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Four different dietary fibers have different effects on serum and liver lipids, in rats
WEDNESDAY, OCTOBER 19 ORIGINAL CONTRIBUTIONS: CLINICAL NUTRITION PRENATAL WEIGHT GAIN PATTERNS AND SPONTANEOUS PRETERM BIRTH AMONG NONOBESE BLACK AND WHITE WOMEN. C.A. Hickey,
RD, PhD, S.P. Cliver, BA, S.F. McNeal, BS, and R.L. Goldenberg, MD, Department of Maternal and Child Health and Department of Obstetrics and Gynecology, University of Alabama at Birmingham. Evidence for the relationship of prepregnancy
weight and prenatal weight gain to preterm delivery (PTD) is mixed; several important methodological issues have prevented the drawing of firm inferences. The objective of this study was to examine, by trimester, the relationship of prenatal weight gain (total, rate) to spontaneous PTD among low-income high-risk nonobese (body mass index: BMI 26.0) black (677) and white (338) multiparous women. Sociodemographic data, reproductive history, and reported prepregnancy weight were obtained by interview during the first prenatal visit. Weight and height were measured without shoes in light clothing, using standard anthropometric procedures. Total gain (kg) and rate of gain (kg/wk) were calculated as follows: first trimester (last weight observation during gestational ages [GA] 10-13 wks minus prepregnancy weight); second trimester (last weight during GA 24-27 wk minus first weight during 14-18 wk); third trimester (last weight prior to delivery minus first weight during GA 28-32 wk). Results revealed that >70% of PTD was at 32-36 wk GA. PTD was higher among black (12.4%) than white (8.0%) women (p-0.033). PTD was higher among white (11.9%) than black (5.1%) women with low prepregnancy BMI (p-0.027). While 45% of the women gained less than current Institute of Medicine guidelines by BMI in the first trimester, and from 22 to 37% gained less than these guidelines during the second trimester, in regression analysis neither total nor rate of gain was associated with GA or PTD. However, third trimester rate of gain (kg/wk) was positively associated with GA for all women (p-0.005) and for black women (p-0.026) with low prepregnancy BMI, but not for white women or for women with normal BMI. These data suggest that the impact of weight gain pattern on PTD varies by prepregnancy BMI, ethnicity, and trimester, and is greatest during the third trimester among women with low BMI.
FOUR DIFFERENT DIETARY FIBERS HAVE DIFFERENT EFFECTS ON SERUM AND LIVER LIPIDS, IN RATS. I. Smolyar, MS, and K.P. Navder, PhD, RD, School of Health Sciences, Hunter College, New York, NY. Sprague-Dawley rats were fed ten diets containing 10% dietary fiber as cellulose (control), psyllium, barley bran, sugarbeet, or oat bran, with or without 0.5% added cholesterol and 0.1% cholic acid, for 6 weeks. No significant differences were seen on serum and liver parameters when fibers were added to diets to which no cholesterol and cholic acid were added. Among rats fed hyperlipidemic diets, the psyllium diet not only lowered total serum cholesterol, serum LDL cholesterol, total liver lipids, and liver cholesterol, but also had significantly higher HDL/LDL serum cholesterol ratio. The group fed barley bran had significatly lower total serum cholesterol, serum LDL cholesterol, total liver lipids and liver cholesterol, but no effect was seen on HDL/LDL cholesterol ratio. The rats fed oat bran had lower serum total and LDL cholesterol levels. However, the total liver lipid and liver cholesterol were higher in the oat bran diet. The group fed sugarbeet fiber showed only a lowering in total serum cholesterol levels. The results of this study indicate that of the fibers studied, psyllium showed the strongest therapeutic effect. The barley bran and oat bran diets showed intermediate hypocholesterolemic effects. Sugarbeet fiber may either have to be fed at a higher level, or for a longer duration to see positive effects.
A-40 / SEPTEMBER 1994 SUPPLEMENT VOLUME 94 NUMBER 9
THE USE OF SEVERITY SCORING TO ESTIMATE RESTING ENERGY EXPENDITURE IN ADULT SURGICAL INTENSIVE CARE PATIENTS. J.R. Rewoldt, BS, G.M. Monteiro, BA, C.A. Meldrum, BBA, R.E. Dechert, MS, RH. Bartlett, MD, Department of General Surgery, University of Michigan Medical Center, Ann Arbor, MI Previous studies have reported a correlation between severity scoring and resting energy expenditure (REE) in critical care patients. This correlation is sometimes used in REE estimations which guide nutritional support recommendations. Fluctuating physiologic status in critical care patients, along with pharmacological interventions, may render this estimation of REE inaccurate at times. We examined the correlation between REE and Acute Physiologic Score (APS) in forty adult, mechanically ventilated patients with varying diagnoses admitted to the surgical intensive care unit. REE was measured by indirect calorimetry when the patient was in a resting state. The APS was calculated for the hour of the study and as a "worst case" score for the day of the study. Correlation coefficients were determined collectively for all measurements and individually by patient day using SYSTAT analytical package. A poor correlation (r = 0.143) was found between REE and APS at the time of the study. We conclude that REE does not correlate collectively or individually with APS in adult, mechanically ventilated surgical intensive care patients. The APS severity scoring system should not be used to estimate resting energy expenditure in this critical care setting, and alternate methods such as indirect calorimetry may provide more accurate REE determinations.
THE IMPACT OF NUTRITION EDUCATION ON HIV INDIVIDUALS NUTRITIONAL STATUS, KNOWLEDGE, ATTITUDE AND BEHAVIOR. L. Y. Wright, MS, RD, James A. Haley Veterans' Hospital, Tampa, Florida. Due to the large percentage of HIV individuals that experience malnutrition and nutrition-related complications, lack nutrition knowledge and are susceptible to nutrition fraud, a randomized clinical trial was conducted to determine the impact of nutrition education on HIV individuals' nutritional status, knowledge, attitude and behavior. Twenty-four subjects were randomly allocated to a control or intervention group for a six-month trial. Weight, serum albumin and body composition measured by bioelectrical impedance analysis were obtained by pre- and poststudy to determine nutritional status. A food frequency questionnaire and 24-hour food recall was obtained pre- and post- study to determine nutrient intake. A nutrition knowledge test, attitude survey and supplemental usage list were obtained pre- and post- study to determine knowledge, attitude and behavior. The experimental group (n=12) received an initial group education session on nutrition and immunity, nutritionrelated complications, unproven and recommended supplements and food safety with two individual follow-up sessions. The control group (n=12) received no nutrition education. Analysis of covariance was used to evaluate treatment/control group differences. There were no significant differences in intervention for body weight, serum albumin, lean body mass, or energy intake. There was a significant increase in the experimental group's post-study protein intake (p=.04), attitude (p=.02), usage of recommended supplements (p=.00) and a significant decrease in the usage of unproven nutritional therapies (p=.00). This study demonstrates that nutrition education improves HIV individuals' nutrition knowledge, attitude, behavior and may help minimize depletion of nutrition status.
RD, PhD, S.P. Cliver, BA, S.F. McNeal, BS, and R.L. Goldenberg, MD, Department of Maternal and Child Health and Department of Obstetrics and Gynecology, University of Alabama at Birmingham. Evidence for the relationship of prepregnancy
weight and prenatal weight gain to preterm delivery (PTD) is mixed; several important methodological issues have prevented the drawing of firm inferences. The objective of this study was to examine, by trimester, the relationship of prenatal weight gain (total, rate) to spontaneous PTD among low-income high-risk nonobese (body mass index: BMI 26.0) black (677) and white (338) multiparous women. Sociodemographic data, reproductive history, and reported prepregnancy weight were obtained by interview during the first prenatal visit. Weight and height were measured without shoes in light clothing, using standard anthropometric procedures. Total gain (kg) and rate of gain (kg/wk) were calculated as follows: first trimester (last weight observation during gestational ages [GA] 10-13 wks minus prepregnancy weight); second trimester (last weight during GA 24-27 wk minus first weight during 14-18 wk); third trimester (last weight prior to delivery minus first weight during GA 28-32 wk). Results revealed that >70% of PTD was at 32-36 wk GA. PTD was higher among black (12.4%) than white (8.0%) women (p-0.033). PTD was higher among white (11.9%) than black (5.1%) women with low prepregnancy BMI (p-0.027). While 45% of the women gained less than current Institute of Medicine guidelines by BMI in the first trimester, and from 22 to 37% gained less than these guidelines during the second trimester, in regression analysis neither total nor rate of gain was associated with GA or PTD. However, third trimester rate of gain (kg/wk) was positively associated with GA for all women (p-0.005) and for black women (p-0.026) with low prepregnancy BMI, but not for white women or for women with normal BMI. These data suggest that the impact of weight gain pattern on PTD varies by prepregnancy BMI, ethnicity, and trimester, and is greatest during the third trimester among women with low BMI.
FOUR DIFFERENT DIETARY FIBERS HAVE DIFFERENT EFFECTS ON SERUM AND LIVER LIPIDS, IN RATS. I. Smolyar, MS, and K.P. Navder, PhD, RD, School of Health Sciences, Hunter College, New York, NY. Sprague-Dawley rats were fed ten diets containing 10% dietary fiber as cellulose (control), psyllium, barley bran, sugarbeet, or oat bran, with or without 0.5% added cholesterol and 0.1% cholic acid, for 6 weeks. No significant differences were seen on serum and liver parameters when fibers were added to diets to which no cholesterol and cholic acid were added. Among rats fed hyperlipidemic diets, the psyllium diet not only lowered total serum cholesterol, serum LDL cholesterol, total liver lipids, and liver cholesterol, but also had significantly higher HDL/LDL serum cholesterol ratio. The group fed barley bran had significatly lower total serum cholesterol, serum LDL cholesterol, total liver lipids and liver cholesterol, but no effect was seen on HDL/LDL cholesterol ratio. The rats fed oat bran had lower serum total and LDL cholesterol levels. However, the total liver lipid and liver cholesterol were higher in the oat bran diet. The group fed sugarbeet fiber showed only a lowering in total serum cholesterol levels. The results of this study indicate that of the fibers studied, psyllium showed the strongest therapeutic effect. The barley bran and oat bran diets showed intermediate hypocholesterolemic effects. Sugarbeet fiber may either have to be fed at a higher level, or for a longer duration to see positive effects.
A-40 / SEPTEMBER 1994 SUPPLEMENT VOLUME 94 NUMBER 9
THE USE OF SEVERITY SCORING TO ESTIMATE RESTING ENERGY EXPENDITURE IN ADULT SURGICAL INTENSIVE CARE PATIENTS. J.R. Rewoldt, BS, G.M. Monteiro, BA, C.A. Meldrum, BBA, R.E. Dechert, MS, RH. Bartlett, MD, Department of General Surgery, University of Michigan Medical Center, Ann Arbor, MI Previous studies have reported a correlation between severity scoring and resting energy expenditure (REE) in critical care patients. This correlation is sometimes used in REE estimations which guide nutritional support recommendations. Fluctuating physiologic status in critical care patients, along with pharmacological interventions, may render this estimation of REE inaccurate at times. We examined the correlation between REE and Acute Physiologic Score (APS) in forty adult, mechanically ventilated patients with varying diagnoses admitted to the surgical intensive care unit. REE was measured by indirect calorimetry when the patient was in a resting state. The APS was calculated for the hour of the study and as a "worst case" score for the day of the study. Correlation coefficients were determined collectively for all measurements and individually by patient day using SYSTAT analytical package. A poor correlation (r = 0.143) was found between REE and APS at the time of the study. We conclude that REE does not correlate collectively or individually with APS in adult, mechanically ventilated surgical intensive care patients. The APS severity scoring system should not be used to estimate resting energy expenditure in this critical care setting, and alternate methods such as indirect calorimetry may provide more accurate REE determinations.
THE IMPACT OF NUTRITION EDUCATION ON HIV INDIVIDUALS NUTRITIONAL STATUS, KNOWLEDGE, ATTITUDE AND BEHAVIOR. L. Y. Wright, MS, RD, James A. Haley Veterans' Hospital, Tampa, Florida. Due to the large percentage of HIV individuals that experience malnutrition and nutrition-related complications, lack nutrition knowledge and are susceptible to nutrition fraud, a randomized clinical trial was conducted to determine the impact of nutrition education on HIV individuals' nutritional status, knowledge, attitude and behavior. Twenty-four subjects were randomly allocated to a control or intervention group for a six-month trial. Weight, serum albumin and body composition measured by bioelectrical impedance analysis were obtained by pre- and poststudy to determine nutritional status. A food frequency questionnaire and 24-hour food recall was obtained pre- and post- study to determine nutrient intake. A nutrition knowledge test, attitude survey and supplemental usage list were obtained pre- and post- study to determine knowledge, attitude and behavior. The experimental group (n=12) received an initial group education session on nutrition and immunity, nutritionrelated complications, unproven and recommended supplements and food safety with two individual follow-up sessions. The control group (n=12) received no nutrition education. Analysis of covariance was used to evaluate treatment/control group differences. There were no significant differences in intervention for body weight, serum albumin, lean body mass, or energy intake. There was a significant increase in the experimental group's post-study protein intake (p=.04), attitude (p=.02), usage of recommended supplements (p=.00) and a significant decrease in the usage of unproven nutritional therapies (p=.00). This study demonstrates that nutrition education improves HIV individuals' nutrition knowledge, attitude, behavior and may help minimize depletion of nutrition status.