Carbohydrate Requirements Research Articles

Continuous glucose monitoring (CGM) for effective glucose control in a pregnant woman living with type IIIa glycogenosis. A case report

Glycogenosis type III is a rare autosomal recessive disease caused by a mutation in the AGL gene that results in a deficiency of the glycogen debranching enzyme. This deficiency impairs fasting tolerance and leads to hypoglycemia. While the symptomatology tends to improve with age, pregnancy can trigger a recurrence of hypoglycemia due to increased carbohydrate requirements. Since the late 1990s, continuous glucose monitoring (CGM) has been used in insulin-dependent diabetes to aid in the prevention of hypoglycemia. It has also been employed in type I glycogenosis for the same purpose. However, it has never been evaluated for the prevention of hypoglycemia in pregnant women with type III glycogenosis. report: We present the case of a 32-year-old pregnant woman with type IIIa glycogenosis diagnosed at the age of 2 years old. The resurgence of nocturnal hypoglycemia initially led to the reinstatement of continuous nocturnal nutrition. We established remote glucose monitoring via CGM, facilitating medical and dietary teleconsultations until delivery. These teleconsultations enabled dietary adjustment according to the patient's needs, based on the CGM data. This subsequently led to a reduction in the frequency and duration of nocturnal hypoglycemia, even after discontinuing continuous nutrition. No severe hypoglycemia was observed. Our results suggest that CGM combined with telemonitoring can provide effective support for individuals living with glycogenosis during pregnancy and may eliminate the need for resuming continuous nocturnal enteral nutrition. However, these results need to be confirmed with additional patient cases. CGM is a safe tool to limit the risk of hypoglycemia and to improve the quality of life of pregnant patients with type III glycogenosis.

6799 RZ358 Therapy. A Novel Approach to Hyperinsulinemia in Metastatic Neuroendocrine Tumor Patients

Abstract Disclosure: J. Noreña: None. T. Akcan: None. S. Patel: None. W. Madeleine: None. S. Shaheen: None. M. Tan: None. RZ358, an intravenously administered monoclonal antibody, targets a unique allosteric site on the insulin receptor. It is under investigation for hypoglycemia due to congenital hyperinsulinism. We present a case of its efficacy in treating refractory hyperinsulinemic-hypoglycemia (HH) due to a metastatic pancreatic neuroendocrine tumor (pNET). Clinical Case: A 50-year-old woman with a 6-year history of HH initially presented in 2016 with epigastric pain and was diagnosed with gastrin secreting pNET pT3N1. After Whipple surgery and cholecystectomy. A well-differentiated, WHO grade 2 NET, positive in immunohistochemistry for AE1/3, synaptophysin and Ki-67 index of 9.2% was confirmed. She presented recurrent disease with liver metastasis requiring somatostatin analogue Lanreotide. Subsequently despite Lanreotide, hypoglycemia persisted, and 72-hour fast confirmed HH. DOTATATE scan showed progression to new liver lesions. Everolimus was started and subsequently peptide receptor radionuclide therapy (PRRT) with fair hypoglycemia control. Unfortunately, her disease progressed. Oral glucose, cornstarch, and diazoxide failed. After a left hepatectomy and transarterial chemoembolization, her severe hypoglycemia improved briefly. Despite high-dose dexamethasone (up to 4 mg daily), octreotide 400 mcg every 8 hours, and high-calorie total parenteral nutrition (TPN) (over 800 grams of carbohydrates daily), she required multiple hospitalizations for persistent symptomatic hypoglycemia. Moreover, these therapies led to significant side effects, including recurrent episodes of volume overload, 240 pounds weight gain over a year, and Cushingoid features. Given RZ358's reports in reversing HH in rodents, humans, and a recent report of successful use in a malignant insulinoma case, we aimed to start RZ358 in our patient. We obtained, emergency use authorization from the FDA, IRB of Stanford University School of Medicine approval, and patient written informed consent. RZ358 was started at 6 mg/kg biweekly, along with octreotide, dexamethasone, and TPN. RZ358 dosage was later increased to 9 mg/kg weekly, allowing a substantial reduction in dexamethasone to physiological doses and a 50% reduction in TPN carbohydrate requirements. She achieved normoglycemia and returned home, but missing a single weekly RZ358 dose caused recurrent severe hypoglycemia until the next dose administration.As her disease progressed, the patient opted for comfort care, discontinuing TPN and RZ358. Conclusion: RZ358 represents a novel and unique treatment option for refractory HH in patients with metastatic NETs and can improve clinical outcomes when standard interventions fail. This case underscores the potential of RZ358, a monoclonal antibody, to treat HH beyond its approved use for congenital cases, suggesting its applicability to cases of hyperinsulinemia secondary to NETs in adults. Presentation: 6/2/2024

9286 RZ358 Therapy. A Novel Approach To Hyperinsulinemia In Metastatic Neuroendocrine Tumor Patients

Abstract Disclosure: J. Noreña: None. T. Akcan: None. S. Patel: None. M. Welsh: None. S. Shaheen: None. M. Tan: None. RZ358, an intravenously administered monoclonal antibody, targets a unique allosteric site on the insulin receptor. It is under investigation for hypoglycemia due to congenital hyperinsulinism. We present a case of its efficacy in treating refractory hyperinsulinemic-hypoglycemia (HH) due to a metastatic pancreatic neuroendocrine tumor (pNET). Clinical Case: A 50-year-old woman with a 6-year history of HH initially presented in 2016 with epigastric pain and was diagnosed with gastrin secreting pNET pT3N1. After Whipple surgery and cholecystectomy. A well-differentiated, WHO grade 2 NET, positive in immunohistochemistry for AE1/3, synaptophysin and Ki-67 index of 9.2% was confirmed. She presented recurrent disease with liver metastasis requiring somatostatin analogue Lanreotide. Subsequently despite Lanreotide, hypoglycemia persisted, and 72-hour fast confirmed HH. DOTATATE scan showed progression to new liver lesions. Everolimus was started and subsequently peptide receptor radionuclide therapy (PRRT) with fair hypoglycemia control. Unfortunately, her disease progressed. Oral glucose, cornstarch, and diazoxide failed. After a left hepatectomy and transarterial chemoembolization, her severe hypoglycemia improved briefly. Despite high-dose dexamethasone (up to 4 mg daily), octreotide 400 mcg every 8 hours, and high-calorie total parenteral nutrition (TPN) (over 800 grams of carbohydrates daily), she required multiple hospitalizations for persistent symptomatic hypoglycemia. Moreover, these therapies led to significant side effects, including recurrent episodes of volume overload, 240 pounds weight gain over a year, and Cushingoid features. Given RZ358's reports in reversing HH in rodents, humans, and a recent report of successful use in a malignant insulinoma case, we aimed to start RZ358 in our patient. We obtained, emergency use authorization from the FDA, IRB of Stanford University School of Medicine approval, and patient written informed consent. RZ358 was started at 6 mg/kg biweekly, along with octreotide, dexamethasone, and TPN. RZ358 dosage was later increased to 9 mg/kg weekly, allowing a substantial reduction in dexamethasone to physiological doses and a 50% reduction in TPN carbohydrate requirements. She achieved normoglycemia and returned home, but missing a single weekly RZ358 dose caused recurrent severe hypoglycemia until the next dose administration.As her disease progressed, the patient opted for comfort care, discontinuing TPN and RZ358. Conclusion: RZ358 represents a novel and unique treatment option for refractory HH in patients with metastatic NETs and can improve clinical outcomes when standard interventions fail. This case underscores the potential of RZ358, a monoclonal antibody, to treat HH beyond its approved use for congenital cases, suggesting its applicability to cases of hyperinsulinemia secondary to NETs in adults. Presentation: 6/2/2024

6799 RZ358 Therapy. A Novel Approach To Hyperinsulinemia In Metastatic Neuroendocrine Tumor Patients

Abstract Disclosure: J. Noreña: None. T. Akcan: None. S. Patel: None. W. Madeleine: None. S. Shaheen: None. M. Tan: None. RZ358, an intravenously administered monoclonal antibody, targets a unique allosteric site on the insulin receptor. It is under investigation for hypoglycemia due to congenital hyperinsulinism. We present a case of its efficacy in treating refractory hyperinsulinemic-hypoglycemia (HH) due to a metastatic pancreatic neuroendocrine tumor (pNET). Clinical Case: A 50-year-old woman with a 6-year history of HH initially presented in 2016 with epigastric pain and was diagnosed with gastrin secreting pNET pT3N1. After Whipple surgery and cholecystectomy. A well-differentiated, WHO grade 2 NET, positive in immunohistochemistry for AE1/3, synaptophysin and Ki-67 index of 9.2% was confirmed. She presented recurrent disease with liver metastasis requiring somatostatin analogue Lanreotide. Subsequently despite Lanreotide, hypoglycemia persisted, and 72-hour fast confirmed HH. DOTATATE scan showed progression to new liver lesions. Everolimus was started and subsequently peptide receptor radionuclide therapy (PRRT) with fair hypoglycemia control. Unfortunately, her disease progressed. Oral glucose, cornstarch, and diazoxide failed. After a left hepatectomy and transarterial chemoembolization, her severe hypoglycemia improved briefly. Despite high-dose dexamethasone (up to 4 mg daily), octreotide 400 mcg every 8 hours, and high-calorie total parenteral nutrition (TPN) (over 800 grams of carbohydrates daily), she required multiple hospitalizations for persistent symptomatic hypoglycemia. Moreover, these therapies led to significant side effects, including recurrent episodes of volume overload, 240 pounds weight gain over a year, and Cushingoid features. Given RZ358's reports in reversing HH in rodents, humans, and a recent report of successful use in a malignant insulinoma case, we aimed to start RZ358 in our patient. We obtained, emergency use authorization from the FDA, IRB of Stanford University School of Medicine approval, and patient written informed consent. RZ358 was started at 6 mg/kg biweekly, along with octreotide, dexamethasone, and TPN. RZ358 dosage was later increased to 9 mg/kg weekly, allowing a substantial reduction in dexamethasone to physiological doses and a 50% reduction in TPN carbohydrate requirements. She achieved normoglycemia and returned home, but missing a single weekly RZ358 dose caused recurrent severe hypoglycemia until the next dose administration.As her disease progressed, the patient opted for comfort care, discontinuing TPN and RZ358. Conclusion: RZ358 represents a novel and unique treatment option for refractory HH in patients with metastatic NETs and can improve clinical outcomes when standard interventions fail. This case underscores the potential of RZ358, a monoclonal antibody, to treat HH beyond its approved use for congenital cases, suggesting its applicability to cases of hyperinsulinemia secondary to NETs in adults. Presentation: 6/2/2024

9286 RZ358 Therapy. A Novel Approach to Hyperinsulinemia in Metastatic Neuroendocrine Tumor Patients

Abstract Disclosure: J. Noreña: None. T. Akcan: None. S. Patel: None. M. Welsh: None. S. Shaheen: None. M. Tan: None. RZ358, an intravenously administered monoclonal antibody, targets a unique allosteric site on the insulin receptor. It is under investigation for hypoglycemia due to congenital hyperinsulinism. We present a case of its efficacy in treating refractory hyperinsulinemic-hypoglycemia (HH) due to a metastatic pancreatic neuroendocrine tumor (pNET). Clinical Case: A 50-year-old woman with a 6-year history of HH initially presented in 2016 with epigastric pain and was diagnosed with gastrin secreting pNET pT3N1. After Whipple surgery and cholecystectomy. A well-differentiated, WHO grade 2 NET, positive in immunohistochemistry for AE1/3, synaptophysin and Ki-67 index of 9.2% was confirmed. She presented recurrent disease with liver metastasis requiring somatostatin analogue Lanreotide. Subsequently despite Lanreotide, hypoglycemia persisted, and 72-hour fast confirmed HH. DOTATATE scan showed progression to new liver lesions. Everolimus was started and subsequently peptide receptor radionuclide therapy (PRRT) with fair hypoglycemia control. Unfortunately, her disease progressed. Oral glucose, cornstarch, and diazoxide failed. After a left hepatectomy and transarterial chemoembolization, her severe hypoglycemia improved briefly. Despite high-dose dexamethasone (up to 4 mg daily), octreotide 400 mcg every 8 hours, and high-calorie total parenteral nutrition (TPN) (over 800 grams of carbohydrates daily), she required multiple hospitalizations for persistent symptomatic hypoglycemia. Moreover, these therapies led to significant side effects, including recurrent episodes of volume overload, 240 pounds weight gain over a year, and Cushingoid features. Given RZ358's reports in reversing HH in rodents, humans, and a recent report of successful use in a malignant insulinoma case, we aimed to start RZ358 in our patient. We obtained, emergency use authorization from the FDA, IRB of Stanford University School of Medicine approval, and patient written informed consent. RZ358 was started at 6 mg/kg biweekly, along with octreotide, dexamethasone, and TPN. RZ358 dosage was later increased to 9 mg/kg weekly, allowing a substantial reduction in dexamethasone to physiological doses and a 50% reduction in TPN carbohydrate requirements. She achieved normoglycemia and returned home, but missing a single weekly RZ358 dose caused recurrent severe hypoglycemia until the next dose administration.As her disease progressed, the patient opted for comfort care, discontinuing TPN and RZ358. Conclusion: RZ358 represents a novel and unique treatment option for refractory HH in patients with metastatic NETs and can improve clinical outcomes when standard interventions fail. This case underscores the potential of RZ358, a monoclonal antibody, to treat HH beyond its approved use for congenital cases, suggesting its applicability to cases of hyperinsulinemia secondary to NETs in adults. Presentation: 6/2/2024

Nutritional value of common carbohydrate sources used in pet foods.

Diet digestibility can vary based on factors such as the type of ingredients, processing techniques, formulation, fiber content, and nutrient interactions. Unlike proteins and fats, there is no specific carbohydrate requirement, which typically constitutes 30%-60% of commercial dried dog foods. Because of the significant proportion of carbohydrates in dog food, this study aimed to evaluate the differences in nutrient digestibility among barley, brown rice, corn, mung bean, and rice, which are common carbohydrate sources in commercial dog foods. All experimental diets had consistent chemical compositions. The digestibility of each carbohydrate source was evaluated using the total feces collection method in four castrated male and four neutered female beagles with an average age of 4.58 ± 0.14 years. The average daily dry matter intake of the five experimental diets was 203.0 ± 3.23 g/day. The percentage of dry matter digestibility of the apparent total tract digestibility (ATTD) was the highest for rice and corn at 92.45% and 92.95%, respectively, followed by brown rice (91.61%), barley (88.81%), and mung beans (80.74%). The percentage of nitrogen-free extract digestibility was also high for rice, corn, and brown rice at 97.08%, 96.14%, and 95.56%, respectively, followed by barley at 90.10% and mung bean at 83.38%. Amino acid digestibility analysis revealed no statistically significant differences between rice, corn, brown rice, and barley, except for methionine, which is an essential amino acid. Although the ATTD and amino acid profile of the mung bean-based diet were less efficient than those of the other test diets, the overall digestibility was satisfactory and there were no significant differences in palatability. The differences in digestibility observed in mung bean-based diets compared to other grain-based diets can be attributed to variations in the starch and fiber content of the raw materials. By leveraging these characteristics, mung bean-based diets may offer strategic benefits for glycemic control and weight management in dogs. Our results may serve as a basis for formulating appropriate diets for dogs.

A broken link: Knowledge of carbohydrate requirements do not predict carbohydrate intake around competition in endurance athletes.

Endurance athletes fail to meet carbohydrate (CHO) guidelines for competition, which may be due to limited knowledge. However, the relationship between knowledge and practice in this population is unknown. To investigate this, we assessed the dietary intake in 50 athletes (37 females) who completed endurance events ≥2.5h in duration and compared CHO intake against the carbohydrates for endurance athletes in competition questionnaire validated nutrition knowledge questionnaire, with specific questions related to CHO loading, pre-competition meal and during-competition intake. CHO-loading guidelines (10-12g·kg-1·day-1) were met in practice by n=5 (10%), but there was no relationship between identified requirements (range 0-12g·kg-1·day-1) and actual intake (rs=0.133, p=0.358), with the n=18 (36%) who correctly identified requirements, ingesting 6.1±1.9g·kg-1·day-1. CHO intake for pre-competition meal guidelines (1-4g·kg-1) was met in practice by n=40 (80%), but there was no relationship between identified requirements (range 0 to >4g·kg-1) and actual intake (rs=0.101, p=0.487), with n=19 (38%) who correctly identified guidelines requirements, ingesting 1.4±0.6g·kg-1. CHO intake during-competition guidelines (60-90g·h-1) was met in practice by n=18 (36%), but there was no relationship between the amounts of CHO required (range 30 to >90g/h) and actual intake (rs=0.028, p=0.849), with n=32 (64%) who correctly identified guidelines requirements, ingesting 56±20g·h-1. Results show no relationship between the knowledge of CHO recommendations and practice, suggesting that theoretical knowledge does not guarantee the achievement of best practice and other important factors may ultimately determine practice.

Potential of Black Rice Mutants (M4) Through Genetic Parameters to Develop Superior Drought-Resistant Varieties

Rice plays an important role in meeting carbohydrate requirement and calorie needs to ensure food security. However, in recent years, rice productivity has decreased due to land conversion and climate change such as El Niño. The productivity of drought-resistant rice can be increased through breeding. Genetic diversity and heritability are important genetic parameters in the plant breeding process. Information about genetic diversity and heritability helps determine genetic progress through selection. This research aims to examine the potential genetic diversity and heritability of several mutant lines (M4) of black rice (G10) in order to develop superior rice varieties that are adaptive to dry land. In this research, we used experimental methods using a Randomized Block Design (RBD), calculating the value of the Genetic Diversity Coefficient (GDC) and heritability between quantitative characters. The results of narrow genetic research were found in the characteristics of the number of productive tillers and weight of 100 grains, while high heritability was found in the characters of plant height, moderate heritability was found in the total number of tillers, panicle length, number of empty grains per panicle, and weight of 100 grains. Overall, this research succeeded in identifying mutant lines (M4) of black rice (G10) which have the potential to be developed into superior varieties, especially for cultivation in dry land.

Applications of Linear Programming on Diet Problem for Subways’ Sets Menu in Malaysia

Consuming a proper and balanced diet is necessary for each and every individual. It makes them fit, healthy, and keep them safe from chronic diseases. However, in today's world, many individuals frequently buy fast food without realising that the food may not provide all the daily nutrients that the body needs. Therefore, this study aims to propose a mathematical modelling on diet problem for the subways sets menu in Malaysia. The proposed mathematical model will be solved by using the Microsoft Excel Solver in order to produce optimal solution, which mean that the chosen menu from the Subway fulfil the daily requirements of calories, protein, carbohydrates, and fats for both men and women.

Female Athlete Triad and Relative Energy Deficiency in Sport (REDs): Nutritional Management.

The female athlete triad (TRIAD) is a spectrum of disorders involving low energy availability (LEA), low bone mineral density, and menstrual disorders. It is increasingly common to use the term 'relative energy deficiency in sport' (RED), emphasising the extensive impact of LEA on the body. The aim of this narrative review was to gather original research encompassing female athletes across various sports as well as to collect findings on the potential of a nutrition-focused approach to prevent or treat the aforementioned disorders. A comprehensive search was conducted in PubMed and Scopus. Several challenges were identified regarding the adequacy of the energy availability, protein, and carbohydrate requirements in the diets of female athletes. Moreover, insufficient intake of vitamin D has been observed across all athlete groups studied. This insufficiency also extends to the average requirement for Ca, Mg, the Ca/P ratio, Zn, and Fe. To address those concerns, a nutritional approach is proposed in the latter part of this review. The factors that can improve the absorption of micronutrients have also been discussed. The TRIAD/REDs affect an ever-growing number of women and require appropriate therapeutic management, particularly through nutritional care. Therefore, cooperation within an interdisciplinary team comprising a physician, nutritionist, physiotherapist, and psychologist is crucial.

Energy Expenditure of Elite Male and Female Professional Tennis Players During Habitual Training.

Understanding the daily energy expenditure of athletes during training is important to support recovery, adaptation, and the maintenance of performance. The aim of the current research was to assess the total daily energy expenditure (TDEE) and the acute energy expenditure (EE) of tennis training sessions during habitual training of elite tennis players. Using a cohort study design, 27 (n = 10, male; age; 22.3 ± 3.2years and n = 17, female; age: 23.8 ± 3.5years) elite singles tennis players were assessed for TDEE and tennis training EE. Using Actiheart activity monitors during a 2- to 5-day training period, male players were analyzed for 26days and 33 (1.3 ± 0.5sessions/day) tennis training sessions, and female players for 43days and 58 (1.2 ± 0.4sessions/day) tennis training sessions. Male TDEE (4,708 ± 583kcal/day) was significantly higher than female (3,639 ± 305kcal/day). Male absolute and relative tennis training EEs (10.2 ± 2.3kcal/min and 7.9 ± 1.4kcal·hr-1·kg-1) were significantly higher than those of females (7.6 ± 1.0kcal/min and 6.8 ± 0.9kcal·hr-1·kg-1). The resting metabolic rate was assessed via indirect calorimetry. The physical activity level for both groups was 2.3AU. The TDEE of male and female players during habitual training now highlights the continual cycle of high energy demands experienced by the elite tennis player. The broad ranges of TDEE and EE reported here suggest individual assessment and nutritional planning be prioritized, with a particular focus on carbohydrate requirements.

Precision nutrition for type 2 diabetes in Benin: leveraging linear goal programming to optimize diets with emphasis on adequacy, affordability, accessibility, and culture.

Nutrition and diet are critical to managing Type 2 diabetes (T2D). Low-income households often face challenges maintaining a healthy and balanced diet due to food insecurity, availability, and cost. To address this issue, we used a linear goal programming (LGP) model to develop nutritionally adequate, affordable, accessible, and culturally acceptable diets for persons with T2D in Benin, a French-speaking sub-Saharan country. The goal was to help persons with T2D manage their condition more effectively. We compiled a robust list of local commonly consumed foods in Benin, and calculated their nutritional value using West African food composition tables and food costs per serving from a market survey. Using mathematical optimization techniques, we designed dietary plans that meet the daily nutrient intake recommended by the World Health Organization (WHO) to prevent chronic diseases in normal adults. While adhering to dietary constraints of T2D, we developed optimized diet plans with varying energy levels that meet all nutrient requirements while considering availability, acceptability, and budgetary constraints. Fifty-two food items and recipes were evaluated to create six low-cost daily menus. Menu 1 was the most affordable at CFA 1,127 (USD 1.88), providing 1890 kcal of energy, while Menu 6 was the most expensive at CFA 1,227 (USD 2.05), providing 1749 kcal. All the menus met the daily WHO minimum requirements for carbohydrates, fat, cholesterol, and fiber content, while other nutrients such as protein, vitamin C, and iron reached the upper limits of the acceptable value range. Linear goal programming can be an effective tool in helping to obtain optimized adequate, accessible, and culturally acceptable diets at minimal cost by interpreting and translating dietary recommendations into a nutritional model, based on local market prices.

Effects of Different Levels of Carbohydrates on Growth Performance, Hepatic and Intestinal Health, and Intestinal Microflora of Juvenile Pikeperch (Sander lucioperca).

Pikeperch (Sander lucioperca) is a species with great potential for aquaculture in Eurasian countries, while feed costs limit the scale of pikeperch farming. Adding carbohydrates to the feed as an energy source is a viable approach to reduce costs and to improve the culture status of pikeperch. In this study, in order to determine the optimal carbohydrate requirement of pikeperch, three tapioca starch (8%, 10%, and 12%) added feeds were produced with isonitrogenous (51%) and isolipidic (11%). For 8 weeks, body weight was 1.20 ± 0.01 g, pikeperch were manually fed the trio of experimental diets until they seemed fully satisfied. The finding revealed that pikeperch can utilize dietary carbohydrate, but excessive dietary carbohydrate will adversely affect the growth performance. The growth and survival rate were decreased in pikeperch in S12 (P < 0.05). The α-amylase activity of S12 reduced in the intestine and lipid deposition was observed in the liver compared with the S8. In addition, proinflammatory cytokines, interleukin 1 beta (il1-β), interleukin 8 (il8), and tumor necrosis factor beta (tnf-β), in the liver and intestine elevate and anti-inflammatory cytokines, interleukin 10 (il10) and transforming growth factor beta (tgf-β), decrease with increasing dietary carbohydrate levels. Hepatic and intestinal antioxidant capacity were also adversely affected, with S12 significantly increasing malondialdehyde (MDA) contents and decreasing glutathione (GSH) and total antioxidant capacity (T-AOC) (P < 0.05). The intestinal barrier function is also damaged, the height and width of intestinal villi decreased, and the expression of occludin-a, occludin-b, and zonula occludens-2 (zo-2) genes was decreased. Elevated levels of starch intake led to harm to gut microflora, reducing bacterial populations, simultaneously boosting the presence of detrimental bacteria (Proteobacteria, Actinobacteriota, Achromobacter, and Rhodococcus) and diminishing the beneficial bacteria (Firmicutes). In conclusion, moderate addition of starch as an energy source can reduce feed costs; however, over addition can bring about organism damage and is recommended to be added at less than 10%.

Analisis kandungan energi dan zat gizi makro pada formula enteral non susu berbasis kacang merah (Phaseolus vulgaris) untuk pasien diabetes mellitus tipe II

Background: Individuals at the age of 40 years face a 6-fold higher risk of developing Type II diabetes. Modification of enteral nutrition is necessary to address nutritional needs in patients with eating difficulties. Nutritional therapy for Type II diabetes patients should focus on controlling blood glucose levels by selecting foods with low glycemic index and high fiber content. Red beans, rich in protein, carbohydrates, and fiber, offer potential benefits in blood glucose control and as a dairy substitute for individuals with cow's milk allergies, making them a viable candidate for hospital-based enteral nutrition.Objectives: This study aims to determine the macronutrient content, flow test, food cost, and organoleptic test of non-dairy liquid food based on local ingredients. The study uses a completely randomized design.Methods: A complete randomized design was employed for this research. Product development activities were conducted in June 2022 at the Nutritional Kitchen of Jantung dan Pembuluh Darah Harapan Kita Hospital. Preparation of non-dairy liquid food using red beans as a base, proximate analysis of nutritional content, flow test through an NGT tube, food cost calculation, and organoleptic assessment involving ten respondents were carried out.Results: Proximate analysis of the formula yielded the following composition: water content 85,88%, ash 0,25%, protein 1,95%, fat 2,343%, carbohydrates 9,60%, and fiber 1,38%. The flow test for the red bean formula through the Fr 16 NGT tube demonstrated a rate of 50cc/31,90 seconds. The calculated food cost for one recipe of red bean formula was Rp. 8,734.00. Organoleptic evaluation results indicated that the majority of respondents favored the aroma (80%), taste (60%), color (100%), and texture (90%).Conclusion: The red bean formula meets the protein and carbohydrate requirements of the diabetes mellitus diet standards, while the fat and fiber content do not yet meet the diabetes mellitus diet standards.

Habitual carbohydrate intake is not correlated with circulating β-hydroxybutyrate levels in pregnant women with overweight and obesity at 28 weeks' gestation

Aims/hypothesisPregnant women are advised to consume a minimum of 175 g per day of carbohydrate to meet maternal and fetal brain glucose requirements. This recommendation comes from a theoretical calculation of carbohydrate requirements in pregnancy, rather than from clinical data. This study aimed to determine whether fasting maternal ketone levels are associated with habitual carbohydrate intake in a subset of participants of the Study of PRobiotics IN Gestational diabetes (SPRING) randomised controlled trial.MethodsFood frequency questionnaires on dietary intake during pregnancy were completed by pregnant women with overweight or obesity at 28 weeks’ gestation (considering their intake from the beginning of pregnancy). Dietary intake from early pregnancy through to 28 weeks was analysed for macronutrient intake. At the same time, overnight fasting serum samples were obtained and analysed for metabolic parameters including serum β-hydroxybutyrate, OGTTs, insulin and C-peptide.ResultsFasting serum β-hydroxybutyrate levels amongst 108 women (mean BMI 34.7 ± 6.3 kg/m2) ranged from 22.2 to 296.5 μmol/l. Median fasting β-hydroxybutyrate levels were not different between women with high (median [IQR] 68.4 [49.1–109.2 μmol/l]) and low (65.4 [43.6–138.0 μmol/l]) carbohydrate intake in pregnancy. Fasting β-hydroxybutyrate levels were not correlated with habitual carbohydrate intake (median 155 [126–189] g/day). The only metabolic parameter with which fasting β-hydroxybutyrate levels were correlated was 1 h venous plasma glucose (ρ=0.23, p=0.03) during a 75 g OGTT.Conclusions/interpretationFasting serum β-hydroxybutyrate levels are not associated with habitual carbohydrate intake at 28 weeks’ gestation in pregnant women with overweight and obesity.Graphical

Gambaran Proses Asuhan Gizi Terstandar (PAGT) pada Pasien Diabetes Melitus Tipe II di Ruang Irna Paru

Background: Diabetes Mellitus is a group of metabolic diseases characterized by hyperglycemia caused by deficiencies in insulin activity, secretion, or both. Nutritionists apply the Standardized Process of Nutritional Care (PAGT), a standardized procedure, to provide high-quality nutritional care services through a series of planned actions, such as evaluating nutritional needs and meeting those needs. By addressing the various elements that cause imbalances or changes in nutritional status, standardized nutritional care methods attempt to help patients overcome nutritional problems. Research Objective: To determine the process of standardized nutritional care (PAGT) for diabetes mellitus patients in the pulmonary irna room at the Patut Patuh Patju Regional General Hospital (RSUD), West Lombok Regency. Research Method: The methodology of this research is descriptive observational research using case studies taken from individuals suffering from type II diabetes mellitus. Research Results: The patient on behalf of Mrs. 62 year old J was admitted to hospital with a diagnosis of Type II Diabetes Mellitus. From the results of the nutritional assessment, the patient's consumption level of energy, protein, fat and carbohydrates was in the low intake category. The results of anthropometric measurements of the patient had poor nutritional status. Based on laboratory results, the patient had laboratory examination levels that were in the abnormal category. The results of the patient's physical examination were in a weak condition with the patient's level of consciousness (CM) and clinical condition in the normal category. The nutritional diagnosis made was inadequate oral intake, decreased carbohydrate requirements, and poor adherence to the diet provided. The type of diet given is the 1500 kcal DM Diet. The results of monitoring and evaluation carried out for 3 days showed that the patient's food intake was still in the category of insufficient food intake (&lt;80%), there was no improvement in nutritional status, the patient's laboratory progress fluctuated during the examination, and the results of the physical and clinical examination were normal and the results of the laboratory examination of blood sugar (GDS) decreased. Conclusion: Based on the intervention carried out, it can be concluded that there was no increase in the patient's food intake, for anthropometric monitoring and evaluation the patient had a poor nutritional status (underweight), then monitoring and evaluating the patient's general condition improved, next, the results of monitoring and evaluating the patient's laboratory data not in the normal category.

Seasonal health tracking of Australian Football League Women’s athletes

ABSTRACT Background Studies evaluating the dietary intake of Australian Football League Women’s (AFLW) athletes are few and limited to the preseason. This prospective observational study aims to evaluate seasonal changes in dietary intake and health parameters of professional AFLW athletes. Methodology Dietary intake (3-day weighed food records), body composition (bioelectrical impedance analysis, skinfolds), physical performance (global positioning system, GPS), and iron status (fasted blood sample) were assessed in 19 athletes (24 ± 5 years, 170 ± 6 cm, 22.8 ± 2.1 kg/m2) at three timepoints: start of preseason, end of preseason, and end of competition season. Sociodemographic information, sports nutrition knowledge (SNK), and risk of low energy availability (LEA) questionnaires were completed at the start of preseason. Results Mean daily energy and carbohydrate (CHO) intakes were lower than recommendations across all seasons (p < 0.05). Mean daily CHO intake was highest at start of preseason (3.6 g/kg/day), decreased during preseason (3.1 g/day) and remained low during competition (3.2 g/day); >80% of players did not meet minimum recommendations at each timepoint (all, p < 0.05). The sum of seven skinfolds and fat mass (%) decreased during preseason (both, p < 0.05). Serum iron fell within recommended ranges for 95% of athletes at all timepoints. The total distance (m) and number of Very High Intensity (>21 km/h) efforts significantly increased across preseason and decreased during competition (all, p < 0.05). Nutrition knowledge was ‘poor’, and 42% of athletes were at risk of LEA. Conclusions AFLW athletes do not meet energy and carbohydrate requirements across the preseason and competition seasons, which may impact health and performance if deficits are sustained.

Nutritional Assessment and Support in Children with Chronic Kidney Disease: The Benefits of Working with a Registered Dietitian.

An unbalanced dietary pattern, characterized by high animal protein content: may worsen metabolic control, accelerate renal deterioration and consequently aggravate the stage of the chronic kidney disease (CKD) in pediatric patients with this condition. to assess the effect of a registered dietitian (RD) intervention on the CKD children's eating habits. Anthropometric and dietetic parameters, obtained at baseline and 12 months after implementing healthy eating and nutrition education sessions, were compared in 16 patients (50% girls) of 8.1 (1-15) years. On each occasion, anthropometry, 3-day food records and a food consumption frequency questionnaire were carried out. The corresponding relative intake of macro- and micronutrients was contrasted with the current advice by the European Food Safety Authority (EFSA) and with consumption data obtained using the Spanish dietary guidelines. Student's paired t-test, Wilcoxon test and Mc Nemar test were used. At Baseline 6% were overweight, 69% were of normal weight and 25% were underweight. Their diets were imbalanced in macronutrient composition. Following nutritional education and dietary intervention 63%, 75% and 56% met the Dietary Reference Values requirements for fats, carbohydrates and fiber, respectively, but not significantly. CKD children decreased protein intake (p < 0.001), increased dietary fiber intake at the expense of plant-based foods consumption (p < 0.001) and a corresponding reduction in meat, dairy and processed food intake was noticed. There were no changes in the medical treatment followed or in the progression of the stages. RD-led nutrition intervention focused on good dieting is a compelling helpful therapeutic tool to improve diet quality in pediatric CKD patients.

ИСПОЛЬЗОВАНИЕ ЙОДОКАЗЕИНА В ПРОИЗВОДСТВЕ ХЛЕБОБУЛОЧНЫХ ИЗДЕЛИЙ

The paper discusses the results of studying the production technology and quality of iodized bakery products. Providing the population with food is one of the crucial issues since human health depends on the foodstuff ingredients. Yakutia is a region with harsh climate where people suffer from a lack of vitamins, macro- and microelements. Therefore, there is an urgent need to develop and introduce new technologies. Bakery products are critical in Russians’ diet. The vast majority of consumers add bakery items to their daily diet. Bakery products are the basic sources of energy and nutrients. Traditionally produced bakery items provide 25–30 % of the protein requirements, 30–40 % of the carbohydrate requirements and 20–25 % of the needs in vitamins, minerals and dietary fibers. Therefore, special attention should be paid to the nutritional and biological value of bakery products. One of the potential ways to improve the nutrition structure of the diet is to use functional ingredients in the bakery production such as dietary fibre, vitamins (C, D, group B), minerals, lipids containing polyunsaturated fatty acids, antioxidants (beta-carotene, tocopherols), oligosaccharides; some types of beneficial microorganisms (lactic acid bacteria). Yakutia puts emphasis on the state policy in the area of people’s healthy nutrition and annually expands the production of functional food products. The paper reports the study findings about organoleptic, physical and chemical parameters of iodized bread, the content of vitamins, amino acids, minerals. The technology of bakery production is also examined in the article.

Analysis of energy requirements and nutritional needs of rock climbing athletes

Measuring the nutritional needs of rock climbing athletes can help athletes, coaches, and managers determine the portion of food and portion of the athlete's training. The purpose of this study is to determine the energy requirements and nutritional needs of FPTI rock climbing athletes in Buleleng Regency as recommendations for feeding. This research is a cross-sectional study that seeks to reveal quantitative variables and qualitative comments involving 12 rock climbing athletes. Data collection procedures by measurement of the nutritional needs of rock climbing athletes are carried out by providing an explanation of nutritional needs and measurement procedures, measuring BMI, calculating BMR and SDA, interviews for non-sports and sports physical activities, calculating total energy needs, determining food portions, and discussing the needs and eating of athletes per day. The calculation results show that the athlete's BMI is in the ideal category. The average energy requirement of athletes per day is 4568.45 calories. The average carbohydrate requirement for rock climbing athletes is 2741.07 calories or 685.27 grams. Energy needs that can be met by fat are 1142.11 calories or 126.9 grams. The energy requirement that can be supplied by protein is 685.27 calories or 171.32 grams. Rock climbing athletes require a diet with a rather low intake of protein and carbohydrates to keep body weight low. Adolescent rock climbing athletes must be careful in managing energy consumption which has an impact on growth and achievement.