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BACKGROUND AND OBJECTIVES: Correlated nutritional assessment data (anthropometric, bioimpedance and biochemical) with computerized tomography (CT) of total, muscle and fat midarm areas. Total body fat and fat-free mass were estimated using bioimpedance. Daily urinary urea and creatinine were also quantified. In all, 28 subjects (13 males, 15 females) were evaluated and, they were clinically divided in obese, malnourished and control subjects. DESIGN: Quantification of total, fat muscle midarm areas by tomography and anthropometry and total body fat and free-fat mass by bioimpedance. RESULTS: CT values were 29% higher for fat area and 4-5% lower for total and muscle midarm areas compared against anthropometric data. The midarm skinfold thickness highly correlated with CT fat midarm area. Total body fat and free-fat mass bioimpedance data showed significant correlation with CT midarm data. Urinary creatinine correlated with CT muscle midarm area. CONCLUSION: Utilization of anthropometry can lead to error estimation of fat and fat-free arm areas and that bioimpedance gives fair correlation between total body and CT midarm measurements.

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This study examined if leucine, arginine or glycine supplementation in adult obese patients (body mass index of 33 +/- 4 kg/m(2)) consuming a Brazilian low energy and protein diet (4.2 MJ/day and 0.6 g protein/kg) affects protein and amino acid metabolism. After four weeks adaptation to this diet, each subject received supplements of these amino acids (equivalent to 0.2 g protein kg(-1) day(-1)) in random order. On the seventh day of each amino acid supplementation, a single-dose 15N-glycine study was carried out. There were no significant differences in protein flux, synthesis or breakdown. The protein flux (grams of nitrogen, gN/9 h) was 55 +/- 24 during the nonsupplemented diet intake and 39 +/- 10, 44 +/- 22 and 58 +/- 35 during the leucine-, glycine- and arginine-supplemented diet intake, respectively; protein synthesis (gN/9 h) was 57 +/- 24, 36 +/- 10, 41 +/- 22 and 56 +/- 36, respectively; protein breakdown (gN/9 h) was 51 +/- 24, 34 +/- 10, 32 +/- 28 and 53 +/- 35, respectively; kinetic balance (gN/9 h) was 3.2 +/- 1.8, 4.1 +/- 1.7, 3.4 +/- 2.9 and 3.9 +/- 1.6. There was no difference in amino acid profiles due to leucine, arginine or glycine supplementation. The present results suggest that 0.6 g/kg of dietary protein is enough to maintain protein turnover in obese women consuming a reduced energy diet and that leucine, arginine or glycine supplementation does not change kinetic balance or protein synthesis.

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This study examined if leucine, arginine or glycine supplementation in adult obese patients (body mass index of 33 + or - 4 kg/m²) consuming a Brazilian low energy and protein diet (4.2 MJ/day and 0.6 g protein/kg) affects protein and amino acid metabolism. After four weeks adaptation to this diet, each subject received supplements of these amino acids (equivalent to 0.2 g protein kg-1 day-1) in random order. On the seventh day of each amino acid supplementation, a single-dose 15N-glycine study was carried out. There were no significant differences in protein flux, synthesis or breakdown. The protein flux (grams of nitrogen, gN/9 h) was 55 + or - 24 during the nonsupplemented diet intake and 39 + or - 10, 44 + or - 22 and 58 + or - 35 during the leucine-, glycine- and arginine-supplemented diet intake, respectively; protein synthesis (gN/9 h) was 57 + or - 24, 36 + or - 10, 41 + or - 22 and 56 + or - 36, respectively; protein breakdown (gN/9 h) was 51 + or - 24, 34 + or - 10, 32 + or - 28 and 53 + or - 35, respectively; kinetic balance (gN/9 h) was 3.2 + or - 1.8, 4.1 + or - 1.7, 3.4 + or - 2.9 and 3.9 + or - 1.6. There was no difference in amino acid profiles due to leucine, arginine or glycine supplementation. The present results suggest that 0.6 g/kg of dietary protein is enough to maintain protein turnover in obese women consuming a reduced energy diet and that leucine, arginine or glycine supplementation does not change kinetic balance or protein synthesis

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Anemia and undernutrition are common all over the world, especially in less developed countries. The relationship between low weight, short stature and iron deficiency should be better understood so that appropriate measures might be taken to prevent these problems. A total of 115 institutionalized children aged 12 to 72 months were studied in day-care institutions in the town of Pontal, Southeastern Brazil, during the second semester of 1999. Personal data, weight, height and hematological profile were obtained from all subjects. Food intake was evaluated in 20 children by a direct food-weighing method. The prevalence of low weight for age (2.6%), low weight for height (1.7%) and low height for age (4.3%) was considered low. Anemia was observed in 68.7% of the children. Diet was found to be adequate in terms of the major nutrients evaluated, but food iron supply was of low bioavailability. In conclusion, the population studied revealed a peculiar behavior i.e., the coexistence of fairly good anthropometric nutritional status along with iron-deficiency anemia. The prevention of this kind of malnutrition cannot be limited to an adequate calorie/protein supply but should also be based on the correction of the severe iron deficiency present in this low socioeconomic level preschool children in Brazil.

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Vitamin A deficiency is one of the major nutritional problems in the world, most common in developing countries. Food fortification is a recognised approach to supply vitamins and minerals to needed populations. Vegetable cooking oils were previously suggested by us as a carrier for vitamin A fortification. Fortification of cooking oil with beta-carotene could also be a strategy to prevent vitamin A deficiency. The objective of this article is to start studies on the use of cooking soya oil as a vehicle for synthetic carotene, to evaluate its stability to heat treatment, and to test its bioavailability and bioconversion to vitamin A in rats. Batches of carotene-fortified soybean oil were prepared, containing 2, 4 and 8 RE/g of diet. Some of them were heated to test its stability. At 100 degrees C there was no loss of carotene, at higher temperature carotene retention was 65%. The bioavailability and bioconversion of beta-carotene added to soybean oil was measured through feeding nursing rats and their pups method. Weight gain was good and plasma vitamin A increased significantly in all groups. Liver vitamin A values of rats fed diets with fortified soybean oil heated at 100 degrees C was similar to the 4 RE non-heated fortified oil group (0.72 +/- 0.06 and 0.64 +/- 0.08 mumol/g, respectively). Heated at 170 degrees C the liver total vitamin A value was reduced (0.45 +/- 0.04 mumol/g), but kept bioavailable vitamin A equivalent to 2 RE (0.47 +/- 0.09 mumol/g). Bioconversion of beta-carotene to vitamin A was validated by the plasma and liver findings. beta-carotene added to soybean oil showed good stability to heat and its bioconversion to vitamin A was shown in rat assays. beta-carotene mixed well with edible soybean oil and the fortified cooking oil showed potential as a carrier to be used for the prevention of vitamin A deficiency.

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Discorre sobre as vitaminas lipossolúveis A, D, E e K em conjunto, mostrando suas peculiaridades de transporte, armazenamento orgânico e excreçäo; sua participaçäo nos alimentos da dieta habitual como suas eventuais fontes, mostrando tabela sobre a recomendaçäo dietética mais recente (1989) dessas vitaminas, segundo o "National Research Council"

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The senior author, immediate past president of the IUNS (International Union of Nutritional Sciences), makes the case here that the standard, recognition, and efficiency of nutritional work in primary care are linked to the status of clinical nutrition in teaching hospitals. There should be opportunities for physicians interested in clinical nutrition to be trained and have a profile similar to other clinical specialists. The clinical nutrition group in the Department of Internal Medicine at the teaching hospital of the Medical School of Ribeirão Preto, Brazil, is an example of a functioning clinical unit. Statistics are presented comparing patient numbers for the clinical nutrition group at Ribeirão Preto with other clinical services (cardiology, nephrology, and geriatrics). Clinical nutrition has its own clinical methodology and technology. When clinical nutrition is visible and recognized in medical schools, skills in nutrition will extend beyond hospital boundaries and become useful in the primary care of patients at the community level.

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Sensitive immunologic techniques for the detection of alterations that occur in protein antigens were used to evaluate the immunogenicity of soybean glycinin after isolation, heat denaturation and pH alteration. The objective was to determine the effect of these agents on the immunogenic ability of this protein fraction. Immunologic assays performed on heat-denatured glycinin up to 80 degrees C in the presence of antinative glycinin serum demonstrated that glycinin retains its immunogenic properties. Above 90 degrees C this biological property begins to disappear, with protein insolubilization and epitope modification due to the conformational changes imposed by temperature. A reduction in immunogenicity also occurred when glycinin was taken to pH 2.0 (below its pl) and pH 11.00 (above its pl) and exposed to high temperatures in the presence of native antiglycinin serum. From these data one can conclude that, at extreme pH values, intramolecular reactions may occur which, in combination with the structural disorganization caused by high temperatures, may contribute to the reduction of immunogenicity.

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Basic biochemical studies have demonstrated the products of protein intraluminal digestion are amino acids and peptides, and the those amino acids as well as small peptides are absorbed by independent mechanisms. The formers are absorbed by specific absorption systems mediated by carriers. The small peptides (di-and tripeptides) are absorbed intact from and may be intracelularlly hydrolised. Peptides with four or more residues are hydrolysed by peptidases located on the brush border of the intestinal villi and then absorbed as amino acids and/or small peptides. Such an absorption through a peptide mechanism is faster than the absorption of free amino acids. These are basic aspects that should direct the use of protein partial enzymatic hydrolisate in human nutrition.

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Complex iron compounds are being used as iron suppliers. Bioavailability of their iron was tested through several parameters. A biological iron prophylactic study in rats was simultaneously carried out with three of these iron complexes products: ferric orthophosphate, iron sodium EDTA and iron glycine chelate. Their iron biodisponibility was compared to that of ferrous sulfate. Five low iron diets were prepared according to AOAC method. Four of them were enriched to a level of 20 mg Fe/kg, with ferrous sulfate and the 3 iron complexes salts under study. These diets were offered to 5 groups of 6 weanling rats each in an iron prophylactic test. Food intake was measured during 5 weeks, weight checked weekly, blood and liver collected for analyses. Weight gain, hemoglobin, hematocrit, transferrin saturation, iron hemoglobin, biodisponibility and relative iron biological values were calculated. The prophylactic iron rat assay proved to be a feasible and practical model to test and compare iron salts biodisponibility. NaFeEDTA and iron aminochelate produced similar results as ferrous sulfate and their iron has a high biological value for the rats. Orthophosphate iron had lower biological value when compared to the reference standard ferrous sulfate and the other complex products studied.

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OBJECTIVE: We set out to determine the daily glycemic profile of healthy and non-insulin-dependent diabetes mellitus (NIDDM) persons and to test the hypothesis that small amounts of sucrose added to NIDDM meals would not change their responses. METHODS: Thirteen NIDDM and six healthy volunteers participated in the study. They initially consumed a diet similar to their home diet and later a diabetic hospital dietary regimen, with and without 30 g/day sugar replacing equivalent food energy. The hospital diet included their usual foods: bread, milk, rice, beans, meat, vegetables and fruits at breakfast, lunch and dinner. To follow their glycemic profile we drew several blood samples during a 22-hour period. RESULTS: The day-long plasma glucose profile of the NIDDM and healthy subjects showed similar patterns, increasing after the meals and returning later to baseline levels. The extra amount of sucrose consumed did not change the daily glycemic profile or the calculated glycemic area under the 22-hour glycemic curves. These results call attention to the importance of the 22-hour glycemic profile compared to other shorter glycemic indexes. CONCLUSION: The 22-hour profile has obvious advantage for planning day-long diabetic diets, taking in consideration local daily foods and usual eating habits. Maintenance of a small and traditional amount of food, e.g., sucrose, without harmful effects to the subjects, is another advantage of this proposition. It improves patient compliance as well as social daily life.

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OBJECTIVE: Several foods have been used as iron (Fe) carriers to fight widespread global Fe deficiency and anemia. This paper describes the longitudinal effect of Fe-fortified drinking water given to a group of Brazilian preschool children. DESIGN: The experimental design included 31 preschool children who attended a day-care institution. Hemoglobin and serum ferritin were the blood parameters used to check the Fe status. Fe++ sulfate (20 mg Fe/L) was added daily to their drinking water container and measurements were obtained before the addition, 4 and 8 months later. RESULTS: The number of Fe-deficient children decreased drastically after they started drinking the Fe-enriched water. Mean hemoglobin values increased from 10.6 to 13.7 g/dL and serum ferritin from 13.7 to 25.6 micrograms/L. There were no problems related to the salt addition or to the children drinking the Fe-enriched water. CONCLUSION: Fe-enriched drinking water was shown to be a practical alternative to supply Fe to children attending a day-care institution.

PIP: Iron deficiency affects more than one billion people worldwide, although it is most common among young children and women of childbearing age. Poor iron status has severe nutritional and health consequences. The authors describe the longitudinal effect of iron-fortified drinking water given to a group of Brazilian preschool children as a way of combatting iron deficiency and anemia. The statuses of 31 preschool children attending a day-care institution for low socioeconomic families in Ribeirao Preto were followed from November 1990 to October 1991. Iron sulfate was added daily to subjects' drinking water container. Measurements of hemoglobin and serum ferritin levels in the children were taken before the addition and four and eight months later to evaluate iron status. Mean hemoglobin values increased from 10.6 to 13.7 g/dL and serum ferritin from 13.7 to 25.6 ug/L with no problems reported related to the salt addition or to the children drinking the iron-enriched water. The number of iron-deficient children decreased drastically after they began drinking the iron-enriched water. It may therefore be concluded that iron-enriched drinking water is a practical alternative to supply iron to children attending a day-care institution.

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The objective of this study was to investigate the food pattern of women with constipation. It was carried out a 24 h recall and a food frequency survey in 31 constipated women and compared the results with a control of 31 women without constipation. Their mean daily crude fiber intake were no statistical different (2.33 +/- 1.4 vs 2.17 +/- 0.9 g/day), but the usual intake of fruits and vegetables of the constipated ones were irregular. These results call the attention for the influence of the kind and schedule of the food rich fiber intake on the intestinal habit.

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It is accepted that atherosclerosis begins early in life and will develop over several years. The type of diet fed to young rats and other mammals plays a role in the regulation of adult lipid homeostasis. Foods vary in fatty acid content. The importance of diet on lipid profile has been demonstrated in several animal studies and in different human population groups. Bridging the effect of early diet and later adult cardiovascular disease deserves decisive collaboration among different specialists, as well as preventive dietary intervention based on recent advances from food composition and dietotherapy.

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This study was conducted to determine the incorporation of 15nitrogen (15N) into liver and kidney of a group of rats (N = 17) fed a mixture of cooked rice and beans for 4 weeks. The beans (Phaseolus vulgaris), grown in soil cultivated with (15NH4)2SO4, had 1.5% 15N enrichment. Three or four rats were sacrificed weekly and a control group (N = 13) received an isonitrogen and isocaloric reference casein diet. The amount of nitrogen transferred from the beans to the liver at the end of the first, second, third and fourth weeks was 17, 11, 27 and 29% of the total nitrogen, respectively. For the kidney, the respective values were 10, 9, 25 and 27% of the total nitrogen. The total nitrogen content of the liver and kidney of rats receiving the reference casein control diet was similar to that of the rice/beans animals. Weight gain was similar for the two groups, indicating the well-balanced biological value of the experimental diet. The present study shows that it is possible to monitor 15N incorporation into beans and subsequently into rat liver and kidney, in contrast to classical methods for protein metabolism evaluation which measure only total body nitrogen intake and excretion or weight gain.

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1. Obligatory nitrogen losses were evaluated in a group of 9 chronic alcoholic adult males of low socioeconomic status, with an intake of approximately 1 liter/day of a Brazilian beverage (45% ethanol by weight) for at least 5 years. 2. The patients were fed a nitrogen-free diet orally or by tube for 7 days. Since endogenous nitrogen excretion was statistically similar for all subjects, the data were pooled for overall analysis. 3. A stable rate of urinary nitrogen output of 28.42 +/- 11.93 mg N kg-1 day-1 was reached in about 3 days both after oral and tube feeding. The obligatory fecal losses for days 4 to 7 were 17.20 +/- 8.86 mg N kg-1 day-1. 4. Based on the factorial approach, considering the skin and other minor nitrogen losses to be 10 mg N kg-1 day-1, the total endogenous obligatory nitrogen loss for this group of alcoholic patients was 55.62 +/- 18.57 mg N kg-1 day-1. 5. The present results are discussed on the basis of the controversy about the nitrogen requirement of alcoholic patients. The endogenous nitrogen excretion demonstrated does not suggest the need for increased nitrogen intake, but the protein malnutrition of the patients points to the need for more protein.

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One hundred and thirty-three children from birth to 1 year of age were studied to investigate the value of breast milk as a solution to the infant nutrition problem. Fifteen per cent of the children were being fed exclusively breast milk, 44 (44.4%) were fed breast milk plus cow's milk and 40.6% were fed only cow's milk. Thirty-three per cent of the breast fed children, 44.4% of those on mixed feeding and 47% of those on cow's milk alone, were malnourished.

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