studies suggest that iron absorption is low from rice-based meals. Comparisons of the effect of rice starch and wheat starch on iron absorption showed that rice had no effect on absorption. Observed differences in effects on iron absorption between different batches of rice starch could be explained by differences in the phytate content. Phytate is always present in rice grains. The content varies markedly depending on the method of milling. In polished rice, the content of phytate-P varied between 11.5 and 66 mg/100 g rice (data from 45 rice mills in Thailand). The bioavailability of iron in a meal composed of meat, a vegetable and rice varied about threefold (22.1-7.5 per cent) depending on the different phytate content of the rice (4 levels between 30 and 175 mg phytate-P were studied). The inhibitory effect of the phytate in rice was overcome by adding different amounts of an ascorbic acid-rich vegetable (green collard) to the meals.

Weight change in middle-aged British men: implications for health.

Abstract: The relationship between weight change over a 5-year period and subsequent mortality during a further 4-year follow-up was examined in a prospective study of 7735 British middle-aged men. Over half of the men remained stable (less than 4 per cent change in body weight), 31 per cent gained weight and 14 per cent lost weight over 5 years. There were 357 deaths from all causes and men with stable weight had the lowest mortality rates. Considerable weight gain (greater than 15 per cent gain in body weight) was associated with an increased risk of cardiovascular (CVD) mortality even after adjustment for initial age, body mass index, blood cholesterol, systolic blood pressure and smoking status. Loss of weight was significantly associated with increased mortality largely due to cancer and other non-cardiovascular causes. The association between weight loss and cancer was more marked in non-obese men and emphasizes that weight loss is a potentially serious symptom. Weight loss to non-obese status was associated with a halving of cardiovascular mortality. The benefit was restricted to hypertensive obese men in whom the mortality reduction was considerable and significant. Considerable weight gain in later adult life, even over a short period of follow-up, is not a benign process, it is harmful to health.

Nutrients excreted in ileostomy effluents after consumption of mixed diets with beans or potatoes. II. Starch, dietary fibre and sugars.

Abstract: The extent of carbohydrate digestion and absorption from two diets including either instant bean flakes (174 g/d) or potato flakes (102 g/d) was measured in seven ileostomy subjects during a 2-day period. Test foods contributed 40 per cent of the total dietary starch intake (160 g/d), the remainder coming from rice and white bread. Overall, 4 per cent and 0.7 per cent of the dietary starch consumed remained unabsorbed during the bean and potato periods, respectively. Between 9.0 and 10.9 per cent of dietary bean starch and less than 1.7 per cent of potato starch were not absorbed. Dietary fibre and resistant starch were completely recovered in ileostomy effluents. In separate meal tests with 40 g starch, beans gave lower blood glucose (P less than 0.05) and serum insulin (P less than 0.01) responses than potatoes. Dietary starch malabsorption from leguminous foods is less than previously estimated and does not explain the attenuated glycaemic and insulinaemic responses.

Estimation of body composition by bioelectrical impedance in cancer patients.

Abstract: Measurement of body composition is important in the assessment of nutritional status in cancer patients. The purpose of this study was to validate the bioelectrical impedance (BI) method for body composition estimation in 33 elderly cancer patients (mean age 66 +/- 9 years) using the deuterium dilution technique (2H2O) as the reference method. Height2/Resistance (H2/R) correlated significantly with total body water (TBW) computed from 2H2O (r = 0.89, P less than 0.001; s.e.e. = 2.4 l). The prediction equation for TBW improved significantly (P less than 0.001) by addition of H2/R to the predictor variables weight, height, age and sex. We conclude that BI is a useful measure for the assessment of body composition in cancer patients.

The possible role of skeletal muscle in the adaptation to periods of energy deficiency.

Abstract: Skeletal muscle accounts for a large portion of the body's energy expenditure both at rest and during exercise. The present review focuses on some possible mechanisms for economizing energy in resting and contracting skeletal muscles, and on the available information about whether these mechanisms are important in the energy-deficient body. There is evidence, both in man and in the rat, that in a state of energy deficiency the size of slow-twitch fibres is better preserved than that of the fast-twitch fibres. Slow-twitch fibres have a lower activation threshold, and this seems to decrease their responsiveness to starvation. This would be advantageous as there is evidence that the energy expenditure per unit tension developed is lowest in slow-twitch fibres. There are reports of a slowing of malnourished muscle, but it is uncertain whether the starvation-induced hypothyroid state leads to some degree of fast-to-slow fibre transformation. Muscle glucose oxidation is depressed by starvation, mainly due to changes outside the muscle itself, but muscle enzymatic adaptations may also be important in this energy-saving process. In this respect, the higher capacity of the fatty acid oxidation and aerobic end-oxidation pathways in slow-twitch fibres tend to make them better adapted than fast-twitch fibres. Further muscle adaptations might include a decrease in BMR, possibly by reductions in protein turnover, ion pumping or futile cycling. The importance and costs of such potential adaptations should be evaluated by further research. This knowledge will be an important step in the further understanding of the pathophysiology of starvation.

Evaluation of near infra-red interactance as a method for predicting body composition.

Abstract: The ability of near infra-red interactance (NIRI) to predict body composition, as measured by whole-body densitometry, was assessed in a group of 29 healthy volunteers; 15 m, 14 f, aged 18-40 years, body mass index (BMI) 18.3-28.5 kg/m2. The results were compared with those obtained by five other predictive methods: whole-body impedance/resistance, skinfold thicknesses, and methods based on weight and height or BMI. The correlation between densitometry and the alternative methods, including NIRI, were found to be remarkably similar, both with respect to fat (r = 0.90-0.92, s.e.e. = 2.12-2.47 kg), and fat-free mass (r = 0.96-0.97, s.e.e. = 2.13-2.71 kg). Percentage body fat (densitometry) correlated better with the near infra-red measurements made in the biceps area than with those made in the triceps of thigh areas, or with a combination of measurements made at two or three sites. The 95 per cent limits of agreement between NIRI and densitometry for the estimation of body constituents were slightly greater than those between densitometry and the other methods. NIRI was also found to underestimate body fat increasingly as the degree of adiposity increased. This underestimation was found to be particularly marked (16 per cent body weight) in a small and separate group of grossly obese women, BMI > 50 kg/m2, whose body composition was assessed by total body potassium as well as by densitometry. This study suggests that, in the healthy group of subjects examined, NIRI has little or no advantage over other simple methods in predicting body composition measured by classical whole-body densitometry.

Bedside and field methods for assessing body composition: comparison with the deuterium dilution technique.

Abstract: Estimates of body composition by the deuterium dilution technique were made in 55 healthy subjects (38 men and 17 women) with a mean age of 28.4 years, weight 65.5 kg and height 173.7 cm (body mass index 16.9-29.4 kg/m2). The results were compared with estimates obtained in the same subjects by 5 bedside techniques (skinfold thickness, impedance, resistance and 2 equations predicting body composition from weight and height). The results of all the bedside predictive methods were found to differ significantly from those of the deuterium dilution method (P less than 0.001). The Holtain impedance method underestimated the fat-free mass (FFM) obtained by deuterium dilution (50.8 +/- 7.9 kg) by a mean difference (mean bias) of 4.1 kg while the other methods overestimated FFM (mean bias or mean difference of -1.3 to -2.4 kg). The resistance (Valhalla equations) and skinfold methods showed the narrowest 95 per cent limits of agreement, when compared with the deuterium dilution technique, while the weight and height equations showed the widest limits of agreement. It is concluded that in this population, the resistance (Valhalla equations) and the skinfold thickness methods were the best predictors of body composition as measured by deuterium dilution. Discrepancies between the bedside methods and deuterium dilution method may be due to (a) methodological or biological differences between the test population used in this study and the original population used to validate the method, (b) differences in the structure of the equations used to interpret the measured biological variables, such as impedance and resistance, and (c) the use of predictive equations that are based on different 'reference' methods, such as deuterium dilution or densitometry, and on different assumptions. Predictive equations based on a combination of these reference methods are preferable to those based on single methods.

Vitamin D status, parathyroid hormone and sunlight in Turkish, Moroccan and Caucasian children in The Netherlands.

Abstract: At the end of the winter circulating concentrations of 25-hydroxyvitamin D (25-OHD) in Asian and Mediterranen immigrants in northwestern European countries are usually very low. This may lead to vitamin D deficiency and eventually to rickets. Children are more prone to develop vitamin D deficiency. The vitamin D status of 8-year-old Turkish, Moroccan and Caucasian children was assessed by measuring plasma concentrations of 25-OHD and parathyroid hormone (PTH) and related to the cumulated global sun radiation (CGSR). The study population was selected from school children in The Hague and Rotterdam (The Netherlands). In each city blood samples were examined from 40 migrant children and a Caucasian reference group (n = 40) (matched for age and sex). Children in The Hague were examined at the end of the winter and early spring (February/April) and those in Rotterdam in late spring and early summer (May/June). Mean plasma 25-OHD concentrations for the migrant children in both cities were significantly lower than for the Caucasian reference group. The lowest 25-OHD values were measured in migrant children in The Hague: 42 per cent of the Turkish and 23 per cent of the Moroccan children had plasma levels 85 pmol/l) was significantly more prevalent. With all pooled data significantly correlation between plasma 25-OHD and PTH was observed (r = 0.24; P < 0.001). Regression analysis indicated that the relationship between both variables did not differ among the three ethnic groups. As expected, 25-OHD concentrations were higher for increased CGSR. Differences in 25-OHD level are mainly explained by differences in skin pigmentation and calcium intake between Mediterranean and Causasian children. The secondary hyperparathyroidism observed in some children confirms that migrant children have a higher risk of developing nutritional rickets when living in areas with a moderate climate.

Diet and alcohol in liver cirrhosis: a case-control study.

Abstract: A retrospective case-control study on alcohol and dietary habits was conducted over 3 years in a Gastroenterology Department on 152 male patients with liver cirrhosis. The study also included 304 hospital controls, selected within the same age range (32-83 years). Alcohol consumption and dietary habits were assessed from a standardized questionnaire by a highly trained dietician. The variations of the relative risk (RR) of liver cirrhosis as a function of the estimated mean daily intakes of alcohol, fats, carbohydrates and proteins were studied using stratified conditional logistic regression models. Obviously the relative risk of liver cirrhosis was found to be strongly and positively correlated with alcohol consumption but, in addition, this study has been able to show a significant and positive association with the mean daily fat intake and negative associations with the mean daily carbohydrate and protein intakes. Whereas in the control group, the calorie percentage from fats was 33.8 (87.11 g/d), it was 39.6 in the cirrhotic group (102.1 g/d). These findings indicate that in addition to alcohol consumption, dietary habits and in particular, high mean daily fat intake, should be considered.

Low energy expenditures in free-living populations.

Abstract: Low energy intakes are reported fairly frequently in populations where the implication is that these populations are free-living and that these intakes represent the norm. Intakes of energy, if they really reflect those pertaining to the average life-style, must also be reasonably indicative of energy expenditure. It is possible to define 'low' energy expenditure on the basis of obligatory metabolism (BMR + dietary induced thermogenesis) plus the energy needed for minimal physical activity--eg 2 h of standing activities and 1 h of walking daily. On that basis, the minimal realistic level is about 1.5 x BMR, and tables are given showing typical values for men and women over a range of body weights. If these values are accepted, considerable doubt must be placed on the interpretation of many reports in the literature of people apparently existing on 'low' energy intakes.

Haemoglobin fortified cereal: a source of available iron to breast-fed infants.

Abstract: We tested in the field an extruded rice flour, fortified with a bovine haemoglobin concentrate (Fe:14 mg/100 g of powder). This cereal has a high iron bioavailability, good protein quality and amino acid score. Healthy, term breast-fed infants were prospectively studied. One group (n = 92) received the fortified cereal (from 4 to 12 months of age). As control, 96 infants received regular solid foods (cooked vegetables and meat) from age 4 months. At the end of the field trial, a subsample of infants in both groups was supplemented with 45 mg Fe during 90 d. Iron nutrition status was determined at 9, 12 and 15 months. At 12 months, iron deficiency anaemia was present in 17 per cent of controls, in 10 per cent of fortified infants as a whole, but only in 6 per cent of the babies who consumed over 30 g of cereal/d. In addition, this latter group did not show any significant changes in iron nutrition status after the supplementation trial. Results demonstrate that the consumption of a haemoglobin fortified cereal is effective in markedly reducing the incidence of iron deficiency in breast-fed infants.

Interrelation between whole-body turnover rates of RNA and protein.

Abstract: In our search for new non-invasive methods to determine metabolic and nutritional state, we have identified several specific, modified, urinary one-way catabolites of rRNA, tRNA and mRNA which permit the assessment of the whole-body turnover of these RNA classes. A comparison of the steady-state turnover of RNA and the proteins actin plus myosin (determined using urinary 3-methylhistidine) in preterm infants and adults showed that preterm infants have about 3 times higher average turnover rates per unit body weight than adults of tRNA and rRNA as well as of actin plus myosin, whereas calculated mRNA turnover was 6 times higher in preterm infants than in adults. These as well as our recent observations of RNA turnover in different mammals are compared here with data on whole-body protein turnover and basal metabolic rates (BMR) in different mammalian species including man, for which data are available. The turnover rates of tRNA, rRNA, protein and energy (BMR) can be described by the relation, turnover = const. x body mass (exp.), the extrapolated exponents being 0.69-0.78. This suggests a common underlying principle, possibly energy turnover, as cause for the coordinated whole-body turnover rates of RNA and protein in the steady state.

Effect of diarrhoea on dietary intake by infants and young children in rural villages of Kwara State, Nigeria.

Abstract: Community-based, quantitative studies of dietary intake by 5- to 28-months-old Nigerian children were conducted during episodes of diarrhoea and subsequent convalescent and healthy periods. Energy intakes during diarrhoea (85.3 kcal/kg per d) were slightly lower than during health (95.9 kcal/kg per d, P less than 0.05), using paired analysis of intra-individual differences. When intake was disaggregated by food source, no differences by illness status were found in energy intake from breast milk or liquid pap. There were no differences in frequency or duration of breastfeeding by illness status, but pap was provided more frequently and in smaller amounts during illness. Energy intake from other foods, including solids, was greater during health than diarrhoea (P less than 0.05) with an increase in number of servings per day. There was no evidence of caretakers either withholding food during illness or providing extra food during the convalescent phase. The magnitude of illness-associated differences in these children's daily intake was small relative to the deficit in their intakes, even on healthy days, when compared to the amounts recommended for this age group.

Inhibitory effect of oat products on non-haem iron absorption in man.

Abstract: Oat products are increasingly used in human nutrition due to the rather high content of soluble fibre. Oat products, however, have a high content of phytate which may interfere with the absorption of non-haem iron. The iron balance situation is critical in several groups, especially in children, teenagers and women in their fertile years. It is therefore important to examine the effect of oat products on non-haem iron absorption in man. The present studies showed that oat bran and oat porridge markedly inhibited the absorption of non-haem iron. The inhibition can be explained by the high phytate content of oat products. This is partly due to a high resistance of oat phytate against exogenous phytase and partly to an inactivation of the endogenous phytase in oats caused by the usual heat treatment of oats which is made to prevent rancidity of oat lipids during storage. The inhibitory effect of oat products on iron absorption is sufficiently marked to be a serious consideration if such products are more regularly consumed.

Effect of meal frequency on the thermic effect of food in women.

Abstract: The effect of meal frequency on the thermic effect of food (TEF), also referred to as dietary induced thermogenesis (DIT), was investigated in eighteen non-obese female subjects. Their metabolic rate before and after consuming the test meal was measured by open circuit indirect calorimetry using the Douglas bag technique, while the subjects were in the resting state (lying down). Eight subjects consumed a high carbohydrate-low fat (HCLF) meal providing 70, 19 and 11 per cent of the energy content from carbohydrate, fat and protein, respectively, and ten other subjects consumed a low carbohydrate-high fat (LCHF) meal providing 24, 65 and 11 per cent of the energy from carbohydrate, fat and protein, respectively. On two separate occasions, each subject consumed the appropriate diet either as one large meal containing 5040 kJ (1200 kcal) or as two smaller meals each containing 2520 kJ (600 kcal). TEF values were calculated for 6 h after the test meal and the mean values after consuming the HCLF meal were 377.0 +/- 30.0 kJ (90 +/- 7.2 kcal) and 381.0 +/- 26.5 kJ (91.0 +/- 6.3 kcal) for the one meal and the two meals, respectively. The mean TEF values for the subjects who consumed the LCHF meal wre 356.0 +/- 23.0 kJ (85.0 +/- 5.5 kcal) and 340 +/- 15.9 kJ (81.0 +/- 3.8 kcal) for the one meal and the two meals, respectively. No significant differences were found between the two feeding regimens (HCLF, P = 0.94; LCHF, P = 0.64) as well as between the compositions (P = 0.57). Thus, meal frequency and meal composition did not seem to influence the TEF.

Zinc in breast milk during prolonged lactation: comparison between the UK and the Gambia.

Abstract: A total of 580 breastmilk samples were collected from 56 lactating women living in rural village community in the Gambia West Africa and 92 samples were obtained from 57 lactating women living in Cambridge England. Total zinc (Zn) content of each sample was measured by atomic absorption spectrometry and pooled samples of the Gambian breastmilks representing successive period of lactation were fractionated into fat whey and insoluble casein fractions to examine Zn distribution. The 2 sets of milks both exhibited a dramatic decline in total Zn concentrations with increasing duration of lactation in common with previous studies. However the UK milks unexpectedly had lower Zn contents at all stages than the Gambian milks. Milk Zn levels were not significantly related to either maternal age or parity in the Gambian women. The proportion of Zn found in the sedimentable fraction remained nearly constant with increasing duration of lactation but the proportion found in the fat fraction increased and the proportion in the whey fraction declined. These observations are potentially relevant for estimations of milk Zn availability and the fulfillment of Zn requirements by infants and hence for infant feeding practices. (authors)