Nutritional Alterations Research Articles

Physiologic estrogen replacement increases bone density in adolescent girls with anorexia nervosa

Anorexia nervosa (AN) is prevalent in adolescents and is associated with decreased bone mineral accrual at a time critical for optimizing bone mass. Low BMD in AN is a consequence of nutritional and hormonal alterations, including hypogonadism and low estradiol levels. Effective therapeutic strategies to improve BMD in adolescents with AN have not been identified. Specifically, high estrogen doses given as an oral contraceptive do not improve BMD. The impact of physiologic estrogen doses that mimic puberty on BMD has not been examined. We enrolled 110 girls with AN and 40 normal-weight controls 12 to 18 years of age of similar maturity. Subjects were studied for 18 months. Mature girls with AN (bone age [BA] ≥15 years, n = 96) were randomized to 100 µg of 17β-estradiol (with cyclic progesterone) or placebo transdermally for 18 months. Immature girls with AN (BA < 15 years, n = 14) were randomized to incremental low-dose oral ethinyl-estradiol (3.75 µg daily from 0 to 6 months, 7.5 µg from 6 to 12 months, 11.25 µg from 12 to 18 months) to mimic pubertal estrogen increases or placebo for 18 months. All BMD measures assessed by dual-energy X-ray absorptiometry (DXA) were lower in girls with AN than in control girls. At baseline, girls with AN randomized to estrogen (AN E + ) did not differ from those randomized to placebo (AN E-) for age, maturity, height, BMI, amenorrhea duration, and BMD parameters. Spine and hip BMD Z-scores increased over time in the AN E+ compared with the AN E- group, even after controlling for baseline age and weight. It is concluded that physiologic estradiol replacement increases spine and hip BMD in girls with AN.

Effect of salt stress on nutrient concentration, photosynthetic pigments, proline and foliar morphology of Salvinia auriculata Aubl.

AIM: This study aimed to investigate the effects of NaCI and Na2So4 salts on Ca, CI, K, Mg N, P, S and Na content as well as on the content of photosynthetic pigments (chlorophyll-a, chlorophyll-b and carotenoids), proline content and on the foliar morphology of Salvinia auriculata Aubl. METHODS: The plants were collected in Jacu lagoon, located in the North of Rio de Janeiro State, and after a five-day-acclimation period, experiments were performed in the greenhouse with 0, 100, 200 mM concentrations of NaCI and Na2SO4 salts and the usual techniques for light and electron microscopy. RESULTS: After seven days of experiment, a decrease in the content of Ca2+, K+, Mg2+, P, N ions as well as in the content of photosynthetic pigments (chlorophyll-a,b and carotenoids) in Salvinia auriculata under saline treatments was observed. The proline content showed an upward tendency as compared to the control. Under transmission electron microscopy, it was observed that, on the foliar limb, there was a membrane system disorder, mainly of chloroplasts, with higher presence of starch grains of plant cells subjected to salinity. Under scanning electron microscope, the integrity of trichomes and foliar limb cells of Salvinia auriculata subjected to the control treatment as well as the changes caused by salinization on the surface of cells were observed. CONCLUSION: As for all the salinization effects evaluated, it was noticed that the increase in Na2SO4 salt concentration resulted in higher morphological and nutritional alterations in the floating aquatic macrophyte, Salvinia auriculata.

Activity of Schinus Areira (Anacardiaceae) Essential Oils against the Grain Storage Pest Tribolium castaneum

Essential oils extracted from leaves and fruits of Schinus areira (Anacardiaceae) were tested for their repellent, toxic and feeding deterrent properties against Tribolium castaneum (Coleoptera: Tenebrionidae) larvae and adults. A topical application assay was employed for the contact toxicity study and filter paper impregnation for the fumigant assay. A treated diet was also used to evaluate the repellent activity and a flour disk bioassay for the feeding deterrent action and nutritional index alteration. The essential oil of the leaves contained mainly monoterpenoids, with alpha-phellandrene, 3-carene and camphene predominant, whereas that from the fruits contained mainly alpha-phellandrene, 3-carene and beta-myrcene. The leaf essential oil showed repellent effects, whereas that from the fruit was an attractant. Both oils produced mortality against larvae in topical and fumigant bioassays, but fumigant toxicity was not found against adults. Moreover, both essential oils produced some alterations in nutritional index. These results show that the essential oils from S. areira could be applicable to the management of populations of Tribolium castaneum.

Género y alteraciones hepáticas, nutricionales y metabólicas del alcoholismo grave: estudio de 480 pacientes

Background and objective To analyze gender differences in the hepatic, nutritional and metabolic complications associated with alcoholism. Patients and methods Cross-sectional study in alcoholic patients admitted to detoxification in two university hospitals of Barcelona between 1999 and 2006. During admission, co-morbidity prior to admission was assessed and blood samples to analyze biological markers were collected. Demographic and anthropometric data, daily alcohol consumption and other drug use characteristics were also obtained at admission. Results There were 566 admissions in 480 patients (375 males). Age at admission was 43 years (IQR: 36.3-49.0 years). Overall, 68.4% showed macrocytosis (MCV > 95 fl), 81.7% GGT > 40 U/L and 57.7% AST > 37 U/L. Regarding liver function tests, frequency of alkaline phosphatase > 120 U/L was significantly higher in women (18.5 vs 10.5%, p = 0.037). However, the prevalence of hyperferritinemia (> 90 ng/mL) was significantly higher in alcoholic men (85.7% vs 62.2%) (p = 0.000). Having multiple liver function test alterations was significantly higher in men (OR: 1.64, 95% CI: 1.01-2.65) (p = 0.043). Women showed significant differences regarding the prevalence of macrocytosis (77.5% vs 65.8%, p = 0.026), low serum creatinine (< 0.7 mg/100 mL) (28.2 vs 14.6%, p = 0.001), low serum ferritin (< 30 ng/mL) (10.8 vs 3.9%, p = 0.020), as well as of multiple nutritional alterations (OR: 1.59, 95% CI: 1.02-2.48) (p = 0.040). However, men had higher prevalence of anemia than women (32.3 vs 21.4%, p = 0.032). Prevalence of type I obesity (BMI > 30 kg/m 2) was significantly higher in alcoholic women (29.2 vs 7.9%, p = 0.007). Conclusions Hepatic, nutritional and metabolic complications of alcoholism in women are frequent, thus increasing the risk of developing adverse clinical outcomes.

Nutritional and metabolic status of HIV-positive patients with lipodystrophy during one year of follow-up

OBJECTIVES:The aim of this prospective study was to compare changes in lipid metabolism and nutritional status after either 6 and 12 months of follow-up in subjects with lipodystrophy syndrome after traditional lifestyle therapy with or without fibric acid analogue intervention (bezafibrate and clofibrate).METHODS:Food intake, alterations in body composition and metabolic abnormalities were assessed in subjects with lipodystrophy syndrome at the beginning of the study. The nutritional status and metabolic alterations of the subjects were monitored, and the subjects received nutritional counseling each time they were seen. The subjects were monitored either two times over a period no longer than six months (Group A; n = 18) or three times over a period of at least 12 months (Group B; n = 35). All of the subjects underwent nutrition counseling that was based on behavior modification. The fibric acid analogue was only given to patients with serum triglyceride levels above 400 mg/dL.RESULTS:After six months of follow-up, Group A showed no alterations in the experimental parameters. After twelve months, there was a decrease in serum triglyceride levels (410.4 ± 235.5 vs. 307.7 ± 150.5 mg/dL, p< 0.05) and an increase in both HDLc levels (37.9 ± 36.6 vs. 44.9 ± 27.9 mg/dL, p<0.05) and lean mass (79.9 ± 7.8 vs. 80.3 ± 9.9 %, p< 0.05) in Group B.CONCLUSION:After one year of follow-up (three sessions of nutritional and medical counseling), the metabolic parameters of the subjects with lipodystrophy improved after traditional lifestyle therapy with or without fibric acid analogue intervention.

Clostridium difficileInfections among Hospitalized Children, United States, 1997–2006

To the Editor: Zilberberg et al. described a notable increase in rates of Clostridium difficile infection (CDI)–related hospitalizations of children during 1997–2006 on the basis of analysis of data from 2 national administrative databases (1). As the authors acknowledge, they used administratively coded databases, which have inherent misclassification and testing biases. Detection of C. difficile toxin indicates that bowel flora have been perturbed. However, the clinical role of toxin detection or isolation of C. difficile organisms in children is controversial. Although primary CDI is a recognized pathologic entity in children, one needs to consider whether another etiology related to a concomitant infection, antimicrobial drug administration, or alteration in enteral nutrition may be the precipitating event resulting in C. difficile toxin production. It is our clinical observation that availability of testing for C. difficile and rapidity of assay results play a role in the submission of stool specimens for analysis. In 2007, we conducted a 5-month retrospective chart review of C. difficile testing practices at 2 local tertiary-care pediatric hospitals. Of 796 stool specimens submitted, 42 (5%) were notable for the detection of toxin A or B; these samples represented 35 patients (2). Medical coders likely face the same challenges as clinicians who must interpret toxin assay results and their clinical role with regard to hospitalized children. Although the ≈2-fold increase in CDI-associated hospitalization rates reported by Zilberberg et al. in their time series and cross-sectional analyses is notable, these results should be interpreted within the context of clinical and epidemiologic factors contributing to generation of this data.

Fetal origins of the metabolic syndrome

The natural history of metabolic syndrome and polycystic ovary syndrome (PCOS), which shares many components of metabolic syndrome, may originate in intrauterine life. Evidence from epidemiological observations, clinical, and experimental animal studies suggest that the nutritional, hormonal, and metabolic environment afforded by the mother may permanently program differentiating target tissues of the offspring toward the development of metabolic syndrome/PCOS phenotype in adult life. The mechanisms of fetal programming are not well understood. Thus, the altered tissue differentiation may be the result of fetal adaptive responses representing homeostatic adaptations due to alterations in fetal nutrition. Also, tissues under the influence of androgen excess may be directed toward a more masculine phenotype with regard to reproductive, neuroendocrine, and metabolic traits, while the importance of epigenetics in fetal origin of metabolic syndrome/PCOS cannot be overlooked.

Anthropometric nutritional evaluation of the pregnant women and its relation with the product of the gestation

The objective of the present study was to evaluate the association between the anthropometric nutritional state of the pregnant women during his third trimester of pregnancy with the anthropometric state nutritional of the product of the gestation, who carried out their prenatal control in the University Hospital of Caracas and the Hospital of Caracas Clinics. The evaluated variables were: pregestational weight, gestational weight, chart, average circumference of the arm and fold of triceps; the anthropometric indicators were constructed: index of corporal mass (IMC) pregestational and gestational and of corporal composition such as greasy and muscular area of the arm. In new born, one evaluated the weight and the stature and so the ponderal index was constructed (IP), as well as the clinical evaluation of the nutritional state of the newborn one (ECEN). Statistical Package SPSS 13,0 for Windows, calculating statistical descriptive basic and coefficient of correlation of Pearson was used (p 0.05). The results indicate that when considering the associations between the maternal variables and anthropometric indicators with the neonatal ones is to a great extent positive correlation, of this form, cases as the average circumference of arm (CMB) maternal were statistically significant with the ponderal index and puntaje ECEN, indicating that the maternal CMB is constituted like an indicative variable of the nutritional state of the newborn one. The early incorporation in the routine monitoring of the prenatal control, the anthropometric valuation with effective simple variables of low cost is recommended and, being able to detect nutritional alterations in which it is found opportunely to prevent adverse results in the newborn one.

Global analysis of circulating metabolites in hibernating ground squirrels

Hibernation in mammals involves major alterations in nutrition and metabolism that would be expected to affect levels of circulating molecules. To gain insight into these changes we conducted a non-targeted LC–MS based metabolomic analysis of plasma using hibernating ground squirrels in late torpor (LT, T b ~ 5 °C) or during an interbout arousal period (IBA, T b ~ 5 °C) and non-hibernating squirrels in spring ( T b ~ 37 °C). Several metabolites varied and allowed differentiation between hibernators and spring squirrels, and between torpid and euthermic squirrels. Methionine and the short-chain carnitine esters of propionate and butyryate/isobutyrate were reduced in LT compared with the euthermic groups. Pantothenic acid and several lysophosphatidylcholines were elevated in LT relative to the euthermic groups, whereas lysophosphatidylethanolamines were elevated during IBA compared to LT and spring animals. Two regulatory lipids varied among the groups: sphingosine 1-phosphate was lower in LT vs. euthermic groups, whereas cholesterol sulfate was elevated in IBA compared to spring squirrels. Levels of long-chain fatty acids (LCFA) and total NEFA tended to be elevated in hibernators relative to spring squirrels. Three long-chain acylcarnitines were reduced in LT relative to IBA; free carnitine was also lower in LT vs. IBA. Our results identified several biochemical changes not previously observed in the seasonal hibernation cycle, including some that may provide insight into the metabolic limitations of mammalian torpor.

Hypervolemia and Blood Pressure

Volume expansion is one of the most important factors that results in higher levels of blood pressure in patients with chronic kidney disease. This has been known for many years, and led to the original description of the concept of dry weight in 1967.1 This is especially important in patients with end-stage renal disease who require dialysis for volume control. Inadequate control of volume or inability to establish and maintain an appropriate dry weight for a dialysis patient may be an important factor in contributing to excess mortality. In this issue of Hypertension , Agarwal2 has importantly demonstrated the value of relative plasma volume slope monitoring in predicting overall mortality among >300 patients on long-term hemodialysis. A simple cross-sectional analysis of relative plasma volume slope during dialysis was predictive of mortality independent of conventional and unconventional cardiovascular risk factors, independent of ultrafiltration volume, ultrafiltration rate, ultrafiltration volume per kilogram, ultrafiltration rate index per postdialysis weight, and interdialytic ambulatory blood pressure. Why is the relative plasma volume slope such a powerful predictor for mortality? Is it simply that steeper slopes of relative plasma volume monitoring are associated with greater likelihood of the attainment of a more euvolemic state and, thus, may put less stretch and strain on the myocardium? Probing for dry weight in clinical practice can be complicated.3 It is an inexact clinical science. The clinical examination is not always helpful to assess volume. Changes in body mass because of alterations in nutrition and dietary electrolyte and volume consumptions may complicate the process of dry weight assessment and achievement. Inadequate achievement of dry weight results in …

Nutrient status, plant availability and seasonal forcing mediate fish herbivory in temperate seagrass beds

Among mechanisms for herbivore choice, palatability and abundance of food resources appear to have a central role in foraging ecology. Hence, nutrient supply due to eutrophication may cause profound alterations to both nutritional and quantitative aspects of primary producers, leading to changes in herbivory pressure and enhancing overall functional changes. We present an experi- ment of water column enrichment in an oligotrophic seagrass bed of Posidonia oceanica (northwest- ern Mediterranean Sea). In this study we measured monthly seasonal changes in fish herbivore behavior following alterations in qualitative (nutrient content, species composition) and quantitative (biomass availability) features of primary producers (seagrass, epiphytes and macroalgae) as a result of nutrient fertilization. Nutrient addition induced changes in both seagrass (enhanced plant N con- tent and leaf growth) and epiphytes (enhanced N content, biomass load and altered species compo- sition) throughout late spring and summer. This nutritional alteration of food organoleptic properties concurred within the seasonal peak of herbivory by the fish Sarpa salpa and caused a disproportion- ate herbivore pressure on enriched plots, until shoots were reduced to around 50% of their original leaf area. When plant biomass on fertilized plots was substantially reduced, herbivores fed mostly on control plots until the end of the summer period. During the rest of the year (autumn and winter), moderate nutrient additions could not disrupt the seasonal inertia of the ecosystem. Hence, our results show evidence that the foraging behavior of herbivorous fish is the result of chemical and visual sensing of the environment. Seasonal forcing, however, tightly controls ecosystem processes and the biological cycles of species, adding a further step to functional alterations in temperate sea- grass meadows subjected to eutrophication.

Metabolic imprinting effects in grass‐fed Wagyu (Japanese Black) beef production

We aim at producing a high‐quality safe beef product while maximising the use of domestic grass resources. Alterations in foetal and early postnatal nutrition and endocrine status may result in developmental adaptations that permanently change the structure, physiology, and metabolism in the adult life of rats, mice, domestic species and humans. This phenomenon is referred to as “metabolic imprinting” based on the concept of “the developmental origins of health and disease (DOHaD)”. In this study, we investigate whether the metabolic imprinting effect of differences in feeding during an early growth influences on the meat quality of Japanese Black (Wagyu) steers or not. The high energy group (HE: n=12) underwent intense nursing till 3 months of age and was fed a high‐concentrate diet for 4 to 10 months of age. On the contrary, the Roughage group (R: n=11) underwent normal nursing and was fed only roughage ad libitum from 3 to 10 months of age. Both groups were fed only roughage ad libitum and grazed from 10 to 30 months of age. Samples of tissues from the longissimus muscles in all animals were collected and biopsied at 3, 10, 14, 20 and 30 months of age. Gene expressions related to adipogenesis, fatty acid synthase etc. in muscle were measured by real‐time PCR. We also investigated meat quality after slaughter. We could show the metabolic imprinting effects on meat quality and quantity of grass‐fed Wagyu.

Metabolic Programming Due to Alterations in Nutrition in the Immediate Postnatal Period1–3

Altered nutritional experiences such as undernutrition, overnutrition, and modified milk formula in the immediate postnatal life via the phenomenon of metabolic programming have been identified as one of the components in the etiology of metabolic syndrome. We have developed a rat model in which an altered dietary experience in the form of a high-carbohydrate (HC) milk formula in the immediate postnatal life of rat pups results in chronic hyperinsulinemia and adult-onset obesity in these rats. The HC dietary modification causes functional alterations in pancreatic islets and the hypothalamus during the period of the dietary modification. These early adaptations in islets (supporting hyperinsulinemia) and the hypothalamus (supporting hyperphagia and increased body weight gain) persist in the postweaning period despite withdrawal of the HC milk formula at the time of weaning. In female rat pups receiving the HC milk formula, metabolic programming effects translate into an adverse (hyperinsulinemic, hyperleptinemic, and obese) intrauterine environment during pregnancy, causing spontaneous transfer of the maternal phenotype to the progeny (generational effect). Our results suggest that alterations in feeding practices for babies (early introduction of cereals, fruits, etc.) and babies born to obese/hyperinsulinemic mothers may be contributing factors for the obesity epidemic prevalent in developed and developing countries.

Body composition in chronic kidney disease patients and haemodialysis

Nutritional alterations are highly prevalent among patients with chronic kidney diseases stage 5 who receive haemodialysis therapy. Body composition alterations are directly related to an increased morbidity and mortality. Nutritional assessment represents a cardinal intervention oriented to improve the outcome and survival in chronic renal patients. To evaluate body composition in a mexican population with chronic kidney disease stage 5 and haemodialysis therapy. Prospective, descriptive and transversal study. Free fatty mass (FFM) and fatty mass (FM) were evaluated by means of bioelectric impedance (BIE), anthropometrics measures (MPA) and dual-energy x-ray absorptiometry (DEXA). 20 patients were evaluated (12 females and 8 males). Mean age was 51.9 +/- 19.3 years. Mean weight was 59.5 +/- 10.5 kg and mean body mass index was 24.9 +/- 3.1 kg/m(2). Mean FFM values were 42.4 +/- 8.6 kg (MPA), 43.6 +/- 8.9 kg (DEXA) y 42.8 +/- 10.2 kg (IBE). Mean FM values: 17.2 +/- 6.2 kg (MPA), 15.9 +/- 6.9 kg (DEXA) and 16.9 +/- 6.9 kg (IBE). Correlation coefficients between the three methods were: FFM, 0.982 (MPA vs IBE), 0.963 (MPA vs DEXA) y 0.947 (IBE vs DEXA). Fatty mass: 0.975 (MPAvs IBE), 0.925 (MPA vs DEXA) y 0.898 (IBE vs DEXA). In the studied population, fatty mass was increased and FFM was within the reference ranges. There was not evidence of protein malnutrition. MPA and BIE are practical and useful tools to evaluate body composition in mexican chronic kidney disease patients who receive haemodialysis therapy. The results obtained by means of MPA and BIE correlated with results obtained by DEXA.

Estado nutricional de escolares segundo a localização geográfica das escolas em Sorocaba, São Paulo

OBJETIVO: Verificar as prevalências de baixo peso, sobrepeso e obesidade em escolares, segundo a localização geográfica das escolas públicas na cidade de Sorocaba (SP), Brasil. MÉTODOS: Foi avaliado o maior número possível de escolares de sete a dez anos de idade, num total de 11.290 indivíduos pertencentes à rede pública municipal de escolas. Para a determinação de baixo peso, sobrepeso e obesidade foram utilizados, respectivamente, os percentis &lt;5, &gt;85 e &gt;95 do índice de massa corpórea por idade para sexo e idade propostos pelos Centers for Disease Control and Prevention (CDC, 2000). Comparou-se a prevalência de alterações nutricionais de acordo com a localização da escola. RESULTADOS: A prevalência de baixo peso, sobrepeso e obesidade nas crianças avaliadas, segundo a região geográfica de Sorocaba foi, respectivamente: Centro 3,4, 17,2 e 15,1%; Sul 4,2, 15,4 e 11,2%; Leste 3,2, 14,7 e 12,7%; Nordeste 4,3, 11,9 e 10,7%; Norte 5,8, 12 e 9,1%; Noroeste 7,5, 11 e 9,1%; Oeste 6,0, 11 e 9,2%. Os meninos apresentaram 5,3, 12,1 e 11,9% e as meninas 5,9, 12,3 e 8,2% de baixo peso, sobrepeso e obesidade, respectivamente. Houve diferença significativa na prevalência de alterações nutricionais entre as regiões da cidade (p&lt;0,001) CONCLUSÕES: O Centro e o Leste de Sorocaba apresentaram as maiores taxas de escolares com excesso de peso, as regiões Noroeste e Oeste, as maiores taxas de baixo peso. Na análise por sexo, os meninos apresentaram maiores taxas de obesidade. Esses resultados podem ajudar a planejar políticas públicas para a prevenção da obesidade em escolares

Efeito do armazenamento à baixa temperatura (-4 ºC) na cor e no teor de acidez da farinha de trigo

Durante o armazenamento de farinha de trigo, podem ocorrer mudanças bioquímicas que resultam em alterações nutricionais e tecnológicas, sendo que em baixa temperatura estas mudanças ocorrem mais lentamente. Entre as alterações, pode-se citar o aumento da acidez, a redução do pH e as modificações na sua cor. O presente trabalho teve por objetivo avaliar os efeitos do armazenamento à baixa temperatura (-4 ºC) na cor e na acidez da farinha de trigo durante seis meses e correlacionar os resultados obtidos para investigar se a acidez tem relação com a cor da farinha. Foram utilizadas farinhas provenientes de dez genótipos de trigo cultivados em Cascavel, no Estado do Paraná. A cor foi determinada no sistema CIEL*a*b* através dos parâmetros de cor: L* (luminosidade), a* e b* (coordenadas de cromaticidade). Usou-se procedimento da AOAC para determinação da acidez de lipídios. As farinhas apresentaram tendência ao branqueamento durante o período de seis meses de armazenamento, com ocorrência de leve aumento da acidez, mas dentro dos teores aceitáveis. A acidez não foi considerada um fator envolvido na alteração da cor das farinhas no armazenamento à baixa temperatura, pois não houve correlação entre estes dois parâmetros.

Combined effects of ghrelin and higher food intake enhance skeletal muscle mitochondrial oxidative capacity and AKT phosphorylation in rats with chronic kidney disease

Skeletal muscle mitochondrial dysfunction and insulin resistance occur in chronic kidney disease. Ghrelin is a gastric hormone previously shown to enhance muscle mitochondrial enzyme activities and AKT-mediated insulin signaling independent of food intake in healthy rats. Here we determined the impact of ghrelin treatment on anorexia, skeletal muscle mitochondrial oxidative capacity, AKT phosphorylation as a measure of insulin signaling, and lean body mass in a rat model of chronic kidney disease. Ghrelin infusion promoted higher food intake and lean body mass. Further, although muscle mitochondrial enzyme activities were low in the rats with CKD (chronic kidney disease), they normalized with ghrelin treatment, a change that was consistent with the increase in the transcript levels of regulators of mitochondrial biogenesis and lipid metabolism. This was associated with a lower muscle triglyceride content and higher AKT phosphorylation. Pair-feeding showed that mitochondrial effects of ghrelin are independent of changes in food intake, whereas combined ghrelin treatment and higher food intake were needed to enhance AKT phosphorylation. Thus, ghrelin-induced muscle mitochondrial changes and lower tissue triglycerides could favor insulin action and muscle anabolism in the presence of improvement in food intake. Our study shows that combined effects of ghrelin on appetite and muscle mitochondria improve muscle metabolic and nutritional alterations in chronic kidney disease. This could have potential beneficial impact on patient morbidity and survival.

Metabolic Response and Nutritional Support in Traumatic Brain Injury: Evidence for Resistance to Renutrition

Abstract Traumatic brain injury (TBI) is one of the most severe injuries encountered in intensive care units. TBI patients exhibit protein wasting and gastrointestinal dysfunction, which may be risk factors for a septic state. Specific nutritional support may be required for these patients, and we hypothesize that standard nutritional support does not allow restoration of the nutritional state of TBI patients. A well-validated rat model of TBI by fluid percussion was used. Rats were randomized into three groups: healthy rats receiving standard chow diet ad libitum (AL), rats sustaining TBI and receiving standard chow diet (TBI), and rats sustaining TBI and receiving a standard enteral diet (TBI-EN) for 4 days. TBI in rats was characterized by anorexia, body weight loss (AL: +15 +/- 5 g versus TBI: -11 +/- 4 g and TBI-EN: -8 +/- 4 g; p < 0.05), decrease in nitrogen balance (AL: 2.9 +/- 0.2 g versus TBI: 1.0 +/- 0.2 g and TBI-EN: 0.2 +/- 0.2 g, p < 0.05) associated with decrease in muscular protein content (extensor digitorum longus [EDL]: AL: 36 +/- 2 mg versus TBI: 26 +/- 3 mg and TBI-EN: 28 +/- 2 mg; p < 0.05), and intestinal atrophy (ileum: AL: 673 +/- 42 mg versus TBI: 442 +/- 23 mg and TBI-EN: 377 +/- 27 mg; p < 0.05). Interestingly, standard enteral nutrition was not effective in restoring any of these parameters. This work confirms that TBI is associated with profound nutritional alterations and has a major impact on nitrogen metabolism and on intestinal trophicity. It also demonstrates that using standard enteral nutrition cannot reverse this phenomenon. Thus, developing new nutritional strategies to cover TBI patients' specific nutritional requirements appears mandatory.

Expressão de genes relacionados à função adrenocortical no estado de caquexia neoplásica

The adrenal gland plays a crucial role in the neuroendocrine response, especially in situations where homeostasis is disturbed. In the neoplastic cachexia process, there is homeostasis impairment by nutritional and metabolic alterations of advanced-stage cancer, involving hypothalamus-pituitary-adrenal axis response. In this assignment, an experimental model of cachexia induced by Walker-256 tumor was performed in Wistar rats. Animals (n=4) were sacrificed 10 days after inoculation of tumor cells, and the adrenal glands were excised. The RNA was isolated for the study of gene expression related to the steroidogenesis control by semi-quantitative RT-PCR. Data analysis showed a significant reduced expression of MC2R (melancortin type 2 receptor), 3sHSD I (3-beta-hydroxysteroid dehydrogenase type I) and TSPO (translocator protein) genes in animals with neoplastic cachexia ( P =0.037, 0.0097 and 0.052, respectively), revealing adrenal cortex failure.

Skeletal muscle fibre plasticity in response to selected environmental and physiological stimuli.

Skeletal muscle constitutes a highly adaptable and malleable tissue that responds to environmental and physiological challenges by changing its phenotype in terms of size and composition, outcomes that are brought about by changes in gene expression, biochemical and metabolic properties. Both the short- and long-term effects of nutritional alterations on skeletal muscle homeostasis have been defined as the object of intensive research over the last thirty years. This review focuses predominantly on assimilating our understanding of the changes in muscle fibre phenotype and functional properties induced by either food restriction or alternatively existing on a high fat diet. Firstly, food restriction has been shown in a number of studies to decrease the myofibre cross sectional area and consistently, it has been found that glycolytic type IIB fibres are more prone to atrophy than oxidative fibres. Secondly, in rodents, a high fat diet has been shown to induce an oxidative profile in skeletal muscle, although obese humans usually show higher numbers of glycolytic type IIB fibres. Moreover, attention is paid to the effect of prenatal maternal food restriction on muscle development of the offspring in various species. A key point related to these experiments is the timing of food restriction for the mother. Furthermore, we explore extensively the seemingly species-specific response to maternal malnutrition. Finally, key signalling molecules that play a pivotal role in energy metabolism, fibre type transitions and muscle hypertrophy are discussed in detail.