e-SPEN Journal

Feasibility of a protein-enriched diet after laparoscopic adjustable gastric banding: Results from a pilot intervention

Alison Dodsworth, Helen Warren-Forward, Surinder Baines — 2012-03-12

Summary: Background & aims: Weight loss following laparoscopic adjustable gastric banding (LAGB) is variable. Increased protein intakes may promote optimal weight and body composition outcomes during weight loss. This study aimed to determine the feasibility of a protein-enriched diet after LAGB and to report pilot data findings.Methods: LAGB patients (n = 47) were allocated to follow a protein-enriched diet or usual care for six months after surgery. Weight, body composition and dietary intake were measured at baseline, three, six and 12 months.Results: Compliance with the protein-enriched diet was problematic. No differences in protein intake, weight or body composition were observed between the intervention and usual care groups. Relative protein intake for the study sample as a whole was not a significant predictor of weight or body composition at any time point.Conclusions: Feasibility of increasing protein intake from usual foods and a dietary supplement following LAGB was limited by compliance difficulties. This may negate any potential utility of a protein-enriched diet after LAGB. Further research is required to establish evidence-based guidelines for protein intake following LAGB and to determine methods to enhance compliance with dietary recommendations.Clinical trial registration number: ACTRN 12609000258257.

Nutritional effects on depressive symptoms in Parkinson’s disease patients

2012-03-12

Abstract: Background & aims: Factors associated with depression in Parkinson’s disease, especially lifestyle and nutrition, have been poorly studied. Our study was conducted to investigate nutritional factors associated with depression in Parkinson’s disease.Methods: The subjects were 82 Parkinson’s disease patients and the same number of sex and age-matched controls recruited from the outpatient clinic of Xiangfan No. 1 People’s Hospital in Hubei, China between 2006 and 2008. The Parkinson’s disease patients were divided into two groups, 24 Parkinson’s disease with depression and 58 Parkinson’s disease without depression. DSM-IV criteria was used for the primary diagnosis of depressive disorders. The severity of depression in patients was assessed by the criteria of the Hamilton Depression Rating Scale (HAMD-17), and a score ≥14 was defined as “depression”. Information about eating habits and other factors was obtained by subject recall of state prior to diagnosis of Parkinson’s disease and depressionResults: Compared with the Parkinson’s disease patients without depression and the controls, the Parkinson’s disease patients with depression had relatively low levels of income and education. Fat and vitamin B1 intake was significantly higher in the Parkinson’s disease patients with depression than in both the Parkinson’s disease patients without depression and the controls. Bean product intake was significantly lower in the Parkinson’s disease patients with depression than in both the Parkinson’s disease patients without depression and the controls.Conclusions: Less fat and vitamin B1 but more bean product intake might be associated with a lower risk for depression in Parkinson’s disease patients from a higher income bracket with better educational background.

Dietary seabuckthorn (Hippophae rhamnoides L.) reduces toxicity of oxidized cholesterol in rats

Yen-Hung Yeh, You-Liang Hsieh, Ya-Ting Lee, You-Cheng Shen — 2012-03-12

Summary: Background & aims: This study focused on the effects of dietary seabuckthorn (Hippophae rhamnoides L. Elaeagnaceae) on the toxicity of oxidized cholesterol in rats.Methods: The rats were divided into eight groups and fed with or without supplement of 0.1% seabuckthorn and 2% oxidized cholesterol in their diets for 8 weeks.Results: It was found that seabuckthorn could improve the body weight decrease and the glutathione (GSH), superoxide dismutase (SOD) and catalase (CAT) level in the liver, and increase of liver and kidney weight to body weight ratio, and thiobarbituric acid-reactive substances (TBARS) level in the liver of rats caused by oxidized cholesterol (P < 0.05). It also reduced the plasma content of alanine transaminase (ALT), aspartate transaminase (AST) and alkaline phosphatase (ALP), indicating that seabuckthorn could protective the hepatotoxicity induced by oxidized cholesterol (P < 0.05).Conclusions: It was also found that seabuckthorn possessed recovering effect and a short-term protective effect on the toxicity of oxidized cholesterol in rats. Taking all these data together, seabuckthorn may play an important role in diminishing the toxic effects of oxidized cholesterol in rats.

Fatty acid profile of pregnant women with asthma

2012-04-01

Summary: Background & aims: One of the most prevalent complications of pregnancy is asthma which is associated with an increased incidence of intrauterine growth restriction. The mechanisms that affect fetal development in pregnancies complicated by asthma are not clearly defined. Dietary fatty acids (FA) especially polyunsaturated fatty acids (PUFA) are particularly important during pregnancy due to their role in fetal growth and development. Dietary PUFAs also have a role in clinical outcomes for non-pregnant asthmatics. The current study was designed to characterize the fatty acid profile in pregnant women with asthma to determine whether asthma severity or reduced fetal growth were associated with an altered FA profile.Methods: Maternal dietary intake and plasma fatty acid profile were examined in women with and without asthma at 18, 30 and 36 weeks gestation. Maternal fatty acids levels were related to measures of fetal growth using Doppler ultrasound and birth outcomes.Results: The data found that pregnant women with moderate/severe asthma had increased circulating plasma fatty acid levels at 36 weeks gestation but reduced dietary intake of fats compared to those women with mild asthma and healthy pregnant controls. In addition, women with moderate/severe asthma had increased circulating n-3PUFA levels at 36 weeks gestation which was associated with reduced fetal and neonatal head circumference.Conclusion: These observations suggest moderate/severe asthma may disrupt lipid metabolism, transport or cellular uptake during pregnancy which subsequently contributes to reduced fetal growth.

Fish oil suppresses angiogenesis, reduces cell proliferation and DNA damage in rat mammary carcinogenesis

Sangita Manna, Subhadeep Das, Kaushik Roy, Ajay Rana, Malay Chatterjee — 2012-04-01

Summary: Background & aims: The current study was designed to evaluate the effect of dietary fish oil and corn oil on carcinogen-induced DNA damage, cell proliferation and angiogenesis in female Sprague-Dawley rats.Methods: Rats were treated with 7,12-dimethylbenz(α)anthracene (DMBA) (0.5 mg/0.2 ml corn oil/100 g body weight) by a tail vein injection. Rats were fed either fish oil or corn oil (0.5 ml/day/rat) by oral gavage. DNA Damage, proliferating cell nuclear antigen labeling index (PCNA-LI) and expression of vascular endothelial growth factor (VEGF) and microvessel density (MVD) of the mammary tissue were included in this study.Results: Tissue levels of both 8-hydroxy-2′deoxyguanosine (8-OHdG), a marker of DNA damage and DNA repair enzyme (PARP-1) were significantly reduced (P = 0.00000006) in the fish oil-treated group, and increased (P = 0.00000006) in the corn oil-treated group when compared to carcinogen counterpart. Furthermore, PCNA-LI, VEGF expressions and the MVD values were lower in fish oil-treated group (P = 0.000078; P = 0.000032; P = 0.000000005 respectively) and higher (P = 0.000027; P = 0.00004; P = 0.0000000003 respectively) in corn oil-treated group when compared to carcinogen control.Conclusions: Our results indicate that fish oil protects against carcinogen-induced DNA damage, cell proliferation and angiogenesis.

Practical use of a new three-chamber bag for parenteral nutrition in pediatric patients

Virginie Colomb, Monica L. Marlowe, Denis Bonnot, Jacques Rigo — 2012-04-01

Summary: Background & aims: Parenteral nutrition (PN) can be life-saving for children who are unable to receive enteral nutrition. The pediatric multichambered bag (Ped3CB), containing lipids, amino acids with electrolytes, and glucose, is the first PN triple-chambered bag designed specifically for children. The aims of the study were to evaluate the ease of handling and use of Ped3CB in children.Methods: This was a prospective, open-label, multicenter, noncomparative Phase 3 clinical trial. Patients were treated for 5 consecutive days with formulations designed for term infants and toddlers up to 2 years of age (Ped3CB-B) or for children and adolescents 2–18 years of age (Ped3CB-C). The volume of Ped3CB administered was based on the patient’s individual needs.Results: A majority of pharmacists and nurses found the Ped3CB system easy to use, and favored Ped3CB formulations over bags compounded on the ward, ready-to-use compounded bags, and premixes prepared by the pharmacy and tailored to patient needs. Ped3CB represented 91% of the PN energy intake among the Ped3CB-B group and 68% in the Ped3CB-C group. PN administered using the Ped3CB system was well tolerated in both groups. Only 10% adverse events were considered potentially related to study treatment.Conclusions: Ped3CB formulations are easy to use for administering PN to pediatric patients.Clinical trial registry EudraCT tracking number: 2007-001378-97

Changes in bile composition and liver ultrastructure after TPN alone and TPN with ultra-short bowel syndrome

2012-03-14

Summary: Background & aims: Two of the factors that can influence bile acid (BA) metabolism and biliary poles are long intestinal resections leading to short bowel syndrome (SBS) and prolonged starvation in total parenteral nutrition (TPN). These can act directly (by altering absorption) and/or indirectly (bacterial translocation, alterations of the hepato-intestinal hormonal complex,…). Our aim was to study the effects on bile metabolism and hepatic structure of the conditions of TPN with and without SBS in an animal model.Methods: We used 3 experimental groups of Dunkin-Hartley guinea pigs: group A (GA: 10 animals), subjected to anæsthesia and a sham laparotomy, and fed for 10 days by TPN; group B (GB: 10 animals), subjected to a jejuno-ileal resection, and fed for 10 days by TPN; and a control group (6 animals) subjected to a sham laparotomy, and fed orally. At the end of the experimental period, bile samples were taken from the hepatic duct to study the bile composition, and blood samples from the vena cava for blood biochemistry. Following liver perfusion, samples of hepatic tissue were taken for electron microscopy.Results: In GA and GB, there were significant losses in weight and increases in glycæmia and serum triglycerides, but a decrease in plasma cholesterol only in GB. For the bile composition, the concentrations of cholic acid (ChA), ketolithocholic acid (KLChA), and total conjugated BA were lowered in both GA and GB, while bile phospholipids (BPh) and bile cholesterol (BCh) were raised in GB only. The electron microscopy showed microsteatosis and a major loss of microvilli in the biliary poles or canaliculi in GA and even more so in GB, with the latter group also showing signs of fibrogenesis.Conclusions: TPN and SBS affect the BPh, BCh, and BA composition, potentially increasing the risk of biliary lithogenicity. This was especially so in the association of SBS and TPN, with affection of the biliary duct anatomy, and induction of fibrogenesis and cholangitis.