Food production and wastage in relation to nutritional intake in a general district hospital—wastage is not reduced by training the staff

Determination of nutrient adequacy of the food catered in the child care homes (CCHs) of Sunsari district

Systematic Review of the Influence of Energy and Protein Intake on Protein Balance in Critically Ill Children

Objective To investigate and analyze the actual intake of protein and energy in adult patients with severe burns during post burn days (PBDs) 3 to 14. Methods Records of 52 adult patients with severe burns [37 males and 15 females, (37±9) years old], admitted to the Department of Plastic Surgery and Burns of Tianjin First Central Hospital from January 1st 2011 to December 31st 2017 and meeting the study inclusion criteria, were retrospectively analyzed. Nutrition intake from routes of oral diet, enteral nutrition preparations, and parenteral nutrition preparations of patients during PBDs 3 to 14 were obtained from critical care records. During PBDs 3 to 7 and PBDs 8 to 14, the personal daily total energy intake and the ratio of it to energy target of patients were calculated and compared; the personal daily intake of carbohydrate, fat, and protein and calorigenic percentages of carbohydrate, fat, and protein accounted for total energy intake, and the ratios of non-protein calories to total nitrogen of patients were calculated and compared; the personal daily energy and protein intake of patients from routes of oral diet, enteral nutrition preparations, and parenteral nutrition preparations were analyzed; the percentages of energy intake from routes of oral diet, enteral nutrition preparations, and parenteral nutrition preparations accounted for total energy intake, and the percentages of protein intake from routes of oral diet, enteral nutrition preparations, and parenteral nutrition preparations accounted for total protein intake of patients were calculated. Vomiting and diarrhea of patients during PBDs 3 to 7 and PBDs 8 to 14 were recorded. Levels of serum albumin, prealbumin, blood glucose, and triglycerides, 24-hour excretion of urinary nitrogen, nitrogen balance values of patients on PBDs 7 and 14 were recorded or calculated. Data were processed with paired t test and chi-square test. Results (1) The personal daily total energy intake of patients during PBDs 3 to 7 and PBDs 8 to 14 were (8 696±573) and (11 980±1 259) kJ respectively, and ratios of them to energy target [(13 290±1 561) kJ] were 65.4% and 90.1% respectively. The personal daily total energy intake of patients during PBDs 3 to 7 was obviously lower than that during PBDs 8 to 14 (t=18.172, P 0.05). The ratios of non-protein calories to total nitrogen (kJ∶g) of patients during PBDs 3 to 7 and PBDs 8 to 14 were 469∶ 1 and 456∶ 1 respectively. (3) The personal daily energy intake of patients from routes of oral diet and parenteral nutrition preparations during PBDs 8 to 14 [(4 394±978), (5 723±898) kJ] were obviously higher than those during PBDs 3 to 7 [(2 137±453), (4 855±825) kJ, t=26.516, 6.583, P 0.05). The constituent ratio of personal daily energy during PBDs 3 to 7 was close to that during PBDs 8 to 14 (χ2=4.100, P>0.05). The personal daily protein intake of patients from route of oral diet during PBDs 8 to 14 was (58±22) g, obviously higher than (25±6) g during PBDs 3 to 7 (t=14.514, P 0.05). The constituent ratio of personal daily protein intake from routes of oral diet, enteral nutrition preparations, and parenteral nutrition preparations accounted for total protein intake during PBDs 8 to 14 was close to that during PBDs 3 to 7 (χ2=5.634, P>0.05). (4) There were 3 patients with vomiting and 4 patients with diarrhea during PBDs 3 to 7, and 1 patient experienced both of them during PBDs 8 to 14. The levels of serum albumin, prealbumin, blood glucose, and triglycerides, 24-hour excretion of urinary nitrogen, and nitrogen balance values of patients on PBDs 7 and 14 were (29±4) and (30±4) g/L, (132±42) and (171±48) mg/L, (7.4±2.8) and (6.7±2.8) mmol/L, (1.5±0.7) and (1.4±0.7) mmol/L, (30.5±4.3) and (34.5±2.2) g, -(25.1±2.6) and -(23.7±3.9) g, respectively. Conclusions The personal daily total energy intake of patients during PBDs 3 to 7 was lower than that during PBDs 8 to 14. The calorigenic constituent ratio of personal daily intake of carbohydrate, fat, and protein accounted for total energy of patients during PBDs 3 to 7 was close to that during PBDs 8 to 14. Energy and protein intake were mostly derived from parenteral nutrition preparations during PBDs 3 to 7, while those during PBDs 8 to 14 were mainly derived from parenteral nutrition preparations and oral diet. Key words: Burns; Nutrition surveys; Energy intake; Proteins

Cutting edge technologies to end food waste

The importance of dietary protein for the maintenance of muscle mass and strength is heavily discussed. However, adequate energy intake is an underlying assumption but often not considered. In this study, we investigated the impact of daily intake and meal distribution of both protein and energy on muscle mass and strength. In a cross-sectional study, a total of 184 older individuals (gender: 86F/98M, age: 70.2 ± 3.9 yrs, BMI: 25.4 ± 3.7 kg/m2; means ± SD) were recruited. Participants underwent a 3-day weighed dietary record, Dual-energy X-ray Absorptiometry (DXA) scan, hand-grip strength, and Maximal Voluntary Isometric knee-extension Contraction (MVIC). Participants were divided into two categories: lower (LOW; < 0.83 g/adjusted(a)BW/day) or higher (HIGH; ≥ 1.1 g/aBW/day) protein intake levels analysed by gender to characterize a daily protein and energy intake pattern. Main meal protein and energy intake distributions were calculated, and correlations were made. Further, energy intake at breakfast and lunch divided by total energy intake (energy ratio) was correlated with appendicular skeletal muscle index (ASMI), hand-grip strength, and MVIC were determined using the LOW/HIGH-protein-intake categorization. Further, gender-specific ASMI, hand-grip strength and knee extension were compared based on the following four distinct daily protein intake ranges: < 0.66; ≥ 0.66- < 0.83; ≥ 0.83- < 1.1; ≥ 1.1 g/aBW/day. A positive correlation appeared between protein and energy intake in all main meals (r ≥ 0.57, p < 0.0001). In the LOW category, positive correlations were found between energy ratio and ASMI (r = 0.16, p = 0.048), hand-grip strength (r = 0.40, p = 0.0009), and MVIC (r = 0.36, p = 0.0019), whereas no associations were found in the HIGH category. ASMI, hand grip, and MVIC were similar regardless of the protein intake ranges, though with women being lower than men (p < 0.05) in all outcomes. These results show that total daily protein intake did not affect muscle mass and strength in our cohort. However, our data demonstrate that greater energy intake in breakfast and lunch relative to total energy intake is associated with higher muscle mass and strength, particularly when protein intake is lower than 0.83 g/aBW/day, indicating the potential importance of meal energy content at lower intakes of protein.

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What are the causes of protein-energy malnutrition in chronic renal insufficiency?

Before the COVID-19 pandemic it was widely reported that, in the United States, over 40 percent of food produced was wasted During the pandemic, news reports have described unprecedented household food waste, up by 30 percent according to Republic Services, one of the largest waste management services in the US (Helmer 2020) But upstream, food waste was, and continues to be, equally problematic When institutions such as schools and universities, large businesses, restaurants, and other venues must shut down, so too must the food supply chain for those locations Farmers who produce food for large-scale public use have been unable to redirect their products for grocery markets, and so in many cases their harvests and dairy cannot be used Elsewhere along the chain, farm and other food laborers (e g , meat-packing workers, delivery workers) without access to protection and health care cannot continue to pack and deliver food at "normal" levels, and so potential food has been left in fields and warehouses (Evich 2020)

We evaluated the protein and energy intakes of infants fed commercial infant Formula A (protein, 2.2g/100 kcal; energy, 68 kcal/100 mL) and examined whether changes in feeding intervals are involved in constant energy intake. Daily nutritional intake of 378 Formula A-fed infants was assessed using reference values and compared to that of infants fed Formulas B (protein: 2.3g/100 kcal, energy: 68 kcal/100 mL) and C (protein: 2.4g/100kcal, energy: 70 kcal/100 mL). From 15 to 149days of age, the mean formula volume and protein intake were 758-887 mL/day and 11.4-13.3g/day, respectively, higher than the protein intake of breast-fed infants. Daily energy intake (86-129kcal/kg/day) was comparable to the estimated energy requirements. Feeding intervals were shorter in infants fed Formulas A and B than in those fed Formula C, whereas energy intake was similar. The protein intake of infants decreased as the protein concentration per energy in infant formula was reduced, and accordingly the protein intake of Formula A-fed infants was significantly lower than that of Formula C-fed infants. In conclusion, the new composition of Formula A is suitable in protein and energy intake of infants, and daily energy intake remains constant by shortening in feeding intervals when the energy concentration in infant formula is reduced.Clinical Trial Registration: UMIN000023110.

The aim of the study was to determine the relationship of dietary nutrients and bone mineral density (BMD) in North Indian women. This cross-sectional study was conducted from April 2006 to March 2008. Subjects included 255 healthy women, aged 20-69 years, who were relatives of patients being admitted in the hospital. Various demographic characteristics including socioeconomic status and serum parameters in relationship to BMD were evaluated. In addition, the daily dietary intake of energy, protein, fat, and calcium and the amount of physical activity were assessed. BMD at the lumbar spine, femoral neck, and Ward's triangle was measured by dual-energy X-ray absorptiometry (DXA). Body mass index (BMI), physical activity, and educational level were positively correlated with BMD. The daily intakes of energy (1563.4 +/- 267.2 kcal) and protein (48.7 +/- 8.7 g) were below the recommended dietary allowance. Daily dietary energy, protein, and calcium intakes were correlated with BMD at the lumbar spine. Stepwise multiple linear regression analyses showed that age, BMI, and physical activity were significant predictors for BMD at all sites. In addition, energy intake was also a predictor for BMD at the lumbar spine. The protein intake was associated with BMD at the spine (P = 0.02 and beta = 0.163) even after making adjustments for energy intake. Thus, dietary pattern coupled with higher education levels and greater physical activity favored bone health.

Animals may face periods of nutritional stress due to short-term food shortage and/or low energy consumption associated with seasonal fluctuations in resource availability. We tested the hypothesis that periods of restricted macronutrient and energy intake result in energy deficits and physiological stress in wild black howler monkeys (Alouatta pigra) inhabiting seasonal tropical semi-deciduous forests. We conducted full-day follows of focal animals recording feeding rates, time spent feeding, and total amount of food ingested. We carried out nutritional analysis of foods collected from feeding trees and calculated the daily nutrient and energy intake of each focal individual. Fecal glucocorticoid metabolites (fGCM) of focal animals were used as an indicator of physiological stress. We found that fluctuations in daily energy intake across seasons did not have significant effects on fGCM of individuals. However, protein intake was negatively associated with fGCM, highlighting the interplay among macronutrients, metabolism, and the endocrine system. Fecal glucocorticoid metabolites were also positively related to fruit availability, but this relationship was most likely due to social stress associated with intergroup encounters and resource defense that occurred when preferred trees were fruiting. Behavioral strategies such as dietary shifts and nutrient mixing, and metabolic adaptations such as low energy expenditure allowed individuals to fulfill their minimum energy requirements even during periods of decreased resource availability and intake. The present study suggests that seasonal variations in food, macronutrient, and energy acquisition may have limited physiological costs for animals that exploit different types of plant resources such as howler monkeys.

Dietary Effects of Replacing Carbohydrate-based Breakfast Foods with Eggs in Adults at Risk for Type 2 Diabetes (P08-044-19)

We sought to evaluate the association between early protein and energy intake and neurodevelopment and growth of extremely low birth weight (<1000 g) infants. Daily protein and energy intakes were collected by chart review for the first 4 weeks of life on 148 extremely low birth weight survivors. A total of 124 infants (84%) returned for evaluation at 18 months' corrected age. Bivariate analysis tested correlations between weekly protein or energy intakes and Bayley Mental Development Index, Psychomotor Development Index, or growth at 18 months. Separate regression models evaluated contributions of protein (grams per kilogram per day) and energy intake (kilojoules per kilogram per day) to the Mental Development Index, Psychomotor Development Index, and growth, while controlling for known confounders. After adjusting for confounding variables, week 1 energy and protein intakes were each independently associated with the Mental Development Index. During week 1, every 42 kJ (10 kcal)/kg per day were associated with a 4.6-point increase in the Mental Development Index and each gram per kilogram per day in protein intake with an 8.2-point increase in the Mental Development Index; higher protein intake was also associated with lower likelihood of length <10th percentile. Increased first-week protein and energy intakes are associated with higher Mental Development Index scores and lower likelihood of length growth restrictions at 18 months in extremely low birth weight infants. Emphasis should be placed on providing more optimal protein and energy during this first week.

Percutaneous endoscopic gastrostomy (PEG) tube feeding of nursing home residents is not associated with improved body composition parameters.

The effects of dehydroepiandrosterone (DHEA) on appetite and weight in the Zucker rat have been examined by many investigators who have reported appetite suppression and metabolic effects. However, these studies compared the treated animals to controls of a similar age. Since animals of different sizes consume different amounts of food, perhaps the treated animals should be compared to controls of a similar size. We studied the effects of DHEA on energy intake and weight gain and analysed the effects by age and metabolic body size. Lean (n = 21) and obese (n = 16) male Zucker rats were fed plain chow or chow containing 6 g DHEA/kg chow (0.6% wt/wt) from age 4 wk to 20 wk. Daily energy intakes and body weights were determined at least once weekly. As expected, the lean and obese rats given DHEA exhibited less daily energy intake (kJ/d) and less weight gain than their respective controls of the same age. The lean rats given DHEA did not exhibit any difference in daily energy intake when determined relative to body weight (b.w.) (kJ x d-1 x g b.w.-1) compared to lean controls of the same metabolic body size, while the obese rats given DHEA exhibited less daily energy intake relative to b.w. (kJ x d-1 x g b.w.-1) compared to obese control of the same metabolic body size. Though DHEA reduced total energy intake among the lean and obese Zucker rats, only the obese rats exhibited less energy intake relative to b.w. compared to controls of the same metabolic body size. Thus, DHEA may exert different effects on energy intake relative to b.w. in lean and obese Zucker rats and perhaps the lean Zucker rat is a better model for evaluating the metabolic effects of DHEA since it does not exhibit any effect on energy intake relative to b.w. compared to rats of the same metabolic body size.