Patterns of daily energy expenditure in normal and marginally undernourished school-aged Colombian children

Using minute-by-minute heart rate recording, the pattern of energy expenditure (EE), total daily energy expenditure (TDEE) and energy expenditure in activity (EAC) were measured in 132 boys and 110 girls 6-8, 10-12 and 14-16 years of age during ordinary school days. The children were living under economically deprived conditions in Colombia; 70 boys and 59 girls were classified as having marginal malnutrition of sufficient degree to retard growth and sexual maturation. EE, TDEE and EAC increased with age, were in general less in undernourished than control subjects and less in girls than in boys. The age and nutritional group effects were ascribable to differences in lean body mass (LBM). However, the reduced activity in girls was greater than could be accounted for by differences in LBM and are probably the result of cultural pressures. Thus, at the levels of normal activity encountered during school days, the reduced energy expenditure found in undernourished children can be accounted for by differences in body size.     

Energy expenditure/basal metabolic rate ratios in normal and marginally undernourished Colombian children 6-16 years of age

Measurements of basal (BMR) and resting (RMR) metabolic rates, maintenance (MEE) and total daily energy expenditures (TDEE) have been made in Colombian children 6-16 years of age classified as nutritionally normal (boys, n = 129; girls, n = 72) and marginally undernourished (boys, n = 171; girls, n = 74). TDEE/BMR ratios were calculated for comparison with those suggested by FAO/WHO/UNU (1985) and to provide data for children less than 10 years of age. TDEE was measured in free-living, individually calibrated subjects by the heart-rate method. TDEE/BMR increased significantly with age in boys from 1.60 to 1.84 in control subjects and 1.46 to 1.92 in undernourished boys. There was no significant increase with age in the girls. There were no statistically significant differences between nutritional groups but girls had significantly lower values than boys. There was a greater rate of increase in TDEE than BMR with age and girls spent more time in light activities and less in high level activities than boys.     

Basal metabolic rate of normal and marginally undernourished mestizo children in Colombia

The basal metabolic rate (BMR) was measured in mestizo children 6-16 years of age living under economically deprived conditions in Colombia. Of a total of 239 boys and 126 girls, 137 boys and 72 girls were classified as marginally malnourished. Differences in BMR by age, sex and nutritional group could be accounted for by differences in lean body mass. The Schofield equations were found to overestimate BMR significantly in the boys. However, the estimates in girls were not significantly different from measured values.     

Systematic review of reviews of intervention components associated with increased effectiveness in dietary and physical activity interventions

Background  

To develop more efficient programmes for promoting dietary and/or physical activity change (in order to prevent type 2 diabetes) it is critical to ensure that the intervention components and characteristics most strongly associated with effectiveness are included. The aim of this systematic review of reviews was to identify intervention components that are associated with increased change in diet and/or physical activity in individuals at risk of type 2 diabetes.     

Predicting body composition from anthropometry and bioimpedance in marginally undernourished adolescents and young adults.

Body-composition prediction equations were developed using data from a sample of 201 female and male Guatemalan ladinos (ie, people of Amerindian-European descent) aged 11-25 y. Fat-free mass (FFM) values were estimated from body density by using the two-component model and age- and sex-specific values for the density of FFM. The root-mean-square error (RMSE) of the best model predicting FFM from a set of simple anthropometric variables was 1.59 kg for females and 1.90 kg for males. The addition of more extensive anthropometry to the set of candidate predictors reduced the RMSE to 1.42 kg for females and 1.88 kg for males. The subsequent addition of a bioelectrical impedance measure (Ht2/R) further reduced the RMSE to 1.32 kg for females and 1.82 kg for males. These results suggest that for a marginally undernourished population with relatively little body fat, simple anthropometrics are as useful as more sophisticated measures for the prediction of body composition.     

Marginal malnutrition in school-aged Colombian boys: anthropometry and maturation

Colombian reference data for weight and height were used to classify 1108 boys 6 to 16 yr old as nutritionally normal, low weight for age, and low weight for height. The normal group in upper socioeconomic urban and normal, low weight for age, low weight for height groups in lower socioeconomic urban and rural populations were studied. The achieved growth, growth velocities, skinfolds, mid-arm and head circumferences, and sexual maturation were all depressed in the nutritionally deprived groups indicating marginal malnutrition. Since normal boys exist in low socioeconomic and rural populations, normative data for economically advantaged children (national standards), on the average, may serve as desirable goals for low socioeconomic and rural populations. Different cutoff points for achieved growth might be established for marginal malnutrition using national or international reference populations. These ought to be age-related because of accumulated effect of slowed growth with age. Head circumference of school-aged children may proved a useful anthropometric tool in deciding early nutritional history.     

Influence of intervention on beverage choices: trends in the dietary intervention study in children (DISC)

OBJECTIVE: To compare treatment, sex, and visit differences in beverage choice and calcium intake in the Dietary Intervention Study in Children, to compare the relationship of other beverages to milk consumption, and document whether or not the dietary intervention affected choice of beverage and milk type over time. DESIGN: Data from the Dietary Intervention Study in Children, a randomized, controlled, multicenter, clinical trial with five sets of three 24-hour recalls. SUBJECTS: Six hundred fifty-three children from six clinics started the study at age 8 to 10 years. Participants had serum low-density lipoprotein cholesterol levels between the 80th and 98th percentiles of age, and were followed for a median of 7.3 years. INTERVENTION: Children were randomized to a total fat- and saturated fat-modified dietary intervention or usual care. MAIN OUTCOME MEASURES: Volume and percent of total energy from soft drinks, fruit-flavored drinks, fruit juice, and milk, calcium intake in milligrams and per 1,000 kcal, and percent reduced-fat and skim milk consumed. STATISTICAL ANALYSES: General Estimating Equations methodology was used to adjust for treatment, sex, and visit differences. RESULTS: The intervention group consumed more reduced-fat or skim milk than the usual care group. The intervention group also reported a greater increase in calcium per 1,000 kcal than those in the usual care group due to nonbeverage sources. Consumption of soft drinks increased over the course of the study, whereas total milk consumption decreased sharply. CONCLUSIONS: With nutrition education, children can make changes in the type of milk consumed, and in the quantity of dietary calcium consumed.     

Marginal malnutrition in school-aged Colombian boys: efficiency of treadmill walking in submaximal exercise

Measurements of oxygen consumption (VO2) were made during submaximal treadmill exercise (3.5 mph) in 658 boys 6 to 16 yr of age classified as nutritionally normal, low weight for age, and low weight for height. Gross efficiency (at 15% grade) increased with age and was significantly lower in low weight for age and height boys than in normal children but delta efficiency showed no statistically significant differences between nutritional groups. It is concluded that marginal malnutrition has no effect on the efficiency of submaximal work during treadmill walking.     

Intestinal parasites increase the dietary lysine requirement in chronically undernourished Indian men

BACKGROUND: We previously used the 24-h indicator amino acid balance method to show that the lysine requirement in undernourished Indian men from low socioeconomic and unsanitary environments is approximately 50% higher than the mean requirement of 30 mg lysine. kg(-1). d(-1) in well-nourished men. OBJECTIVE: It is possible that this higher lysine requirement in persons with chronic undernutrition is due to environmental influences, including the presence of intestinal parasites. We assessed this possibility by using 24-h indicator amino acid balance (with leucine) at both the "normal" requirement for lysine intake and the higher requirement, before and after successful treatment to eradicate intestinal parasites in affected, undernourished men. DESIGN: Fourteen chronically undernourished men were studied before and after treatment for intestinal parasites, during each of two 7-d (6-d dietary adaptation plus 1-d tracer experiment) diet periods supplying either 30 (n = 7) or 45 (n = 7) mg lysine. kg(-1). d(-1) from an L-amino acid diet. Twenty-four-hour indicator amino acid balance was estimated on day 6 by [(13)C]leucine tracer infusion. RESULTS: Before the parasite treatment, subjects were in neutral 24-h leucine balance at both lysine intakes. After the eradication of intestinal parasites, there was a significant (P < 0.001) improvement in 24-h leucine balances, which were positive at both lysine intakes. CONCLUSIONS: On the basis of the 24-h indicator amino acid balance approach, it appears that intestinal infestation with parasites increases the requirement for lysine and that this may be one factor responsible for the higher lysine requirement observed in persons with chronic undernutrition.     

Reports on dietary intervention in autistic disorders

Autism is a developmental disorder for which no cure currently exists. Gluten and/or casein free diet has been implemented to reduce autistic behaviour, in addition to special education, since early in the eighties. Over the last twelve years various studies on this dietary intervention have been published in addition to anecdotal, parental reports. The scientific studies include both groups of participants as well as single cases, and beneficial results are reported in all, but one study. While some studies are based on urinary peptide abnormalities, others are not. The reported results are, however, more or less identical; reduction of autistic behaviour, increased social and communicative skills, and reappearance of autistic traits after the diet has been broken.     

Marginal malnutrition in school-aged Colombian boys: metabolic rate and estimated daily energy expenditure

Total daily energy expenditure (TDEE) and energy expenditure in activity (EAc) were estimated in 114 free-ranging, nutritionally normal, and undernourished boys 6-16 yr of age by measuring basal and resting metabolic rates, average daily heart rate while awake, and oxygen consumption and heart rate during exercise on a treadmill. Mean daily heart rates were in the range of exercising heart rates and gave reasonable estimates of TDEE and EAc. TDEE increased with age (p less than 0.001) and was reduced in undernourished boys (p = 0.011). Results indicate that nutritional group differences in TDEE were due to differences in body size. EAc increased with age but did not show significant differences between nutritional groups, indicating that in the marginal malnutrition of school-aged children, reduced growth and associated economy of energy expenditure in locomotion is sufficient physiological adaptation. Peer pressure in school and play activities may interfere with the protective mechanism of reduced activity.     

Endogenous corticosterone rather than dietary sucrose as a modulator for intestinal sucrase activity in artificially reared rat pups

The effects of sucrose and corticosterone on the expression of intestinal sucrase activity in preweanling rat pups were studied using an artificial rearing (AR) technique. When AR rat pups were isocalorically fed diets containing lactose or sucrose, or a carbohydrate-free diet from d 12-16, jejunal and ileal sucrase and maltase activities were induced to similar levels in all AR rats, whereas ileal lactase activity was precociously decreased. In separate experiments, enzyme activities were measured in ileal isografts subcutaneously implanted in littermates at birth. In AR rats fed the lactose diet, these isografts showed sucrase and maltase activities comparable with those of host ileum and also to isografts from AR rats fed the sucrose diet. In contrast, lactase activity was significantly higher in isografts than host ileum in all AR rats. Serum corticosterone levels were significantly elevated in AR rats for 24 h after intragastric cannular implantation. Precocious expression of ileal sucrase activity occurred in corticosterone treated, but not in untreated, adrenalectomized AR rats. In conclusion, dietary sucrose has no specific role in enhancing intestinal sucrase activity, and endogenous corticosterone is responsible for the induction of sucrase activity in AR rats.     

Influence of dietary protein levels on beta-alanine aminotransferase expression and activity in rats.

beta-Alanine-oxoglutarate aminotransferase (beta-AlaAT I) and beta-alanine-pyruvate aminotransferase (beta-AlaAT II) catalyze the transamination reaction of omega-amino acids such as beta-alanine, beta-aminoisobutyrate, and gamma-aminobutyrate, amino acids that are not protein constituents. The influence of dietary protein levels on the expression and activities of these enzymes was investigated by using male rats. Both beta-AlaAT I and beta-AlaAT II activities in the liver were increased with the level of protein in the diet in accordance with changes in their mRNA levels. However, the beta-AlaAT I activity in the kidney was increased by protein-free and low-protein diets in relation to changes in its mRNA level. On the other hand, the level of beta-AlaAT II activity in the kidney was slightly decreased by a protein-free diet. Neither beta-AlaAT I nor beta-AlaAT II activities in the kidney were affected by a high-protein diet. These results suggested that beta-alanine may be used efficiently in animals fed a proteinfree or low-protein diet because the kidney provides beta-alanine by means of the hydrolysis of beta-alanyl-L-histidine (carnosine). The addition of beta-alanine to the diet significantly activated beta-AlaAT I in the kidneys of rats in accordance with changes in its mRNA level. In the rat brain, beta-AlaAT I activity was not altered by the dietary protein level or by the beta-alanine diet, and beta-AlaAT II activity was not detected.     

Validity of repeated dietary measurements in a dietary intervention study.

The aim of the study was to evaluate the compliance in a dietary intervention study. When drawing conclusions about the relationship between dietary intake and disease occurrence/disease-related variables it is important to obtain valid dietary data. 20 healthy, non-smoking normal-weight omnivores changed from a mixed to a lactovegetarian diet. Dietary surveys (four 24 h recalls per person and time-period), urinary and faecal sample collections were performed before and 3, 6 and 12 months after the dietary shift. The validation of energy, protein, sodium and potassium yielded approximately the same ratio of dietary intake to biological marker at 0 and 3 months. This ratio decreased towards 6 months and continued to decrease towards 12 months. The fibre intake was compared to the total faecal weight directly and indirectly by calculating the fibre intake from the stool weight, the water content in faeces and the excretion of short-chain fatty acids (SCFAs). These four methods of fibre validation showed that the ratio of dietary intake to biological marker was always highest at 12 months, indicating an overestimation of the fibre intake at the end of the study. This is the first time these methods of validating fibre intake have been used in an epidemiological study. The ratio of dietary calcium intake to urinary and faecal calcium excretion did not show any statistical difference between the period before and 3 months after the dietary shift. To conclude, almost all investigated dietary data show approximately the same validity before and 3 months after the dietary shift, and show the least validity 12 months after the dietary shift. Thus, this study demonstrates that it is difficult to obtain valid dietary data 1 year after a drastic dietary change, indicating a decreased compliance to the new dietary regimen at the end of the 1 year study period. This represents important information when attempting to relate biological effects to dietary intake, and illustrates the importance of using biological markers for food intake in dietary surveys.     

Comparison of dietary assessment methods in a low-fat dietary intervention program

The food frequency questionnaire (FFQ) is commonly utilized for assessment of dietary fat intake, but its validity among individuals following a low-fat diet is unclear. We evaluated the agreement of nutrient estimates derived from FFQ, 24-h recall, and 3-day food records obtained from 104 participants in a randomized trial of a low-fat dietary intervention for women at elevated breast cancer risk. Comparisons were made for total calories, percent calories from fat, and total fat after 1 yr. Correlation was assessed using standard methods based on a null hypothesis of no agreement between instruments as well as by a methodology based on a null hypothesis that the instruments should be in agreement. With the use of standard methods, FFQ estimates for women on the low-fat diet were significantly correlated to records only for percent calories from fat (r = 0.39), whereas recall and record estimates were significantly correlated for all three dietary variables. Using the new method, we found no significant correlation between FFQ and either recalls or records for women following a low-fat diet but significant correlation between recall and record estimates for total calories (r = 0.67). Traditional correlation testing may overestimate the extent of agreement in dietary instruments among women on a low-fat diet. We found empirical support for the nontraditional method.