RESUMO
Resting energy expenditure and nutritional status in pediatric patients was determined before and then 1 and 2 years after lung transplantation. Mean resting energy expenditure was increased (132%) before transplantation and declined (112%) after transplantation. Body mass index and weight z-scores improved posttransplantation, but nutritional measurements remained below normal population values.
Assuntos
Metabolismo Energético , Transplante de Pulmão , Estado Nutricional , Metabolismo Basal , Composição Corporal , Índice de Massa Corporal , Peso Corporal , Calorimetria Indireta , Criança , Pré-Escolar , Fibrose Cística/fisiopatologia , Fibrose Cística/terapia , Feminino , Volume Expiratório Forçado , Humanos , Pneumopatias/terapia , MasculinoRESUMO
Cooked white rice (CWR) provides up to 71% of the dietary protein for many people worldwide. The protein digestibility-corrected amino acid (AA) score is the method adopted by FAO/WHO to evaluate protein quality. Our group has proposed the metabolic availability (MA) of AAs as another determinant of protein quality. It measures the percentage of an indispensable AA that is incorporated during protein synthesis. This study is the first to our knowledge to assess the MA of l-lysine (L-Lys) from CWR in humans using the indicator AA oxidation (IAAO) technique. Three amounts of L-Lys, 10, 15, and 19 mg · kg(-1) · d(-1) (= 28.5, 42.8, and 54.3% of the mean L-Lys requirement of 35 mg · kg(-1) · d(-1)), were studied in 5 healthy young men in a repeated-measures design. To test the principle that the Maillard reaction has an effect on the MA of LLys, we also assessed the MA of L-Lys in oven-browned, cooked rice (n = 3) in the amount of 19 mg · kg(-1) · d(-1) L-Lys. The MA of L-Lys was estimated by comparing the IAAO response with varying L-Lys intakes in rice compared with the IAAO response to varying l-Lys intakes in the reference protein (crystalline AA mixture patterned after egg protein) using the slope ratio method. The MA of L-Lys from CWR was high (97%), but the effect of the Maillard reaction reduced it to 70%. The results show that despite its relatively low content in rice, L-Lys has a high MA when the rice is cooked without being browned.
Assuntos
Culinária/métodos , Dieta , Proteínas Alimentares/metabolismo , Lisina/metabolismo , Oryza/química , Adulto , Disponibilidade Biológica , Digestão , Ovos , Humanos , Reação de Maillard , Masculino , Oxirredução , Valores de Referência , Sementes/químicaRESUMO
OBJECTIVE: To determine prospectively the long-term natural history of glucose homeostasis in adult patients with cystic fibrosis (CF). STUDY DESIGN: Between 1996 and 2005, a total of 971 modified oral glucose tolerance tests (OGTTs) were performed in 329 patients with CF without recognized CF-related diabetes (CFRD). Patients were classified as having normal glucose tolerance (NGT), impaired glucose tolerance (IGT), CFRD without fasting hyperglycemia (FH), or CFRD with FH. Data were collected at baseline from the Toronto Cystic Fibrosis database. RESULTS: On first OGTT, 63% of the 257 patients with pancreatic insufficiency (PI) had NGT, 23% had IGT, 11% had CFRD without FH, and 3% had CFRD with FH. Burkholderia cepacia complex colonization was correlated with worsening glucose tolerance category. There was a weak inverse relationship among weight, body mass index, forced expiratory volume in 1 minute, and 2-hour plasma glucose obtained during OGTT. Of the 168 PI patients who had a second OGTT, 17% improved their category of glucose tolerance, 70% remained unchanged, and 13% worsened. A similar trend was seen during the progression between any one test to a subsequent test. CONCLUSIONS: Annual screening of glucose tolerance in patients with CF reveals highly variable results over time. Fluctuating levels of insulin resistance, probably with variable degrees of ongoing inflammation, affect the results and hinder prediction of future development of CFRD. Home glucose monitoring following abnormal OGTT results was essential in establishing the diagnosis of CFRD.
Assuntos
Glicemia/metabolismo , Fibrose Cística/complicações , Intolerância à Glucose/etiologia , Adulto , Índice de Massa Corporal , Fibrose Cística/sangue , Fibrose Cística/epidemiologia , Progressão da Doença , Feminino , Seguimentos , Fluxo Expiratório Forçado/fisiologia , Intolerância à Glucose/sangue , Intolerância à Glucose/epidemiologia , Teste de Tolerância a Glucose , Humanos , Incidência , Masculino , Ontário/epidemiologia , Prognóstico , Estudos Prospectivos , Fatores de TempoRESUMO
We compared measured resting energy expenditure (MREE) and predicted resting energy expenditure (PREE) in 398 chronically ill children and found a wide variability for %MREE/PREE (standard deviation +/- 27.2). Bland-Altman analysis also suggested poor agreement between MREE and PREE (mean bias, 43.2 kcal; range, -645 to 1118.1 kcal). Our findings suggest that resting energy expenditure should be measured in chronically ill children.
Assuntos
Metabolismo Energético/fisiologia , Necessidades Nutricionais , Adolescente , Criança , Pré-Escolar , Doença Crônica , Ingestão de Energia , Feminino , Seguimentos , Hospitais Pediátricos , Humanos , Lactente , Masculino , Valor Preditivo dos Testes , Descanso , Sensibilidade e Especificidade , Índice de Gravidade de DoençaRESUMO
The use of oral dietary supplements was compared with dietary counseling in 13 malnourished patients (3 males, mean age 18.1 years) with cystic fibrosis. Energy intake and nutritional status were evaluated over 3 months. There was no significant change in energy intake or percent ideal body weight in either group.
Assuntos
Fibrose Cística/complicações , Suplementos Nutricionais , Aconselhamento Diretivo , Ingestão de Energia , Desnutrição/terapia , Estado Nutricional , Administração Oral , Adolescente , Adulto , Criança , Feminino , Humanos , Masculino , Desnutrição/etiologia , Falha de TratamentoRESUMO
OBJECTIVES: To assess the efficacy of combining unprotected powder enzymes and oral enteric-coated microsphere (ECM) and to ECM alone in treating nutrient maldigestion in patients with cystic fibrosis. STUDY DESIGN: Patients were randomly assigned into 2 consecutive, 2-week phases; ECM alone, and ECM plus unprotected powder enzymes. Fecal fat, energy, and nitrogen output were compared with intake at the end of each phase. Two-tailed, paired t tests were performed to compare outcomes. RESULTS: The mean age of the 14 patients (3 girls) was 5.7 +/- 3.2 years (range, 1.9 to 13.4 years). There was no significant difference in percent malabsorption of fat (15.6% vs 18.2%), energy (13.3% vs 13.4%), or nitrogen (11.8% vs 11.3%) between phases. CONCLUSIONS: The addition of powder enzymes to ECM did not improve nutrient maldigestion compared with ECM alone.