The effectiveness of dietary counselling versus oral nutrition supplements in improving nutritional intake in malnourished patients with Chronic Obstructive Pulmonary Disease (COPD)

The evidence for nutritional support in COPD is almost entirely based on oral nutritional supplements (ONS) yet despite this dietary counseling and food fortification (DA) are often used as the first line treatment for malnutrition. This study aimed to investigate the effectiveness of ONS vs. DA in improving nutritional intake in malnourished outpatients with COPD. 70 outpatients (BMI 18.4 SD 1.6 kg/m2, age 73 SD 9 years, severe COPD) were randomised to receive a 12-week intervention of either ONS or DA (n 33 ONS vs. n 37 DA). Paired t-test analysis revealed total energy intakes significantly increased with ONS at week 6 (+302 SD 537 kcal/d; p = 0.002), with a slight reduction at week 12 (+243 SD 718 kcal/d; p = 0.061) returning to baseline levels on stopping supplementation. DA resulted in small increases in energy that only reached significance 3 months post-intervention (week 6: +48 SD 623 kcal/d, p = 0.640; week 12: +157 SD 637 kcal/d, p = 0.139; week 26: +247 SD 592 kcal/d, p = 0.032). Protein intake was significantly higher in the ONS group at both week 6 and 12 (ONS: +19.0 SD 25.0 g/d vs. DA: +1.0 SD 13.0 g/d; p = 0.033 ANOVA) but no differences were found at week 26. Vitamin C, Iron and Zinc intakes significantly increased only in the ONS group. ONS significantly increased energy, protein and several micronutrient intakes in malnourished COPD patients but only during the period of supplementation. Trials investigating the effects of combined nutritional interventions are required.

Antioxidants in Athlete's Basic Nutrition: Considerations towards a Guideline for the Intake of Vitamin C and Vitamin E

Antioxidants in acute physical exercise and exercise training remain a hot topic in sport nutrition, exercise physiology and biology, in general (Jackson, 2008; Margaritis and Rousseau, 2008; Gomez-Cabrera et al., 2012; Nikolaidis et al., 2012). During the past few decades, antioxidants have received attention predominantly as a nutritional strategy for preventing or minimising detrimental effects of reactive oxygen and nitrogen species (RONS), which are generated during and after strenuous exercise (Jackson, 2008, 2009; Powers and Jackson, 2008). Antioxidant supplementation has become a common practice among athletes as a means to (theoretically) reduce oxidative stress, promote recovery and enhance performance (Peternelj and Coombes, 2011). However, until now, requirements of antioxidant micronutrients and antioxidant compounds for athletes training for and competing in different sport events, including marathon running, triathlon races or team sport events involving repeated sprinting, have not been determined sufficiently (Williams et al., 2006; Margaritis and Rousseau, 2008). Crucially, evidence has been emerging that higher dosages of antioxidants may not necessarily be beneficial in this context, but can also elicit detrimental effects by interfering with performance-enhancing (Gomez-Cabrera et al., 2008) and health-promoting training adaptations (Ristow et al., 2009). As originally postulated in a pioneering study on exercise-induced production of RONS by Davies et al. (1982) in the early 1980s, evidence has been increasing in recent years that RONS are not only damaging agents, but also act as signalling molecules for regulating muscle function (Reid, 2001; Jackson, 2008) and for initiating adaptive responses to exercise (Jackson, 2009; Powers et al., 2010). The recognition that antioxidants could, vice versa, interact with the signalling pathways underlying the responses to acute (and repeated) bouts of exercise has contributed important novel aspects to the continued discussion on antioxidant requirements for athletes. In view of the recent advances in this field, it is the aim of this report to examine the current knowledge of antioxidants, in particular of vitamins C and E, in the basic nutrition of athletes. While overviews on related topics including basic mechanisms of exercise-induced oxidative stress, redox biology, antioxidant defence systems and a summary of studies on antioxidant supplementation during exercise training are provided, this does not mean that this report is comprehensive. Several issues of the expanding and multidisciplinary field of antioxidants and exercise are covered elsewhere in this book and/or in the literature. Exemplarily, the reader is referred to reviews on oxidative stress (Konig et al., 2001; Vollaard et al., 2005; Knez et al., 2006; Powers and Jackson, 2008; Nikolaidis et al., 2012), redox-sensitive signalling and muscle function (Reid, 2001; Vollaard et al., 2005; Jackson, 2008; Ji, 2008; Powers and Jackson, 2008; Powers et al., 2010; Radak et al., 2013) and antioxidant supplementation (Williams et al., 2006; Peake et al., 2007; Peternelj and Coombes, 2011) in the context with exercise. Within the scope of the report, we rather aim to address the question regarding requirements of antioxidants, specifically vitamins C and E, during exercise training, draw conclusions and provide practical implications from the recent research.

Effects of Nutrition and Time of Weaning on Dry Season Liveweight Loss of Breeder Cows

In the seasonally dry tropics of northern Australia, breeder cows may lose up to 30% liveweight during the dry season when pasture is of low nutritive value. This is a major cause of low reproductive rates and high mortality. Weaning early in the dry season is effective to reduce this liveweight loss of the breeder (Holroyd et al. 1988). An experiment examined the dry season liveweight loss of breeders for a range of weaning times and levels of nutrition. From April to October through the dry season, 209 Bos indicus x Shorthorn cross cows 4-6 years of age grazed speargrass pastures in north Queensland. The cows had been joined with bulls from late January until April. Twenty-nine breeders had not suckled a calf during the previous wet season (DRY cows). In addition 180 cows lactating in April were weaned in late April, mid July or early September. The cows were allocated by stratified randomisation based on lactational status, stage of pregnancy and body condition to 15 x 40 ha paddocks. Five paddocks with low fertility soils provided LOW nutrition, while 10 paddocks with medium fertility soils and no supplementation or with supplementation provided MEDIUM and HIGH nutrition, respectively. The supplement consisted of molasses containing 14% urea offered ad libitum. Liveweight was measured at intervals and conceptus-free liveweight (CF-LW) calculated. Data were analyses by AOV within groups of paddocks. Animal production for a consuming world : proceedings of 9th Congress of the Asian-Australasian Association of Animal Production Societies [AAAP] and 23rd Biennial Conference of the Australian Society of Animal Production [ASAP] and 17th Annual Symposium of the University of Sydney, Dairy Research Foundation, [DRF]. 2-7 July 2000, Sydney, Australia.

Short-term nutritional supplementation during management of pulmonary exacerbations in cystic fibosis: A controlled study, including effects of protein turnover

Effects of nutritional supplements on minimizing weight loss and abnormalities of protein turnover during pulmonary exacerbations in cystic fibrosis (CF) were studied by controlled trial. Patients received pulmonary therapy and either standard diet (n = 10) or adjunctive enteral supplements (n = 12). Initial protein turnover, measured by [15N]glycine kinetics, showed alterations of protein synthesis (P Syn) and catabolism (P Cat), which correlated with the degree of underweight, and negligible net protein deposition (P Dep). With treatment both groups had significant increases in mean body weight and forced expiratory volume in 1 s, expressed as percent predicted value for height (FEV1) by 3 wk, but a significant correlation between initial underweight and subsequent weight gain was observed only in supplemented patients. Mean P Syn and P Dep increased significantly (p < 0.001) only in the supplemented group. Pulmonary exacerbations in CF have important adverse effects on body-protein metabolism, similar to changes in protein-energy malnutrition and infection. These effects are reversed by short-term nutritional support. Strategic nutritional intervention should thus be considered in management, especially in malnourished patients.

Protein supplementation and growth enhancer strategies in successive years to maximise growth of Brahman cross steers grazing sown grass pastures on brigalow lands

A strategy comprising a winter/spring protein supplement, rumen modifier and hormonal growth promotant (Compudose 400) was used in either the first year (Tl), second year (T2), or in both years (T1+2) following weaning in Brahman cross steers as a means of increasing liveweight gain up to 2.5 years of age. T2 produced the heaviest final liveweight (544.7 kg) and highest overall liveweight gain (366.7 kg), but these were not significantly different from T1 (538.6 kg; 360.9 kg), or T1+2 (528.7 kg; 349.3 kg). However, final liveweight and overall liveweight gains of T1 and T2 but not T1+2 were significantly greater than for untreated (C) steers (504.9 kg; 325.2 kg, both P < 0.05). Regardless of the strategy imposed, liveweight and liveweight gain were enhanced, however final liveweights in each treatment were below the preferred minimum target liveweight (570-580 kg) for premium export markets. Treatment in both years gave no benefit over treatment in 1 year only. 19th Biennial Conference. 5-9 July 1992. LaTrobe University, Melbourne.

Neonatal intestinal obstruction associated with oral calcium supplementation

A case report of a 920 g infant developing a small intestinal obstruction following therapy for congestive cardiac failure is presented. Although the causation was thought to be milk curd obstruction, subsequent analysis revealed high concentration of calcium and phosphate in the stools. The possible pathogenesis is discussed in relation to the inspissated milk syndrome.

Influence of food supplementation on the fitness of two biological control agents: a predatory nabid bug and a bollworm pupal parasitoid

Many arthropod predators and parasitoids exhibit either stage-specific or lifetime omnivory, in that they include extra-floral nectar, floral nectar, honeydew or pollen in their immature and/or adult diet. Access to these plant-derived foods can enhance pest suppression by increasing both the individual fitness and local density of natural enemies. Commercial products such as Amino-Feed®, Envirofeast®, and Pred-Feed® can be applied to crops to act as artificial-plant-derived foods. In laboratory and glasshouse experiments we examined the influence of carbohydrate and protein rich Amino-Feed UV® or Amino-Feed, respectively, on the fitness of a predatory nabid bug Nabis kinbergii Reuter (Hemiptera: Nabidae) and bollworm pupal parasitoid Ichneumon promissorius (Erichson) (Hymenoptera: Ichneumonidae). Under the chosen conditions, the provision of either wet or dry residues of Amino-Feed UV had no discernable effect on immediate or longer-term survival and immature development times of N. kinbergii. In contrast, the provision of honey, Amino-Feed plus extrafloral nectar, and extrafloral nectar alone had a marked effect on the longevity of I. promissorius, indicating that they were limited by at least carbohydrates as an energy source, but probably not protein. Compared with a water only diet, the provision of Amino-Feed plus extrafloral nectar increased the longevity of males and females of I. promissorius by 3.0- and 2.4-fold, respectively. Not only did female parasitoids live longer when provided food, but the total number of eggs laid and timing of deposition was affected by diet under the chosen conditions. Notably, females in the water and honey treatments deposited greater numbers of eggs earlier in the trial, but this trend was unable to be sustained over their lifetime. Egg numbers in these treatments subsequently fell below the levels achieved by females in the Amino-Feed plus extrafloral nectar and cotton extrafloral nectar only treatments. Furthermore, there were times when the inclusion of the Amino-Feed was beneficial compared with cotton extrafloral nectar only. Artificial food supplements and plant-derived foods are worthy of further investigation because they have potential to improve the ecosystem service of biological pest control in targeted agroecosystems by providing natural enemies with an alternative source of nutrition, particularly during periods of prey/host scarcity.

Using automated supplementation systems to meet growth targets for grazing sheep

Remote drafting technology now available for sheep allows targeted supplementation of individuals within a grazing flock. This paper reports results of three experiments. Experiment 1 examined the weight change of Merino wethers allowed access to either lupin grain or whole cottonseed 0, 1, 2 or 7 days/week for 6 weeks. Experiment 2 examined the weight change of Merino wethers allowed access to either lupins or a sorghum + cottonseed meal (CSM) supplement 0, 2, 4 or 7 days/week for 8 weeks. Experiment 3 investigated the relationship between five allocations of trough space at the supplement self-feeders (5–50 cm/sheep) and the weight change of Merino wethers allowed access to lupins 1 day/week for 8 weeks. In all experiments, the Merino wethers had free access as a single group to drinking water and low quality hay in a large group pen and were allowed access to supplement once per day on their scheduled days of access. No water was available in the areas containing supplement, but one-way flow gates allowed animals to return to the group pen in their own time. There was a linear response in growth rate to increased frequency of access to lupins in Experiments 1 and 2, with each additional day of access increasing liveweight gain by 26 and 21 g/day, respectively. Similarly, the response to the sorghum + CSM supplement was linear, although significantly lower (P < 0.05), at 12 g/day. Providing access to whole cottonseed resulted in no significant change in growth rate compared with the control animals. In Experiment 3, decreasing trough space from 50 to 5 cm/sheep had no effect on sheep liveweight change. It was concluded that the relationships developed here, for growth response to increased frequency of access to lupins or a sorghum + CSM supplement, could be used to indicate the most appropriate frequency of access to supplement, through a remote drafting unit, to achieve sheep weight change targets. Also, that a trough space of 5 cm/sheep appears adequate in this supplementation system.

Nutrition and Nutritional Care of Elderly People in Finnish Nursing Homes and Hospitals

Background: Malnutrition is a common problem for residents of nursing homes and long-term care hospitals. It has a negative influence on elderly residents and patients health and quality of life. Nutritional care seems to have a positive effect on elderly individuals nutritional status and well-being. Studies of Finnish elderly people s nutrition and nutritional care in institutions are scarce. Objectives: The primary aim was to investigate the nutritional status and its associated factors of elderly nursing home residents and long-term care patients in Finland. In particular, to find out, if the nursing or nutritional care factors are associated with the nutritional status, and how do carers and nurses recognize malnutrition. A further aim was to assess the energy and nutrient intake of the residents of dementia wards. A final objective was to find out, if the nutrition training of professionals leads to changes in their knowledge and further translate into better nutrition for the aged residents of dementia wards. Subjects and methods: The residents (n=2114) and patients (n=1043) nutritional status was assessed in all studies using the Mini Nutritional Assessment test (MNA). Information was gathered in a questionnaire on residents and patients daily routines providing nutritional care. Residents energy and nutrient intake (n=23; n=21) in dementia wards were determined over three days by the precise weighing method. Constructive learning theory was the basis for educating the professionals (n=28). A half-structured questionnaire was used to assess professionals learning. Studies I-IV were cross-sectional studies whereas study V was an intervention study. Results: Malnutrition was common among elderly residents and patients living in nursing homes and hospitals in Finland. According to the MNA, 11% to 57% of the studied elderly people suffered from malnutrition, and 40-89% were at risk of malnutrition, whereas only 0-16% had a good nutritional status. Resident- and patient-related factors such as dementia, impaired ADL (Activities of Daily Living), swallowing difficulties and constipation mainly explained the malnutrition, but also some nutritional care related factors, such as eating less than half of the offered food portion and not receiving snacks were also related to malnutrition. The intake of energy and some nutrients by the residents of dementia wards were lower than those recommended, although the offered food contained enough energy and nutrients. The proportion of residents receiving vitamin D supplementation was low, although there is a recommendation and known benefits for the adequate intake of vitamin D. Nurses recognized malnutrition poorly, only one in four (26.7%) of the actual cases. Keeping and analysing food diaries and reflecting on nutritional issues in small group discussions were effective training methods for professionals. The nutrition education of professionals had a positive impact on the energy and protein intake, BMIs, and the MNA scores of some residents in dementia wards. Conclusions: Malnutrition was common among elderly residents and patients living in nursing homes and hospitals in Finland. Although residents- and patient related factors mainly explained malnutrition, nurses recognized malnutrition poorly and nutritional care possibilities were in minor use. Professionals nutrition education had a positive impact on the nutrition of elderly residents. Further studies describing successful nutritional care and nutrition education of professionals are needed.

Acute and chronic effects of dietary nitrate supplementation on blood pressure and the physiological responses to moderate-intensity and incremental exercise

Dietary nitrate (NO3−) supplementation with beetroot juice (BR) over 4–6 days has been shown to reduce the O2 cost of submaximal exercise and to improve exercise tolerance. However, it is not known whether shorter (or longer) periods of supplementation have similar (or greater) effects. We therefore investigated the effects of acute and chronic NO3− supplementation on resting blood pressure (BP) and the physiological responses to moderate-intensity exercise and ramp incremental cycle exercise in eight healthy subjects. Following baseline tests, the subjects were assigned in a balanced crossover design to receive BR (0.5 l/day; 5.2 mmol of NO3−/day) and placebo (PL; 0.5 l/day low-calorie juice cordial) treatments. The exercise protocol (two moderate-intensity step tests followed by a ramp test) was repeated 2.5 h following first ingestion (0.5 liter) and after 5 and 15 days of BR and PL. Plasma nitrite concentration (baseline: 454 ± 81 nM) was significantly elevated (+39% at 2.5 h postingestion; +25% at 5 days; +46% at 15 days; P < 0.05) and systolic and diastolic BP (baseline: 127 ± 6 and 72 ± 5 mmHg, respectively) were reduced by ∼4% throughout the BR supplementation period (P < 0.05). Compared with PL, the steady-state V̇o2 during moderate exercise was reduced by ∼4% after 2.5 h and remained similarly reduced after 5 and 15 days of BR (P < 0.05). The ramp test peak power and the work rate at the gas exchange threshold (baseline: 322 ± 67 W and 89 ± 15 W, respectively) were elevated after 15 days of BR (331 ± 68 W and 105 ± 28 W; P < 0.05) but not PL (323 ± 68 W and 84 ± 18 W). These results indicate that dietary NO3− supplementation acutely reduces BP and the O2 cost of submaximal exercise and that these effects are maintained for at least 15 days if supplementation is continued.

Spirulina (Spirulina platensis) algae supplementation increases microbial protein production and feed intake and decreases retention time of digesta in the rumen of cattle

Cattle consuming pastures low in protein have low liveweight gain due to low rumen degradable protein (RDP) supply and thus low microbial crude protein (MCP) production and efficiency of MCP production [EMCP, g MCP/kg digestible organic matter (DOM)]. Nitrogen supplements can increase MCP production and EMCP of cattle grazing low protein pastures. The objective of this study was to compare the effects of supplementation with a non-protein-N source (NPN), in this case urea and ammonium sulfate (US), with a single-cell algal protein source (Spirulina platensis), on intake, microbial protein supply and digestibility in cattle. Nine cannulated Bos indicus steers [initial liveweight 250.1 ± 10.86 (s.d.) kg] were fed Mitchell grass hay (Astrebla spp; 6.1 g N, 746 g NDF/kg DM) ad libitum and were supplied with increasing amounts of US (0, 6, 13, 19 and 33 g US DM/kg hay DM) or Spirulina 0, 0.5, 1.4, 2.5 and 6.1 g Spirulina DM/kg W.day in an incomplete Latin square design. The response of MCP production and EMCP to increasing amounts of the two supplements was different, with a greater response to Spirulina evident. The MCP production was predicted to peak at 140 and 568 g MCP/day (0.64 and 2.02 g MCP/kg W.day) for the US and Spirulina supplements, respectively. The highest measured EMCP were 92 and 166 g MCP/kg DOM for the US and Spirulina treatments at 170 and 290 g RDP/kg DOM, respectively, or a Spirulina intake of 5.7 g DM/kg W.day. Increasing RDP intake from US and Spirulina resulted in an increase in Mitchell grass hay intake and rumen NH3-N concentration and reduced the retention time of liquid and particulate markers and digesta DM, NDF and lignin in the rumen with greater changes due to Spirulina. Total DM intake peaked at a Spirulina supplement level of 4.6 g Spirulina DM/kg W.day with a 2.3-fold higher DOM intake than Control steers. Rumen NH3-N concentrations reached 128 and 264 mg NH3-N/L for the US and Spirulina treatments with a significant increase in the concentration of branched-chain fatty acids for the Spirulina treatment. The minimum retention time of liquid (Cr-EDTA; 23 and 13 h) and particulate (Yb; 34 and 22 h) markers in the rumen were significantly lower for Spirulina compared with US and lower than unsupplemented animals at 24 and 34 h for Cr-EDTA and Yb, respectively. Spirulina could be provided safely at much higher N intakes than NPN supplements. The results suggest that, at an equivalent RDP supply, Spirulina provided greater increases than US in MCP production, EMCP and feed intake of Bos indicus cattle consuming low protein forage and could also be fed safely at higher levels of N intake.

Improving cost-effectiveness of supplementation systems for breeder herds in northern Australia

Low level strategic supplements constitute one of the few options for northern beef producers to increase breeder productivity and profitability. Objectives of the project were to improve the cost-effectiveness of using such supplements and to improve supplement delivery systems. Urea-based supplements fed during the dry season can substantially reduce breeder liveweight loss and increase fertility during severe dry seasons. Also when fed during the late wet season these supplements increased breeder body liveweight and increased fertility of breeders in low body condition. Intake of dry lick supplements fed free choice is apparently determined primarily by the palatability of supplements relative to pasture, and training of cattle appears to be of limited importance. Siting of supplementation points has some effect on supplement intake, but little effect on grazing behaviour. Economic analysis of supplementation (urea, phosphorus or molasses) and weaning strategies was based on the relative efficacy of these strategies to maintain breeder body condition late in the dry season. Adequate body condition of breeders at this time of the year is needed to avoid mortality from under-nutrition and achieve satisfactory fertility of breeders during the following wet season. Supplements were highly cost-effective when they reduced mortality, but economic returns were generally low if the only benefit was increased fertility.

Effect of ethanol extract of alga Laurencia supplementation on DNA oxidation and alkylation damage in mice

Laurencia terpenoid extract (LET) had been extracted from the red alga Laurencia tristicha. The study is to investigate the effects of LET supplementation on DNA oxidation and alkylation damages in mice. Forty healthy kunming mice weighing between 18g and 25g were randomly assigned into 4 groups, each consisting of ten animals. The mice were orally intubated respectively for 60 days with the designed concentrations of LET (25, 50, 100 mg/kg b.w.) for three exposed groups and salad oil (0.2 ml) for the blank group. Food and water were free for the animals. Mice in the blank and exposed groups were sacrificed after the last treatment and the blood of each animal was quickly taken for further experiments. The spontaneous and oxidized DNA damages of peripheral lymphocytes induced by H2O2 were analysed by SCGE. O-6-Methy-guanine (O-6-MeG) was measured by high performance capillary zone electrophoresis. There was no significantly difference in DNA spontaneous damage on peripheral lymphocytes of all the mice. The oxidative DNA damage in the 50 mg/Kg body weight supplement group are 286AU with the oxidation of 10 mu mol/L H2O2, significantly lower than the blank group 332AU (p<0.05). The contents of O-6-MeG in plasma in the 50mg/kg b.w. and 100mg/kg b.w. supplement group were 1.50 mu mol/L andl.88 mu mol/L, significantly lower than that of the blank group, which was 2.89 mu mol/L(p<0.05). The results from the present study indicated that the LET were rich in terpenoids and safety to be taken orally and it could improve antioxidative and decrease DNA damage effectively.

Early nutrition and eczema in infancy

Eczema prevalence rates among Irish infants are unreported, despite eczema being the most common inflammatory condition of infancy. Maternal and infant nutritional status including vitamin D and other fat-soluble vitamins as well as early infant feeding have been linked with eczema initiation and development. Therefore, early nutrition could be a potential modifiable risk factor. The objective of this thesis was to prospectively describe early infant feeding and complementary feeding practices, to evaluate infant vitamin D supplementation practice, to quantify cord serum 25-hydroxyvitamin D [25(OH)D] and propose reference intervals for vitamin D metabolites, to report eczema prevalence and explore the potential role of infant nutrition and eczema. These research needs were investigated through the Cork BASELINE (Babies After SCOPE: Evaluating the Longitudinal Impact with Neurological and Nutritional Endpoints) Birth Cohort Study (n 2137). This thesis was the first comprehensive report from the birth cohort, therefore it was important to describe the cohort sociodemographic profile. Although socio-demographic characteristics compared well with national data, there was an over-representation of educated mothers which may limit the generalizability of the results. From August 2008 through November 2011, comprehensive postnatal assessments were completed at day 2 and at 2, 6, 12 and 24 months. Breastfeeding rates were low, while complementary feeding practices were broadly compliant with national guidelines. The implementation of a national infant vitamin D supplementation policy had a major impact on supplementation practice. Low levels of serum 25(OH)D were universal among Irish neonates. Eczema is a complex and multifaceted disease, which is increasing globally. This was the first report of eczema prevalence data among Irish infants which compared with international reports. Given the high prevalence and considerable burden eczema has on the lives of sufferers, intensive research efforts to identify a cause and therapeutic strategies to prevent/reduce eczema was re-emphasized in this thesis.