Kilocalorie Intake Research Articles

The Prevalence and Nutritional Implications of Fast Food Consumption Among Patients Receiving Hemodialysis

Fast food consumption has increased dramatically in the general population over the last 25 years. However, little is known about the prevalence and nutritional implications of fast food consumption among patients receiving hemodialysis. By using a cross-sectional study design, we obtained data on fast food consumption and nutrient intake (from four separate 24-hour dietary recalls) and nutritional parameters (from chart abstraction) for 194 randomly selected patients from 44 hemodialysis facilities in northeast Ohio. Eighty-one subjects (42%) reported consuming at least one fast food meal or snack in 4 days. Subjects who consumed more fast food had higher kilocalorie, carbohydrate, total fat, saturated fat, and sodium intakes. For example, kilocalorie per kilogram intake per day increased from 18.9 to 26.1 with higher frequencies of fast food consumption (P = .003). Subjects who consumed more fast food also had higher serum phosphorus levels and interdialytic weight gains. Fast food is commonly consumed by patients receiving hemodialysis and is associated with a higher intake of kilocalories, carbohydrates, fats, and sodium and adverse changes in phosphorus and fluid balance. Further work is needed to understand the long-term benefits and risks of fast food consumption among patients receiving hemodialysis.

Dietary habits of Welsh 12—13 year olds

This study examined the dietar y habits of Welsh 12—13 year olds. A cohor t of 84 boys and 81 girls, age 12.9 SD 0.3 years; body mass 51.3 SD 12.6kg; and stature 1.54 SD 0.08m, completed a food frequency questionnaire and seven-day food diary. Mean daily kilocalories (kcal/d), and percentages of total fat, saturated fat, carbohydrate, and protein, as well as fibre intake were calculated. The mean daily intake of total fat for this cohor t was 34.7 percent, for saturated fat the value was 13.8 percent. The mean daily intake of carbohydrate and protein were 50.5 and 14.9 percent, respectively. The schoolchildren in this study repor ted a mean daily fibre intake of 12.3g. The absolute intake of kilocalories was significantly greater ( p ≤ 0.05) among boys than girls, but no other significant differences were repor ted. This study revealed that the diets of Welsh 12—13 year olds exceeded recommendations for fat, while at the same time did not meet the recommendations for fibre, and particularly fruit and vegetable intake. Our data indicated that, despite schools offering a range of healthy lunchtime foods, young people continue to consume an energy-dense and nutrient-poor diet, both at school and at home.

Nutritional Management of Pregnancy in Chronic Kidney Disease

The nutritional management of pregnant adults with chronic kidney disease (CKD) presents the challenge of combining necessary modifications in nutrient requirements for both pregnancy and kidney impairment. The dietitian must follow these women closely to ensure adequate intakes of kilocalories, protein, and specific vitamins and minerals. Combining the suggested energy and protein needs for CKD recommended by the Kidney Disease Outcomes Quality Initiative (K/DOQI) guidelines with those for the general population seems feasible during pregnancy. Vitamin and mineral requirements are also a combination of those for CKD and pregnancy. Although diets may need to be restricted because of CKD, goals are to have good communication among members of the health-care team to allow the patient optimal nutrition combined with quality medical care.

Relation of Higher Folate Intake to Lower Risk of Alzheimer Disease in the Elderly

Higher intake of folate and vitamins B6 (pyridoxine hydrochloride) and B12 (cyanocobalamin) may decrease the risk of Alzheimer disease (AD) through the lowering of homocysteine levels. To relate intake of folate and vitamins B6 and B12 to AD risk. We followed up 965 persons 65 years or older without dementia at baseline for a mean +/- SD period of 6.1 +/- 3.3 person-years after the administration of a semiquantitative food frequency questionnaire. Total, dietary, and supplement intake of folate and vitamins B6 and B12 and kilocalorie intake were estimated from the questionnaire responses. We related energy-adjusted intake of folate and vitamins B6 and B12 to incident AD using the Cox proportional hazards regression model. Incident AD. We found 192 cases of incident AD. The highest quartile of total folate intake was related to a lower risk of AD (hazard ratio, 0.5; 95% confidence interval, 0.3-0.9; P=.02 for trend) after adjustment for age, sex, education, ethnic group, the epsilon4 allele of apolipoprotein E, diabetes mellitus, hypertension, current smoking, heart disease, stroke, and vitamin B6 and B12 levels. Vitamin B6 and B12 levels were not related to the risk of AD. Higher folate intake may decrease the risk of AD independent of other risk factors and levels of vitamins B6 and B12. These results require confirmation with clinical trials.

Calcium and vitamin D intakes are positively associated with brain lesions in depressed and non‐depressed elders

Objective: To examine the cross-sectional associations between calcium and vitamin D intakes and brain lesion volumes in those with and without late-life depression in an elderly cohort. Methods: Calcium and vitamin D intakes were assessed in 232 elderly subjects (95 with depression, 137 without depression) using a Block 1998 food frequency questionnaire. Calcium, vitamin D, and kilocalorie intake were determined. Brain lesion volumes were calculated from magnetic resonance imaging (MRI) scan. Subjects were age 60 or over. Results: Calcium and vitamin D intakes were significantly positively correlated with brain lesion volume. In two separate multivariable models, controlling for age, hypertension, diabetes, heart disease, group (depression/comparison), lesion load (high/low), and total kilocalories, these positive associations remained significant. In a multivariable model containing both calcium and vitamin D, only vitamin D remained significantly positively associated with lesion volume. Conclusions: Calcium and vitamin D consumption were associated with brain lesions in elderly subjects. These associations may be due to a vascular calcification mechanism. Potential adverse effects of high intakes of calcium and vitamin D need to be elucidated. This project was funded by the following NIMH grants: MH40159, MH54846, MH60451, and MH70027.

Highlights From The Literature

Highlights From The Literature

Food group intake and brain lesions in late-life vascular depression

Studies indicate that diet may be related to the occurrence of brain lesions. The cross-sectional association between food intake and brain lesion volumes in late-life depression was examined in a cohort of elderly individuals with current or prior depression. Food intake was assessed in 54 elderly vascular depression subjects (vascular depression defined by presence of hyperintensities on brain MRI) using a Block 1998 food frequency questionnaire. Food and kilocalorie intake were determined. Brain lesion volumes were calculated from MRI. Subjects were aged 60 or over and were participants in a longitudinal study of major depression. All subjects received psychiatric assessment and treatment, and medical comorbidity assessments. High-fat dairy and whole grains were significantly positively correlated with brain lesion volume, while other food groups were not significantly associated with lesion volume. In multivariable analyses, controlling for age, sex, hypertension, diabetes and total kilocalories, the positive association with lesion volume remained significant for both high-fat dairy and whole grains. High fat dairy and whole grain consumption may be associated with brain lesions in elderly subjects with depression.

Genetic variance contributes to ingestive processes: A survey of eleven inbred mouse strains for fat (Intralipid) intake

Genetic variation across inbred and outbred mouse strains have been observed for intake of sweet solutions, salts, bitter tastants and a high-fat diet. Our laboratory recently reported marked strain differences in the amounts and/or percentages of kilocalories of sucrose consumed among 11 inbred and one outbred mouse strains exposed to a wide range of nine sucrose concentrations (0.0001–5%) in two-bottle 24-h preference tests. To assess whether differences in fat intake were similarly associated with genetic variation, the present study examined intake of chow, water and an emulsified fat source (Intralipid) across nine different concentrations (0.00001–5%) in the same 11 inbred and 1 outbred mouse strains using two-bottle 24-h preference tests, which controlled for Intralipid concentration presentation effects, Intralipid and water bottle positions, and measurement of kilocalorie intake consumed as Intralipid or chow. Strains displayed differential increases in Intralipid intake relative to corresponding water with significant effects observed at the seven (BALB/cJ: 0.001% threshold sensitivity), four (AKR/J, C57BL/6J, DBA/2J, SWR/J: 0.5% threshold sensitivity), three (CD-1, C57BL/10J, SJL/J: 1% threshold sensitivity) and two (A/J, CBA/J, C3H/HeJ, 129P3/J: 2% threshold sensitivity) highest concentrations. In assessing the percentage of kilocalories consumed as Intralipid, SWR/J mice consumed significantly more at the three highest concentrations to a greater degree than BALB/cJ, C57BL/6J, CD-1, C3H/HeJ, DBA/J and 129P3/J strains which in turn consumed more than A/J, AKR/J, CBA/J, C57BL/10J and SJL/J mice. Relatively strong ( h 2 = 0.73–0.79) heritability estimates were obtained for weight-adjusted Intralipid intake at those concentrations (0.001–1%) that displayed the largest strain-specific effects in sensitivity to Intralipid. The identification of strains with diverging abilities to regulate kilocalorie intake when presented with high Intralipid concentrations may lead to the successful mapping of genes related to hedonics and obesity.

Resistance exercise training attenuates alcohol-induced cardiac oxidative stress

Myocardial oxidative stress is believed to play an important role in the pathogenesis of alcoholic cardiomyopathy. Strenuous physical exercise has been shown to increase or decrease myocardial oxidative stress depending on the mode and duration of the exercise intervention. Given the possibility of individuals to engage in both alcohol consumption and weight-training exercise, we have examined the effect of resistance exercise training and chronic alcohol consumption on myocardial oxidative stress in rats. Forty Sprague-Dawley rats were randomly assigned to one of four experimental groups: sedentary, sedentary plus alcohol treatment, resistance training, or resistance training plus alcohol treatment. Rats in the alcohol groups received a liquid diet containing alcohol (35% of kilocalorie intake) for 6 weeks. Non-alcohol groups were pair-fed the same liquid diet supplemented with a maltose dextrin caloric substitute. Rats in the resistance training groups were trained to rise onto their hind limbs while wearing lead-weighted vests 30 times per training session, 3 days per week during the 6 week experimental period. Alcohol treatment in the sedentary animals resulted in greater levels of cardiac malondialdehyde, a marker of lipid peroxidation, and a depressed index of myocardial antioxidant potential compared with all other groups (P<0.05). Hearts from the resistance training plus alcohol animals exhibited malondialdehyde and antioxidant levels similar to sedentary controls, suggesting that resistance training protected against the alcohol-induced myocardial stress. These results suggest that resistance training may attenuate the damaging effects of alcohol on the heart and preserve myocardial antioxidant capacity.

The Pedometer as a Tool to Enrich Science Learning in a Public Health Context

The United States is experiencing an obesity epidemic: A science-technology-society public health issue tied to our built environment, which is characterized by heavy dependence on automobiles and reduced opportunities to walk and bicycle for transportation. This presents an informal science education opportunity within “science in personal and social perspectives'' to use pedometer technology for enhancing students' understandings about human energy balance. An exploratory study was conducted with 29 teachers to investigate how pedometers could be used for providing academic enrichment to secondary students participating in after-school Health Sciences and Technology Academy clubs. Frequency analysis revealed that the pedometer activities often investigated kilocalorie expenditure and/or incorporated hypothesis testing/experimenting. Teachers' perspectives on learning outcomes most frequently conveyed that students increased their awareness of the importance of health habits relative to kilocalorie intake and expenditure. Pedometers have considerable merit for the regular science curriculum as they allow for numerous mathematics applications and inquiry learning and target concepts such as energy and equilibrium that cut across the National Science Education Standards. Pedometers and associated resources on human energy balance are important tools that science teachers can employ in helping schools respond to the national call to prevent childhood obesity.

Inbred mouse strain survey of sucrose intake

Mouse strain differences for intake of sucrose and saccharin have been reported across studies, and some of these differences have been related to variants of the Tas1r3 taste receptor gene. However, several methodological concerns remain, including use of relatively few strains and/or a limited number of palatable concentrations in previous analyses. The present study examined strain differences in sucrose intake among 11 inbred (A/J, AKR/J, BALB/cJ, CBA/J, C3H/HeJ, C57BL6/J, C57BL10/J, DBA/2J, SJL/J, SWR/J, 129P3/J) and one outbred (CD-1) mouse strains across nine different sucrose concentrations (0.0001–20%) using two-bottle 24-h preference tests which controlled for sucrose concentration presentation effects, sucrose and water bottle positions, and measurement of kilocalorie intake as sucrose or chow. A/J, C57BL/6J, CD-1 and SWR/J strains consumed the greatest (11.6–22 ml) amount of sucrose, whereas the A/J, C57BL/10J, SJL/J and SWR/J strains consumed the greatest (44–56%) percentages of kilocalories as sucrose. The AKR/J, CBA/J, C3H/HeJ and DBA/2J strains consumed the least (6.9–7.9 ml) amount of sucrose, and displayed lower (20–30%) percentages of kilocalories consumed as sucrose. Whereas A/J, C57BL/6J, C57BL/10J, CD-1, SWR/J and SJL/J strains all displayed the most pronounced compensatory decreases in chow intake as the percentage of kilocalories consumed as sucrose increased, the AKR/J, C3H/HeJ and DBA/2J strains failed to significantly alter chow intake even at high sucrose concentrations. There was a paucity of significant correlations in the percentage of sucrose intake between sucrose concentrations, but percentage of sucrose intake at lower concentrations did correlate with previous descriptions of saccharin intake and variants of the Tas1r3 taste receptor gene. These data demonstrate clear mouse strain differences across a range of measures in sucrose intake across a wide range of concentrations, but caution against extrapolating between extremely high and low concentrations. The identification of strains with diverging abilities to regulate kilocalorie intake when presented with high sucrose concentrations may lead to the successful QTL mapping of this trait.

Coronary heart disease risk factors in young people of differing socio-economic status

This study determined the prevalence of coronary heart disease (CHD) risk factors in young people1 of differing socio-economic status (SES). A cohort of 100 boys and 108 girls, aged 12.9, SD 0.3 years drawn of differing SES were assessed for CHD risk factors. Measurements included indices of obesity, blood pressure, aerobic fitness, diet, blood lipids and lipoproteins. Significant differences ( P ≤ 0.05) were detected with respect to SES, for systolic blood pressure, total cholesterol and low density lipopro tein cholesterol, but in boys only. Significant sex differences ( P ≤ 0.05) were identified for systolic blood pressure, diastolic blood pressure, aerobic fitness, waist to hip ratio, summation of four skinfold thicknesses, average daily kilocalorie intake, total choles terol and low density lipoprotein cholesterol. Moreover, increased body fatness, low aerobic fitness, a high fat diet and elevated lipoprotein (a), were the most frequently identified CHD risk factors in this cohort. This study reveals a high incidence of CHD risk factors in young people irrespective of SES and sex, and highlights the need for vigilance in identifying such risk factors from a young age.

Changes in dietary intake after diagnosis of breast cancer

Objective To quantify change in intake of kilocalories, macronutrients, and fruit and vegetable servings after diagnosis of breast cancer, and to correlate these changes with subject characteristics and with self-reported global change in dietary patterns. Design Food frequency questionnaires were completed by women newly diagnosed with breast cancer shortly after diagnosis. They were asked to recall intake 1 year before diagnosis. Two years after the initial interview another food frequency questionnaire was completed recalling intake during the previous year. At the 2-year follow-up interview women were also asked if they had changed their intake of fruit, vegetables, and fat since diagnosis. Subjects/Setting Two hundred sixty New Mexico women with newly diagnosed breast cancer between July 1997 and March 1999. Analysis Two-year change scores for kilocalories, macronutrients, and fruit and vegetable servings were calculated and tested for difference from zero using paired t tests or Wilcoxon signed rank tests. Subjects’ characteristics were related to change in kilocalories and linear regression was used to determine the relative importance of these characteristics. Amount of change in fruit and vegetable servings and fat intake were calculated using food frequency data for women who reported increasing their intake of fruits and vegetables or decreasing their intake of fat after diagnosis. Results Small but significant decreases in intake of total energy and macronutrients were found 2 years postdiagnosis, with younger women reporting the greatest decreases. Fat as a percentage of diet increased over this period. There was no change in mean intake of fruit and vegetable servings. There is agreement between change as measured by food frequency questionnaire and change reported by more global questions on dietary habits; however, the amount of change measured was small. Women reporting an increase in fruit and vegetable intake postdiagnosis described an increase of one-quarter serving of fruit and one-third serving of vegetables per day. Conclusions Breast cancer diagnosis results in modest dietary changes. Small changes in fruit and vegetable consumption suggest that efforts are needed to encourage increased consumption of these foods.

Recreational Physical Activity and the Risk of Breast Cancer in Postmenopausal Women: The Women’s Health Initiative Cohort Study

McTiernan, Anne; Kooperberg, Charles; White, Emily; Wilcox, Sara; Coates, Ralph; Adams-Campbell, Lucile L.; Woods, Nancy; Ockene, Judith

Assessment of the nutrition status of patients with Huntington's disease

Objective The purpose of the present study was to compare the nutrition status of patients with Huntington's disease (HD) with that of control subjects by analyzing anthropometric and biochemical indicators, energy, and macronutrient intake and to determine which indicators are most altered in HD patients. Methods We assessed the nutrition status of 25 HD patients and 25 age- and sex-matched controls by measuring anthropometric and biochemical indicators. Food intake data were obtained by the 3-d record method to assess mean daily energy and macronutrient intake. We studied variables reported by the patients such as increased or decreased appetite, mastication difficulties, and solid food and liquid food dysphagia. A neurologist assessed the clinical features of HD patients by using the Unified Huntington's Disease Rating Scale. Results HD patients showed significantly lower anthropometric variables but significantly higher kilocalorie intake. Among the subjective variables analyzed, patient-referred weight loss, increased appetite, mastication, and solid food dysphagia were significantly more frequent in HD patients than in controls. We also found relations between motor disability and some anthropometric parameters in HD patients. In particular, we found a significant correlation between total motor disability score and body mass index and arm muscle circumference ( r = −0.464 and −0.445, respectively; P < 0.05) and with percentage of body fat ( r = −0.496, P = 0.012). Conclusions It is of the utmost importance to identify nutritional alterations in HD patients and to find strategies to cover their kilocalorie and nutrient requirements to improve their quality of life.

Independent effects of diet palatability and fat content on bout size and daily intake in rats

Although considerable evidence attests to the hyperphagic effects of high-fat (HF) diets, the attribute(s) of these diets (e.g., palatability, caloric density, and postingestive effects) which promote overeating is still unclear. The present studies investigated the independent effects of diet palatability and macronutrient composition on intake using the self-regulated intragastric infusion paradigm. In Experiment 1, rats were infused with either HF or high-carbohydrate (HC) diet while drinking either saccharin (Sacc) or a more palatable saccharin–glucose (SaccGlu) test solution for 9 days. HF elicited greater daily intake than HC; lick pattern analysis revealed that HF produced larger but not more frequent bouts. Test solution was not related to intake, possibly due to the relatively modest palatability manipulation. Experiment 2 provided a more sensitive test: The palatability manipulation was strengthened and diet infusion made optional by provision of chow. HF again elicited larger bout size and total daily intake (diet+chow) than HC. Rats given the more palatable solution significantly increased intake (via larger bouts) and thus the amount of diet infused, but chow intake decreased such that total kilocalorie intake was not significantly related to solution palatability. The reliable observation that HF promoted larger bout size and greater total kilocalorie intake than HC provides additional evidence that fat sends weaker feedback signals relevant to controls of both satiation (suppression of ongoing eating, behaviorally manifest in meal size) and satiety (suppression of subsequent intake, reflected in total daily intake).

The impact of nutrition intervention on a reliable morbidity and mortality indicator: the hemodialysis-prognostic nutrition index

Objective: To determine the prevalence of risk for hospitalization in hemodialysis (HD) patients and examine the impact of oral kilocalorie and protein supplementation in two Midwestern outpatient dialysis centers. Design/Setting: This was a prospective intervention study conducted at 2 outpatient dialysis centers in the Midwest. Patients: The inclusion criteria for patients were (1) more than 18 years of age, (2) receiving HD 3 times per week, and (3) a functioning gastrointestinal tract. Intervention: Patients who met study criteria and signed an informed consent form were screened using the hemodialysis prognostic nutrition index (HD-PNI) to determine risk for hospitalization. Patients determined to be at high risk (HD-PNI ≥0.8) were included in the treatment group, and patients at low risk did not receive the intervention. They followed their normal nutritional regimen. The intervention group received an oral supplement daily for 3 months. The team of the dietitian, patient, researcher, and physician determined the type of oral supplements based on patient needs and preferences. Main Outcome Measures: Before and after HD-PNI, 24-hour recall and subjective global assessments (SGA) were conducted to assess risk for hospitalization, dietary intake, and nutritional status, respectively. Results: A total of 117 patients were screened, with a total of 26 in the treatment group (high risk) and 91 in the low-risk group. Baseline SGA distribution was 23% for patients with low nutritional risk (group A), 64% for those with moderate nutritional risk (group B), and 13% for those with severe nutritional risk (group C). When the HD-PNI scores of the treatment group were analyzed using paired t-tests, significant differences were observed between pre- and post-HD-PNI mean scores, 1.92 ± 1.16 and 1.42 ± 1.59, ( P < .05) respectively. When comparing the responders versus the nonresponders by the dependent and independent variables (pre- and post-HD-PNI, SGA, kilocalorie intake, diabetic status, and presence of hypertension) only post-HD-PNI score was significantly different (0.96 ± 1.69 and 2.20 ± 1.09, respectively). Conclusion: This study succeeded in showing that 22% of the hemodialysis patients in 2 Midwestern centers were at an increased risk for hospitalization. Furthermore, dietitian intervention with oral kilocalorie and protein supplements decreased the patients’ hemodialysis prognostic nutrition index scores and thereby decreased the patients’ risks for hospitalization.

Sibutramine reduces kilocalorie intake during binge-eating episodes,

Sibutramine reduces kilocalorie intake during binge-eating episodes,

EATING LESS AND GETTING FATTER

Results from the most recent National Health and Nutrition Examination Survey indicate that over 65% of the US population are overweight. We realize that this is the unhealthy consequence of too much intake and too little physical activity. PURPOSE To test the hypothesis that much of the increase in the prevalence of overweight could be the consequence of decreased physical activity accompanied by insufficient decreases in energy intakes. METHODS A meta-analysis of peer-reviewed diet intake reports of healthy Americans with study dates 1930–1990. Over 100 articles were reviewed, and 47 of these had usable energy intake data for adolescent (12–19) or adult (20–50) Caucasian US males and females. Excluded were data from athletes, strenuous physical laborers, impoverished subjects, subjects with illnesses, or individuals on special diets. Only data from food recall and diet records were used. The final data set included average daily energy intakes from 12,078 adult females, 11,487 adult males, 4,483 adolescent females, and 4,381 adolescent males. Both weighted and unweighted regressions of mean caloric intake on study data were performed. RESULTS Among the first three groups we observed significant decreases in energy intake: adult females, p = 0.001; adult males, p = 0.02; adolescent females, p = 0.01. Although a decrease in energy intake was observed for the adolescent males, it did not reach significance, p = 0.14. The mean decrease in daily kilocalorie intakes and (percentage decreases) were: adult males: −640kcal (−20%); adult females: −325kcal (−16%); adolescent females: −460 kcal (−20%); and adolescent males: −340 kcal (−11%). CONCLUSIONS Results provide a qualitative estimate of the decrease in daily physical activity among these four US populations over the period 1930–1990.

QTL analysis of self-selected macronutrient diet intake: fat, carbohydrate, and total kilocalories.

The present study investigated the inheritance of dietary fat, carbohydrate, and kilocalorie intake traits in an F(2) population derived from an intercross between C57BL/6J (fat-preferring) and CAST/EiJ (carbohydrate-preferring) mice. Mice were phenotyped for self-selected food intake in a paradigm which provided for 10 days a choice between two macronutrient diets containing 78/22% of energy as a composite of either fat/protein or carbohydrate/protein. Quantitative trait locus (QTL) analysis identified six significant loci for macronutrient intake: three for fat intake on chromosomes (Chrs) 8 (Mnif1), 18 (Mnif2), and X (Mnif3), and three for carbohydrate intake on Chrs 17 (Mnic1), 6 (Mnic2), and X (Mnic3). An absence of interactions among these QTL suggests the existence of separate mechanisms controlling the intake of fat and carbohydrate. Two significant QTL for cumulative kilocalorie intake, adjusted for baseline body weight, were found on Chrs 17 (Kcal1) and 18 (Kcal2). Without body weight adjustment, another significant kcal locus appeared on distal Chr 2 (Kcal3). These macronutrient and kilocalorie QTL, with the exception of loci on Chrs 8 and X, encompassed chromosomal regions influencing body weight gain and adiposity in this F2 population. These results provide new insight into the genetic basis of naturally occurring variation in nutrient intake phenotypes.