Nutrition with 'light and water'? In strict isolation for 10 days without food - a critical case study

In her book 'Living on Light', Jasmuheen tries to animate people worldwide to follow her drastic nutrition rules in order to boost their quality of life. Several deaths have been reported as a fatal consequence. A doctor of chemistry who believably claimed to have been 'living on light' for 2 years, except for the daily intake of up to 1.5 l of fluid containing no or almost no calories was interested in a scientific study on this phenomenon. PARTICIPANT AND METHODS: The 54-year-old man was subjected to a rigorous 10-day isolation study with complete absence of nutrition. During the study he obtained an unlimited amount of tea and mineral water but had no caloric intake. Parameters to monitor his metabolic and psychological state and vital parameters were measured regularly and the safety of the individual was ensured throughout the study. The subject agreed on these terms and the study was approved by the local ethics committee.

Role of nutrition in liver transplantation for end-stage chronic liver disease

Patients with end-stage liver disease often reveal significant protein-energy malnutrition, which may deteriorate after listing for transplantation. Since malnutrition affects post-transplant survival, precise assessment must be an integral part of pre- and post-surgical management. While there is wide agreement that aggressive treatment of nutritional deficiencies is required, strong scientific evidence supporting nutritional therapy is sparse. In practice, oral nutritional supplements are preferred over parenteral nutrition, but enteral tube feeding may be necessary to maintain adequate calorie intake. Protein restriction should be avoided and administration of branched-chain amino acids may help yield a sufficient protein supply. Specific problems such as micronutrient deficiency, fluid balance, cholestasis, encephalopathy, and comorbid conditions need attention in order to optimize patient outcome.

ESPEN Guidelines on Parenteral Nutrition: geriatrics

Older subjects are at increased risk of partial or complete loss of independence due to acute and/or chronic disease and often of concomitant protein caloric malnutrition. Nutritional care and support should be an indispensable part of their management. Enteral nutrition is always the first choice for nutrition support. However, when patients cannot meet their nutritional requirements adequately via the enteral route, parenteral nutrition (PN) is indicated. PN is a safe and effective therapeutic procedure and age per se is not a reason to exclude patients from this treatment. The use of PN should always be balanced against a realistic chance of improvement in the general condition of the patient. Lower glucose tolerance, electrolyte and micronutrient deficiencies and lower fluid tolerance should be assumed in older patients treated by PN. Parenteral nutrition can be administered either via peripheral or central veins. Subcutaneous administration is also a possible solution for basic hydration of moderately dehydrated subjects. In the terminal, demented or dying patient the use of PN or hydration should only be given in accordance with other palliative treatments.

Access technique and its problems in parenteral nutrition - Guidelines on Parenteral Nutrition, Chapter 9

Catheter type, access technique, and the catheter position should be selected considering to the anticipated duration of PN aiming at the lowest complication risks (infectious and non-infectious). Long-term (>7-10 days) parenteral nutrition (PN) requires central venous access whereas for PN <3 weeks percutaneously inserted catheters and for PN >3 weeks subcutaneous tunnelled catheters or port systems are appropriate. CVC (central venous catheter) should be flushed with isotonic NaCl solution before and after PN application and during CVC occlusions. Strict indications are required for central venous access placement and the catheter should be removed as soon as possible if not required any more. Blood samples should not to be taken from the CVC. If catheter infection is suspected, peripheral blood-culture samples and culture samples from each catheter lumen should be taken simultaneously. Removal of the CVC should be carried out immediately if there are pronounced signs of local infection at the insertion site and/or clinical suspicion of catheter-induced sepsis. In case PN is indicated for a short period (max. 7-10 days), a peripheral venous access can be used if no hyperosmolar solutions (>800 mosm/L) or solutions with a high titration acidity or alkalinity are used. A peripheral venous catheter (PVC) can remain in situ for as long as it is clinically required unless there are signs of inflammation at the insertion site.

Practical handling of AIO admixtures - Guidelines on Parenteral Nutrition, Chapter 10

All-in-one admixtures (AIO-admixtures) provide safe, effective and low-risk PN (parenteral nutrition) for practically all indications and applications. Water, energy (carbohydrates and lipids), amino acids, vitamins and trace elements are infused together with PN either as industrially-manufactured AIO admixtures provided as two- or three-chamber bags (shelf life usually more than 12 months) completed with electrolytes and micronutrients where appropriate or as individually compounded ready-to-use AIO admixtures (compounding, usually prepared by a pharmacy on either a daily or weekly basis and stored at 2-8 degrees C). Physico-chemical and microbial stability of an AIO admixture is essential for the safety and effectiveness of patient-specific PN, and its assurance requires specialist pharmaceutical knowledge. The stability should be documented for an application period of 24 (-48) hours. It is advisable to offer a limited selection of different PN regimes in each hospital. For reasons of drug and medication safety, PN admixtures prepared for individual patients must be correctly labelled and specifications for storage conditions must also be followed during transport. Monitoring is required where applicable. Micronutrients are usually administered separately to AIO admixtures. In case compatibility and stability have been well documented trace elements and/or combination preparations including water-soluble or water-soluble/fat soluble vitamin supplements can be added to PN admixtures under strict aseptic conditions. AIO admixtures are usually not used as vehicles for drugs (incompatibilities).

Evaluation of Condition Scoring of Feeder Calves as a Tool for Management and Nutrition

Two experiments were conducted to evaluate the effects of body condition scores of beef calves on performance efficiency and carcass characteristics. In Experiment 1, 111 steer calves were stratified by breed and condition score (CS) and randomly allotted to 14 pens. The study was analyzed as a 2 x 3 factorial design, with two breeds (Angus and Simmental) and three initial CS (4.4, 5.1, and 5.6). In Experiment 2, 76 steer calves were allotted to six pens by CS. The resultant pens averaged 3.9, 4.5, 4.7, 5.0, 5.1, and 5.6 in CS. Calves in both studies were fed a corn-based finishing diet formulated to 13.5% crude protein. All calves were implanted with Synovex- SÒ initially and reimplanted with Revalor-SÒ. In Experiment 1, 29-day dry matter intake (lb/day) increased with CS (17.9, 18.1, and 19.1 for 4.4, 5.1, and 5.6, respectively; p < .04). Daily gain (29 days) tended to decrease with increasing CS (4.19, 3.71, and 3.26; p < .13). Days on feed decreased with increasing CS (185, 180, and 178d; p < .07). In Experiment 2, daily gains also increased with decreasing initial CS for the first 114 days (p < .05) and tended to increase overall (p < .20). In Experiment 1, calves with lower initial CS had less external fat at slaughter (.48, .53, and .61 in. for CS 4.4, 5.1, and 5.6, respectively; p < .05). This effect was also noted at slaughter (p < .10), as well as at 57 days (p < .06) and at 148 days (p < .06) as measured by real-time ultrasound. Measurements of intramuscular fat and marbling were not different in either study. These data suggest that CS of feeder calves may be a useful tool for adjusting energy requirements of calves based on body condition. Also, feeder cattle may be sorted into outcome or management groups earlier than currently practiced using body condition and/or real-time ultrasound.

Food Fury: Online Casual Game Development for Nutrition Education

Introduction: The United States is currently experiencing increased prevalence of obesity. This is a particular problem amongst children who require dietary and activity behavioral change to mitigate this problem. The use of computer games as channels to motivate health behavior in children is increasing. Casual games are a subset of computer games that are simple in design, easy to access and play, popular with children, and have the potential to be effective for drill and practice learning. [See PDF for complete abstract]