Improvement In Anthropometric Parameters Research Articles

Benefit of gluten‐free diet in idiopathic pulmonary hemosiderosis in association with celiac disease

Lane-Hamilton syndrome refers to the uncommon co-occurrence of idiopathic pulmonary hemosiderosis and celiac disease (CD). Three children aged between 7 and 14 years with IPH were detected to have co-existing non-diarrheal CD. Institution of gluten-free diet in each of the three children resulted in amelioration of the pulmonary symptoms along with improvement of anthropometric parameters and hemoglobin over a short-term follow-up period of 8-17 months. Inhaled/oral steroids and immunosuppressants could be weaned off after dietary exclusion therapy in each of the three children. Gluten free diet should be instituted in all patients diagnosed with Lane-Hamilton syndrome. It ameliorates both the pulmonary as well as the intestinal symptoms although the precise mechanism of the pulmonary response is as yet unclear.

Dietary Counseling Versus Dietary Supplements for Malnutrition in Chronic Pancreatitis: A Randomized Controlled Trial

Up to 50% of patients with chronic pancreatitis (CP) are malnourished. There are limited data on the role of dietary intervention in improving the nutritional status of such patients. The aim was to compare the efficacy of medium chain triglyceride (MCT)-enriched commercial dietary supplements with dietary counseling for homemade food in the management of malnutrition in patients with CP. In a randomized controlled trial, consecutive undernourished patients with CP (body mass index [BMI] <18.5 kg/m(2)) at a tertiary care hospital were randomized to receive either dietary counseling for regular homemade food or commercial MCT-enriched dietary supplements for a period of 3 months to compensate for the dietary calorie deficit. All patients received standard management for CP including pancreatic enzyme supplements. Primary outcome measure was improvement in BMI. Sixty malnourished patients with CP were randomized to counseling group (n = 29; mean age, 32 +/- 10 years; male, 83%) and supplementation group (n = 31; mean age, 28 +/- 10 years; male, 84%). BMI increased in both the counseling group and supplementation group (17.2 +/- 1.7 vs 18.1 +/- 1.8 kg/m(2), P = .001; 16.7 +/- 1.6 vs 18.2 +/- 1.6 kg/m(2), P = .001). There were similar improvements in triceps skinfold thickness, dietary intake, fecal fat, and pain score during a period of 3 months in both groups. There was, however, no significant difference between the counseling and supplementation groups with regard to any of the outcome measures. Dietary counseling for a balanced homemade diet is as good as commercial food supplements in improving malnutrition in patients with CP.

Decreased Basal Levels of Glucagon-Like Peptide-1 after Weight Loss in Obese Subjects

Objective: Basal glucagon-like peptide-1 (GLP-1) concentrations seem to be attenuated in obese subjects, although statistical significance is unclear. Only a few studies have investigated the effect of weight reduction on GLP-1 concentrations and have found unclear results. The aim of the present study was to determine whether subjects who lose weight on a hypocaloric diet experience the same change in circulating GLP-1 levels as subjects who do not lose weight. Material and Methods: A population of 99 obese nondiabetic outpatients was analyzed in a prospective way. Weight and blood pressure were determined. Basal glucose, C-reactive protein, insulin, total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides, and basal GLP-1 blood levels were measured before and after 3 months of hypocaloric diet. Bipolar impedance examination was performed in all patients to assess body composition. The lifestyle modification program consisted of a hypocaloric diet (1,520 kcal, 52% carbohydrates, 25% lipids and 23% proteins). The exercise program consisted of aerobic exercise for at least 3 times per week (60 min each). Results: Ninety-nine patients (20 male/79 female) gave informed consent and were enrolled in the study. Fourteen patients (2 male/12 female) did not lose weight (group I: weight increase of 2 ± 1.1 kg, NS) and 75 patients (18 male/67 female) lost weight (group II, weight loss of 4 ± 1.6 kg, p < 0.05). Weight, body mass index, fat mass, waist circumference, insulin, HOMA, LDL cholesterol, triglycerides and systolic blood pressure improved in group II, without significant statistical changes in group I. In group I, basal GLP-1 levels remained unchanged (7.4 ± 3.1 vs. 7.15 ± 3.6 ng/ml, NS). In group II, GLP-1 levels decreased significantly (8.4%, 6.88 ± 2.5 vs. 6.3 ± 2.4 ng/ml, p < 0.05). In the multivariate analysis with a dependent variable (levels of GLP-1 after hypocaloric diet adjusted by age and sex), only insulin levels remained as an independent predictor in the model (F = 5.9; p < 0.05), with an increase of 0.6 ng/ml (CI 95%: 0.1–1.1) in GLP-1 concentrations with each 1-mIU/ml increase of insulin. Conclusion: Hypocaloric diet decreased GLP-1 levels in patients with weight loss with a significant improvement in anthropometric parameters and cardiovascular risk factors. Nevertheless, patients without weight loss after dietary treatment exhibited unchanged GLP-1 levels. Basal insulin correlates with basal GLP-1.

Use of physiological doses of human growth hormone in haematological patients receiving intensive chemotherapy promotes haematopoietic recovery: a double-blind randomized, placebo-controlled study

In vivo and in vitro studies suggest human growth hormone (hGH) receptors on bone marrow stem cells may be biologically active and could be exploited to promote haemopoetic recovery after intensive chemotherapy. Patients with haematological malignancies receiving intensive chemotherapy and requiring hospitalization were randomized in a double-blind, placebo-controlled single-centre trial. Patients were randomly assigned to receive either hGH 500 microg/day or placebo, for 6 weeks. There was no significant difference in patient characteristics at baseline between the placebo and treatment arms. Patients treated with hGH showed significantly faster recovery of platelets to 25 x 10(9)/l (median of 16 versus 19 days; P = 0.03) compared to the placebo-controlled arm (hazard ratio 1.47 favouring hGH, 95% confidence interval (CI), 1.03-2.08). Time to relapse did not differ significantly between arms. There was no change in the anthropometric parameters at the start and end of hGH/placebo therapy. The study drug was well tolerated. Treatment with hGH in physiological doses improves platelet recovery, but is not associated with a lower relapse rate or improved anthropometric parameters in patients receiving intensive chemotherapy.

Nutritional status and anemia in Suruí Indian children, Brazilian Amazon

To assess the nutritional status of Suruí Indian children aged less than 10 years by means of anthropometric measurements and determination of hemoglobin concentration levels. The study was carried out from February to March 2005 in the Sete de Setembro Indian Reservation, located on the boundary between the states of Rondônia and Mato Grosso, Amazonia, Brazil. Height and weight were measured according to standard procedures and then compared with the National Center for Health Statistics reference values (n = 284). Hemoglobin concentration was determined by a portable Beta-hemoglobinometer (Hemocue) (n = 268). The percentages of children <or= -2 z scores for height for age, weight for age and weight for height were 25.4, 8.1 and 0%, respectively. For children aged less than 5 years, the percentages were 31.4, 12.4 and 0%. Most children had anemia (80.6%), with a rate of up to 84.0% among those aged 6 to 59 months. There is a high prevalence of protein-energy undernutrition and anemia among Suruí children. Comparison with a previous survey indicated that the prevalence of height for age deficit significantly decreased between 1987 and 2005 (from 46.3 to 26.7% in children younger than 9 years). On the other hand, 3.9% of the children were overweight in 2005, a finding that had not been reported in 1987. The prevalence of anemia did not change remarkably between these years. Despite the improvement in anthropometric parameters, the prevalence of nutritional deficit has been persistently higher than that observed in the Brazilian population at large. It is therefore necessary that systematic and regular monitoring of indigenous children's growth and development be implemented, focusing mainly on nutritional surveillance.

Valoración nutricional en ancianos frágiles en atención primaria

To determine in primary care the nutritional status of elderly people at risk of malnutrition and to evaluate their evolution after an intervention. Descriptive, with follow-up. Urban health centre. Patients over 65, with criteria as fragile elderly or incapacitated and registered on a doctor's list (N=131). Nutritional risk factors were identified in the consultation or at home in 46 of those included in the study (March-September 2003). Age, sex. Factors in risk of malnutrition: loss of weight, acute or chronic illness associated with malnutrition, social factors. Anthropometric indices: Body Mass Index (BMI), tricipital fold (TF) and percentage, brachial perimeter (BP), calf perimeter (CP), arm muscular circumference (AMC), and percentage. Analytic indices: lymphocytes, transferrin, albumin. Malnutrition: when at least 2 of the above parameters were disturbed. Type: calories, protein, mixed. Degree: light, moderate, or severe. special diets and/or nutritional supplements. Parameters were re-assessed at 6 months (t test, paired samples). Average age of 83, with 63% women. Nutritional risk factors: loss of weight 41%, acute illness 39%, chronic illness 10.5%, cognitive deterioration 4%, social risk 2%. 80.4% suffered malnutrition (32.5% calories, 46% mixed, 21.5% protein; 27% light, 56.7% moderate, 16.3% severe). Mean values on anthropometric parameters: BMI 21, TF 11.3 mm (TF% 72%), BP 22 cm, AMC 19.4 (%AMC 90%), CP 28 cm (%CP 87%). Mean analytic values were: transferrin 243, albumin 3.7, lymphocytes 1600. Nutritional supplements were indicated in 11 cases. 32 cases were re-evaluated later and no significant improvement was found for any parameter (=.05). Malnutrition is common in the elderly with risk factors (loss of weight and acute illness), with calorie or mixed malnutrition the most common kinds. There was no improvement in anthropometric parameters at 6 months follow-up.