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EFFECTS OF ORAL GLUTAMINE SUPPLEMENTATION ON RESTING ENERGY EXPENDITURE IN CHILDREN WITH SICKLE CELL DISEASE
Journal of the American Dietetic Association Online
trays of dementia patients living in a dementia special care unit was conducted. Eight patients completed the study. Trays were weighed prior to delivery to the patients and after patients had eaten. For three weeks, patients received all three meals on white plates. For the following three weeks, patients received all three meals on orange plates. The tray weights prior to and after eating were compared. The results of the study were that there was an increase in intake with orange plates versus white plates. While a small increase, there could be a positive impact over time on the patients' weights and nutritional status. Patients' weights were reviewed, however, due to the short length of the study, no connection between the increase in intake and weights could be seen. More studies are needed to better define the connection between bright plates and increased food intake in dementia patients. TITLE: A MULTIDISCIPLINARY BEHAVIORAL APPROACH IS EFFECTIVE IN THE TREATMENT OF OBESE PATIENTS IN THE PRIMARY CARE SETTING AUTHOR(S): V.M. Nethery1 , Ph.D.; L.E. Pietz1, B.S.; F. Gough2, M.D.; T. Girolami2, M.D.; Exercise Science Laboratory, Central Washington University1, Ellensburg, WA and Sound Health Solutions Medical Clinic2, Bellevue, WA LEARNING OUTCOME: To increase awareness of behavior modification as an effective treatment for obese patients in the primary care setting. TEXT: Overweight and obese individuals suffer a significantly greater number of health problems than individuals of desirable weight, and the mortality rate associated with obesity makes it a chief cause of preventable death. Obesity is characterized by an adipose dominant morphology, accompanied by a variety of psychological and clinical symptoms. While many factors are recognized as contributors to obesity, the rapid rise in incidence over the past three decades is strongly suggestive of changes in lifestyle behaviors that affect energy balance. Thirty-three patients (males n=17, females n=16) (overall mean±SE: age = 38.7±1.2yrs; Body Mass Index (BMI) = 42.0±1.7kg/m2) completed a clinic-based 12week lifestyle reorientation program that included multiple nutrition and psychological counseling, and exercise guidance sessions each week. Significant reductions (p<0.05) were observed in body weight (5.3±0.9kg), BMI (1.73±0.3kg/m2), and Fat % (3.4±0.7%). In contrast, lean body mass (LBM) did not change (71.8 vs. 72.5kg). More importantly, the proportion of LBM to total mass increased significantly (58.1% vs. 61.5%). In addition, two key psychological measures (Beck's Depression Index (BDI) and Rosenberg's Self Esteem (RSE)) showed significant improvements. BDI decreased from 11.4±1.3 to 2.8±0.7 whereas RSE increased from 29.3±1.1 to 34.1±0.8. Male and female patients responded in a qualitatively and quantitatively similar manner for all dependent measures. These data suggest that an individualized, clinic supported behavioral modification program is effective in reducing key morphological and psychometric characteristics of patients suffering from obesity. TITLE: EFFECTS OF ORAL GLUTAMINE SUPPLEMENTATION ON RESTING ENERGY EXPENDITURE IN CHILDREN WITH SICKLE CELL DISEASE AUTHOR(S): R. Williams, MS, RD, EdD, S. Olivi, LPN, C-S. Li, PhD, M. Storm, PhD, L. Cremer, W. Wang, MD; St. Jude Children's Research Hospital and The University of Tennessee, Memphis, TN
http://www2.us.elsevierhealth.com/inst/serve?article=jjada0310309ab01&arttype=full (45 of 117) [3/21/2008 8:45:18 AM]
Journal of the American Dietetic Association Online
LEARNING OUTCOME: To understand the effect of glutamine on resting energy expenditure in children with sickle cell disease. TEXT: Patients with sickle cell disease (SCD) have resting energy expenditure (REE) measurements that are 16-22% higher than healthy controls, which may be due to increases in erythrocyte production, protein turnover rates, and/ or glutamine utilization. We hypothesized that providing oral glutamine supplementation may lower REE in children with SCD. Patients were eligible for the study if they were between 5 and 18 years of age, had hemoglobin SS or S ° thalassemia, and had normal hepatic and renal function. Children in this study received oral glutamine supplementation (600 mg/kg/day) for 24 weeks. Patients had REE, muscle strength measurement, and nutrition assessment at baseline and week 24. Twenty-seven patients, all HbSS, ages 5.2 to 17.9 years (median 11.0 years), completed the study. After 24 weeks on glutamine, mean REE decreased by 6% and nutrition parameters improved. Muscle strength also improved significantly. TITLE: EFFECTS OF ORAL GLUTAMINE SUPPLEMENTATION ON AMINO ACID PROFILES IN CHILDREN WITH SICKLE CELL DISEASE AUTHOR(S): R. Williams, MS, RD, EdD, S. Olivi, LPN, C-S. Li, PhD, M. Storm, PhD, W. Wang, MD; St Jude Children's Research Hospital and The University of Tennessee, Memphis, TN LEARNING OUTCOME: To understand amino acid levels in children with sickle cell disease and the effects of glutamine on them. TEXT: Patients with sickle cell disease (SCD) have lower plasma amino acid levels than healthy children and adults. We hypothesized that providing additional glutamine may improve amino profiles. Children received oral glutamine supplementation (6 g/kg/day) for 24 weeks. Twenty-seven subjects, all HbSS, ages 5.2 to 17.9 years (median 11.0 years) completed the study. At baseline 11 amino acid levels were normal (citrulline, glutamine, glycine, lysine, methionine, ornithine, proline, serine, threonine, tyrosine, valine) but 8 were significantly lower than normal. After 24 weeks, patients had significantly increased levels of 4 amino acids. The table below shows amino acids that were different from normal before or after glutamine. Better understanding of the abnormal amino acid profiles in SCD may suggest other interventions for this group of patients.
Plasma Mean and Standard Error Normal1
Baseline
At 24-weeks
Alanine
364 ± 25.5
270 ± 13.82
285 ± 16.9
Arginine
78.0 ± 6.43
54.4 ± 2.803
54.5 ± 2.99
Glutamine
672 ± 42.6
616 ± 18.7
653 ± 22.3
Histidine
90.2 ± 3.81
77.9 ± 2.80
78.6 ± 2.28
Isoleucine
69.3 ± 5.68
50.5 ± 2.60
55.0 ± 3.10
Amino Acid (nmol)
http://www2.us.elsevierhealth.com/inst/serve?article=jjada0310309ab01&arttype=full (46 of 117) [3/21/2008 8:45:18 AM]
P4
<0.001 0.03
trays of dementia patients living in a dementia special care unit was conducted. Eight patients completed the study. Trays were weighed prior to delivery to the patients and after patients had eaten. For three weeks, patients received all three meals on white plates. For the following three weeks, patients received all three meals on orange plates. The tray weights prior to and after eating were compared. The results of the study were that there was an increase in intake with orange plates versus white plates. While a small increase, there could be a positive impact over time on the patients' weights and nutritional status. Patients' weights were reviewed, however, due to the short length of the study, no connection between the increase in intake and weights could be seen. More studies are needed to better define the connection between bright plates and increased food intake in dementia patients. TITLE: A MULTIDISCIPLINARY BEHAVIORAL APPROACH IS EFFECTIVE IN THE TREATMENT OF OBESE PATIENTS IN THE PRIMARY CARE SETTING AUTHOR(S): V.M. Nethery1 , Ph.D.; L.E. Pietz1, B.S.; F. Gough2, M.D.; T. Girolami2, M.D.; Exercise Science Laboratory, Central Washington University1, Ellensburg, WA and Sound Health Solutions Medical Clinic2, Bellevue, WA LEARNING OUTCOME: To increase awareness of behavior modification as an effective treatment for obese patients in the primary care setting. TEXT: Overweight and obese individuals suffer a significantly greater number of health problems than individuals of desirable weight, and the mortality rate associated with obesity makes it a chief cause of preventable death. Obesity is characterized by an adipose dominant morphology, accompanied by a variety of psychological and clinical symptoms. While many factors are recognized as contributors to obesity, the rapid rise in incidence over the past three decades is strongly suggestive of changes in lifestyle behaviors that affect energy balance. Thirty-three patients (males n=17, females n=16) (overall mean±SE: age = 38.7±1.2yrs; Body Mass Index (BMI) = 42.0±1.7kg/m2) completed a clinic-based 12week lifestyle reorientation program that included multiple nutrition and psychological counseling, and exercise guidance sessions each week. Significant reductions (p<0.05) were observed in body weight (5.3±0.9kg), BMI (1.73±0.3kg/m2), and Fat % (3.4±0.7%). In contrast, lean body mass (LBM) did not change (71.8 vs. 72.5kg). More importantly, the proportion of LBM to total mass increased significantly (58.1% vs. 61.5%). In addition, two key psychological measures (Beck's Depression Index (BDI) and Rosenberg's Self Esteem (RSE)) showed significant improvements. BDI decreased from 11.4±1.3 to 2.8±0.7 whereas RSE increased from 29.3±1.1 to 34.1±0.8. Male and female patients responded in a qualitatively and quantitatively similar manner for all dependent measures. These data suggest that an individualized, clinic supported behavioral modification program is effective in reducing key morphological and psychometric characteristics of patients suffering from obesity. TITLE: EFFECTS OF ORAL GLUTAMINE SUPPLEMENTATION ON RESTING ENERGY EXPENDITURE IN CHILDREN WITH SICKLE CELL DISEASE AUTHOR(S): R. Williams, MS, RD, EdD, S. Olivi, LPN, C-S. Li, PhD, M. Storm, PhD, L. Cremer, W. Wang, MD; St. Jude Children's Research Hospital and The University of Tennessee, Memphis, TN
http://www2.us.elsevierhealth.com/inst/serve?article=jjada0310309ab01&arttype=full (45 of 117) [3/21/2008 8:45:18 AM]
Journal of the American Dietetic Association Online
LEARNING OUTCOME: To understand the effect of glutamine on resting energy expenditure in children with sickle cell disease. TEXT: Patients with sickle cell disease (SCD) have resting energy expenditure (REE) measurements that are 16-22% higher than healthy controls, which may be due to increases in erythrocyte production, protein turnover rates, and/ or glutamine utilization. We hypothesized that providing oral glutamine supplementation may lower REE in children with SCD. Patients were eligible for the study if they were between 5 and 18 years of age, had hemoglobin SS or S ° thalassemia, and had normal hepatic and renal function. Children in this study received oral glutamine supplementation (600 mg/kg/day) for 24 weeks. Patients had REE, muscle strength measurement, and nutrition assessment at baseline and week 24. Twenty-seven patients, all HbSS, ages 5.2 to 17.9 years (median 11.0 years), completed the study. After 24 weeks on glutamine, mean REE decreased by 6% and nutrition parameters improved. Muscle strength also improved significantly. TITLE: EFFECTS OF ORAL GLUTAMINE SUPPLEMENTATION ON AMINO ACID PROFILES IN CHILDREN WITH SICKLE CELL DISEASE AUTHOR(S): R. Williams, MS, RD, EdD, S. Olivi, LPN, C-S. Li, PhD, M. Storm, PhD, W. Wang, MD; St Jude Children's Research Hospital and The University of Tennessee, Memphis, TN LEARNING OUTCOME: To understand amino acid levels in children with sickle cell disease and the effects of glutamine on them. TEXT: Patients with sickle cell disease (SCD) have lower plasma amino acid levels than healthy children and adults. We hypothesized that providing additional glutamine may improve amino profiles. Children received oral glutamine supplementation (6 g/kg/day) for 24 weeks. Twenty-seven subjects, all HbSS, ages 5.2 to 17.9 years (median 11.0 years) completed the study. At baseline 11 amino acid levels were normal (citrulline, glutamine, glycine, lysine, methionine, ornithine, proline, serine, threonine, tyrosine, valine) but 8 were significantly lower than normal. After 24 weeks, patients had significantly increased levels of 4 amino acids. The table below shows amino acids that were different from normal before or after glutamine. Better understanding of the abnormal amino acid profiles in SCD may suggest other interventions for this group of patients.
Plasma Mean and Standard Error Normal1
Baseline
At 24-weeks
Alanine
364 ± 25.5
270 ± 13.82
285 ± 16.9
Arginine
78.0 ± 6.43
54.4 ± 2.803
54.5 ± 2.99
Glutamine
672 ± 42.6
616 ± 18.7
653 ± 22.3
Histidine
90.2 ± 3.81
77.9 ± 2.80
78.6 ± 2.28
Isoleucine
69.3 ± 5.68
50.5 ± 2.60
55.0 ± 3.10
Amino Acid (nmol)
http://www2.us.elsevierhealth.com/inst/serve?article=jjada0310309ab01&arttype=full (46 of 117) [3/21/2008 8:45:18 AM]
P4
<0.001 0.03