The justification for providing dietary guidance for the nutritional intake of boron

Because a biochemical function has not been defined for boron (B), its nutritional essentiality has not been firmly established. Nonetheless, dietary guidance should be formulated for B, because it has demonstrated beneficial, if not essential, effects in both animals and humans. Intakes of B commonly found with diets abundant in fruits, vegetables, legumes, pulses, and nuts have effects construed to be beneficial in macromineral, energy, nitrogen, and reactive oxygen metabolism, in addition to enhancing the response to estrogen therapy and improving psychomotor skills and cognitive processes of attention and memory. Perhaps the best-documented beneficial effect of B is on calcium (Ca) metabolism or utilization, and thus, bone calcification and maintenance. The paradigm emerging for the provision of dietary guidance that includes consideration of the total health effects of a nutrient, not just the prevention of a deficiency disease, has resulted in dietary guidance for chromium (Cr) and fluoride; both of these elements have beneficial effects in humans, but neither has a defined biochemical function. Knowledge of B nutritional effects in humans equals or is superior to that of Cr and fluoride; thus, establishing a dietary reference intake for B is justified. An analysis of both human and animal data suggests that an acceptable safe range of population mean intakes of B for adults could well be 1–13 mg/d. Recent findings indicate that a significant number of people do not consistently consume more than 1 mg B/d; this suggests that B could be a practical nutritional or clinical concern.     

口服营养补充研究进展

疾病相关营养不良是住院病人一个重要的不良预后因素,影响病人的生活质量,除去吞咽困难及消化道不健全,当患者摄入不能满足机体的需求时建议给予口服营养补充(ONS)。越来越多的证据证明口服营养补充在营养不良治疗中的重要有利作用,尤其对急性病、老年人及低营养状态的病人效果显著。口服营养补充符合人体生理特点,安全、经济、易于吸收且依从性较好,可以有效改善患者的能量及营养元素的摄取,提高患者的生活质量。ONS越来越多的在临床应用,但其应用时间,具体方法以及临床效果的评价还存在争议,本文从以下几方面对ONS的研究进行综述,介绍ONS的起源与发展,完善ONS的定义,准确评估其临床疗效,具体阐明ONS在肿瘤疾病中的应用,为ONS更好的应用于临床提供比较好的理论依据。     

Should bioactive trace elements not recognized as essential,but with beneficial health effects,have intake recommendations

Today, most nutritionists do not consider a trace element essential unless it has a defined biochemical function in higher animals or humans. As a result, even though it has been found that trace elements such as boron and silicon have beneficial bioactivity in higher animals and humans, they generally receive limited attention or mention when dietary guidelines or intake recommendations are formulated. Recently, the possibility of providing dietary intake recommendations such as an adequate intake (AI) for some bioactive food components (e.g., flavonoids) has been discussed. Boron, chromium, nickel, and silicon are bioactive food components that provide beneficial health effects by plausible mechanisms of action in nutritional and supra nutritional amounts, and thus should be included in the discussions. Although the science base may not be considered adequate for establishing AIs, a significant number of findings suggest that statements about these trace elements should be included when dietary intake guidance is formulated. An appropriate recommendation may be that diets should include foods that would provide trace elements not currently recognized as essential in amounts shown to reduce the risk of chronic disease and/or promote health and well-being.     

Increased predation of nutrient-enriched aposematic prey

Avian predators readily learn to associate the warning coloration of aposematic prey with the toxic effects of ingesting them, but they do not necessarily exclude aposematic prey from their diets. By eating aposematic prey ‘educated’ predators are thought to be trading-off the benefits of gaining nutrients with the costs of eating toxins. However, while we know that the toxin content of aposematic prey affects the foraging decisions made by avian predators, the extent to which the nutritional content of toxic prey affects predators'' decisions to eat them remains to be tested. Here, we show that European starlings (Sturnus vulgaris) increase their intake of a toxic prey type when the nutritional content is artificially increased, and decrease their intake when nutritional enrichment is ceased. This clearly demonstrates that birds can detect the nutritional content of toxic prey by post-ingestive feedback, and use this information in their foraging decisions, raising new perspectives on the evolution of prey defences. Nutritional differences between individuals could result in equally toxic prey being unequally predated, and might explain why some species undergo ontogenetic shifts in defence strategies. Furthermore, the nutritional value of prey will likely have a significant impact on the evolutionary dynamics of mimicry systems.     

Update on human health effects of boron

In vitro, animal, and human experiments have shown that boron is a bioactive element in nutritional amounts that beneficially affects bone growth and central nervous system function, alleviates arthritic symptoms, facilitates hormone action and is associated with a reduced risk for some types of cancer. The diverse effects of boron suggest that it influences the formation and/or activity of substances that are involved in numerous biochemical processes. Several findings suggest that this influence is through the formation of boroesters in biomolecules containing cis-hydroxyl groups. These biomolecules include those that contain ribose (e.g., S-adenosylmethionine, diadenosine phosphates, and nicotinamide adenine dinucleotide). In addition, boron may form boroester complexes with phosphoinositides, glycoproteins, and glycolipids that affect cell membrane integrity and function. Both animal and human data indicate that an intake of less than 1.0 mg/day inhibits the health benefits of boron. Dietary surveys indicate such an intake is not rare. Thus, increasing boron intake by consuming a diet rich in fruits, vegetables, nuts and pulses should be recognized as a reasonable dietary recommendation to enhance health and well-being.     

Comparative analysis of energy intake and physical activity according to household type and presence of metabolic syndrome in middle-aged men based on data from the 7th Korea national health and nutrition examination survey (KNHANES) (2016-2018)

[Purpose] This study analyzed data from the 7^th Korean National Health and Nutrition Examination Survey (2016‒2018) to compare the differences in energy intake and physical activity (PA) levels in middle-aged Korean men aged 40-59 years according to household type and the presence of metabolic syndrome (MetS).[Methods] Data from 2,266 young adults (aged >39 years and <60 years) were obtained from the KNHANES. We analyzed the differences in energy intake and PA levels according to household type and MetS. The presence or absence of MetS was determined by measuring waist circumference, blood pressure, fasting blood glucose, triglyceride, and HDL-C levels.[Results] Regarding total nutritional intake, no relationship with MetS was observed regardless of household type (interaction between MetS and household type: p = 0.875). No differences in total PA were observed between multiple- and single-person households (interaction between MetS and household type: p = 0.122). The relationship between MetS and MetS components according to nutritional intake showed that participants with a higher energy intake had a 27% lower prevalence of low high-density lipoprotein cholesterol (HDL-C) (p < 0.05) and a 36% higher prevalence of high blood pressure (p < 0.01). The relationship between MetS and MetS components according to the PA level showed significantly reduced prevalence of MetS by approximately 39%, 35%, and 43% (p < 0.01, 0.01, and 0.001) in subjects who were somewhat active, active, and very active, respectively, compared to inactivity.[Conclusion] Middle-aged men showed no difference in nutritional intake and PA between multiple- and single-person households. However, the risk of MetS was significantly higher in participants with approximately 1.5 times the energy intake compared to the group with the lowest energy intake. Moreover, higher levels of PA had a marked positive effect on the risk factors and prevalence of MetS. Therefore, we suggest that reducing the total energy intake and increasing total PA are important for preventing MetS in middle-aged men regardless of household type.     

Increased Physical Activity Not Decreased Energy Intake Is Associated with Inpatient Medical Treatment for Anorexia Nervosa in Adolescent Females

There is a dearth of data regarding changes in dietary intake and physical activity over time that lead to inpatient medical treatment for anorexia nervosa (AN). Without such data, more effective nutritional therapies for patients cannot be devised. This study was undertaken to describe changes in diet and physical activity that precede inpatient medical hospitalization for AN in female adolescents. This data can be used to understand factors contributing to medical instability in AN, and may advance rodent models of AN to investigate novel weight restoration strategies. It was hypothesized that hospitalization for AN would be associated with progressive energy restriction and increased physical activity over time. 20 females, 11–19 years (14.3±1.8 years), with restricting type AN, completed retrospective, self-report questionnaires to assess dietary intake and physical activity over the 6 month period prior to inpatient admission (food frequency questionnaire, Pediatric physical activity recall) and 1 week prior (24 hour food recall, modifiable activity questionnaire). Physical activity increased acutely prior to inpatient admission without any change in energy or macronutrient intake. However, there were significant changes in reported micronutrient intake causing inadequate intake of Vitamin A, Vitamin D, and pantothenic acid at 1 week versus high, potentially harmful, intake of Vitamin A over 6 months prior to admission. Subject report of significantly increased physical activity, not decreased energy intake, were associated with medical hospitalization for AN. Physical activity and Vitamin A and D intake should be carefully monitored following initial AN diagnosis, as markers of disease progression as to potentially minimize the risk of medical instability.     

Physical fitness level is reflected by alterations in the human plasma metabolome

An excessive energy intake combined with a low level of physical activity induces detrimental processes involved in disease development, e.g. type 2 diabetes and cardiovascular disease. However the underlying mechanisms for regulation of metabolic capacity and fitness status remain unclear. Metabolomics involves global studies of the metabolic reactions in an organism or cell. Thus hypotheses regarding biochemical events can be generated to increase the understanding of disease development and thereby aid in the development of novel treatments or preventions. We present the first standardized intervention study focusing on characterizing the human metabolome in relation to moderate differences in cardiorespiratory fitness. Gas chromatography-time of flight/mass spectrometry (GC-TOF/MS) was used to characterize 460 plasma samples from 27 individuals divided into two groups based on physical fitness level (VO(2)max). Multi- and univariate between group comparisons based on 197 metabolites were carried out in samples collected at rest prior to any intervention, over time following a nutritional load or a standardized exercise scheme, with and without nutritional load. We detected decreased levels of gamma-tocopherol (GT), a vitamin E isomer, in response to a high fitness level, whereas the opposite was seen for the alpha isomer (AT). In addition, the high fitness level was associated with elevated ω3-PUFA (DHA, 22 : 6ω3) and a decrease in ω6-PUFA (18 : 2ω6) as well as in saturated (16 : 0, 18 : 0), monounsaturated (18 : 1) and trans (16 : 1) fatty acids. We thus hypothesize that high fitness status induces an increased cardiorespiratory inflammatory and antioxidant defense system, more prone to deal with the inflammatory response following exercise and nutrition intake.     

Genetic and environmental influences on nutrient intake

The relationship between genetic and the environment represents a pathway to better understand individual variations in nutrition intake and food preferences. However, the present literature is weakened somewhat by methodological flaws (e.g., overreliance on self-report questionnaires), discrepancies in statistical approaches, and inconsistent findings. Little research on this topic to date has included examination of micronutrient intake. The purpose of this study is to improve the existing literature on genetic and environmental influences on energy and nutrient intake by addressing these gaps. Twin pairs (N = 358; age 11–13 years) provided 3-day food intake diaries, which were assessed for intake of total energy, macronutrients, and micronutrients. Structural equation modeling revealed that genetic influences accounted for a significant portion of the total variance in total energy (48 %), macronutrients (35–45 %), minerals (45 %), and vitamins (21 %). Consistent with previous studies, the shared environment appeared to contribute little to nutritional intake. Findings on vitamin and mineral intake are novel and are particularly beneficial for further research on the contribution of micronutrients to individual physical health status. Better understanding of the linkage between genes, environment, and nutritional intake and deficiencies can clarify behavioral and physical outcomes, potentially informing risk reduction, primary prevention, and intervention strategies.     

Supplementation with a new trypsin inhibitor from peanut is associated with reduced fasting glucose,weight control,and increased plasma CCK secretion in an animal model

Ingestion of peanuts may have a beneficial effect on weight control, possibly due to the satietogenic action of trypsin inhibitors. The aim of this study was to isolate a new trypsin inhibitor in a typical Brazilian peanut sweet (paçoca) and evaluate its effect in biochemical parameters, weight gain and food intake in male Wistar rats. The trypsin inhibitor in peanut paçoca (AHTI) was isolated. Experimental diets were prepared with AIN-93G supplemented with AHTI. Animals had their weight and food intake monitored. Animals were anesthetized, euthanized, and their bloods collected by cardiac puncture for dosage of cholecystokinin (CCK) and other biochemical parameters. Supplementation with AHTI significantly decreased fasting glucose, body weight gain, and food intake. These effects may be attributed to increased satiety, once supplemented animals showed no evidence of impaired nutritional status and also because AHTI increased CCK production. Thus, our results indicate that AHTI, besides reducing fasting glucose, can reduce weight gain via food intake reduction.     

Phenylketonuria—Experience at One Center in the First Year of Screening in California

One year''s experience with phenylketonuria during the calendar year 1966, the first year for compulsory newborn screening in California, was reviewed. The over-all prevalence rate from reported cases in California during this period was one case per 19,500 persons tested. Fifty-seven persons suspected of having pku were evaluated, and 25 of them were determined to be phenylketonuric. Eleven of the 25 were infants in whom the abnormality was detected through the newborn screening program or because it was detected in a sibling through a screening program. All the newborn phenylketonuric patients were developing normally at the time of last report (although the follow-up periods were short).In nine of the other children, pku was detected because they were retarded. Five retarded children who were diagnosed as phenylketonuric at another clinic were given dietary assistance.Five additional infants had elevated serum phenylalanines but did not have the classic biochemical findings of pku and are being evaluated further. Nine infants with positive screening tests exhibited biochemical and clinical findings consistent with transient tyrosinemia. Eighteen other children were evaluated and found to have no metabolic abnormality.The newborn screening program for pku is of decided benefit in early identification of a group of infants who have a high rate of potentially serious metabolic disease. Early identification permits treatment soon enough to prevent mental retardation. Newly identified patients should be evaluated in a medical setting capable of careful pediatric, biochemical and nutritional surveillance.     

Diet and retarded growth.

The diets of 36 children below the third centile for height but with no organic disease were compared with the diets of a control group. In most cases retarded growth was associated with a long-continued deficiency in calorie intake. When the diets were reassessed about a year later the shortfall in calorie intake was significantly reduced. This improvement, which tended to be followed by an increase in the rate of growth in height, might have been due to alteration in the child''s circumstances or improvement in the family attitudes and feeding habits or both. Advice given at the clinic is thought to have played a part in bringing these changes about.     

Sward height and bite size affect the functional response of barnacle geese Branta leucopsis

Intake rate, the rate in which herbivores can process their food, is presumed to be an important factor in habitat selection down to the scale of the foraging patch. Much attention has been given to the selection of swards of high nutritional quality, but much less has been given to the influences of sward structure on patch selection in small herbivores. In this study we tested the effects of sward density and height on the functional foraging response of barnacle geese, Branta leucopsis. The functional response curve for herbivores describes how intake rate is affected by food availability. We conducted feeding trials to determine intake rate and bite size of barnacle geese on experimentally manipulated swards. Results indicate that intake rate is mainly dependent on sward height and that there is a strong correlation between bite size and intake rate. Sward density does not influence the rate of food consumption; it is, however, a crucial parameter affecting potential total yield. We conclude that bite size is the crucial parameter influencing intake rate. Bite size is explained both by sward height and individual differences in bill morphology. Furthermore, intake rate seems to be dependent on the physical structure of the grass species consumed.     

肠内营养在直肠癌术后急性放射性肠炎中的临床应用研究

目的:研究肠内营养在直肠癌术后急性放射性肠炎中的临床应用。方法:选择2012年7月~2013年7月在我院接受治疗的104例直肠癌手术后发生急性放射性肠炎的患者作为研究对象。依照数字法随机分成观察组(51例)和对照组(53例)。对照组予以(半)流质食物,观察组则予以能全力肠内营养支持治疗。分别在治疗前以及治疗后7d测定血生化、营养以及电解质指标。结果:经7d治疗后,观察组的前白蛋白(PA)、白蛋白(Alb)、视黄醇结合蛋白(RBP)及体重(BW)水平均显著高于治疗前以及对照组,C反应蛋白(CRP)显著低于对照组,差异均有统计学意义(均P0.05);但两组治疗后的总蛋白(TP)水平差异无统计学意义(P0.05);两组治疗前后的谷丙转氨酶(ALT)、血清碱性磷酸酶(AKP)、凝血酶原时间(PT)、胆红素(BIL)、尿素氮(BUN)、肌酐(Cr)及血糖(Glu)等血生化指标以及钾离子(K+)、钠离子(Na+)、氯离子(Cl-)、钙离子(Ca2+)等电解质指标的差异均无统计学意义(均P0.05)。结论:通过肠内营养治疗直肠癌手术后发生的放射性肠炎,可改善患者的营养状况,效果显著,值得推广。     

Effect of a nutrition supplement and physical activity program on pneumonia and walking capacity in Chilean older people: a factorial cluster randomized trial

Background

Ageing is associated with increased risk of poor health and functional decline. Uncertainties about the health-related benefits of nutrition and physical activity for older people have precluded their widespread implementation. We investigated the effectiveness and cost-effectiveness of a national nutritional supplementation program and/or a physical activity intervention among older people in Chile.

Methods and Findings

We conducted a cluster randomized factorial trial among low to middle socioeconomic status adults aged 65–67.9 years living in Santiago, Chile. We randomized 28 clusters (health centers) into the study and recruited 2,799 individuals in 2005 (∼100 per cluster). The interventions were a daily micronutrient-rich nutritional supplement, or two 1-hour physical activity classes per week, or both interventions, or neither, for 24 months. The primary outcomes, assessed blind to allocation, were incidence of pneumonia over 24 months, and physical function assessed by walking capacity 24 months after enrolment. Adherence was good for the nutritional supplement (∼75%), and moderate for the physical activity intervention (∼43%). Over 24 months the incidence rate of pneumonia did not differ between intervention and control clusters (32.5 versus 32.6 per 1,000 person years respectively; risk ratio = 1.00; 95% confidence interval 0.61–1.63; p = 0.99). In intention-to-treat analysis, after 24 months there was a significant difference in walking capacity between the intervention and control clusters (mean difference 33.8 meters; 95% confidence interval 13.9–53.8; p = 0.001). The overall cost of the physical activity intervention over 24 months was US$164/participant; equivalent to US$4.84/extra meter walked. The number of falls and fractures was balanced across physical activity intervention arms and no serious adverse events were reported for either intervention.

Conclusions

Chile''s nutritional supplementation program for older people is not effective in reducing the incidence of pneumonia. This trial suggests that the provision of locally accessible physical activity classes in a transition economy population can be a cost-effective means of enhancing physical function in later life.

Trial registration

Current Controlled Trials ISRCTN 48153354 Please see later in the article for the Editors'' Summary     

Valoración del estado nutricional en Geriatría: declaración de consenso del Grupo de Nutrición de la Sociedad Española de Geriatría y Gerontología

Ongoing population ageing is one of the factors influencing the increase in the prevalence of undernutrition, as elderly people are a vulnerable group due to their biological, psychological and social characteristics.Despite its high prevalence, undernutrition is underdiagnosed in the geriatric sphere. For this reason, the aim of this consensus document is to devise a protocol for geriatric nutritional assessment. A multidisciplinary team has been set up within the Spanish Society of Geriatrics and Gerontology (in Spanish Sociedad Española de Geriatría y Gerontología [SEGG]) in order to address undernutrition and risk of undernutrition so that they can be diagnosed and treated in an effective manner.The MNA-SF is a practical tool amongst the many validated methods for nutritional screening. Following suspicion of undernutrition, or after establishing the presence of undernutrition, a full assessment will include a detailed nutritional history of the patient. The compilation of clinical-nutritional and dietetic histories is intended to help in identifying the possible risk factors at the root of a patient's undernutrition. Following this, an anthropometric assessment, combined with laboratory data, will describe the patient's physical and metabolic changes associated to undernutrition. Currently, the tendency is for further nutritional assessment through the use of non-invasive techniques to study body composition in association with functional status. The latter is an indirect index for nutritional status, which is very interesting from a geriatrician's point of view. To conclude, correct nutritional screening is the fundamental basis for an early undernutrition diagnosis and to assess the need for nutritional treatment. In order to achieve this, it is fundamental to foster research in the field of nutritional geriatrics, in order to expand our knowledge base and to increasingly practice evidence-based geriatrics.     

Recent developments in the biochemistry of chromium(III)

Chromium is generally believed to be an essential trace element and to have a role in maintaining proper carbohydrate and lipid metabolism, probably by enhancing insulin signaling. Three recent events have strongly influenced biochemical and nutritional studies of Cr(III): (1) the Food and Nutrition Board’ new daily adequate intake (AI) of Cr, (2) the Food Standards Agency’s determination that Cr picolinate might have the potential to cause cancer, and (3) the National Institutes of Health’s program announcement “Chromium as an adjuvant therapy for type 2 diabetes and impaired glucose tolerance.” A discussion of these three events allows the current understanding of the nutritional biochemistry of Cr to be outlined.     

Update on the possible nutritional importance of silicon

Convincing evidence that silicon is a bioactive beneficial trace element continues to accumulate. The evidence, which has come from human, animal, and in vitro studies performed by several laboratories, indicate that silicon in nutritional and supra nutritional amounts promotes bone and connective tissue health, may have a modulating effect on the immune or inflammatory response, and has been associated with mental health. A plausible mechanism of action for the beneficial effects of silicon is the binding of hydroxyl groups of polyols such that it influences the formation and/or utilization of glycosaminoglycans, mucopolysaccharides, and collagen in connective tissue and bone. In addition, silicon may affect the absorption, retention or action of other mineral elements (e.g., aluminum, copper, magnesium). Based on findings from both animal and human experiments, an intake of silicon of near 25 mg/d would be a reasonable suggestion for an adequate intake that would assure its nutritional benefits. Increased intakes of silicon through consuming unrefined grains, certain vegetables, and beverages and cereals made from grains should be recognized as a reasonable dietary recommendation.     

Induction of low-nutritious food intake by subsequent nutrient supplementation in sheep (Ovis aries)

Acceptance of and preference for a particular food depends not only on its intrinsic (e.g. nutritional) properties but also on expected or recent food experiences. An instance of this type of phenomenon has been called induction effect, which consists of an increased intake of a type of food when it precedes a hedonically preferred food in a sequence familiar to the animal, relative to controls that have access only to the less-preferred food. The purpose of our study was to assess intake induction of a low-nutritious food when followed by different high-nutritious supplements in sheep (Ovis aries). In this experiment, we ran a supplemented phase where animals fed oat hay (a low-nutritious food) in the first part of the daily feeding sessions followed by a supplement with either a high (soya bean meal; group GS) or a low (ground corn; group GC) protein–energy ratio in the second part ate more oat hay than controls that were fed oat hay in both parts of sessions (group GH). In addition, supplemented animals presented a stronger preference for oat hay over alfalfa hay than controls in a subsequent choice. When all animals received no food in the second part of the sessions (Non-supplemented phase), intake of oat hay converged to the control's intake level in all the groups, suggesting that the presence of supplements after access to oat hay was responsible for intake induction. Lastly, we repeated the supplemented phase with a different control group where animals received oat hay in the first part of the sessions and no food in the second part (group NF), thus equalizing groups in terms of the time of access to oat hay in a session. Groups GS and GC still developed higher intake of oat hay than group NF. In both supplemented phases of the experiment, we estimated animals’ daily metabolizable energy (ME) and crude protein (CP) intake. CP intake was higher in group GS than in groups GC, GH and NF, but there was no difference between group GC and the controls. In turn, groups did not differ in ME intake in the First supplemented phase, and only group GS presented higher ME intake than the rest of the groups in the Second supplemented phase. Therefore, a nutritional account of the present induction effect seems insufficient. We propose that a learned association between oat hay and the post-ingestive feedback from the subsequent high-nutritious supplements underlay sheep's intake induction and increased preference for oat hay.