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Energy Intake (energy + intake)
Kinds of Energy Intake Terms modified by Energy Intake Selected AbstractsImpact of nutrition on outcome: A prospective randomized controlled trial in patients with head and neck cancer undergoing radiotherapyHEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 8 2005Paula Ravasco MD Abstract Background. We aimed to determine the effect of dietary counseling or oral supplements on outcome for patients with cancer, specifically, nutritional outcome, morbidity, and quality of life (QOL), during and 3 months after radiotherapy. Methods. Seventy-five patients with head and neck cancer who were referred for radiotherapy (RT) were randomized to the following groups: group 1 (n = 25), patients who received dietary counseling with regular foods; group 2 (n = 25), patients who maintained usual diet plus supplements; and group 3 (n = 25), patients who maintained intake ad lib. Nutritional intake (determined by diet history) and status (determined by Ottery's Subjective Global Assessment), and QOL (determined by the European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire version 3.0 [EORTC QLQ-C30]) were evaluated at baseline, at the end of RT, and at 3 months. Results. Energy intake after RT increased in both groups 1 and 2 (p , .05). Protein intake also increased in both groups 1 and 2 (p , .006). Both energy and protein intake decreased significantly in group 3 (p < .01). At 3 months, group 1 maintained intakes, whereas groups 2 and 3 returned to or below baseline levels. After RT, >90% of patients experienced RT toxicity; this was not significantly different between groups, with a trend for reduced symptomatology in group 1 versus group 2/group 3 (p < .07). At 3 months, the reduction of incidence/severity of grade 1+2 anorexia, nausea/vomiting, xerostomia, and dysgeusia was different: 90% of the patients improved in group 1 versus 67% in group 2 versus 51% in group 3 (p < .0001). After RT, QOL function scores improved (p < .003) proportionally with improved nutritional intake and status in group 1/group 2 (p < .05) and worsened in group 3 (p < .05); at 3 months, patients in group 1 maintained or improved overall QOL, whereas patients in groups 2 and 3 maintained or worsened overall QOL. Conclusions. During RT, nutritional interventions positively influenced outcomes, and counseling was of similar/higher benefit; in the medium term, only counseling exerted a significant impact on patient outcomes. © 2005 Wiley Periodicals, Inc. Head Neck27: XXX,XXX, 2005 [source] Hydroxypropylated Tapioca Starch Retards the Development of Insulin Resistance in KKAy Mice, a Type 2 Diabetes Model, Fed a High-Fat DietJOURNAL OF FOOD SCIENCE, Issue 7 2009Makoto Tachibe ABSTRACT:, The hypoglycemic and antidiabetic effect of hydroxypropyl tapioca starch (HPTS, degree of substitution = 0.180) was investigated in male KKAy mice. Mice were fed a purified high-fat (20%) diet without or with HPTS (5% or 10%) for 33 d. Gelatinized tapioca starch (TS) was used as a reference. Fasting blood glucose concentrations, days 14 and 28, were significantly lower in the 10% HPTS group compared with the reference. In an oral glucose tolerance test (OGTT), day 28, blood glucose concentrations in the 5% HPTS group, at 60, 90, and 120 min, and in the 10% HPTS group, at 30, 60, and 90 min after oral administration of glucose, were significantly lower compared with the reference. The area under the glucose curve (AUC) for glucose in both HPTS groups was significantly lower compared with the reference. Energy intake was significantly lower in the 10% HPTS group compared with the reference. At the end of the experiment, adiponectin concentrations were significantly higher in the 10% HPTS group compared with the reference. A homeostasis model assessment of insulin resistance (HOMA-IR) tended to be lower in the 10% HPTS group compared with the reference, whereas a quantitative insulin sensitivity check index (QUICKI) was significantly higher in both HPTS groups compared with the reference. These results show that HPTS retards the development of insulin resistance in KKAy mice fed a high-fat diet. [source] High-Hydroxypropylated Tapioca Starch Improves Insulin Resistance in Genetically Diabetic KKAy MiceJOURNAL OF FOOD SCIENCE, Issue 3 2009R. Kato ABSTRACT:, The hypoglycemic and antidiabetic effect of hydroxypropyl tapioca starch (HPTS) with a varying degree of substitution (DS: 0.058, 0.091, and 0.180) was investigated in rats and KKAy mice, an animal model of type 2 diabetes. The positive incremental area under the curve (IAUC) for glucose significantly decreased as the DS of HPTS increased. The IAUC after intragastric intubation of the highest HPTS (HPTS-III, DS = 0.180) was 55% of the IAUC of tapioca starch (TS). After 28 d, fasting blood glucose and insulin concentrations were significantly lower in rats fed HPTS-III (50 g/kg diet) than in those fed TS (P < 0.05). In KKAy mice fed HPTS-III (50 or 100 g/kg diet) for 33 d, as compared with TS, there was a delay in the detection of glucose in urine and also a decreased incidence of finding glucose in urine on days 7, 21, and 28; in addition, the AUCs for glucose in the oral glucose tolerance test on days 14 and 28 were significantly lower (P < 0.05 and P < 0.05, respectively). The plasma adiponectin concentration and the quantitative insulin sensitivity check index (QUICKI) were significantly higher in mice fed HPTS-III than in those fed TS (P < 0.01), whereas the homeostasis model assessment of insulin resistance (HOMA-IR) was lower (P < 0.01). Energy intake was significantly lower in mice fed HPTS-III than in those fed TS. These findings show that HPTS with a high DS resists digestion by ,-amylase and improves insulin resistance in KKAy mice by decreasing energy intake. However, the potential mechanism by which HPTS-III decreases energy intake is unclear at present. [source] A randomised, controlled trial of the effects of an energy-dense supplement on energy intake, appetite and blood lipids in malnourished community-based elderly patientsJOURNAL OF HUMAN NUTRITION & DIETETICS, Issue 4 2008G.P. Hubbard Background:, Disease-related malnutrition is common in the elderly and if left untreated may have severe consequences (Stratton & Elia, 2003). One of the strategies used to combat malnutrition is the use of high-energy, low-volume [18.8 kJ mL,1 (4.5 kcal ml,1)] nutritional supplements. This study aimed to investigate the effects of an energy dense supplement on energy intake, appetite and blood lipids in elderly patients at risk of malnutrition. Methods:, In this randomised, controlled, parallel study, 42 community-based patients (mean (SD) age: 84 (7.0) years, mean body mass index (BMI): 20.9 (3.5) kg m,2), identified as being at medium or high risk of malnutrition [Malnutrition Universal Screening Tool (MUST) (Elia, 2003)] were randomised (using standard randomisation methods) to receive either; (i) 1674 kJ day,1 (400 kcal day,1) (in 3 × 30 mL doses) of an energy-dense supplement (Calogen, Nutricia®) (n = 19) or (ii) dietary advice in the form of a standardised dietary advice sheet (n = 23), for 4 weeks. Energy intake, appetite, blood lipids [i.e. total cholesterol, low density lipoprotein (LDL) cholesterol (subset analysis only)], body weight, gastro-intestinal tolerance, product compliance and product acceptability were assessed during the 4 week study. Results are presented as mean (SD). Paired t -test and one way anova statistical analyses were undertaken using SPSS v15. Ethical approval for this study was obtained from the appropriate committee. Results:, Supplementation with the energy dense supplement significantly increased mean total daily energy intake by +1736 kJ (+415 kcal, P = 0.009) from 6456 (2330) kJ [1543 (557) kcal] to 8192 (1477) kJ [1958 (353) kcal], with no significant effect on voluntary food intake or appetite scores (for hunger, fullness and desire to eat). In the dietary advice group, although mean total daily energy intake was also significantly increased by +1105 kJ (+264 kcal, P = 0.026) from 5623 (2107) kJ [1344 (503) kcal] to 6728 (2029) kJ [1608 (485) kcal], it was significantly lower than in the energy dense group [-1464 kJ (-350 kcal), P = 0.012] at week 4. Both energy-dense and dietary advice groups maintained weight during the study. No significant adverse effects on blood lipid concentrations were observed in either group, with a significant decrease in total cholesterol concentrations [from 4.26 (1.0) mM to 3.96 (0.8) mM, P = 0.03] and LDL cholesterol concentrations [from 2.32 (0.6) mM to 2.06 (0.5) mM, P = 0.03] in the energy dense group (subset analysis, n = 9). Both supplementation with energy dense supplement and dietary advice were well tolerated with no gastro-intestinal side effects. The energy dense supplement was well accepted with >80% of patients rating it as pleasant and convenient, with an enjoyable taste. Compliance with the energy dense supplement was high, with 95% of patients consuming the recommended dose of 3 × 30 mL throughout the study. Discussion:, This study in elderly patients with or at risk of malnutrition suggests that the energy dense supplement is effective in significantly improving total intakes of energy with no suppression of appetite or voluntary dietary intake, enabling patients to maintain weight and that the energy dense supplement is well tolerated and accepted, with excellent compliance and no adverse effects on blood lipids. Conclusions:, This randomised controlled trial suggests that an energy-dense supplement is an effective, well tolerated and safe method of providing energy supplementation for the management of elderly patients with or at risk of malnutrition in clinical practice. References, Elia, M. (2003) The "MUST" report. Nutritional screening for adults: a multidisciplinary responsibility. Redditch, UK: BAPEN. Available at http://www.bapen.org.uk (accessed on 15 March 2008). Stratton, R.J., Green, C.J. & Elia, M. (2003) Disease-related malnutrition: an evidence-based approach. Oxford: CABI publishing. [source] The French longitudinal study of growth and nutrition: data in adolescent males and femalesJOURNAL OF HUMAN NUTRITION & DIETETICS, Issue 6 2002M. Deheeger Abstract Objectives To assess nutritional intake, growth parameters, physical activity and television viewing in French adolescents. Method A longitudinal study of dietary intake and anthropometric data recorded in the same children (n = 94) from 10 to 16 years of age is presented here. Results Energy intake increased from age 10,16 years in boys, whereas it decreased in girls from the age of 14. Height and weight increased in both males and females over the same period of time. Energy intake was positively associated with age at menarche. Nutritional intake, such as fat and calcium, did not meet recommendations for French adolescents. Height was higher than reference values, but the difference was not significant for girls between 14 and 16 years. Overweight (BMI > 97th percentile of the French reference) was found to be 13,14% between age 10 and 16 years. Time watching TV/computer increased with age from 1.4 to 2.2 h day,1 from 10 to 16 years. Active children had nutritional intake closer to recommendations. Conclusion In conclusion, this study shows that during adolescence, some nutritional variations can be explained by normal individual growth processes. Low intake of calcium in girls and sedentary lifestyle are of particular concern. [source] Norwegian adolescents with asthma are physical active and fit,ALLERGY, Issue 3 2009S. Berntsen Background:, Evidence regarding habitual physical activity levels and aerobic fitness of asthmatic compared to nonasthmatic children and adolescents is contradictory, and it is unclear if low physical activity levels can contribute to asthma development. The present study therefore aimed to determine whether adolescents with asthma have reduced physical activity levels and aerobic fitness, or increased energy intake and body fat compared to controls. Methods:, From the environment and childhood asthma study in Oslo, 174 (13- to 14-year old) adolescents, 95 (66 boys) with and 79 (41 boys) without asthma performed maximal running on a treadmill with oxygen consumption measurement (aerobic fitness) and had the sum of four skinfolds and waist circumference recorded (body fat), followed by wearing an activity monitor and registering diet for four consecutive days. Asthma was defined by at least two of the following three criteria fulfilled: (1) dyspnoea, chest tightness and/or wheezing; (2) a doctor's diagnosis of asthma; (3) use of asthma medication. Participants with asthma used their regular medications. Results:, Neither aerobic fitness, total energy expenditure nor hours in moderate to very vigorous intensity physical activity during week and weekend differed between adolescents with and without asthma. Energy intake and body fat was similar in both groups. Conclusions:, Total energy expenditure, aerobic fitness and hours in moderate to very vigorous intensity physical activity were not reduced and energy intake and body fat measured with skinfolds not increased among Norwegian adolescents with asthma. [source] Energy intake in predialysis patientsNEPHROLOGY, Issue 2005David Voss [source] A quantitative analysis of energy intake reported by young menNUTRITION & DIETETICS, Issue 4 2008Selma C. LIBERATO Abstract Aim:, To quantitatively analyse energy intake reported by young men and the accuracy of the Goldberg cut-off method for identifying misreporters. Methods:, This was a cross-sectional study in which: food intake was assessed by a four-day food record; resting metabolic rate was assessed by indirect calorimetry; percentage body fat was measured by dual-energy X-ray absorptiometry; and energy expenditure was assessed by physical activity record completed simultaneously with food intake measurements. Energy intake was analysed by direct comparison of energy intake and energy expenditure and by the Goldberg cut-off. Subjects: 34 healthy men aged 18,25 years. Setting: Queensland University of Technology, Queensland, Australia. Main outcome measures: percentage of misreporters in a group of young men using different methods. Statistical analyses: data are presented as means and standard deviations. The analyses were conducted using Statistic for Windows 5.5 software. Results:, Seven underreporters were identified by direct comparison of energy intake and energy expenditure. The Goldberg cut-off found six out of the seven underreporters identified by direct comparison of energy intake and energy expenditure, but wrongly identified two acceptable reporters as underreporters. The sensitivity and specificity of the Goldberg cut-off method were 0.86 and 0.93, respectively. Conclusions:, Seven out of 34 participants underreported their energy intake. In the absence of physical activity measurements, the Goldberg cut-off method identified underreporters in this group of young men with assessed resting metabolic rate. [source] Effects of castration on insulin levels and glucose tolerance in the mouse differ from those in manTHE PROSTATE, Issue 15 2010Takamitsu Inoue Abstract BACKGROUND Plasma insulin concentration is increased in prostate cancer patients during androgen deprivation therapy (ADT) and hyperinsulinemia has been associated with aggressive prostate cancer behavior. To investigate the possible role of castration-induced hyperinsulinemia as a mechanism that may attenuate the beneficial effects of ADT in patients with prostate cancer, a murine model would be useful. We therefore investigated long-term metabolic effects of castration in several mouse models. METHODS We studied the long-term influence of castration on energy intake, body weight, glucose tolerance, plasma-insulin, plasma insulin-like growth factor-1 (IGF-1), plasma adiponectin, and plasma leptin in C57BL/6, Swiss nu/nu, and CB17 scid mice receiving various diets. In each case, mice were randomized to have either bilateral orchiectomy or a sham operation. RESULTS Energy intake, body weight, blood glucose levels in glucose tolerance test, plasma insulin, plasma IGF-1, and plasma leptin level in all had a trend to be decreased in castrated as compared to sham operated mice. Plasma adiponectin level was increased in the castrated mice. CONCLUSIONS The effects of castration on glucose, insulin, and related markers in several mouse models studied does not coincide with clinical observations; further studies in this area will require clinical research and/or the use of alternate models such as the dog. Prostate 70: 1628,1635, 2010. © 2010 Wiley-Liss, Inc. [source] Influence of herring (Clupea harengus) and herring fractions on metabolic status in rats fed a high energy dietACTA PHYSIOLOGICA, Issue 3 2009H. Lindqvist Abstract Aim:, Few dietary studies have looked beyond fish oil to explain the beneficial metabolic effects of a fish-containing diet. Our aim was to study whether addition of herring, or sub-fractions of herring, could counteract negative metabolic effects known to be induced by a high-fat, high-sugar diet. Methods:, Rats were given six different diets: standard pellets; high energy diet with chicken mince (HiE control); high energy diet with herring mince (HiE herring); and high energy diet with chicken mince and either herring oil (HiE herring oil), herring press juice, PJ (HiE PJ) or herring low molecular weight PJ (HiE LMW-PJ). Factors associated with the metabolic syndrome were measured. Results:, There were no differences in energy intake or body weight between the groups, but animals fed high energy diets had a higher body fat content compared with the pellet group, although not statistically significant in all groups. Mesenteric adipocyte size was smaller in the HiE herring oil group compared with the HiE control. Glucose clamp studies showed that, compared with the pellet group, the HiE control and HiE herring diets, but not the HiE herring oil diet, induced insulin resistance. Addition of herring or herring oil to the high energy diet decreased total cholesterol levels, triacylglycerols and the atherogenic index compared with the HiE control group. Conclusions:, The results suggest that addition of herring or herring oil counteracts negative effects on blood lipids induced by a high energy diet. The lipid component of herring thus seems to be responsible for these beneficial effects. [source] Neurophysiology of hunger and satietyDEVELOPMENTAL DISABILITIES RESEARCH REVIEW, Issue 2 2008Pauline M. Smith Abstract Hunger is defined as a strong desire or need for food while satiety is the condition of being full or gratified. The maintenance of energy homeostasis requires a balance between energy intake and energy expenditure. The regulation of food intake is a complex behavior. It requires discrete nuclei within the central nervous system (CNS) to detect signals from the periphery regarding metabolic status, process and integrate this information in a coordinated manner and to provide appropriate responses to ensure that the individual does not enter a state of positive or negative energy balance. This review of hunger and satiety will examine the CNS circuitries involved in the control of energy homeostasis as well as signals from the periphery, both hormonal and neural, that convey pertinent information regarding short-term and long-term energy status of the individual. © 2008 Wiley-Liss, Inc. Dev Disabil Res Rev 2008;14:96,104. [source] Improved cardiovascular health following a progressive walking and dietary intervention for type 2 diabetesDIABETES OBESITY & METABOLISM, Issue 9 2009S. T. Johnson Aim: To examine the impact of two different lifestyle programmes on cardiovascular health and glycaemic control among people with type 2 diabetes. Methods: A two-phase 24-week randomized trial. During the first phase, participants were to increase daily steps using a pedometer. At week 12, participants were randomly allocated to either an enhanced lifestyle programme (ELP) targeting walking speed or a basic lifestyle programme (BLP) targeting total daily steps. Both programmes focused on increasing the intake of low glycaemic index foods but utilized different goal setting strategies. Clinical measurements were completed at baseline, week 12 and week 24. Principal outcomes were change in resting pulse rate (PR) and glycated haemoglobin A1c (A1c) between week 12 and week 24 compared between groups using analysis of covariance. Results: Forty-one participants [mean ± s.d. : age = 56.5 ± 7.2 years, body mass index (BMI) = 32.7 ± 6.1 kg/m2] were randomized. After 12 weeks, we observed an increase in average total daily steps of 1562 (95% confidence interval: 303,2821, p = 0.02). Weight, BMI and systolic and diastolic blood pressure improved (p < 0.01 for all). No changes were observed for energy intake. At week 24, those in the ELP had a lower resting PR (71 ± 12 b.p.m.) compared with those in the BLP (78 ± 12 b.p.m.) (adjusted p = 0.03), while no group differences for total daily steps or glycaemic control were observed. Conclusions: Improvements in cardiovascular health can be expected following a pedometer-based lifestyle modification programme that progresses from walking more to walking faster. [source] Physical activity and energy intake in adolescent girls with Type 1 diabetesDIABETIC MEDICINE, Issue 7 2005S. Särnblad Abstract Aims Girls with Type 1 diabetes often gain excessive weight during puberty. The aims of this study were to compare objectively assessed physical activity and energy intake in girls with Type 1 diabetes with those in healthy age-matched controls. Methods This prospective cohort study comprised 26 girls with Type 1 diabetes and 49 control girls. The mean age of the diabetic girls was 15.7 ± 2.1 years and that of the control girls 15.8 ± 2.1 years. In the diabetic group, mean haemoglobin A1c was 7.6 ± 1.4% and daily insulin dosage was 1.1 ± 0.3 U/kg. Physical activity was measured during 7 consecutive days with a uniaxial accelerometer, and energy intake was assessed concurrently with a 7-day food diary. Results There was a tendency towards lower total amount of physical activity in the diabetes group but the difference between the study groups did not reach statistical significance (Diabetes: 464 ± 123 counts/min/day; Controls: 523 ± 138 counts/min/day; P = 0.06). No difference was found between the groups regarding total energy intake (Diabetes: 8.5 ± 1.8 MJ/day; Controls: 8.4 ± 2.6 MJ/day). The carbohydrate intake was lower and the protein and fibre intakes were higher in girls with diabetes. No association was observed between physical activity, energy intake and HbA1c. Conclusions In this prospective cohort study, we found a tendency towards lower physical activity but no differences in energy intake between girls with Type 1 diabetes and age-matched controls. Larger studies are needed to further explore the importance of the total amount of physical activity for excessive weight gain in adolescent girls with Type 1 diabetes. [source] Neuropeptides and appetite controlDIABETIC MEDICINE, Issue 8 2002J. P. H. Wilding Abstract Obesity is important in the aetiology of type 2 diabetes, and presents a major barrier to its successful prevention and management. Obesity develops when energy intake exceeds energy expenditure over time. A complex system has evolved to maintain energy homeostasis, but this is biased towards weight gain. Meal size is controlled by a series of short-term hormonal and neural signals that derive from the gastrointestinal tract, such as cholecystokinin whereas others may initiate meals, such as the recently discovered hormone, ghrelin. Other hormones such as insulin and leptin, together with circulating nutrients, indicate long-term energy stores. All these signals act at several central nervous system (CNS) sites but the pathways converge on the hypothalamus, which contains a large number of peptide and other neurotransmitters that influence food intake. As energy deficit is most likely to compromise survival, it is not surprising that the most powerful of these pathways are those that increase food intake and decrease energy expenditure when stores are depleted. When energy stores are low, production of leptin from adipose tissue, and thus circulating leptin concentrations fall, leading to increased production of hypothalamic neurotransmitters that strongly increase food intake, such as neuropeptide Y (NPY), galanin and agouti-related protein (AGRP) and decreased levels of ,-melanocyte-stimulating hormone (,-MSH), cocaine and amphetamine-regulated transcript (CART) and neurotensin that reduce food intake and increase energy expenditure. The finding that mutations in leptin and POMC lead to severe early onset obesity in bumans has highlighted the importance of these peptides in humans. This new understanding may eventually lead to new treatments for obesity that will be of particular benefit in the prevention and treatment of type 2 diabetes. Diabet. Med. 19, 619,627 (2002) [source] Prey size selection in piscivorous pikeperch (Stizostedion lucioperca) includes active prey choiceECOLOGY OF FRESHWATER FISH, Issue 4 2002H. Turesson Abstract,,,Knowledge of the mechanisms behind prey selection in piscivorous fish is important for our understanding of the dynamics of freshwater systems. Prey selection can involve active predator choice or be a passive process. We experimentally studied size-selectivity in pikeperch, feeding on roach and rudd. When given a choice of different prey sizes, pikeperch selected small prey. Passive selection mechanisms (encounter rate, capture success and satiation) could not fully explain the pattern of diet choice. Instead, behavioural analysis revealed that the pikeperch actively selected small-sized prey. Optimal foraging theory, predicting that predators will choose prey sizes giving highest energy return per time spent foraging, is assumed to explain active choice. We measured handling times for a range of prey sizes and found that the most profitable sizes were also the chosen ones, both in experiments and in the field. This suggests that pikeperch choose their prey to maximise energy intake per unit time. [source] A new optimal foraging model predicts habitat use by drift-feeding stream minnowsECOLOGY OF FRESHWATER FISH, Issue 1 2002G. D. Grossman Abstract , There is substantial need for models that accurately predict habitat selection by fishes for purposes ranging from the elaboration of ecological theory to the preservation of biodiversity. We have developed a new and highly tractable optimal foraging model for drift-feeding fishes that is based on the profitability of occupying varying focal-point velocities in a stream. The basic model can be written as: Ix = (Ex * Px) = {(D * A * V) * [1/(1 + e(b + cV))]} , Sx, where: (1) Ix is the net energy intake at velocity x; (2) E is prey encounter rate; (3) P is prey capture success rate which can be modelled as 1/(1 + e(b + cV)) where b and c are fitting constants from the prey capture success curve; (4) D is the energy content of prey (J/m3) in the drift; (5) A is the visual reactive area of the fish; (6) V is velocity (cm/s); and (7) S is the cost of maintaining position (J/s). Given that D, A and S can be considered constant over the range of velocities occupied by these fishes, the model reduces to e(b + cV) = 1/(cV , 1) which we solved iteratively to yield an optimal focal-point velocity for species in each sample. We tested the model by comparing its predictions to the mean focal-point velocities (i.e. microhabitats) occupied by four species of drift-feeding minnows in two sites in a stream in North Carolina, USA. The model successfully predicted focal-point velocities occupied by these species (11 out of 14 cases) in three seasonal samples collected over 2 years at two sites. The unsuccessful predictions still were within 2 cm/s of the 95% confidence intervals of mean velocities occupied by fishes, whereas the overall mean deviation between optimal velocities and mean fish velocities was small (range = 0.9 and 3.3 cm/s for the warpaint shiner and the Tennessee shiner, respectively). Available focal-point velocities ranged from 0,76 to 0,128 cm/s depending on site and season. Our findings represent one of the more rigorous field tests of an optimal foraging/habitat selection model for aquatic organisms because they encompass multiple species and years, and for one species, multiple sites. Because of the ease of parameterization of our model, it should be readily testable in a range of lotic habitats. If validated in other systems, the model should provide critical habitat information that will aid in the management of riverine systems and improve the performance of a variety of currently used management models (e.g. instream flow incremental methodology (IFIM) and total maximum daily load calculations (TMDL)). Resumen 1. Existe una grave necesidad de modelos que predigan con precisión la selección de hábitat por parte de los peces con fines que van del desarrollo de la teoría ecológica a la conservación de la biodiversidad. Nosotros hemos desarrollado un modelo nuevo y de fácil manejo de alimentación óptima para peces que se alimentan de la deriva que se fundamenta en los diferentes beneficios energéticos derivados de ocupar velocidades focales distintas en un río. 2. El modelo básico puede formularse como: Ix = (Ex * Px) = {(D * A * V) * [1/(1 + e(b + cV))]} , Sx, donde: (1) Ix es el energía neta obtenida a la velocidad, x; (2) V es la velocidad (cm/s); (3) A es el area visual de reacción del pez; (4) D es la energía contenida en las presas (J/m3) en la deriva; (5) E es la tasa de encuentro de presas; (6) P es la probabilidad de captura de la presa, que puede representarse como 1/(1 + e(b + cV)) donde b y c son constantes; y (7) S es el coste de nadar para mantener la posición en la corriente (J/s). Puesto que D, A y S pueden considerarse constantes en el rango de velocidades que ocupan estos peces, el modelo se reduce a e(b + cV) = 1/(cV , 1) que resolvimos iterativamente para obtener una velocidad focal óptima para cada especie en cada muestreo. 3. Probamos el modelo comparando su predicciones con la velocidades focales medias (i.e. microhabitats) ocupadas por cuatro especies de ciprínidos que se alimentan de la deriva en un río de Carolina del Norte. El modelo predijo con éxito las velocidades focales ocupadas por estas especies (11/14 casos) en tres muestreos estacionales llevados a cabo a lo largo de dos años en dos estaciones. Incluso las predicciones fallidas se diferenciaron en menos de 2 cm/s del límite de confianza al 95% CIs de las velocidades medias ocupadas, y la diferencia media entre predicciones y observaciones fue pequeña (rango = 0.9 cm/s warpaint shiner, a 3.3-cm/s Tennessee shiner). El rango de las velocidades focales medias disponibles fue de 0,76 cm/s a 0,128 cm/s dependiendo de la localidad y estación del año. 4. Nuestros resultados son una de las pruebas de campo más rigurosas de un modelo de alimentación óptima/selección de hábitat para organismos acuáticos puesto que incluyen diversas especies, años y, para una de las especies, localidades. La facilidad de la estima de los parámetros del modelo hace que sea fácil probarlo en diversos hábitats lóticos. Si es validado en ellos, el modelo debería proporcionar información valiosa que ayudará a la gestión de los sistemas fluviales y mejorará los resultados obtenidos a través de varios modelos usados actualmente para la gestión (p.e. IFIM y cálculos TMDL). [source] Growth hormone and changes in energy balance in growth hormone deficient adultsEUROPEAN JOURNAL OF CLINICAL INVESTIGATION, Issue 9 2008D. Deepak ABSTRACT Background, Adults with growth hormone deficiency (AGHD) have an adverse body composition with an increased prevalence of obesity. It is not known whether growth hormone replacement (GHR) results in alterations in energy intake (EI) and/or energy expenditure (EE). The aim of the study was to investigate the effects of GHR on EI and EE. Materials and methods, Nineteen hypopituitary adults (14 males, 5 females, mean age 46·2 years) with severe GHD (peak GH response to glucagon , 9 mU L,1) were studied. All patients self-injected recombinant human GH starting with 0·3 mg s.c. daily. The following were measured before and following 6 months of stable maintenance of GHR: food intake during a test meal, appetite ratings, resting EE (indirect calorimetry) and voluntary physical activity (accelerometry). Results, GHR nearly doubled voluntary physical activity (mean activity units 3319 vs. 1881, P = 0·007) and improved quality of life score (mean score 9·1 vs. 16·5, P < 0·0001). Subjects reported higher fasting hunger ratings (mean 64·8 vs. 49·6, P = 0·02) but ad libitum energy intake remained unchanged. Eating behavioural traits were favourably altered with lower disinhibition (mean 6·0 vs. 7·2, P = 0·02) and lower susceptibility to hunger ratings (4·6 vs. 6·8, P = 0·001) after GHR. Additionally, GHR did not result in significant changes in resting EE, body weight and body mass index. Conclusions, GHR in AGHD significantly improves voluntary physical activity and quality of life. Following GHR, subjects experience greater ,state' (physiological) hunger, reductions in eating disinhibition and hunger susceptibility, but no effects on calorie intake or macronutrient choice were detected. [source] Trans fatty acids and cancers: AFSSA recommendationsEUROPEAN JOURNAL OF LIPID SCIENCE AND TECHNOLOGY, Issue 9 2007Mariette Gerber Abstract The results of epidemiological studies were too few and inconsistent to enable a conclusion to be drawn as to whether dietary trans fatty acids (TFA) including conjugated linoleic acids (CLA) were beneficial or detrimental to the various sites of cancer studied. The effect of CLA isomers has only been studied in animal models, and mainly on mammary tumours. CLA , particularly the 9c,11t CLA , exerted an inhibitory effect on the initiation and development of these tumours, whereas a similar effect has not been observed in humans, whose intake level is much lower than the threshold required for an antitumour effect to be detectable in rodents. The aforementioned effect has been obtained in animal models at prolonged and high intakes, from 0.5 to 2% of the total energy intake, which corresponds approximately to 5,10,g/day in humans. The underlying mechanisms have not been identified and are probably indirect and multiple. [source] Foraging tactics in alternative heterochronic salamander morphs: trophic quality of ponds matters more than water permanencyFRESHWATER BIOLOGY, Issue 9 2007MATHIEU DENOEL Summary 1. In lentic freshwater habitats, the composition of animal assemblages shifts along a gradient from temporary to permanent basins. When habitats with different degrees of permanence are at the scale of the home range of species, they constitute alternatives in terms of energy acquisition through feeding. 2. In this context, previous studies showed an advantage of metamorphic over paedomorphic tiger salamanders (Ambystoma tigrinum) in temporary ponds which are only available to metamorphs. The aim of this study was to establish whether salamanders obtain similar benefits in ponds that do not differ in water permanence and whether salamanders shifted from detrimental to advantageous ponds. To this end, we determined the feeding habits, body condition and movement patterns of the two morphs in a complex of four permanent and four temporary ponds. 3. Consistent with previous studies, metamorphs consumed higher-quality diets than paedomorphs in term of energy intake. However, these differences occurred because metamorphs consumed fairy shrimp in a single temporary pond. Individual movement patterns confirmed that most of the metamorphs used different aquatic habitats both within and between years and that most of them moved from permanent ponds for breeding towards the most profitable temporary pond in terms of foraging. 4. These results indicate that habitat selection by salamanders is optimal in term of energy intake in metamorphs that use high quality ponds independently of hydroperiod. It seems that both spatial and temporal variation can influence the relative foraging success of each morph. [source] The reproductive role hypothesis explains trophic morphology dimorphism in the northern map turtleFUNCTIONAL ECOLOGY, Issue 5 2008G. Bulté Summary 1Sexually dimorphic traits often reflect factors limiting the reproductive success of animals. Thus, most sexually dimorphic traits can be directly linked to the reproductive role of each sex. Sexual dimorphism in trophic structures (e.g. beak, jaws, teeth), however, often lacks a direct link to reproduction. 2Trophic structures can be linked indirectly to reproductive allocation via energy acquisition. The reproductive role hypothesis (also known as the dimorphic niche hypothesis) posits such an indirect link, but has received heretofore little direct empirical support. We tested this hypothesis in a molluscivorous turtle exhibiting marked female-biased trophic morphology dimorphism. 3Bite force analysis showed that females have stronger jaws than males and dietary analysis revealed that females ingest snails closer to their maximum biting capacity than males. Body condition of both sexes and reproductive output of females increased with relative head width, indicating that fitness is tightly linked to head size and bite force. 4Our study provides strong evidence that reproductive role contributes to sexual dimorphism in trophic morphology. Our findings should apply to any animal in which energy intake is limited by trophic morphology. [source] The effect of forage type and level of concentrate supplementation on the performance of spring-calving dairy cows in early lactationGRASS & FORAGE SCIENCE, Issue 3 2002P. Dillon Abstract In 1993 and 1994, 40 cows in early lactation in early spring were assigned randomly to four feeding treatments. One group of cows was kept indoors with access to grass silage ad libitum, plus 6 kg of concentrate daily. The other three groups had access to grass pasture (5,6 h per day in 1993 and 11,12 h per day in 1994) plus grass silage similar to that fed to the previous group while indoors plus 6, 4 or 2 kg of concentrate daily. The average daily allocations of herbage (> 3·5 cm) were 8·5 and 14·0 kg DM cow,1 day,1 in 1993 and 1994 respectively. The treatments were applied for 8 weeks (26 February to 23 April) in 1993, and 7 weeks (11 March to 29 April) in 1994. Cows with access to pasture had lower (P < 0·001) silage dry-matter (DM) intakes and higher (P < 0·001) total forage DM intakes in both years than those kept indoors. This resulted in significantly higher yields of milk, fat, protein and lactose. Similarly, milk protein concentration was higher (P < 0·05 in 1993; P < 0·001 in 1994). There was a significant linear increase in total DM intake in both years with increased concentrate supplementation. In 1993, there was a linear increase in milk (P < 0·01), fat (P < 0·01), protein (P < 0·001) and lactose (P < 0·01) yields with increased concentrate supplementation. In 1994, only milk protein yield (P < 0·05) was increased. Concentrate supplementation had no effect on milk composition or liveweight change. Cows with access to grazed grass had higher liveweight gains (P < 0·05) than those kept indoors in both years. In 1993, increasing the energy intake increased the processing qualities of the milk produced. The results showed that access to grass pasture resulted in higher milk production, in reduced silage requirement and in reduced level of concentrate supplementation required for a given level of milk production with spring-calving cows in early lactation compared with those kept indoors. [source] Does a late evening meal reduce the risk of hepatocellular carcinoma among patients with chronic hepatitis C?HEPATOLOGY RESEARCH, Issue 9 2008Satoko Ohfuji Aim:, Some studies have suggested that nutritional support might protect against the recurrence of hepatocellular carcinoma (HCC) among postoperative HCC patients. However, no epidemiological studies have evaluated the effect of nutritional support on HCC incidence. This study aimed to investigate the association between a late evening meal and HCC. Methods:, We conducted a hospital-based, case-control study comparing 73 cases with HCC to 253 matched controls among patients with chronic hepatitis C. A questionnaire elicited information on the consumption of a late evening meal, which was defined as a snack or meal within 2 h before bedtime. The odds ratios (OR) and 95% confidence intervals (CI) were calculated by the conditional logistic regression model. Results:, After adjustment for potential confounders, patients who consumed a late evening meal had a lower OR as compared to those who did not consume one (OR, 0.08; 95% CI, 0.01,0.48). In terms of frequency of intake, a clear inverse exposure,response relationship was observed (trend P = 0.009). In addition, a negative association between a late evening meal and HCC was more pronounced among patients with an ,-fetoprotein level of less than 20 ng/mL and those with a body mass index of less than 25 kg/m2. Conclusion:, A late evening meal might protect against HCC, particularly among patients with a normal ,-fetoprotein level and who are not obese, although these relations might be accounted for other factors, including total energy intake. Further studies with larger study sizes are needed to corroborate these findings. [source] Ingestion patterns and daily energy intake on a sugary diet: the Red Lory Eos bornea and the Malachite Sunbird Nectarinia famosaIBIS, Issue 3 2000COLLEEN T. DOWNS This study examines whether nectarivorous birds regulate daily energy intake as proposed by Lloyd in 1991. Two Old World nectarivorous species, a large non-passerine, the Red Lory Eos bornea, and a small passerine, the Malachite Sunbird Nectarinia famosa, were fed 0.25 mol/1 sucrose (9%), 0.73 mol/1 sucrose [24%] or 0.73 mol/1 glucose in separate laboratory trials to determine hourly and overall daily rate of sugar intake and consumption. Overall daily energy intake rates of the Malachite Sunbird and the Red Lory support the hypothesis of regulated energy intake for nectarivorous Old World birds. However, the species differ in their ingestion patterns through the day. The Red Lory ingests large volumes initially, regardless of sugar type. This is possibly a consequence of their large size and having a crop in which food can be stored. The Malachite Sunbird showed more regular hourly consumption through the day, and no change in mass during the day. Intake rates of both species were greater on lower sugar concentrations. [source] Nutriose, a prebiotic low-digestible carbohydrate, stimulates gut mucosal immunity and prevents TNBS-induced colitis in piglets,INFLAMMATORY BOWEL DISEASES, Issue 5 2010Philippe R. Pouillart PhD Abstract Background: We investigated a prebiotic low-digestible carbohydrate (LDC) as a possible food ingredient to stimulate bowel functions in the treatment of inflammatory bowel disease. The study aimed to assess a fermentable dextrin fiber (Nutriose) and its relationship to the immune management of the disease and the microbiota profile in colitis-bearing piglets. Methods: In a randomized placebo-controlled parallel blind preclinical study, 32 male piglets were fed LDC (4% Nutriose) or dextrose placebo for 44 days before being challenged with trinitrobenzene sulfonic acid (TNBS) to induce colitis. We followed the microbiota profile using real-time polymerase chain reaction (PCR) targeted to 9 bacterial genera. Secretory IgA was evaluated by enzyme-linked immunosorbent assay (ELISA). Inflammatory protein profiles were monitored in blood and colonic tissues. Both histological scoring of biopsy samples and live endoscopic scoring were used to measure colitis development. Results: Prior and continuing LDC supplementation alleviated the symptoms of colitis (body weight loss, bloody stools) induced by a TNBS challenge. This effect was associated with an improvement in endoscopic and histological scores. LDC was shown to selectively downregulate some of the proinflammatory factors and their concomitant pyretic events and to stimulate the Th2-related immune pathway (IL-10 and s-IgA). Conclusions: At the dose tested, LDC is a well-tolerated prebiotic agent able to not only stimulate butyrogenic bacteria strains and reduce intestinal transit disorders and energy intake, but also to prevent chronic inflammatory intestinal injuries. Inflamm Bowel Dis 2010 [source] Fruit and vegetable consumption and pancreatic cancer risk in the European Prospective Investigation into Cancer and NutritionINTERNATIONAL JOURNAL OF CANCER, Issue 8 2009Alina Vrieling Abstract Many case-control studies have suggested that higher consumption of fruit and vegetables is associated with a lower risk of pancreatic cancer, whereas cohort studies do not support such an association. We examined the associations of the consumption of fruits and vegetables and their main subgroups with pancreatic cancer risk within the European Prospective Investigation into Cancer and Nutrition (EPIC). EPIC is comprised of over 520,000 subjects recruited from 10 European countries. The present study included 555 exocrine pancreatic cancer cases after an average follow-up of 8.9 years. Estimates of risk were obtained by Cox proportional hazard models, stratified by age at recruitment, gender, and study center, and adjusted for total energy intake, weight, height, history of diabetes mellitus, and smoking status. Total consumption of fruit and vegetables, combined or separately, as well as subgroups of vegetables and fruits were unrelated to risk of pancreatic cancer. Hazard ratios (95% CI) for the highest versus the lowest quartile were 0.92 (0.68,1.25) for total fruit and vegetables combined, 0.99 (0.73,1.33) for total vegetables, and 1.02 (0.77,1.36) for total fruits. Stratification by gender or smoking status, restriction to microscopically verified cases, and exclusion of the first 2 years of follow-up did not materially change the results. These results from a large European prospective cohort suggest that higher consumption of fruit and vegetables is not associated with decreased risk of pancreatic cancer. © 2008 Wiley-Liss, Inc. [source] Fibre intake and renal cell carcinoma: A case-control study from ItalyINTERNATIONAL JOURNAL OF CANCER, Issue 8 2007Carlotta Galeone Abstract Only 2 previous studies, conducted in Australia, United States and northern Europe, considered the role of dietary fibre intake on renal cell carcinoma (RCC) risk, and both showed a modest, inverse association. Therefore, we investigated in depth the topic of fibres and RCC, using data from a multicenter case-control study conducted in Italy from 1992 to 2004, including 767 cases with incident, histologically confirmed RCC and 1,534 controls admitted to the same network of hospitals as cases with acute nonmalignant conditions. Multivariate odds ratios (OR) and 95% confidence intervals (CI) were obtained after allowance for major identified confounding factors, including total energy intake. The continuous OR for an increase in intake equal to the difference between the 80th and the 20th percentile were 0.94 (95% CI: 0.82,1.08) for total dietary fibre, 0.98 (95% CI: 0.85,1.13) for soluble noncellulose polysaccharides, 0.92 (95% CI: 0.80,1.05) for total insoluble fibre, 0.90 (95% CI: 0.78,1.04) for cellulose, 0.95 (95% CI: 0.84,1.06) for insoluble noncellulose polysaccharides and 1.06 (95% CI: 0.93,1.21) for lignin. With reference to the sources of fibre, we found an inverse association with vegetable fibre (OR = 0.84, 95% CI: 0.73,0.97), but no association with fruit (OR = 0.98, 95% CI: 0.86,1.12) and grain fibre (OR = 1.05, 95% CI: 0.95,1.15). The inverse association with vegetable fibre may reflect a real favorable effect, or be an indicator of a beneficial role of a diet rich in vegetable on RCC risk. © 2007 Wiley-Liss, Inc. [source] Dietary acrylamide and human cancerINTERNATIONAL JOURNAL OF CANCER, Issue 2 2006Claudio Pelucchi Abstract Low levels of acrylamide have been found in several foods cooked at high temperatures. While there is sufficient evidence for the carcinogenicity of acrylamide in experimental animals, the few epidemiologic studies conducted to date on occupational and dietary exposure to acrylamide have found no consistent evidence of association with human cancer risk. Using data from an integrated network of Italian and Swiss hospital-based case-control studies, we analyzed the relation between dietary acrylamide intake and cancers of the oral cavity and pharynx (749 cases, 1,772 controls), esophagus (395 cases, 1,066 controls), large bowel (1,394 cases of colon, 886 cases of rectal cancer, 4,765 controls), larynx (527 cases, 1,297 controls), breast (2,900 cases, 3,122 controls), ovary (1,031 cases, 2,411 controls) and prostate (1,294 cases, 1,451 controls). All the studies included incident, histologically confirmed cancer cases and controls admitted to the same network of hospitals for acute nonneoplastic conditions. We calculated odds ratios (ORs) using multivariate logistic regression models, adjusted for energy intake and other major covariates of interest. The ORs for the highest versus the lowest quintile of acrylamide intake were 1.12 (95% CI = 0.76,1.66) for cancer of the oral cavity/pharynx, 1.10 (95% CI = 0.65,1.86) for esophageal, 0.97 (95% CI = 0.80,1.18) for colorectal, 1.23 (95% CI = 0.80,1.90) for laryngeal, 1.06 (95% CI = 0.88,1.28) for breast, 0.97 (95% CI = 0.73,1.31) for ovarian and 0.92 (95% CI = 0.69,1.23) for prostate cancer. None of the trend in risk was significant. This uniquely large and comprehensive data set does not show any consistent association between intake of acrylamide and the risk of breast and several other common cancers. © 2005 Wiley-Liss, Inc. [source] Dietary carotenoids and risk of colon cancer: Case-control studyINTERNATIONAL JOURNAL OF CANCER, Issue 1 2004André Nkondjock Abstract Some epidemiological studies suggest that consumption of fruits and vegetables with a high carotenoid content may protect against colon cancer (CC). The evidence, however, is not completely consistent. Given the inconsistencies in findings in previous studies and continued interest in identifying modifiable risk factors for CC, a case-control study of French-Canadian in Montreal, Canada, was undertaken to examine the possible association between dietary carotenoids and CC risk and to investigate whether this association varies in relation to lifestyle factors such as smoking or diet, and particularly the high consumption of long-chain polyunsaturated fatty acids (LCPUFA). A total of 402 colorectal cases (200 males and 202 females) and 688 population-based controls matched for age, gender and place of residence were interviewed. Dietary intake was assessed through a validated food frequency questionnaire that collected information on over 200 food items and recipes. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated in unconditional logistic regression models. After adjustment for important variables such as total energy intake, no association was found between dietary intake of carotenoids and CC risk. For women with high intakes of LCPUFA, an inverse association was found between lutein + zeaxanthin and CC risk. ORs were 0.41; 95%CI (0.19,0.91), p=0.03 for eicosapentaenoic acid, and OR=0.36, 95%CI (0.19,0.78), p=0.01 for docosahexaenoic acid, when the upper quartiles of intake were compared to the lower. Among never-smokers, a significantly reduced risk of CC was associated with intake of ,-carotene [OR=0.44, 95%CI (0.21,0.92) and p=0.02], whereas an inverse association was found between lycopene intake and CC risk [OR=0.63, 95%CI (0.40,0.98) and p=0.05] among smokers. The results of our study suggest that a diet rich in both lutein + zeaxanthin and LCPUFAs may help prevent CC in French-Canadian females. © 2004 Wiley-Liss, Inc. [source] Are Elderly Hospitalized Patients Getting Enough Protein?JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 6 2008Cathy Gaillard MSc OBJECTIVES: To determine the protein requirements of elderly hospitalized patients. DESIGN: Cross-sectional evaluation of nitrogen balance. SETTING: Short-stay geriatric ward or rehabilitation care unit. PARTICIPANTS: Thirty-six elderly hospitalized patients (aged 65,99) admitted to short-stay and rehabilitation care units. MEASUREMENTS: Resting energy expenditure and nitrogen balance were determined under usual and spontaneous energy and protein intake after subjects were clinically stable (3,5 days after admission). All items consumed over a 3-day period were weighed to determine energy and protein intake. RESULTS: Energy (23.5±6.3 kcal/kg per day) and protein (0.99±0.24 g/kg per day) intake were similar in men and women, and nitrogen balance was neutral (0.37±2.6 g/day; P=.41 vs a neutral nitrogen balance, i.e., 0 g/d). Half of the patients had a positive nitrogen balance. Plasma C-reactive protein, renal function, nutritional status, and initial diagnosis had no influence on nitrogen balance. In contrast, energy and protein intakes correlated positively with nitrogen balance. Linear regression analysis suggested that an elderly hospitalized patient with an energy intake of 1.31 times resting energy expenditure or greater appears to require a minimum protein intake of 1.06±0.28 g/kg per day. CONCLUSION: Mean protein intake to reach a neutral nitrogen balance in elderly hospitalized patients is 1.06±0.28 g/kg per day, which is higher than current recommendations for healthy elderly people. Safe protein intake (that would be adequate to ensure that 95% of patients remain in positive nitrogen balance) is difficult to establish. [source] Energy-Containing Nutritional Supplements Can Affect Usual Energy Intake Postsupplementation in Institutionalized Seniors with Probable Alzheimer's DiseaseJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 9 2006Matthew D. Parrott BSc OBJECTIVES: To determine whether increases in caloric intake associated with consumption of a mid-morning nutritional supplement for 3 weeks were maintained in the week after stopping the supplement and to investigate the effects of body mass index (BMI) and cognitive and behavioral measures on this response. DESIGN: Secondary analysis of a previously published randomized, crossover, nonblinded clinical trial. SETTING: A fully accredited geriatric care facility affiliated with the University of Toronto. PARTICIPANTS: Thirty institutionalized seniors with probable Alzheimer's disease (AD) who ate independently. MEASUREMENTS: Investigator-weighed food intake, body weight, cognitive (Severe Impairment Battery; Global Deterioration Scale) and behavioral (Neuropsychiatric Inventory,Nursing Home version; London Psychogeriatric Rating Scale) assessments. RESULTS: Individuals who responded successfully to supplementation as indicated by increases in daily energy intake were likely to maintain 58.8% of that increase postsupplementation, although stopping the supplement was associated with decreased habitual energy intake in low-BMI individuals who reduced their daily intakes during supplementation in response to the extra calories. Cognitive/behavioral tests were not reliable predictors of postsupplement intake. CONCLUSION: Institutionalized seniors with probable AD are likely to alter their usual energy intakes to maintain changes resulting from 3 weeks of supplementation. This effect may allow for rotating supplementation schedules in nursing homes that could reduce staff burden, but only for those individuals who are most likely to respond favorably. These data indicate that nutritional supplements and diet plans should be carefully prescribed in low-BMI individuals to limit variability in total energy provided and thus prevent lower-than-normal intake. [source] | |||||||||||||||||||||||||||||||||||||||||||