Use of a renal-specific oral supplement by haemodialysis patients with low protein intake does not increase the need for phosphate binders and may prevent a decline in nutritional status and quality of life.

BACKGROUND: Protein-energy wasting is a frequent and debilitating condition in maintenance dialysis. We randomly tested if an energy-dense, phosphate-restricted, renal-specific oral supplement could maintain adequate nutritional intake and prevent malnutrition in maintenance haemodialysis patients with insufficient intake. METHODS: Eighty-six patients were assigned to a standard care (CTRL) group or were prescribed two 125-ml packs of Renilon 7.5(R) daily for 3 months (SUPP). Dietary intake, serum (S) albumin, prealbumin, protein nitrogen appearance (nPNA), C-reactive protein, subjective global assessment (SGA) and quality of life (QOL) were recorded at baseline and after 3 months. RESULTS: While intention to treat analysis (ITT) did not reveal strong statistically significant changes in dietary intake between groups, per protocol (PP) analysis showed that the SUPP group increased protein (P < 0.01) and energy (P < 0.01) intakes. In contrast, protein and energy intakes further deteriorated in the CTRL group (PP). Although there was no difference in serum albumin and prealbumin changes between groups, in the total population serum albumin and prealbumin changes were positively associated with the increment in protein intake (r = 0.29, P = 0.01 and r = 0.27, P = 0.02, respectively). The SUPP group did not increase phosphate intake, phosphataemia remained unaffected, and the use of phosphate binders remained stable or decreased. The SUPP group exhibited improved SGA and QOL (P < 0.05). CONCLUSION: This study shows that providing maintenance haemodialysis patients with insufficient intake with a renal-specific oral supplement may prevent deterioration in nutritional indices and QOL without increasing the need for phosphate binders.

Protein intake and exercise for optimal muscle function with aging: recommendations from the ESPEN Expert Group.

The aging process is associated with gradual and progressive loss of muscle mass along with lowered strength and physical endurance. This condition, sarcopenia, has been widely observed with aging in sedentary adults. Regular aerobic and resistance exercise programs have been shown to counteract most aspects of sarcopenia. In addition, good nutrition, especially adequate protein and energy intake, can help limit and treat age-related declines in muscle mass, strength, and functional abilities. Protein nutrition in combination with exercise is considered optimal for maintaining muscle function. With the goal of providing recommendations for health care professionals to help older adults sustain muscle strength and function into older age, the European Society for Clinical Nutrition and Metabolism (ESPEN) hosted a Workshop on Protein Requirements in the Elderly, held in Dubrovnik on November 24 and 25, 2013. Based on the evidence presented and discussed, the following recommendations are made (a) for healthy older people, the diet should provide at least 1.0-1.2 g protein/kg body weight/day, (b) for older people who are malnourished or at risk of malnutrition because they have acute or chronic illness, the diet should provide 1.2-1.5 g protein/kg body weight/day, with even higher intake for individuals with severe illness or injury, and (c) daily physical activity or exercise (resistance training, aerobic exercise) should be undertaken by all older people, for as long as possible.

Elevated energy expenditure and reduced energy intake in obese prepubertal children: paradox of poor dietary reliability in obesity?

The purpose of this study was to assess the validity of two common methods used to assess energy intake. A 3-day weighed dietary record and a dietary history were collected and compared with the total daily energy expenditure (TEE) assessed by the heart rate method in a group of 12 obese and 12 nonobese prepubertal children (mean age 9.3 +/- 1.1 years vs 9.3 +/- 0.4 years). The TEE value was higher in obese than in nonobese children (9.89 +/- 1.08 vs 8.13 +/- 1.39 MJ/day; p < 0.01). Energy intake assessed by the dietary record was significantly lower than TEE in the obese children (7.06 +/- 0.98 MJ/day; p < 0.001) but comparable to TEE in the nonobese children (8.03 +/- 0.99 MJ/day; p = not significant). Energy intake assessed by diet history was lower than TEE in the obese children (8.37 +/- 1.35 MJ/day, p < 0.05) but close to TEE in the nonobese children (8.64 +/- 1.54 MJ/day, p = not significant). These results suggest that obese children underreport food intake and that the dietary record and the diet history are not valid means of assessing energy intake in obese prepubertal children.

Use of nicotine substitute prescribed at hourly plus ab libitum intake or ad libitum for heavy smokers willing to quit: a randomized controlled trial.

OBJECTIVE: To assess the impact of instructional guidance in the regular use of use nicotine nasal spray (NNS) on the true use of NNS during the first three weeks of smoking cessation for heavy smokers who are willing to quit. METHODS: This randomized, open, controlled trial included 50 patients who were heavy smokers, were willing to quit, and attending an academic outpatient clinic in Western Switzerland. Patients were randomised to instruction on NNS use as "ad libitum" (administration whenever cravings appear; control group) or to use NNS when craving appears and at least every hour when awake (intervention group). Intakes were monitored using an electronic device fixed in the spray unit (MDILog) during the first three weeks of use. Self reported abstinence from smoking at six months was confirmed by expired-air carbon monoxide. Using intention-to-treat analysis, random-effect GLS regression was used to calculate the mean difference of daily doses between groups controlling for lack of independence between measures from the same individual. RESULTS: One patient was lost to follow-up. At baseline randomization, the group receiving instruction to use NNS hourly included more women, patients with previous desires to quit, and patients with more psychiatric comorbidities and less somatic complaints compared to the group instructed to use NNS with cravings (group imbalance). Both groups self-administered more than the daily recommended dosage of 8 uses. Mean daily usage was 13.6 dose/day and 11.1 dose/day for the group instructed to use NNS hourly and with cravings, respectively. Adjusting for baseline imbalance, the increased daily doses in the intervention group (hourly use) remained nonsignificant compared to ad libitum use (-0.5 dose/day; CI 95% -6.2; 5.3, from day 1 to day 7; and 2.3 dose/day; CI 95% -5.4; 10.0, from day 8 to day 21). Instructing patients to use the NNS daily had no effect on smoking cessation at six months (RR = 0.69; CI 95% 0.34; 1.39). CONCLUSION: Heavy smokers willing to quit use NNS frequently, regardless of the instructions given. Recommending the use of NNS only when craving appears for heavy smokers willing to quit seems acceptable compared to prescribing hourly administration. TRIAL REGISTRATION: ClinicalTrials.gov: NCT00861276.

Oxidative stress is increased in critically ill patients according to antioxidant vitamins intake, independent of severity: a cohort study

Introduction. Critically ill patients suffer from oxidative stress caused by reactive oxygen species (ROS) and reactive nitrogen species (RNS). Although ROS/RNS are constantly produced under normal circumstances, critical illness can drastically increase their production. These patients have reduced plasma and intracellular levels of antioxidants and free electron scavengers or cofactors, and decreased activity of the enzymatic system involved in ROS detoxification. The pro-oxidant/antioxidant balance is of functional relevance during critical illness because it is involved in the pathogenesis of multiple organ failure. In this study the objective was to evaluate the relation between oxidative stress in critically ill patients and antioxidant vitamin intake and severity of illness. Methods. Spectrophotometry was used to measure in plasma the total antioxidant capacity and levels of lipid peroxide, carbonyl group, total protein, bilirubin and uric acid at two time points: at intensive care unit (ICU) admission and on day seven. Daily diet records were kept and compliance with recommended dietary allowance (RDA) of antioxidant vitamins (A, C and E) was assessed. Results. Between admission and day seven in the ICU, significant increases in lipid peroxide and carbonyl group were associated with decreased antioxidant capacity and greater deterioration in Sequential Organ Failure Assessment score. There was significantly greater worsening in oxidative stress parameters in patients who received antioxidant vitamins at below 66% of RDA than in those who received antioxidant vitamins at above 66% of RDA. An antioxidant vitamin intake from 66% to 100% of RDA reduced the risk for worsening oxidative stress by 94% (ods ratio 0.06, 95% confidence interval 0.010 to 0.39), regardless of change in severity of illness (Sequential Organ Failure Assessment score). Conclusion. The critical condition of patients admitted to the ICU is associated with worsening oxidative stress. Intake of antioxidant vitamins below 66% of RDA and alteration in endogenous levels of substances with antioxidant capacity are related to redox imbalance in critical ill patients. Therefore, intake of antioxidant vitamins should be carefully monitored so that it is as close as possible to RDA.

Impact de la consommation de sel sur la santé: les croyances de la population suisse [Impact of salt intake on health: beliefs of the Swiss population].

Excessive salt intake increases the risk of developing hypertension and cardiovascular disease. Sodium intake remains high both in developed and emerging countries. The Swiss Federal Office of Public Health has ordered a national survey on the salt intake in Switzerland, realized in different centers. This article presents the results of the awareness of the Swiss population concerning the relationship between excessive salt intake and health. This survey reveals a lack of knowledge regarding the association between high salt intake and cardiovascular disease, the sodium content of usual food, and the recommended daily value of sodium intake. Strategies to reduce salt consumption need to be reinforced by collaborations between health authorities and health care professionals.

Physical activity in daily life is associated with lower adiposity values than doing weekly sports in Lc65+ cohort at baseline.

BACKGROUND: Overweight and obesity prevalence is the highest at age 65-75 years in Lausanne (compared with younger classes). We aimed to describe 1) eating habits, daily physical activity (PA), and sports frequency in community-dwelling adults aged 65-70, 2) the links of these behaviors with socio-economic factors, and 3) with adiposity. METHODS: Cross-sectional analysis of Lc65+ cohort at baseline, including 1260 adults from the general population of Lausanne aged 65-70 years. Eating habits (8 items from MNA) and PA (sports frequency and daily PA: walking and using stairs) were assessed by questionnaires. Body mass index (BMI), supra-iliac (SISF), triceps skin-folds (TSF), waist circumference (WC), and WHR were measured. RESULTS: Prevalence of overweight (BMI 25.0-29.9 kg/m2), obesity (BMI ≥ 30.0 kg/m2), and abdominal obesity was 53%, 24%, and 45% in men; 35%, 23%, and 45% in women.Intake of fruits or vegetables (FV) ≥ twice/day was negatively associated with male sex (prevalence 81% versus 90%, chi-square P < 0.001). The proportion avoiding stairs in daily life was higher among women (25%) than among men (20%, chi-square P=0.003).In multivariate analyses among both sexes, eating FV, using stairs in daily life ("stairs"), and doing sports ≥ once/week were significantly negatively associated with financial difficulties (stairs: OR=0.54, 95% CI=0.40-0.72) and positively with educational level (stairs: OR=1.68, 95% CI=1.17-2.43 for high school).For all five log-transformed adiposity indicators in women, and for all indicators except SISF and TSF in men, a gradual decrease in adiposity was observed from category "no stairs, sports < once/week" (reference), to "no stairs, sports ≥ once/week", to "stairs, sports < once/week", and "stairs, sports ≥ once/week" (for example: WC in men, respectively: ß= -0.03, 95% CI= -0.07-0.02; ß= -0.06, 95% CI= -0.09- -0.03; ß= -0.10, 95% CI= -0.12- -0.07). CONCLUSIONS: In this population with high overweight and obesity prevalence, eating FV and PA were strongly negatively associated with financial difficulties and positively with education. Using stairs in daily life was more strongly negatively associated with adiposity than doing sports ≥ once/week.

Feed intake and growth performance of goats supplemented with soy waste

The objective of this work was to evaluate the effects of supplemental feeding of soy waste on the feed intake and growth rate of goats. Twenty male crossbred (Boer x local) goats were assigned to two isonitrogenous diet groups: one of commercial pellet and the other of soy waste. The commercial pellet (1.0%) and soy waste (0.8%) were provided on the dry matter basis of body weight (BW) per day, to the respective group of each diet. The soy waste group had lower daily intakes of total dry matter (0.79 vs. 0.88 kg) and organic matter (665.71 vs. 790.44 g) than the group fed pellet; however, the differences on daily intakes for grass (0.62 vs. 0.64 kg), crude protein (96.81 vs. 96.83 g), and neutral detergent fibre (483.70 vs. 499.86 g) were not significant. No differences were observed between groups for BW gain. The feed conversion ratio and feed cost per kilogram of BW gain were lower for the group fed soy waste than for the one fed pellet. Goats fed supplemental soy waste have a lower total dry matter intake, feed conversion ratio, and feed cost per kilogram of body weight gain than those fed commercial pellets.

Improvements in Air Intake on Frame 6 Gas Turbines

Työssä tarkastellaan kahta kaasuturbiinin imuilman sisäänottojärjestelmän kehitysmenetelmää, imuilman jäähdytystä ja sähköstaattista suodatusta. Imuilman jäähdytysmenetelmien tarkastelussa käytettiin kahta kaasuturbiinin tehonlisäystekniikoiden laskentatyökalua. Arviointi kohdistettiin Glanford Brigg Generating Station -voimalaitoksen kaasuturbiinityyppiin ja paikallisiin englantilaisiin ilmasto-olosuhteisiin. Tarkastelussa olivat kostutusjäähdytys ja overspray. Tuloksia vertailtiin keskenään ja näiden perusteella arvioitiin menetelmien vaikutuksia tehoon, hyötysuhteeseen sekä veden kulutukseen. Sähköstaattisen suodattimen prototyyppi oli rakennettu Briggin voimalaitokselle. Järjestelmää kehitetään kaupalliseksi tuotteeksi ja tätä varten kerättiin tekninen dokumentaatio kokonaisuudeksi, jota voitiin hyödyntää tuotteistusprosessissa. Imuilman jäähdyttämisellä voidaan saavuttaa merkittävä tehonlisäys ilmasto-olosuhteista riippuen. Menetelmällä voidaan myös tasata lämpötilan vuorokausi-vaihtelusta aiheutuvia tehoeroja. Sähköstaattisen suodattimen prototyyppi saavutti kehitysvaiheelle asetetut tavoitteet. Sähköstaattinen suodatus tarjoaa useita etuja perinteiseen mekaaniseen suodatukseen verrattuna.

Alcohol dependence induced in rats by semivoluntary intermittent intake

The objective of the present experiment was to assess ethyl alcohol (ETOH) dependence brought about by a semivoluntary intermittent intake regimen in rats. Male Wistar rats weighing 150-250 g at the onset of the experiment were assigned to the following groups: 0% ETOH (N = 11), 5% ETOH (N = 20), 20% ETOH (N = 20) and 40% ETOH (N = 18). ETOH solutions were offered at the end of the day and overnight from Monday to Friday, and throughout weekends, for 90 days. The concentration of the ETOH solutions was increased in a stepwise fashion allowing the rats to get used to the taste of alcohol. Reposition of pure water was permitted during 1-h water drinking periods in the morning. Daily volume intake (± SEM) averaged 25.4 ± 0.4 ml (0% ETOH), 23.8 ± 0.6 ml (5% ETOH), 17.6 ± 0.7 ml (20% ETOH) and 17.5 ± 0.6 ml (40% ETOH). ETOH consumption differed significantly (P<0.05) among groups, averaging 4.4 ± 0.2 g kg-1 day-1 (5% ETOH), 10.3 ± 0.3 g kg-1 day-1 (20% ETOH) and 26 ± 1.2 g kg-1 day-1 (40% ETOH). Furthermore, ETOH detection in plasma 10-12 h after offering the solution indicated that its consumption in the 40% ETOH group was sufficient to override its metabolism. Overt signs of ETOH dependence, such as increased thirst, hyperactivity, puffing, hair ruffling and startle responsiveness as well as reduced drowsiness, were significantly increased in the 20% and 40% ETOH groups compared to the 0% and 5% groups. Accordingly, the model described here proved to be a useful tool for the evaluation of subtle or moderate behavioral and physical consequences of long-term ETOH intake

Dietary fiber intake, stool frequency and colonic transit time in chronic functional constipation in children

The objective of the present study was to evaluate associations between fiber intake, colonic transit time and stool frequency. Thirty-eight patients aged 4 to 14 years were submitted to alimentary evaluation and to measurement of colonic transit time. The median fiber intake of the total sample was age + 10.3 g/day. Only 18.4% of the subjects presented a daily dietary fiber intake below the levels recommended by the American Health Foundation. In this group, the median left colonic transit time was shorter than in the group with higher dietary fiber intake (11 vs 17 h, P = 0.067). The correlation between stool frequency and colonic transit time was negative and weak for left colon (r = -0.3, P = 0.04), and negative and moderate for rectosigmoid and total colon (r = -0.5, P<0.001 and r = -0.5, P<0.001, respectively). The stool frequency was lower in the group with slow transit time (0.8 vs 2.3 per week, P = 0.014). In conclusion, most patients with chronic functional constipation had adequate dietary fiber intake. The negative correlation between stool frequency and colonic transit time increased progressively from proximal segments to distal segments of the colon. Patients with normal and prolonged colonic transit time differ in terms of stool frequency.

Matching salt intake to physiological need in rats using foraging protocols

Several studies of the quantitative relationship between sodium need and sodium intake in rats are reviewed. Using acute diuretic treatment 24 h beforehand, intake matches need fairly accurately when intake is spread out in time by using a hypotonic solution of NaCl. In contrast, using a hypertonic solution, intake is typically double the need. Using the same diuretic treatment, although the natriuresis occurs within ~1 h, the appetite appears only slowly over 24 h. Increased plasma levels of aldosterone parallel the increased intake; however, treatment with metyrapone blocks the rise in aldosterone but has no effect on appetite. Satiation of sodium appetite was studied in rats using sodium loss induced by chronic diuretic treatment and daily salt consumption sessions. When a simulated foraging cost was imposed on NaCl access in the form of a progressive ratio lever press task, rats showed satiation for NaCl (break point) after consuming an amount close to their estimated deficit. The chronic diuretic regimen produced hypovolemia and large increases in plasma aldosterone concentration and renin activity. These parameters were reversed to or toward non-depleted control values at the time of behavioral satiation in the progressive ratio protocol. Satiation mechanisms for sodium appetite thus do appear to exist. However, they do not operate quantitatively when concentrated salt is available at no effort, but instead allow overconsumption. There are reasons to believe that such a bias toward overconsumption may have been beneficial over evolutionary time, but such biasing for salt and other commodities is maladaptive in a resource-rich environment.

Intake, growth and meat quality of steers given diets based on varying proportions of maize silage and grass silage

Simmental × Holstein-Friesian steers were offered four forage diets. These comprised grass silage (G); proportionately 0·67 grass silage, proportionately 0·33 maize silage (GGM); 0·33 grass silage, 0·67 maize silage ( MMG); maize silage ( M) from 424 (s.d. = 11·5) kg to slaughter at a minimum weight of 560 kg. Forages were mixed and offered ad libitum. Steers were offered 2 kg of a concentrate daily, the concentrate being formulated such that all steers had similar crude protein intakes across dietary treatments. A sample of steers was slaughtered at the beginning of the experimental period to allow the calculation of the rate of gain of the carcass and its components. Carcass dissection of a sample of steers allowed the development of a prediction equation of carcass composition based on thoracic limb dissection of all carcasses. Forage dry matter intake and live-weight gain increased linearly as maize silage replaced grass silage in the forage mixture, resulting in improvements in food conversion ratio (all P = 0·001). Killing-out proportion increased with maize silage inclusion ( P < 0·001) but fat and conformation scores did not differ significantly between diets. However, increasing maize inclusion in the diet resulted in a greater weight ( P = 0·05) and proportion ( P = 0·008) of fat in the carcass, and significant increases in internal fat deposition. The inclusion of maize led to a progressive increase in the daily gains of carcass ( P < 0·001), and significant increases in the daily gains of both fat ( P < 0·001) and lean tissue ( P < 0·001). Fat colour was more yellow in cattle given diets G and GGM than diets MMG and M ( P < 0·001) and colour intensity was lower on diet M than the other three diets ( P < 0·001). There were no significant differences in any aspects of eating quality between diets. Therefore, maize silage has the potential to reduce the time taken for finishing beef animals to achieve slaughter weight with no apparent detrimental effects on subsequent meat quality.

Intake, live-weight gain and carcass characteristics of beef cattle given diets based on forage maize silage harvested at different stages of maturity

Advancing maturity of forage maize is associated with increases in the proportion of dry matter (DM) and starch, and decreases in the proportions of structural carbohydrates in the ensiled crop. This experiment investigated the effects of three maize silages of 291 (low), 339 (medium) and 393 (high) g DM per kg fresh weight on the performance of 48 Simmental. Holstein-Friesian cattle. Equal numbers of steers (mean start weight = 503 (s.d. 31.3) kg) and heifers (mean start weight = 378 (s.d. 11.2) kg) were offered individually isonitrogenous diets composed of the three silages plus a protein supplement with minerals once daily until slaughter at the target live weight of 575 and 475 kg for steers and heifers, respectively. Intake was reduced on the low diet (P < 0.01) compared with the other two treatments. Dietary starch intake increased by a total of 1 kg/day between low and medium diets but by only 0.2 kg/day between medium and high diets. Unlike starch intake, total neutral-detergent fibre intake showed no significant difference (P > 0.05) between diets. There were no differences in live-weight gain between treatments but differences (P < 0.05) in food conversion efficiency indicated relative gains of 115, 100 and 102 g gain per kg DM intake for diets low, medium and high, respectively. There were no differences between diets in carcass weights, fat score and overall conformation.

Effects of corn silage derived from a genetically modified variety containing two Transgenes on feed intake, milk production, and composition, and the absence of detectable Transgenic deoxyribonucleic acid in milk in holstein dairy cows

The objectives were to compare the chemical composition, nutritive value, feed intake, milk production and composition, and presence in milk of transgenic DNA and the encoded protein Cry1Ab when corn silages containing 2 transgenes (2GM: herbicide tolerance: mepsps and insect resistance: cry1Ab) were fed as part of a standard total mixed ration (TMR) compared with a near isogenic corn silage ( C) to 8 multiparous lactating Holstein dairy cows in a single reversal design study. Cows were fed a TMR ration ad libitum and milked twice daily. Diets contained [ dry matter (DM) basis] 45% corn silage, 10% alfalfa hay, and 45% concentrate (1.66 Mcal of net energy for lactation/kg of DM, 15.8% crude protein, 35% neutral detergent fiber, and 4.1% fat). Each period was 28-d long. During the last 4 d of each period, feed intake and milk production data were recorded and milk samples taken for compositional analysis, including the presence of transgenic DNA and Cry1Ab protein. There was no significant difference in the chemical composition between C and 2GM silages, and both were within the expected range (37.6% DM, 1.51 Mcal of net energy for lactation/kg, 8.6% crude protein, 40% neutral detergent fiber, 19.6% acid detergent fiber, pH 3.76, and 62% in vitro DM digestibility). Cows fed the 2GM silage produced milk with slightly higher protein (3.09 vs. 3.00%), lactose ( 4.83 vs. 4.72%) and solids-not-fat (8.60 vs. 8.40%) compared with C. However, the yield (kg/d) of milk (36.5), 3.5% fat-corrected milk (34.4), fat (1.151), protein (1.106), lactose (1.738), and solids-not-fat ( 3.094), somatic cell count (log(10): 2.11), change in body weight (+ 7.8 kg), and condition score (+ 0.09) were not affected by type of silage, indicating no overall production difference. All milk samples were negative for the presence of transgenic DNA from either trait or the Cry1Ab protein. Results indicate that the 2GM silage modified with 2 transgenes did not affect nutrient composition of the silages and had no effect on animal performance and milk composition. No transgenic DNA and Cry1Ab protein were detected in milk.