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1.
Relationship between Energy Intake and Changes in Thigh Echo Intensity during the Acute Phase of Stroke in Older Patients with Hemiplegia.
Kokura, Y, Kato, M, Kimoto, K, Okada, Y, Habu, D
Medical principles and practice : international journal of the Kuwait University, Health Science Centre. 2021;(5):493-500
Abstract
OBJECTIVE The aim of this study was to investigate the relationship between energy intake and changes in thigh echo intensity (TEI) during the acute phase of stroke in older patients with hemiplegia. SUBJECTS AND METHODS Older hemiplegic inpatients with stroke were enrolled in this post hoc analysis of a prospective observational study. Patients were divided into 2 groups according to energy intake during the 7 days after admission as follows: energy sufficient (ES) and energy insufficient (EIS) groups. The outcome was the rate of changes in TEI of the paralyzed and nonparalyzed sides between admission and after 4 weeks. A decrease in skeletal muscle quality is defined as an increase in intramuscular adipose tissues, which shows as an increase in echo intensity. RESULTS The study included 44 males and 39 females (median age 81 years). The rate of change of TEI in each group was as follows: +4.5% in the ES/paralyzed group, +6.7% in the EIS/paralyzed group, -0.9% in the ES/nonparalyzed group, and +4.4% in the EIS/nonparalyzed group. The univariate analyses showed no significant difference in the rate of change in TEI between ES and EIS groups in both paralyzed side (p = 0.190) and nonparalyzed side (p = 0.183). Multivariate analysis showed that higher energy intake was associated with a smaller increase in the rate of change in TEI on the nonparalyzed side (B = -4.115, 95% confidence interval, -7.127 to -1.103). CONCLUSIONS Higher energy intake during 7 days after admission was associated with a smaller increase in the rate of change in TEI on the nonparalyzed side upon admission and after 4 weeks.
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Dietary Inflammatory Potential and Risk of Cardiovascular Disease Among Men and Women in the U.S.
Li, J, Lee, DH, Hu, J, Tabung, FK, Li, Y, Bhupathiraju, SN, Rimm, EB, Rexrode, KM, Manson, JE, Willett, WC, et al
Journal of the American College of Cardiology. 2020;(19):2181-2193
Abstract
BACKGROUND Inflammation plays an important role in cardiovascular disease (CVD) development. Diet modulates inflammation; however, it remains unknown whether dietary patterns with higher inflammatory potential are associated with long-term CVD risk. OBJECTIVES This study sought to examine whether proinflammatory diets are associated with increased CVD risk. METHODS We prospectively followed 74,578 women from the Nurses' Health Study (NHS) (1984-2016), 91,656 women from the NHSII (1991-2015), and 43,911 men from the Health Professionals Follow-up Study (1986-2016) who were free of CVD and cancer at baseline. Diet was assessed by food frequency questionnaires every 4 years. The inflammatory potential of diet was evaluated using a food-based empirical dietary inflammatory pattern (EDIP) score that was pre-defined based on levels of 3 systemic inflammatory biomarkers. RESULTS During 5,291,518 person-years of follow-up, we documented 15,837 incident CVD cases, including 9,794 coronary heart disease (CHD) cases and 6,174 strokes. In pooled analyses of the 3 cohorts, after adjustment for use of anti-inflammatory medications and CVD risk factors including body mass index, a higher dietary inflammatory potential, as indicated by higher EDIP scores, was associated with an increased risk of CVD (hazard ratio [HR] comparing the highest to lowest quintiles: 1.38; 95% confidence interval [CI]: 1.31 to 1.46; p for trend <0.001), CHD (HR: 1.46; 95% CI: 1.36 to 1.56; p for trend <0.001), and stroke (HR: 1.28; 95% CI: 1.17- to 1.39; p for trend <0.001). These associations were consistent across cohorts and between sexes, and they remained significant after further adjustment for other dietary quality indices. In a subset of study participants (n = 33,719), a higher EDIP was associated with a higher circulating profile of proinflammatory biomarkers, lower levels of adiponectin, and an unfavorable blood lipid profile (p < 0.001). CONCLUSIONS Dietary patterns with a higher proinflammatory potential were associated with higher CVD risk. Reducing the inflammatory potential of the diet may potentially provide an effective strategy for CVD prevention.
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Do Youth Consume More Calories than they Expended in Youth Sports Leagues? An Observational Study of Physical Activity, Snacks, and Beverages.
Bennion, N, Spruance, LA, Maddock, JE
American journal of health behavior. 2020;(2):180-187
Abstract
Objectives: Childhood obesity rates remain high. The youth sports environment is an opportunity to combat obesity. The purpose of this study was to determine the types of beverages/ snacks provided at youth sports and determine associations between energy consumption and expenditure. Methods: This cross-sectional study observed 4 different sports in a youth sports league (N = 189). The System for Observing Fitness Instruction Time (SOFIT) was used to quantify physical activity. Food environmental scans were used to quantify caloric intake. A t-test was conducted to examine differences between energy consumption and expenditure. We conducted a separate analysis for games that did not offer snacks/beverages. Results: The average energy expenditure was 170.3 calories per game; males were more physically active than females. The average caloric content was 213.3 calories for games that did not offer snacks/beverages and average sugar provided was 26.4 grams per game. The majority of sugar came from sugar-sweetened beverages. Conclusions: Calorie intake was higher than expenditure. Children were consuming more sugar in one game than daily recommendations. Youth sports would benefit from an intervention aimed at the food environment.
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Impact of Energy intake at One Week after Hospitalization on Prognosis for Older Adults with Pneumonia.
Shirado, K, Wakabayashi, H, Maeda, K, Nishiyama, A, Asada, M, Isse, H, Saito, S, Kakitani, C, Momosaki, R
The journal of nutrition, health & aging. 2020;(1):119-124
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Abstract
OBJECTIVES This study objectives to investigate the influence of average energy intake at 1 week of hospitalization on prognosis for older adults with pneumonia. DESIGN Retrospective observational cohort study. SETTING The Japan Rehabilitation Nutrition Database comprise those with pneumonia in acute care hospitals. PARTICIPANTS The study included 329 pneumonia patients (aged over 65 years) who entered into the Japan Rehabilitation Nutrition Database (JRND) from November 2015 to March 2018. MEASUREMENTS Logistic regression analysis was performed to confirm the relationship of energy intake with the rate of mortality, discharge home, and pneumonia recurrence during hospitalization. Variables included in the multiple regression analysis model were age, sex, Mini Nutritional Assessment-Short Form score (MNA-SF) at hospitalization, A-DROP, Charlson comorbidity index (CCI), and presence or absence of rehabilitation. RESULTS Of 315 patients with pneumonia (median age 85 years), 63.8% were men. 57.7% were assigned to the lack of energy intake (LEI) at 1 week after admission. Patients in the LEI group were older (p = 0.033), had higher A-DROP score (p < 0.001), and showed higher malnutrition rate in MNA-SF at hospitalization (p < 0.001) than those in the control group. Mortality, pneumonia recurrence (p = 0.001), median body mass index (p = 0.012), and low malnutrition in MNA-SF (p < 0.001) at discharge were significantly higher in the LEI group than in the control group. Logistic regression analysis showed that LEI was an independent risk factor for mortality (Odds ratio: 5.07, p = 0.002), discharge home (Odds ratio: 0.33, p = 0.007), and pneumonia recurrence (Odds ratio: 3.26, p = 0.007). CONCLUSIONS LEI at 1 week after hospitalization in older adults with pneumonia was an independent risk factor for mortality, difficult at-home recovery, and pneumonia recurrence. These findings suggest the importance of adequate energy intake from the early days of hospitalization.
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Energy Balance of Canadian Armed Forces Personnel during an Arctic-Like Field Training Exercise.
Ahmed, M, Mandic, I, Desilets, E, Smith, I, Sullivan-Kwantes, W, Jones, PJ, Goodman, L, Jacobs, I, L'Abbé, M
Nutrients. 2020;(6)
Abstract
Operating in temperature extremes frequently leads to a discrepancy in energy balance. Investigating the effects of operating in extreme cold temperatures on metabolic requirements has not been well described in Canadian Armed Forces (CAF) personnel. The objective was to accurately assess energy deficits using the "gold standard" methodology for measuring energy intake (EI) and energy expenditure (EE). Nutritional intake of a convenience sample of 10 CAF Class A Reservists, completing a basic military qualification (land) course under winter weather conditions, was assessed using the daily measured food intake/food waste collections. EE was measured by the doubly-labelled water method. Average EI was 2377 ± 1144 kcal/day, which was below the EE (4917 ± 693 kcal/day), despite having ~5685 kcal available in the field rations. A significant body weight loss of 2.7% was associated with the average daily energy deficit of 2539 ± 1396 kcal. As a result, participants demonstrated voluntary anorexia. Such results may have important implications for the impairment of performance and health under longer duration operations.
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Dietary Intake and Energy Expenditure During Two Different Phases of Athletic Training in Female Collegiate Lacrosse Players.
Kumahara, H, Ohta, C, Nabeshima, E, Nakayama, A, Mine, S, Yamato, T
Journal of strength and conditioning research. 2020;(6):1547-1554
Abstract
Kumahara, H, Ohta, C, Nabeshima, E, Nakayama, A, Mine, S, and Yamato, T. Dietary intake and energy expenditure during two different phases of athletic training in female collegiate lacrosse players. J Strength Cond Res 34(6): 1547-1554, 2020-This study aims to investigate the state of nutrient intake and energy expenditure (EE) among various phases of periodization in female collegiate lacrosse players. A total of 17 Japanese female collegiate lacrosse players (age: 20.0 ± 0.9 years) were enrolled in this study. Physical activity (PA) and dietary intake were assessed over each 1-week period during the training preparatory phase (P-phase) and transition phase (T-phase). The exercise training-related EE (EEE) and EE associated with other daily living activities (i.e., nonexercise activity thermogenesis [NEAT]), were measured using accelerometers and heart rate (HR) monitoring using the flex-HR method. The total daily EE during the P-phase was significantly higher than that of the T-phase (2,168 ± 248 vs. 1744 ± 138 kcal·d; p < 0.01); however, no significant differences were observed in the total energy intake. Moreover, EEE during the P-phase was significantly higher than that of the T-phase, whereas no significant difference was found in NEAT. Furthermore, no significant differences were noted in any macronutrient intake variable observed between the 2 phases (protein:fat:carbohydrate ratio: 12.6 ± 1.5:32.9 ± 3.9:54.1 ± 5.1% in the P-phase vs. 12.1 ± 1.7:30.7 ± 3.9:55.7 ± 5.2% in the T-phase). The carbohydrate and protein intake were below recommended levels during the P-phase. Conversely, the saturated fatty acid ratio was higher than the dietary goals for disease prevention. Based on the changes in the PA volume observed during different training phases, female collegiate lacrosse players did not attain optimal nutrient intake required for optimal athletic performance and health.
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Association of Low Energy Availability and Suppressed Metabolic Status in Korean Male Collegiate Soccer Players: A Pilot Study.
Lee, S, Kuniko, M, Han, S, Oh, T, Taguchi, M
American journal of men's health. 2020;(6):1557988320982186
Abstract
Low energy availability (EA) can impair physiological function in athletes. The purpose of this study was to investigate EA status, metabolic status, and bone metabolism with biochemical analysis in Korean male soccer players. Twelve male athletes (18-20 years) completed the study. Body composition and bone mineral density were measured using dual energy X-ray absorptiometry (DXA), while VO2 max was determined by an incremental exercise test. Blood samples were taken for bone marker and hormone analyses. Resting energy expenditure (REE) was measured using the Douglas bag method and predicted using the DXA method. Food diaries and heart rates (HR) during training were recorded, and the Profile of Mood States 2 and Eating Attitude Test 26 were completed. Group differences between low EA (LEA <30 kcal/kg FFM/d, n = 5) and high EA (HEA ≥30 kcal/kg FFM/d, n = 7) were evaluated. The mean EA of the all participants was 31.9 ± 9.8 kcal/kg FFM/d with only two participants having an EA above 45 kcal/kg FFM/d. LEA showed suppressed REE (LEA: 26.0 ± 1.7 kcal/kg/d, HEA: 28.8 ± 1.4 kcal/kg/d, p = .011) with a lower REEratio (LEA: 0.91 ± 0.06, HEA: 1.01 ± 0.05, p = .008) as well as a lower insulin-like growth factor 1 (IGF-1) level (LEA: 248.6 ± 51.2 ng/mL, HEA: 318.9 ± 43.4 ng/mL, p = .028) compared to HEA. There were no group differences in bone markers or other hormone levels. Korean male athletes exhibited low EA status with suppressed metabolism, but there was limited evidence on the effect of EA on bone metabolism, endocrine system, and psychological parameters.
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Weight Gain, Energy Intake, Energy Expenditure, and Immunosuppressive Therapy in Kidney Transplant Recipients.
Taşdemir, D, Aksoy, N
Progress in transplantation (Aliso Viejo, Calif.). 2020;(4):322-328
Abstract
BACKGROUND Weight gain after kidney transplantation is a common health problem. The factors in weight gain after kidney transplant include many factors such as age, ethnicity, gender, change in lifestyle (eg, kilocalorie intake and physical activity level), and immunosuppressive therapy. RESEARCH QUESTIONS This study aimed to evaluate the relationship between weight gain and energy intake in dietary, energy expenditure in physical activity, and immunosuppressive therapy in kidney transplant recipients. DESIGN This prospective, observational study included 51 participants who underwent kidney transplant, during 6 months from the start of the study. Anthropometric measurements were performed at first week, third- and sixth-month follow-ups of transplant recipients. Participants also completed 3-day "Dietary Record Form" and the "Physical Activity Record Form" at each follow-up. Simple frequency, analysis of variance analysis, and correlation analysis were used for data analysis. RESULTS Weight gain in sixth month follow-up compared to baseline value was positively related to energy intake in first week (r = 0.59), third month (r = 0.75), and sixth month (r = 0.67) follow-ups, and energy expenditure in first week (r = 0.35) and sixth month (r = 0.34) follow-ups. However, weight gain was negatively related to mycophenolate mofetil dose (mg/d) in sixth month (r = -0.31) follow-up (P < .05). DISCUSSION The results of this study provide an opportunity to reflect and discuss on modifiable risk factors such as energy intake and energy expenditure that affect weight gain posttransplantation in participants. It also examines the relationship between immunosuppressive therapy. Additionally, these results can be effective in designing interventions and managing risk factors to achieve weight management goals.
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Establishment of Adequate Nutrient Intake Criteria to Achieve Target Weight Loss in Patients Undergoing Bariatric Surgery.
Lim, HS, Kim, YJ, Lee, J, Yoon, SJ, Lee, B
Nutrients. 2020;(6)
Abstract
Although bariatric surgery is the best treatment modality for morbidly obese patients, a 10-30% rate of weight recidivism has been reported in various specialized centers. We examined changes in energy and macronutrients after bariatric surgery and performed analysis to establish appropriate nutritional guidelines for reaching the target percentage of weight loss after surgery. A total of 189 subjects who underwent bariatric surgery were classified into success and failure groups depending on whether or not they reached 50% loss of excess weight at 12 months after bariatric surgery. Physical examinations and dietary surveys were completed before and 1, 6, and 12 months after surgery. Using receiver operating characteristic (ROC) analysis, the optimal cutoff points for nutrient intakes for determining success after bariatric surgery were computed based on maximal Youden's index. At 6 and 12 months after surgery, the success group had significantly lower carbohydrate and fat intakes than the failure group. The cutoff calorie intake for success in weight loss was <835.0, <1132.5, and <1523.0 kcal/day at 1, 6, and 12 months post operation, respectively. With regard to protein, the cutoff intakes were >44.5, >41.5, and >86.5 g/day at 1, 6, and 12 months post operation, respectively. At 12 months, the cutoff ratio for energy obtained from carbohydrates, protein, and fat was <49.0, >24.5, and <28.0%, respectively. Our findings confirm that the level of diet control and nutrition restriction affect the achievement of target weight loss, emphasizing that long-term weight loss is related to compliance with nutrient recommendations.
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Energy balance in obese, mechanically ventilated intensive care unit patients.
Vest, MT, Newell, E, Shapero, M, McGraw, P, Jurkovitz, C, Lennon, SL, Trabulsi, J
Nutrition (Burbank, Los Angeles County, Calif.). 2019;:48-53
Abstract
OBJECTIVES The aims of this study were, first, to compare the predicted (calculated) energy requirements based on standard equations with target energy requirement based on indirect calorimetry (IC) in critically ill, obese mechanically ventilated patients; and second, to compare actual energy intake to target energy requirements. METHODS We conducted a prospective cohort study of mechanically ventilated critically ill patients with body mass index ≥30.0 kg/m2 for whom enteral feeding was planned. Clinical and demographic data were prospectively collected. Resting energy expenditure was measured by open-circuit IC. American Society of Parenteral and Enteral Nutrition (APSPEN)/Society of Critical Care Medicine (SCCM) 2016 equations were used to determine predicted (calculated) energy requirements. Target energy requirements were set at 65% to 70% of measured resting energy expenditure as recommended by ASPEN/SCCM. Nitrogen balance was determined via simultaneous measurement of 24-h urinary nitrogen concentration and protein intake. RESULTS Twenty-five patients (mean age: 64.5 ± 11.8 y, mean body mass index: 35.2 ± 3.6 kg/m2) underwent IC. The mean predicted energy requirement was 1227 kcal/d compared with mean measured target energy requirement of 1691 kcal/d. Predicted (calculated) energy requirements derived from ASPEN/SCCM equations were less than the target energy requirements in most cases. Actual energy intake from enteral nutrition met 57% of target energy requirements. Protein intake met 25% of target protein requirement and the mean nitrogen balance was -2.3 ± 5.1 g/d. CONCLUSIONS Predictive equations underestimated target energy needs in this population. Further, we found that feeding to goal was often delayed resulting in failure to meet both protein and energy intake goals.