Total Daily Calories Research Articles

Choosing Healthy Fats

Fat has traditionally been attributed to causing weight gain and increasing insulin resistance, which has led people to think that it has a direct relationship with diabetes. However, according to recent studies it was found that fat does not have a connection with insulin sensitivity, and in several observational studies, total fat intake is not associated with diabetes risk. Many academic societies, based on established research, have reported that the quality of fat is more important than total fat intake. Although the suggested daily intake varies, most say to reduce the intake of saturated fat and trans fat in order to prevent coronary heart diseases. According to the 2013 National Health and Nutrition Examination Survey, Koreans' fat intake made up 21.2% of their daily calorie intake. Although not as high as those in western countries, the intake of fat especially that coming from animals has been quite high among young people. According to the Korean Society for the Study of Obesity and the Korean Society of Lipidology and Atherosclerosis, it is best to keep daily fat calorie intake under 30% of the total daily calorie intake, and to avoid low quality fats, as the quality is thought to have a more direct impact than the quantity of fat. In order to prevent cardio vascular diseases, balanced intake of healthy fatty acids is needed. In this paper we will review the influence of fat, both in quality and quantity, on coronary heart diseases of diabetes patients.

Added sugars in kids' meals from chain restaurants.

ObjectiveTo analyze the added sugars in kids' meals from Canadian chain restaurants in relation to the World Health Organization's proposed sugar recommendation (less than 5% of total daily calories should come from added sugars) and current recommendation (less than 10% of total daily calories should come from added sugars).MethodsTotal sugar levels were retrieved from the websites of 10 fast-food and 7 sit-down restaurants in 2010. The added sugar levels in 3178 kids' meals from Canadian chain restaurants were calculated in 2014 (in Toronto, Canada) by subtracting all naturally occurring sugars from the total sugar level.ResultsThe average amount of added sugars in restaurant kids' meals (25 ± 0.36 g) exceeded the WHO's proposed daily recommendation for sugar intake. There was a wide range of added sugar levels in kids' meals ranging from 0 g to 114 g. 50% of meals exceeded the WHO's proposed daily sugar recommendation, and 19% exceeded the WHO's current daily sugar recommendation.ConclusionThere is a wide range of sugar levels in kids' meals from restaurants, and many contain more than a day's worth of sugar.

Oral calorie supplements for cystic fibrosis.

Poor nutrition occurs frequently in people with cystic fibrosis (CF) and is associated with other adverse outcomes. Oral calorie supplements are used to increase total daily calorie intake and improve weight gain. However, they are expensive and there are concerns they may reduce the amount of food eaten and not improve overall energy intake. To establish whether in people with CF, oral calorie supplements: increase daily calorie intake; and improve overall nutritional intake, nutritional indices, lung function, survival and quality of life. To assess adverse effects associated with using these supplements. We searched the Cochrane CF Trials Register comprising references from comprehensive electronic database searches, handsearches of relevant journals and abstract books of conference proceedings. We contacted companies marketing oral calorie supplements.Last search: 03 July 2014. Randomised or quasi-randomised controlled trials comparing use of oral calorie supplements for at least one month to increase calorie intake with no specific intervention or additional nutritional advice in people with CF. We independently selected the included trials, assessed risk of bias and extracted data. We contacted the authors of included trials and obtained additional information for two trials. We identified 21 trials and included three, reporting results from 131 participants lasting between three months and one year. Two trials compared supplements to additional nutritional advice and one to no intervention. Two of the included trials recruited only children. In one trial the risk of bias was low across all domains, in a second trial the risk of bias was largely unclear and in the third mainly low. Blinding of participants was unclear in two of the trials. Also, in one trial the clinical condition of groups appeared to be unevenly balanced at baseline and in another trial there were concerns surrounding allocation concealment. There were no significant differences between people receiving supplements or dietary advice alone for change in weight, height, body mass index, z score or other indices of nutrition or growth. Changes in weight (kg) at three, six and twelve months respectively were: MD 0.32 (95% CI -0.09 to 0.72); MD 0.47 (95% CI -0.07 to 1.02 ); and MD 0.16 (-0.68 to 1.00). Total calorie intake was greater in people taking supplements at 12 months, MD 265.70 (95% CI 42.94 to 488.46). There were no significant differences between the groups for anthropometric measures of body composition, lung function, gastrointestinal adverse effects or activity levels. Oral calorie supplements do not confer any additional benefit in the nutritional management of moderately malnourished children with CF over and above the use of dietary advice and monitoring alone. While nutritional supplements may be used, they should not be regarded as essential. Further randomised controlled trials are needed to establish the role of short-term oral protein energy supplements in people with CF and acute weight loss and also for the long-term nutritional management of adults with CF or advanced lung disease, or both.

Dietary rice bran protects against rotavirus diarrhea and promotes Th1-type immune responses to human rotavirus vaccine in gnotobiotic pigs.

Rice bran (RB) contains a distinct stoichiometry of phytochemicals that can promote gut mucosal immune responses against enteric pathogens. The effects of RB on rotavirus diarrhea and immunogenicity of an attenuated human rotavirus (HRV) vaccine were evaluated in gnotobiotic pigs. The four treatment groups studied were RB plus vaccine, vaccine only, RB only, and mock control. Pigs in the RB groups were fed the amount of RB that replaced 10% of the pigs' total daily calorie intake from milk starting from 5 days of age until they were euthanized. Pigs in the vaccine groups were orally inoculated with two doses of the attenuated HRV vaccine. A subset of pigs from each group was orally challenged with the homologous virulent HRV on postinoculation day 28. Diarrhea and virus shedding were monitored daily from postchallenge day 0 to day 7. RB feeding significantly protected against diarrhea upon virulent HRV challenge and enhanced the protective rate of the vaccine against rotavirus diarrhea. Consistent with protection, RB significantly increased gamma interferon (IFN-γ)-producing CD4(+) and CD8(+) T cell responses in intestinal and systemic lymphoid tissues. Furthermore, RB also increased the number of total IgM- and IgA-secreting cells, total serum IgM, IgG, and IgA titers, and HRV-specific IgA titers in intestinal contents. RB reduced the numbers of intestinal and systemic HRV-specific IgA and IgG antibody-secreting cells and reduced serum HRV-specific IgA and IgG antibody titers before the challenge. These results demonstrate clear beneficial effects of RB in protection against rotavirus diarrhea and stimulation of nonspecific and HRV-specific immune responses, as well as its biased Th1-type adjuvant effect for the vaccine.

A new method to monitor the contribution of fast food restaurants to the diets of US children.

BackgroundAmerican adults consume 11.3% of total daily calories from foods and beverages from fast food restaurants. The contribution of different types of fast food restaurants to the diets of US children is unknown.ObjectiveTo estimate the consumption of energy, sodium, added sugars, and solid fats among US children ages 4–19 y by fast food restaurant type.MethodsAnalyses used the first 24-h recall for 12,378 children in the 2003–2010 cycles of the nationally representative National Health and Nutrition Examination Survey (NHANES 2003–2010). NHANES data identify foods by location of origin, including stores and fast food restaurants (FFR). A novel custom algorithm divided FFRs into 8 segments and assigned meals and snacks to each. These included burger, pizza, sandwich, Mexican, Asian, fish, and coffee/snack restaurants. The contribution of each restaurant type to intakes of energy and other dietary constituents was then assessed by age group (4–11 y and 12–19 y) and by race/ethnicity.ResultsStore-bought foods and beverages provided 64.8% of energy, 61.9% of sodium, 68.9% of added sugars, and 60.1% of solid fats. FFRs provided 14.1% of energy, 15.9% of sodium, 10.4% of added sugars and 17.9% of solid fats. Among FFR segments, burger restaurants provided 6.2% of total energy, 5.8% of sodium, 6.2% of added sugars, and 7.6% of solid fats. Less energy was provided by pizza (3.3%), sandwich (1.4%), Mexican (1.3%), and chicken restaurants (1.2%). Non-Hispanic black children obtained a greater proportion of their total energy (7.4%), sodium (7.1%), and solid fats (9.5%) from burger restaurants as compared to non-Hispanic white children (6.0% of energy, 5.5% of sodium, and 7.3% of solid fat).ConclusionsThese novel analyses, based on consumption data by fast food market segment, allow public health stakeholders to better monitor the effectiveness of industry efforts to promote healthier menu options.

The Beneficial Effects of Weight Reduction in Overweight Patients With Chronic Proteinuric Immunoglobulin A Nephropathy: A Randomized Controlled Trial

This study was conducted to examine the effects of weight reduction on proteinuria, adipokines, and renal function in overweight immunoglobulin A nephropathy (IgAN) patients (body mass index > 23 kg/m2) with chronic proteinuria more than 6 months. This was a single-center, prospective, randomized controlled trial. The study was performed at the outpatient clinic at King Chulalongkorn Memorial Hospital, Bangkok, Thailand, from July 2012 to February 2013. Twenty-six overweight patients with chronic proteinuric biopsy-proven IgAN were randomized into a control group (n = 13) or a low-calorie normal protein diet group (n = 13). All patients received the maximum dosage of angiotensin-converting enzyme inhibitor or angiotensin receptor blocker and other antihypertensive agents to achieve a blood pressure less than 125/75 mmHg. The study intervention was a low-calorie diet (target energy per day as 500-kcal subtraction from total energy requirement) for a 6-month period. At baseline and after 6 months of a low-calorie diet, body weight, body content, and clinical and laboratory parameters were determined and compared. After initiating a low-calorie diet for 6 months, the normalized protein nitrogen appearance values were not different, indicating comparable protein intake. The low-calorie group had lower total daily calorie intake (1,307.1 ± 171.8 vs. 1,772.2 ± 315.4 kcal/d, P < .01) and significant reductions in body weight (-5.1 ± 3.3%, P < .001), fat content (-12.7 ± 14.1%, P < .05), and 24-hour urine protein (-45.2 ± 15.4%, P < .001). Blood pressure and renal function parameters were unaltered. The low-calorie group had approximately 20% lower plasma levels of leptin but unchanged adiponectin. There were positive correlations between the amount of protein reduction and the changes of body weight, fat mass, and leptin. A 6-month low-calorie diet leads to weight reduction and results in diminished fat content and decreased proteinuria in overweight IgAN patients with chronic proteinuria. This beneficial effect might be mediated by changes in adipokines.

Effects of a popular 2‐week weight‐loss program on body weight and waist circumference: a meta‐analysis of intervention trials (640.7)

Relatively faster initial weight loss may improve long‐term weight reduction and maintenance by enhancing participant motivation, thus adherence to a longer‐term plan and overall healthier lifestyle. The objective of this meta‐analysis was to examine the effects of a popular, short‐term, kick‐start program on body weight and waist circumference in ten trials conducted across seven countries. This portion‐controlled, 2‐week program recommends replacement of two meals per day with ready‐to‐eat cereal or waffles, incorporation of portion‐controlled snacks, fruits, or vegetables into snacking occasions, and consumption of one sensible meal per day to help participants either begin a weight loss program or attain short‐term weight loss for their ongoing weight maintenance efforts. Random effects meta‐analyses found that body weight and waist circumference were statistically significantly decreased in the within‐group analyses (differences from baseline to trial end) and the between‐group analyses (intervention vs. control, where applicable). Overall, successful short‐term weight loss was achieved, showing that a simple and convenient program that restricts energy intake with calorie‐controlled meals and snacks can result in reduced total daily calorie intake over the course of participation.

Dietary therapy for a patient affected with 3-hydroxy-3-methylglutaric aciduria

3-Hydroxy-3-methylglutaric aciduria (OMIM 246450) is an extremely rare genetic metabolic disorder of leucine caused by deficiency of 3-hydroxy-3-methylglutaryl-CoA lyase (HMG-CoA lyase). Affected patients present with life-threatening metabolic acidosis, hyperammonemia, and nonketotic hypoglycemia. Optimal outcome for patients depends on early diagnosis and treatment, prompt management of acute metabolic decompensation during the chronic stage, and long-term interprofessional health care programs. Nutritionists play a pivotal role in the care of metabolic disorders throughout the rest of a patient’s life. A 4-year-old intubated Bunun tribe female patient was admitted to the pediatric intensive care unit of the Buddhist Tzu Chi General Hospital (Hualien, Taiwan) due to status epilepticus, hypoglycemia, and severe metabolic acidosis. Results of urine gas chromatography with mass spectrometry revealed markedly elevated 3-methylglutaric acid, 3-hydroxy-3-methylglutaryl-CoA, and 3-hydroxyisovaleric acid, a finding consistent with a diagnosis of HMG-CoA lyase deficiency. She received an interdisciplinary health care program after acute management. Dietary therapy was the major part of the transdisciplinary health delivery process. Total daily calories were increased from 1400 kcal/day (targeted 60e80%) to 2100e2200 kcal/day (targeted 100%). The ratio of protein lipid and carbohydrate was 13%:24%:63% as recommended for healthy children. Lifelong protein restriction was essential. Total daily protein was given at a dose of 1.5e2 g/kg/day (target: above 50 g/day after the age of 4 years) and was administered at different growth and developmental stages. The daily leucine dose was 1000 mg (suggested dose ¼ 700e900 mg/day), 1.5% of the total protein amount was designed for her. Because leucine is an essential amino acid, close monitoring of optimal serum levels through blood sampling should be reached for better growth and development. Food avoidance was a major focus on restriction of protein from milk, meat, cheese, fish, poultry (including egg), beans, and nutlets, and even any foods containing milk and egg. Partial limited foods included sprouts (alfalfa, clover), radish, red bean, and murgbean. Unlimited fruits included vegetables and low protein starch such as green bean noodles, rice flour, pearl sago, lotus root powder, cornstarch, and corn flour, and low leucine foods such as potato powder were advised. The patient’s major protein source was from a special formula (I-Valex I and II; Abbott, Chicago, USA). Other nutrients such as multivitamins and minerals were prescribed. Daily oral L-carnitine was also prescribed to increase excretion of organic acid. The ability to recognize food labeling was taught to the parents, the patient, and school nurses. Servings for daily dietary content (Table 1) and sample meal plans were designed (Table 2).

Composition of personalized and standard nutritional mixtures in patients on home parenteral nutrition

The compounding of personalized parenteral nutrition mixtures (PPNMs) for home parenteral nutrition (HPN) gives the possibility to better satisfy nutritional requirements for patients in selected clinical conditions. The objective of this study was to compare the composition of PPNMs prescribed in selected cases, by a practitioner nutritionist, with that of industrially manufactured standard parenteral nutrition mixtures (SPNMs). Two hundred and ninety-eight patients (151 men, 147 women, aged 17-87 years) on HPN, followed up in 2011 at our Center, were retrospectively recruited. Industrially manufactured SPNMs were prescribed in 230 (77.2%) patients, whereas compounded PPNMs were prescribed in 68 (22.8%). Formulation of PPNMs, adjusted for body weight, did not significantly differ from SPNMs as regards total daily calorie amount, but was significantly different as far as nutrient composition is concerned (P<0.01). Analysis on the daily amount of nutrients per kg of body weight and per patient disease showed that 16/34 (47%) benign chronic intestinal failure (CIF) patients, 47/233 (20%) cancer patients and 5/31 (16%) patients grouped as 'having other diseases' needed personalized mixtures (in PPNMs 4-9 nutrients were significantly different from those in SPNMs). Moreover, in CIF patients receiving PPNMs, frequent changes in the formulation (mean 6 times per year, range 1-28) were necessary. Our data suggest that, presently, PPNMs cannot be completely replaced by SPNMs owing to special needs in macro and/or micronutrients of some patients and/or the necessity of frequent changes in the nutritional mixture composition, at least until stabilization of clinical and metabolic conditions.

Piloting “Sodabriety”: A School‐Based Intervention to Impact Sugar‐Sweetened Beverage Consumption in Rural Appalachian High Schools

Sugar-sweetened beverages (SSBs) are the largest source of added sugar in the US diet. In adolescents aged 12-19, these drinks account for 13% to 28% of total daily calories. Compared with other adolescents, those residing in Appalachia have the highest consumption rates of SSBs. Using a Teen Advisory Council (TAC), a student-designed and student-led intervention was conducted at 2 high schools in a rural Appalachian county. Using repeated-measures models design with Bonferroni correction, data were collected on daily and weekly consumption of SSBs and of water at baseline, immediately post-intervention, and 30 days post-intervention. Vending machine surveys were completed. The 186 participants reported purchasing SSBs from school vending machines (41.4%), cafeteria (36.5%), and school stores (7.7%). Daily SSB servings decreased from an average of 2.32 (SD = 2.14) to 1.32 (SD = 1.29) (p < .001). Weekly consumption decreased from an average of 4.30 (SD = 2.40) days/week to 2.64 (SD = 1.91) (p < .001). Water consumption increased 19% from baseline to immediately post-intervention. Student-directed efforts to support behavioral change are feasible and effective at affecting individual lifestyle behaviors. Small and manageable changes may lead to net improvements in lifestyle behaviors.

Associations between Body Composition, Hormonal and Lifestyle Factors, Bone Turnover, and BMD

BackgroundThe relative importance of body composition, lifestyle factors, bone turnover and hormonal factors in determining bone mineral density (BMD) is unknown. We studied younger postmenopausal women to determine whether modifiable or nonmodifiable risk factors for osteoporosis have stronger associations with BMD.MethodsIn multivariable linear regression models, we tested associations between non-bone body composition measures, self-reported measures of physical activity and dietary intake, urinary N-telopeptide (NTx), sex hormone concentrations, and BMD in 109 postmenopausal women aged 50 to 64 years, adjusting for current hormone therapy use and clinical risk factors for low BMD. Lean mass, fat mass and areal BMD (aBMD) at the lumbar spine, femoral neck, total hip and distal radius were measured using dual energy X-ray absorptiometry.ResultsHigher body weight and self-reported nonwhite race were independently associated with higher aBMD at the lumbar spine, femoral neck, total hip and distal radius. Lean and fat mass were not independently associated with aBMD. Older age and higher urinary NTx were independently associated with lower aBMD at the distal radius but not at weight-bearing sites. Sensitivity analyses demonstrated lack of an independent association between total daily protein or calorie intake and BMD.ConclusionsBMD, weight and race were the most important determinants of aBMD at all sites. Older age and higher bone turnover were independently associated with lower aBMD at the distal radius. In a limited analysis, self-reported physical activity, dietary protein and calorie intake were not associated with aBMD after adjustment for the other variables.

Clinical Practice Guidelines for Healthy Eating for the Prevention and Treatment of Metabolic and Endocrine Diseases in Adults: Cosponsored by the American Association of Clinical Endocrinologists/The American College of Endocrinology and the Obesity Society Executive Summary

J. Michael Gonzalez-Campoy, MD, PhD, FACE1; Sachiko T. St. Jeor, PhD, RD2; Kristin Castorino, DO3; Ayesha Ebrahim, MD, FACE4; Dan Hurley, MD, FACE5; Lois Jovanovic, MD, MACE6; Jeffrey I. Mechanick, MD, FACP, FACN, FACE, ECNU7; Steven M. Petak, MD, JD, MACE, FCLM8; Yi-Hao Yu, MD, PhD, FACE9; Kristina A. Harris10; Penny Kris-Etherton, PhD, RD11; Robert Kushner, MD12; Maureen Molini-Blandford, MPH, RD13; Quang T. Nguyen, DO14; Raymond Plodkowski, MD15; David B. Sarwer, PhD16; Karmella T. Thomas, RD17

Medicinal Chemistry of the Epigenetic Diet and Caloric Restriction

The pronounced effects of the epigenetic diet (ED) and caloric restriction (CR) have on epigenetic gene regulation have been documented in many pre-clinical and clinical studies. Understanding epigenetics is of high importance because of the concept that external factors such as nutrition and diet may possess the ability to alter gene expression without modifying the DNA sequence. The ED introduces bioactive medicinal chemistry compounds such as sulforaphane (SFN), curcumin (CCM), epigallocatechin gallate (EGCG) and resveratrol (RSV) that are thought to aid in extending the human lifespan. CR, although similar to ED in the target of longevity, mildly reduces the total daily calorie intake while concurrently providing all beneficial nutrients. Both CR and ED may act as epigenetic modifiers to slow the aging process through histone modification, DNA methylation, and by modulating microRNA expression. CR and ED have been proposed as two important mechanisms that modulate and potentially slow the progression of age-related diseases such as cardiovascular disease (CVD), cancer, obesity, Alzheimer's and osteoporosis to name a few. While many investigators have examined CR and ED as separate entities, this review will primarily focus on both as they relate to age-related diseases, their epigenetic effects and their medicinal chemistry.

Evening hyperphagia and food motivation: A preliminary study of neural mechanisms

Evening hyperphagia (EH; consumption of ≥25% of total daily calories after the evening meal) is a circadian delay in the pattern of daily food intake and is a core criterion of night eating syndrome (Allison et al., 2010). This preliminary study examined the brain response to food cues using functional magnetic resonance imaging (fMRI) in seven obese adults with EH compared to seven obese adults without EH. When contrasting food to non-food and blurry baseline images pre-meal, groups differed in brain activation in the inferior frontal gyrus, precentral gyrus, cingulate gyrus, superior temporal gyrus and cerebellum. At post meal, groups differed in brain activation in the fusiform gyrus, inferior frontal gyrus, inferior parietal lobule and the cerebellum. Significant interactions between time (pre-meal, post-meal) and group (EH, control) when contrasting food to non-food images were also noted in the inferior frontal gyrus and the superior temporal gyrus. Further research is necessary to replicate these findings and determine if they have a mechanistic role in the development of circadian delayed eating behavior in obese adults with EH.

Chronotype Is Independently Associated With Glycemic Control in Type 2 Diabetes

OBJECTIVETo examine whether chronotype and daily caloric distribution are associated with glycemic control in patients with type 2 diabetes independently of sleep disturbances.RESEARCH DESIGN AND METHODSPatients with type 2 diabetes had a structured interview and completed questionnaires to collect information on diabetes history and habitual sleep duration, quality, and timing. Shift workers were excluded. A recently validated construct derived from mid-sleep time on weekends was used as an indicator of chronotype. One-day food recall was used to compute the temporal distribution of caloric intake. Hierarchical linear regression analyses controlling for demographic and sleep variables were computed to determine whether chronotype was associated with HbA1c values and whether this association was mediated by a higher proportion of caloric intake at dinner.RESULTSWe analyzed 194 completed questionnaires. Multiple regression analyses adjusting for age, sex, race, BMI, insulin use, depressed mood, diabetes complications, and perceived sleep debt found that chronotype was significantly associated with glycemic control (P = 0.001). This association was partially mediated by a greater percentage of total daily calories consumed at dinner.CONCLUSIONSLater chronotype and larger dinner were associated with poorer glycemic control in patients with type 2 diabetes independently of sleep disturbances. These results suggest that chronotype may be predictive of disease outcomes and lend further support to the role of the circadian system in metabolic regulation.

Effect of meal size on total daily energy intake among people with type 2 diabetes

We assessed the association between distribution of energy intake and total daily energy intake among individuals with type 2 diabetes, using data from 1219 men and women who completed the 1999–2004 National Health and Nutrition Examination Survey (NHANES). History of diabetes was self‐reported. Daily energy intake, overall and by meal (breakfast, lunch, dinner) and snack, was estimated from a 24‐h food frequency questionnaire. Multiple regression models were used to estimate the association between percent of daily energy intake at each meal and snack with daily energy intake. Models were controlled for sex, age, race/ethnicity, body mass index and physical activity. Intake of energy (mean ± standard deviation), as percent of total daily intake, at breakfast, lunch, dinner and snack was 22.9% ± 15.7%, 23.2% ± 20.0%, 35.2% ± 21.3%, and 12.4% ± 16.3%, respectively. A larger breakfast (≥ 20% vs. &lt;10% of total daily calories) was associated with 293 ± 104 (mean ± standard error) kilocalories lower total daily energy intake. No association was found between meal size at lunch, dinner or snack and total energy intake. The results suggest a possible role of food pattern in daily intake of energy. Consuming a higher energy breakfast may help decrease the overall daily intake of energy, which is critical for management of type 2 diabetes.

The Relationship between Prevalence of Osteoporosis and Proportion of Daily Protein Intake

BackgroundThe association between daily protein intake and osteoporosis is still controversial and only a few studies have explored the issue in Korea. This study investigated the relationship between daily protein intake and the prevalence of osteoporosis in Korean adults.MethodsThis study analyzed data extracted from the Korean National Health and Nutrition Examination Survey 4. Participants were aged 19 years or older and had never been treated for osteoporosis. The percentage of calories coming from protein intake was assessed by 24-hour recall method, and participants were divided into three groups according to recommended daily dietary protein intake as a proportion of total daily calories (i.e., <10%, 10%-20%, and >20%). A lumbar or femur neck bone mineral density T-score less than -2.5 was indicative of the presence osteoporosis. The influence of daily protein intake on the prevalence of osteoporosis was analyzed.ResultsIn both sexes, the group with the highest protein intake had significantly lower odds of developing lumber osteoporosis when compared to the group with the lowest protein intake, after adjusting for associated factors (females: odds ratio [OR], 0.618; 95% confidence interval [CI], 0.610 to 0.626; P for trend <0.001; males: OR, 0.695; 95% CI, 0.685 to 0.705; P for trend <0.001).ConclusionSufficient daily protein intake lowered the prevalence of osteoporosis in Korean adults. Further prospective studies are necessary to verify the preventive effect of adequate protein intake on osteoporosis.

Effect of Daikenchuto (TJ-100) on abdominal bloating in hepatectomized patients

To evaluate the clinical usefulness of Daikenchuto (DKT) in hepatecomized patients. Twenty patients were enrolled with informed consent. Two patients were excluded because of cancelled operations. The remaining 18 patients were randomly chosen for treatment with DKT alone or combination therapy of DKT and lactulose (n = 9, each group). Data were prospectively collected. Primary end points were Visual Analogue Scale (VAS) score for abdominal bloating, total Gastrointestinal Symptoms Rating Scale (GSRS) score for abdominal symptoms, and GSRS score for abdominal bloating. The VAS score for abdominal bloating and total GSRS score for abdominal symptoms recovered to levels that were not significantly different to preoperative levels by 10 d postoperation. Combination therapy of DKT and lactulose was associated with a significantly poorer outcome in terms of VAS and GSRS scores for abdominal bloating, total GSRS score, and total daily calorie intake, when compared with DKT alone therapy. DKT is a potentially effective drug for postoperative management of hepatectomized patients, not only to ameliorate abdominal bloating, but also to promote nutritional support by increasing postoperative dietary intake.

OP009 EVALUATING THE VALIDITY OF THE “CATEGORIES METHOD”: A NEW METHOD FOR SELF-REPORT ASSESSMENT OF DAILY CALORIE INTAKE: A PILOT STUDY

Rationale: Weight loss is mainly the result of reduction in daily caloric intake. Hence many people are interested in counting and tracking their daily caloric intake however, studies show that in fact only ~10% can accurately estimate it. We suggest a new self-assessment method for calorie intake called The “categories method”: a single categorical estimation per meal set of five categories. The aim of this study was to evaluate the validity of this new method in comparison with the 24 hours diary recall. Methods: This was a cross-sectional study of 29 participants (2 men) aged 44.2±11.4. All were interviewed face to face on 1 occasion to obtain self-category estimation and 24 hours diary recall using the USDA “4 pass” interview method. The Categories method included: Category “1” less than 200 kcal, Category “2” 200 500 kcal, Category “3” 501 800 kcal, Category “4” 801 1200 kcal and Category “5” above 1200 kcal. Displaying the average value of each category (e.g., Category 3: 500 800 Avg = 650 kcal), patients and professionals can sum up meals and estimate the total daily calorie intake. T-test and Pearson correlation test were used for statistical analysis. The study received ethical approval from the Assuta Hospital Systems ethics committee. NIH clinicaltrials.gov #NCT01408784. Results: BMI was 25.9±8.7 kg/m2. Reliability rate in selecting the right categories was 81.5%. The total calculate calories intake and estimate by the “categories method” were not significantly different (1671±600 vs. 1584±556 kcal/day) and the correlation was high (r = 0.73, p < 0.05). Conclusion: The “categories method” was shown to be reliable and accurate and might simplify the process of counting calories, especially with assembled or cooked meal. It makes it easier to track any given meal even to those who are not so familiar with the caloric value of a product. Disclosure of Interest: None Declared.

PP221-MON EVALUATING THE VALIDITY OF THE “CATEGORIES METHOD”: A NEW METHOD FOR SELF-REPORT ASSESSMENT OF DAILY CALORIE INTAKE: A PILOT STUDY

Rationale: Weight loss is mainly the result of reduction in daily caloric intake. Hence many people are interested in counting and tracking their daily caloric intake however, studies show that in fact only ~10% can accurately estimate it. We suggest a new self-assessment method for calorie intake called The “categories method”: a single categorical estimation per meal set of five categories. The aim of this study was to evaluate the validity of this new method in comparison with the 24 hours diary recall. Methods: This was a cross-sectional study of 29 participants (2 men) aged 44.2±11.4. All were interviewed face to face on 1 occasion to obtain self-category estimation and 24 hours diary recall using the USDA “4 pass” interview method. The Categories method included: Category “1” less than 200 kcal, Category “2” 200 500 kcal, Category “3” 501 800 kcal, Category “4” 801 1200 kcal and Category “5” above 1200 kcal. Displaying the average value of each category (e.g., Category 3: 500 800 Avg = 650 kcal), patients and professionals can sum up meals and estimate the total daily calorie intake. T-test and Pearson correlation test were used for statistical analysis. The study received ethical approval from the Assuta Hospital Systems ethics committee. NIH clinicaltrials.gov #NCT01408784. Results: BMI was 25.9±8.7 kg/m2. Reliability rate in selecting the right categories was 81.5%. The total calculate calories intake and estimate by the “categories method” were not significantly different (1671±600 vs. 1584±556 kcal/day) and the correlation was high (r = 0.73, p < 0.05). Conclusion: The “categories method” was shown to be reliable and accurate and might simplify the process of counting calories, especially with assembled or cooked meal. It makes it easier to track any given meal even to those who are not so familiar with the caloric value of a product. Disclosure of Interest: None Declared.