The Effects of Oral Energy-Dense Supplements on Nutritional Status in Nondiabetic Maintenance Hemodialysis Patients

Background and objectives: Fat-based energy-dense nutritional supplements may offer benefits over protein or carbohydrate dense supplements for patients receiving dialysis because of the adverse metabolic consequences of the latter. We conducted a randomized controlled trial to assess the effects of the short-term use of a fat-based nutritional supplement on various measures of nutritional status in patients receiving maintenance hemodialysis who have low dietary energy intake. Design, setting, participants, and measurements: We enrolled nondiabetic patients receiving hemodialysis for more than 3 months and had inadequate dietary energy intake (<30kcal/kg/d). The participants were randomly assigned in a 1:1 ratio to receive an oral fat-based energy-dense supplement (300kcal daily) or routine care for 12 weeks (n=120 per group). The primary outcome was the change in phase angle, measured by bioelectrical impedance analysis, a marker of cell integrity and body cell mass, from the baseline to week 12. The secondary outcomes were changes in quality of life. Other outcomes included laboratory nutritional indicators and physical examinations. Results: The average age of the total population was 47 (SD: 12) years and 55% were male. The median of dialysis vintage was 43.4 (22.5, 76.3) months. 240 participants were randomly assigned to the intervention (n=120) or control group (n=120). In total, 228 (95%) participants completed the trial. The change in phase angle did not differ significantly between the intervention and the control groups (estimate (95% confidence interval [CI]): 0.0 (-0.1, 0.1) vs. 0.0 (-0.1, 0.1); estimated difference, 0.0; 95% [CI], −0.2 to 0.2; P=0.99). None of the 19 domains of quality of life differed between the groups. Adverse events were reported in 23 (19%) participants in the control group and 40 (33%) participants in the intervention group. Conclusions: In nondiabetic maintenance hemodialysis patients, short-term administration of fat-based energy-dense nutritional supplement has no clinically significant effect on nutritional status as measured by phase angle.

The use of participatory action research to improve energy intake of the soccer athletes

It was estimated that 5, 3 % of Universitas Negeri Semarang (UNNES) soccer athletes were malnourished. The consumption survey results show that the average dietary energy intake (DEI) was 63.24% of the dietary reference intake (DRI). The purpose of this study was to improve the energy intake of athletes. This research was using a participatory action research method. The study was divided into 2 cycles which allocated in 30 days. This research was using a total sampling method. A total of 19 UNNES soccer athletes were involved as research subjects. Data on nutritional status and energy intake were analyzed to evaluate the success of participatory action research. Semi-Quantitative Food Frequency Questionnaire (SQ-FFQ) used to take dietary energy intake data, Nutrition status measured by BMI using Seca scales and microtome. A non-parametric test was used to analyze the success of the participatory action research program. Results showed that participatory action research can improve energy intake (EI) in athletes. Baseline data showed that the average percentage of DEI was 63.24% from the DRI. The average percentage of DEI increased became 71.38% at the end of the first cycle and rose into a 91.91 % at the end of the second cycle. It is recommended for trainers to include nutrition assistance activities as part of the exercise program for athletes.

Estimating my equilibrium energy intake during lockdown: very introspective study

ObjectiveTo estimate the daily dietary energy intake for me to maintain a constant body weight. How hard can it be?DesignVery introspective study.SettingAt home. In lockdown. (Except every Tuesday afternoon and Saturday morning, when I went for a run.)ParticipantsMe. n=1.Main outcome measuresMy weight, measured each day.ResultsSleeping, I shed about a kilogram each night (1.07 (SD 0.25) kg). Running 5 km, I shed about half a kilogram (0.57 (SD 0.15) kg). My daily equilibrium energy intake is about 10 000 kJ (10 286 (SD 201) kJ). Every kJ above (or below) 10 000 kJ adds (or subtracts) about 40 mg (35.4 (SD 3.2) mg).ConclusionsBody weight data show persistent variability, even when the screws of control are tightened and tightened.

Cropland Footprints of Australian Dietary Choices

Food systems vitally depend on croplands, which are a scarce natural resource. Croplands are also heterogeneous, differing in productive capability and in environmental context. Some are in regions of high biodiversity conservation importance, others in regions vulnerable to food insecurity. In this study, life cycle assessment was used to quantify cropland scarcity footprints, cropland biodiversity footprints and cropland malnutrition footprints for 9341 individual Australian adult daily diets. Dietary cropland scarcity footprints averaged 7.1 m2yr-e person−1 day−1, exceeding a target of 6.1 m2yr-e person−1 day−1, consistent with the proposed global cropland planetary boundary of 15% of the ice-free land area. Discretionary foods, which are energy-dense and nutrient-poor foods high in saturated fat, added sugars and salt, and alcohol and are not essential to a healthy diet, made the largest contribution, followed by fresh meats and alternatives, breads and cereals, fruit, dairy and alternatives and vegetables. Around 45% of the variation in cropland footprint between individuals was explained by differences in total dietary energy intake. Diets characterised by higher diet quality and lower cropland scarcity footprint required only 4.2 m2yr-e person−1 day−1 and recommended diets based on the food choices of this subgroup required 5.9 m2yr-e person−1 day−1. Eating within the global cropland planetary boundary appears realistic if Australians greatly reduce their intake of discretionary foods and moderate their food choices within the “meat and alternatives” food group.

Influence of dietary energy intake on nephrolithiasis - A meta-analysis of observational studies

Objective: Obesity has been associated with an increased risk of kidney stone formation. The presence of obesity is due to an imbalance between energy intake and energy consumption resulting from physical activity and resting metabolic rate. The purpose of this meta-analysis was to assess the differences in dietary energy intake levels between patients developing urinary stones versus healthy individuals. Materials and methods: Medline/PubMed and EMBASE databases search was performed using the terms “urolithiasis”, “kidney stones*”, “calcul*”, “energy”, “calor*”, “intake”, “food”, “kilojoule/kjoule”, “Kilocal*/kcal” from January 1st, 2000, and were assessed as up to date on September 30th, 2019. Results: After having screened 1.782 records, four studies were included in the meta-analysis. The total population was 467.063, including 453.078 healthy men and/or women and 13.985 men and/or women affected by nephrolithiasis. When energy intake data were pooled irrespective of the sex of participants, mean calory intake values were significantly higher in nephrolithiasis patients, compared to healthy individuals. The mean difference (MD) was 39.16 kcal (95% CI 18.53 to 59.78, p = 0.0002, random-effects model, inverse-variance weighing). The odds ratio for this comparison – calculated from the standardized mean difference – is significant (OR = 1.946; 95% CI: 1.869 to 5.561). Conclusions: Patients affected by urolithiasis show a significantly higher energy intake in various patient populations (USA, China and Korea) including subjects of both sexes. The relevance of this finding should be confirmed by studies in populations showing different and diverse dietary patterns, and by evaluating energy consumption linked to physical activity and metabolic rate in renal stone formers.

New evidence on the effect of smoking on the obesity risk among adults, Findings from the China Health and Nutrition Survey (CHNS, 1991-2015)

Background: To estimate the approximately causal effects of smoking on the obesity risk among Chinese adults.Methods: Using China Health and Nutrition Survey (CHNS) datasets from 1991 to 2015, this study consisted of 35,907 males and 39,441females aged 18-65 years. Using ordinary-least squares and probit models to investigate the effects of smoking on risk of obesity among Chinese adults.Results: Male current smokers had a higher dietary energy intake (23.28 unit), percentage of dietary energy intake from fat (0.47 unit), physical activity (9.96 unit), drinking (0.61 unit) but less likely to be general obesity (0.17 unit) and abdominal obesity (0.12 unit) than nonsmokers. Female current smokers less likely to be general obesity (0.03 unit) and abdominal obesity (0.12 unit) than nonsmokers. Male heavy smokers (>25 cigarettes/d) had higher dietary energy intake (89.65 unit), physical activity (15.31 unit), drinking (0.08 unit) and more likely to be general obesity (0.18 unit) and abdominal obesity (0.10 unit) than other smokers.Conclusions: Compared with nonsmokers, current smokers had lower probability of being general obesity and abdominal obesity among Chinese adults regardless of gender. Male heavy smokers increased the risk of obesity than other smokers. These findings may improve the understanding on how cigarette smoking affects fat distribution and provide scientific evidence regarding intervention in smoking and obesity, especially for male heavy smokers