Effect of dietary protein restriction on nutritional status in the Modification of Diet in Renal Disease Study

The safety of dietary protein and phosphorous restriction was evaluated in the Modification of Diet in Renal Disease (MDRD) Study. In Study A, 585 patients with a glomerular filtration rate (GFR) of 25 to 55 ml/min/1.73 m2 were randomly assigned to a usual-protein diet (1.3 g/kg/day) or a low-protein diet (0.58 g/kg/day). In Study B, 255 patients with a GFR of 13 to 24 ml/min/1.73 m2 were randomly assigned to the low-protein diet or a very-low-protein diet (0.28 g/kg/day), supplemented with a ketoacid-amino acid mixture (0.28 g/kg/day). The low-protein and very-low-protein diets were also low in phosphorus. Mean duration of follow-up was 2.2 years in both studies. Protein and energy intakes were lower in the low-protein and very-low-protein diet groups than in the usual-protein group. Two patients in Study B reached a "stop point" for malnutrition. There was no difference between randomized groups in the rates of death, first hospitalizations, or other "stop points" in either study. Mean values for various indices of nutritional status remained within the normal range during follow-up in each diet group. However, there were small but significant changes from baseline in some nutritional indices, and differences between the randomized groups in some of these changes. In the low-protein and very-low-protein diet groups, serum albumin rose, while serum transferrin, body wt, percent body fat, arm muscle area and urine creatinine excretion declined. Combining patients in both diet groups in each study, a lower achieved protein intake (from food and supplement) was not correlated with a higher rate of death, hospitalization or stop points, or with a progressive decline in any of the indices of nutritional status after controlling for baseline nutritional status and follow-up energy intake. These analyses suggest that the low-protein and very-low-protein diets used in the MDRD Study are safe for periods of two to three years. Nonetheless, both protein and energy intake declined and there were small but significant declines in various indices of nutritional status. These declines are of concern because of the adverse effect of protein calorie malnutrition in patients with end-stage renal disease. Physicians who prescribe low-protein diets must carefully monitor patients' protein and energy intake and nutritional status.     

Dietary protein, urea nitrogen appearance and total nitrogen appearance in chronic renal failure and CAPD patients

This study was carried out to examine the mathematical relationships between the urea nitrogen appearance (UNA), total nitrogen appearance (TNA) and dietary nitrogen intake (DNI) in patients with chronic renal failure. Studies were conducted in 20 nondialyzed patients with advanced chronic renal failure (CRF) who were fed 27 constant protein diets for 24.8 +/- 9.5 days (SD) and eight patients undergoing continuous ambulatory peritoneal dialysis (CAPD), who ingested 13 constant protein diets for 20.3 +/- 4.9 days. All patients lived in a hospital research ward throughout the study and underwent full nitrogen balance measurements. Data were analyzed after patients attained equilibrium or near equilibrium with each dietary protein intake. In the CRF patients, using the mean values obtained during the equilibrium phase, there was a direct and precise correlation between the TNA and UNA, where TNA g/day = 1.19 UNA g/day + 1.27 g/day, r = 0.948. The correlation between DNI and UNA was also highly significant, but less precise, with somewhat greater 95% confidence intervals: DNI g/day = 1.20 UNA g/day + 1.74 g/day, r = 0.865. The relationship between DNI and TNA was not much more precise: DNI g/day = 0.97 TNA g/day + 0.65 g/day, r = 0.880. With the CAPD patients, the relationships were as follows: TNA g/day = 0.94 UNA g/day + 5.54 g/day, r = 0.956; DNI g/day = 0.97 UNA g/day + 6.80 g/day, r = 0.705; DNI g/day = 1.07 TNA g/day + 0.63 g/day, r = 0.760. For the CAPD patients, the lowest 95% confidence intervals were also found for the correlation between TNA and UNA. Thus, in both CRF and CAPD patients, the TNA is highly and precisely correlated with the UNA. The DNI is also significantly correlated with UNA and TNA, but the relationship is less precise. In both of these two groups of patients, the difference between the regression equations for TNA versus UNA and DNI versus UNA was, to a substantial degree, accounted for by the intercept.     

Should we patch corneal erosions?

This prospective study was performed to investigate epidemiological characteristics in terms of the age- and sex-specific incidence in patients with perforated and nonperforated appendicitis. The study population comprised 1486 consecutive patients who underwent appendectomy for suspected acute appendicitis between 1989 and 1993. Two patient cohorts [n = 544 (37%)] were analyzed with regard to prehospitalization duration of symptoms and in-hospital observation time. The crude incidence of acute appendicitis was 86 per 100,000 per year. Although the incidence of nonperforated appendicitis was highest among adolescents and young adults (13-40 years of age), perforated appendicitis occurred at almost the same incidence in all sex and age groups. The diagnostic accuracy was 76%. Perforated appendicitis occurred in 19%, with higher rates in small children and the elderly, irrespective of gender. A high diagnostic accuracy was not associated with an increased rate of perforation. In small children and the elderly, the diagnostic accuracy was low and the perforation rate high. Patients with perforation had a significantly longer duration of symptoms as well as in-hospital observation time than did patients with nonperforated appendicitis. Perforated appendicitis showed a different incidence pattern than nonperforated appendicitis and was associated with a significantly longer duration of symptoms and in-hospital observation time, probably due to patient-related factors. We suggest this observation deserves attention regarding clinical diagnosis and treatment decision-making for patients with suspected acute appendicitis.     

Food intake is inversely correlated with central nervous system histamine receptor (H1) concentrations in male Sprague-Dawley rats fed normal, low protein, low energy or poor quality protein diets

The reported studies were designed to examine relationships between whole-brain histamine receptors (H1) and food intake in male Sprague-Dawley rats. Three different experiments were conducted. In each experiment, control rats were fed normal protein (25 g casein/100 g food) and normal metabolizable energy (16.21 kJ/100 g food) diets. Feeding low protein diets (1 g casein/100 g food) elevated central H1 receptor concentrations (P < 0.0027) and reduced voluntary food intake (P < 0.007) compared with normal diets. Feeding low energy diets lowered H1 receptor concentrations (P < 0.0089) and increased voluntary food intake (P < 0.0012). Low quality protein diets also affected the central nervous histaminergic system. Whole-brain H1 receptor concentrations were significantly higher for rats fed low quality protein (25 g gelatin/100 g food) compared with rats fed casein (P < 0.0001). Rats fed medium quality protein (25 g wheat gluten/100 g food) or low quality protein ate significantly less food (P < 0.0001). In all experiments, dietary manipulation affected central histamine receptors. Elevated concentrations of H1 receptors were associated with a decrease in food intake whereas lowered concentrations of H1 receptors were associated with an increase in food intake (P < 0.001). The results of these experiments support the hypothesis that central histamine H1 receptor concentrations in male rats are inversely correlated with voluntary food intake and affected by dietary composition.     

U-shape relationship between change in dietary cholesterol absorption and plasma lipoprotein responsiveness and evidence for extreme interindividual variation in dietary cholesterol absorption in humans

A possible relationship between change in dietary cholesterol absorption and plasma lipoprotein responsiveness was examined in 18 normal subjects fed low fat low cholesterol, high fat low cholesterol, and high fat high cholesterol diets. For the group, neither dietary cholesterol nor dietary fat affected the percentage dietary cholesterol absorption, whereas dietary cholesterol intake raised total and LDL-C and dietary fat raised total, LDL, and HDL-C. On a fixed diet there was approximately a 2-fold variation among subjects in percentage dietary cholesterol absorption. Subjects also varied in response to dietary cholesterol and fat with regard to dietary cholesterol absorption and plasma lipoprotein responsiveness. There was a U-shaped parabolic relationship between dietary cholesterol-induced percent change in LDL-C and the change in percentage dietary cholesterol absorption (R2 = 0.62, P = 0.005). A similar but weaker relationship characterized the responsiveness of HDL-C (R2 = 0.38, P = 0.05). For the group, increased cholesterol intake raised dietary cholesterol mass absorption from 1.6 to 4.6 mg/kg per day, but the range of increase was from 1 to 4.7 mg/kg per day. Increased fat intake also affected dietary cholesterol mass absorption with most subjects displaying a strong inverse relationship between fat intake and mass absorption (r = -0.77, P < 0.003). In summary: i) the percentage change in dietary cholesterol absorption in response to dietary cholesterol does appear to regulate diet responsiveness of LDL and HDL-C, and ii) the large variability in percent absorption and changes in percentage and mass absorption in response to dietary cholesterol suggest the presence of genetically determined differences among individuals in the regulation of dietary cholesterol absorption.     

Influence of environmental temperature on in vivo energy expenditure in vitro ouabain-sensitive respiration in duodenal mucosa and liver in rats fed different levels of dietary fiber or protein

Seventy two Wistar rats were used in two repeat studies to investigate the effect of environmental temperature (18 degrees C or 28 degrees C) and increasing levels of dietary fibre (low, 68 g/kg DM; medium 110 g/kg DM; high, 157 g/kg DM) or protein (low, 91 g/kg DM; medium, 171 g/kg DM; high, 262 g/kg DM) on digestive tract, visceral organ size, energy metabolism, and respiration attributable to Na+,K(+)-ATPase activity in duodenal mucosa and liver. Total and ouabain-sensitive (a measure of Na+,K(+)-ATPase activity) O2 consumption in vitro of tissues were measured polarographically using a Clark-style YSI biological O2 monitor. Whole body heat production (in vivo) was measured using open-circuit respiration chambers. The weight of the visceral organs was higher in rats housed at 18 degrees C than at 28 degrees C. The empty weight of the small intestine, caecum, and colon increased as the level of dietary fibre increased (P 0.05). Heat production as a proportion of metabolizable energy was higher (P < 0.05) at 18 degrees C than at 28 degrees C in the first experiment but this difference was significant in the second experiment. Rats fed the low protein diet had significantly higher (P > 0.05) heat production than those fed medium or high protein diets. Compared to 28 degrees C, environmental temperature of 18 degrees C caused an increased total and ouabain-sensitive O2 consumption in duodenal mucosa. There was no significant effect of environmental temperature on total and ouabain-sensitive O2 consumption in the liver. However, ouabain-sensitive O2 consumption in liver was significantly higher (P 0.05) when rats were fed a low protein diet compared to the medium or high protein diet. Total and ouabain-sensitive O2 consumption increased in duodenal mucosa of rats fed low level of dietary fibre compared to the medium or high dietary fibre diets. The in vitro results corresponded with the whole animal energy expenditure and O2 consumption in vivo.     

The success of dietary protein restriction in alkaptonuria patients is age-dependent

Alkaptonuria is characterized by an increased urinary excretion of homogentisic acid, pigmentation of cartilage and connective tissues, and ultimately the development of inflammatory arthropathy. Various diets low in protein have been designed to decrease homogentisic acid excretion and to prevent the ochronotic pigmentation and arthritic lesions. However, limited information is available on the long-term beneficial effects of these diets. We reviewed the medical records of 16 patients aged 3-27 years (4 > 18 years) to ascertain the age of diagnosis, growth, development, social behaviour, signs of complications and longitudinal dietary compliance. The diagnosis of alkaptonuria was made at an average age of 1.4 years (2 months-4 years); following the diagnosis all patients were prescribed a diet with a protein content of 1.5 g/kg per day. All patients showed normal growth and development, and no major complications of the disease. Behavioural problems associated with poor dietary compliance emerged as the main problem. Dietary compliance decreased progressively with age. The effect of dietary protein restriction in homogentisic acid excretion was studied by fixing the amounts of protein in the diet at 1 g/kg per day and 3.5-5 g/kg per day during 8 days. Twelve patients, aged 4-27 years, participated in the investigation. Protein restriction resulted in a significantly lower excretion of homogentisic acid in the urine of children younger than 12 years (p < 0.01), whereas this effect was less obvious for adolescent and adult patients. The results suggest that restriction of protein intake may have a beneficial effect on alkaptonuric children; but continuation of this regimen to older age seems questionable and not practical.     

On the automaticity of ipsilateral response activation in the Simon effect

The purpose of this investigation was to establish whether plasma cholesterol and triacylglycerol(s) in copper deficiency can be increased or decreased by hepatic iron levels. Weanling male Sprague-Dawley rats were randomly divided into six dietary groups based on levels of dietary copper and iron. They were fed from weaning their respective diets for 6 wk. Forty percent of the copper-deficient rats fed a 15.7 mumol Fe/g diet died; 22% of those fed a diet containing 8.6 mumol Fe/g died; and there were no deaths in the 3.4 mumol Fe/g diet group. Rats belonging to the group fed the high-iron diet also exhibited the highest levels of liver iron, liver glutathione, and plasma cholesterol and triacylglycerol(s) compared with those fed either the adequate or low levels of dietary iron. There was a direct correlation (r = 0.82 and 0.77, respectively) between levels of cholesterol and triacylglycerol(s) in plasma and hepatic iron concentrations. These results provide strong evidence that points to a major involvement of iron in the lipemia of copper deficiency. These data may be important to those individuals who consume large quantities of fortified iron foods and supplement with iron but whose intake of copper is suboptimal.     

Decrease in insulin and insulin-like growth factor I (IGF-I) binding to erythrocytes from patients with cystic fibrosis

Guidelines for a healthy diet often recommend limiting dietary sugars and fats. Some researchers have called these aims mutually incompatible, suggesting that fat and sugar intakes, when expressed as percent dietary energy, are inversely linked. Others have argued that sugar, more specifically sucrose, acts as a vehicle for dietary fat and serves to suppress the overall quality of the diet. This study examined the relationship between age, sucrose and fat intakes, body mass index (BMI), and measures of dietary diversity and variety in a community-based sample of 837 French adults. Consistent with other studies, high consumption of added sucrose (in g/day or g/1000 kcal per day) was associated with higher consumption of energy and fat and lower consumption of vegetables and fruit. However, eating patterns were strongly influenced by age. High-sucrose consumers were significantly younger and had lower BMI values than did low-sucrose consumers, who were both older and had higher BMIs. High-sucrose diets had minimal effect on the diet diversity score and were associated with more varied diets, as evidenced by a higher dietary variety score.     

Alteration of laminin production in small-cell lung carcinoma: possible correlation with the absence of the basement membrane

The amount of protein recommended to minimise N loss in critically ill patients receiving total parenteral nutrition (TPN) varies in the literature. Therefore, we studied the effect of increased protein intake on the N balance, administering TPN with either 1.2 g protein/kg/day (low N diet) or 1.8 g protein/kg/day (high N diet). Fifteen mechanically ventilated critically ill patients were studied in a surgical intensive care unit. After at least two days of standard TPN, patients were randomly assigned to either the low or the high N diet. Ten patients were studied on the low N diet and 11 on the high N diet; 6 patients were studied on both diets. Nonprotein energy was supplied according to estimated energy requirements. For five consecutive days, the N balance was measured daily. Total urinary nitrogen (TUN) was analysed using the Kjeldahl method. There was no difference in N balance between the groups. On the low N diet, N balance was -0.113 +/- 0.088 and on the high N diet -0.113 +/- 0.109 g N/kg/day. In patients studied twice, N balance was -0.087 +/- 0.054 and -0.050 +/- 0.060 g N/kd/day respectively. Results of a previous pilot study showed that in 20 similar patients the N balance became 80% less negative (from -5.7 +/- 5.1 to -1.1 +/- 8.2 g N/day) when protein intake was increased from 0.9 to 1.5 g/kg/day. Since these results are consistent with other studies, we conclude that the optimal range of protein supply in this type of critically ill patients is approximately 1.1-1.5 g protein/kg/day.     

Folate, vitamin D, and iron intakes are low among pregnant Finnish women

OBJECTIVE: To evaluate dietary habits and nutrient intake of Finnish pregnant women, to relate these to the use of dietary supplements, and to explore possible dietary variations according to age and education. DESIGN: A random dietary survey using two five day estimated food records. SETTING: Pregnant women from 13 maternity clinics in the city of Oulu, Finland. SUBJECTS: One hundred and eighteen pregnant women in their third trimester. MAIN RESULTS: The main sources of energy were cereal products and milk products. The consumption of fish and poultry was low. Women with a higher educational level consumed more vegetables, fruit, fruit juices, and tea and less sausages, inner organs and coffee than women with a lower educational level. Younger women (< 25 y) consumed more sugar and pork and less berries, butter and inner organs than older women. On average 15% of the total energy was supplied by protein, 33% by fats, 52% by carbohydrates, and 12% by sucrose. Compared to the Nordic nutrition recommendations, the proportion of polyunsaturated fatty acids and the intake of dietary fibre were low and the intake of sugar high. The intakes of vitamins and minerals met or exceeded the recommended allowances, except for vitamin D, folate, and iron. Of the subjects 70% used dietary supplements. With the exception of vitamin D, folate, and iron, both the supplement users and non-users had an adequate nutrient intake from their diet. CONCLUSIONS: A balanced diet covers the increased nutrient requirements during pregnancy, with the exception for vitamin D, folate, and iron. The use of dietary supplements during pregnancy is excessive and partly focused on the wrong nutrients. Young and less educated, and smoking pregnant women need more nutritional guidance.     

Selective dietary restriction of protein and calorie intakes prevents spontaneous proteinuria in male MWF rats

BACKGROUND/AIMS: Previous observations indicate that protein and calorie restrictions can affect the course of renal disease progression. We compared the effects of selective protein and calorie restriction on glomerular hemodynamics and proteinuria in a model of spontaneous glomerular injury in the rat. METHODS: Three groups of male MWF rats were assigned to three different diets: standard diet (ST, 19% protein, 3.4 kcal/g), low protein (LP) and low calorie (LC). Proteinuria and systolic blood pressure were periodically measured. Glomerular hemodynamics and tuft volume were determined after 2 months of dietary treatment. RESULTS: The effective mean protein intake was 3.4 +/- 0.4, 1.6 +/- 0.2, and 3.2 +/- 0.2 g/day/rat, respectively, for the ST, LP, and LC diets, while caloric intake averaged 60 +/- 7, 59 +/- 9, and 30 +/- 2 kcal/day/rat. Both LP and LC diets significantly prevented proteinuria (104 +/- 32, 36 +/- 9, and 18 +/- 8 mg/day, respectively, in the three groups). The systolic blood pressure was unaffected by the diets. The LC diet induced lower body and kidney weights than the ST diet. The glomerular filtration rate was slightly but significantly increased by the LP diet, but not by the LC diet (0.64 +/- 0.14, 0.81 +/- 0.08, and 0.67 +/- 0.12 ml/min, respectively, for ST, LP and LC diets). The glomerular hydraulic pressures were not affected by the diets. No differences were also observed in glomerular volume. The incidences of glomerulosclerosis and tubulointerstitial changes were comparable in ST and LP diets and completely absent in the LC diet group. CONCLUSION: These results indicate that restriction of both protein and calorie intakes prevents spontaneous proteinuria in male MWF rats by preventing deterioration of glomerular perm-selective functions.     

Effects of dietary fat and a vegetable-fruit mixture on the development of intestinal neoplasia in the ApcMin mouse

The variation in colorectal cancer (CRC) incidence worldwide strongly suggests a role for dietary influences. Based on epidemiological data, protective effects of vegetables and fruit intake on CRC are widely claimed, while other data indicate a possible increased CRC risk from (higher) dietary fat intake. Therefore, we have investigated single and interactive effects of dietary fat and a vegetable-fruit mixture (VFM) in the ApcMin mouse, a mouse model for multiple intestinal neoplasia. In this study, four different diets (A-D) were compared, which were either low in fat (20% energy diets A/B) or high in fat (40% energy diets C/D). In addition, 19.5% (wt/wt) of the carbohydrates in diets B and D were replaced by a freeze-dried VFM. The diets were balanced so that they only differed among each other in fat/carbohydrate content and the presence of specific plant-constituents. Because the initiation of intestinal tumors in ApcMin mice occurs relatively early in life, exposure to the diets was started in utero. Without the addition of VFM, mice maintained at a high-fat diet did not develop significantly higher numbers of small or large intestinal adenomas than mice maintained at a low-fat diet. VFM added to a low-fat diet significantly lowered multiplicity of small intestinal polyps (from 16.2 to 10.2/mouse, 15 animals/group), but not of colon tumors in male ApcMin mice only. Strikingly, addition of VFM to female mice maintained on a low-fat diet and to both sexes maintained on a high-fat diet significantly enhanced intestinal polyp multiplicity (from 16.5 to 26.7 polyps/mouse). In conclusion, our results indicate that neither a lower fat intake nor consumption of VFM included in a high-fat diet decreases the development of polyps in mice genetically predisposed to intestinal tumor development.     

Fibre and nutrient intakes of chronic care elderly patients

It has been previously suggested that chronic care elderly patients are at increased nutritional risk. However dietary intake studies have not completely supported this statement. To determine usual dietary intakes, 32 elderly patients, mean (+/- SEM) age 84 +/- 1 years, from two hospitals, had 3-day dietary intakes estimated or weighed and analyzed for nutrient composition. The group as a whole had low intakes of dietary fibre but intakes of other nutrients were equal to or greater than the Canadian recommendations. The distribution of macronutrients also met recommended guidelines. In general, this group of elderly patients appeared to be eating well, however, some individuals results suggest nutritional risk.     

Methionine requirement of channel catfish fed soybean meal-corn-based diets

A soybean meal-corn-based diet was used to determine dietary methionine (Met) required by 14-g channel catfish (Ictalurus punctatus) in a 42-d experiment at 25 degrees C. The basal diet with balanced limiting amino acids relative to the catfish whole-body amino acid profile contained 277 g of CP, 3.6 g of Met, 4.0 g of cystine (Cys), and 10 MJ of DE/kg of DM. DL-Methionine was added to the basal diet from 0 to 12.0 g/kg in 2-g intervals at the expense of L-glutamic acid to produce seven isonitrogenous and isocaloric diets. A reference diet contained 331 g of CP, 8 g of Met, 5 g of Cys, and 10 MJ of DE/kg of DM (included 8% fish meal). Seven graded Met levels resulted in quadratic responses (P < .01) of weight gain, specific growth rate, feed or GE intake, feed or energy efficiency, protein or energy retention, protein efficiency ratio, and apparent net protein or energy utilization. Channel catfish required 9.4 g of Met/kg of DM (34.1 g/kg of CP) with a total 11.3 g/kg of calculated digestible sulfur-containing amino acids based on multiple regression dose-response models or 270 mg of Met/kg of fish per day based on a broken-line response of protein gain to Met intake. At the adequate Met level, catfish with the lowest (P < .05) liver lipids showed feed intake and protein or energy utilization efficiency similar (P > .05) to that of catfish fed the reference diet. Catfish fed all-plant-protein diets require more dietary methionine than previously reported. Catfish fed corn-soybean meal diets fortified adequately with methionine result in performance that approaches that of fish fed a fish meal-based diet.     

Starch and dietary fiber components are excreted and degraded to variable extents in ileostomy subjects consuming mixed diets with wheat- or oat-bran bread

The study was conducted to determine if the excretion of starch and dietary fiber components varies in ileostomy subjects consuming diets high or low in dietary fiber. Excretion of starch, enzyme-resistant starch and dietary fiber components was studied in nine human subjects with ileostomies, who consumed (in a crossover design) a wheat bread-based diet (daily intake 274 g starch, 2.4 g enzyme-resistant starch and 14.4 g total dietary fiber) and a high fiber diet based on oat-bran bread (daily intake 243 g starch, 2.7 g enzyme-resistant starch and 40.2 g total dietary fiber). Food and excreta were collected on d 3 and 17. No significant differences in excretion of starch, enzyme-resistant starch or dietary fiber components were found on these 2 d in each dietary period. When subjects consumed the wheat bread-based diet they excreted (mean +/- SD) 3.3 +/- 1.7 g starch and 2.4 +/- 0.4 g enzyme-resistant starch daily, whereas when consuming the oat bran-based diet they excreted 4.5 +/- 3.1 g starch and 2.5 +/- 0.4 g enzyme-resistant starch. During both dietary periods subjects excreted significantly greater amounts of certain dietary fiber polysaccharide residues (fucose, galactose and uronic acid) than they ingested. This indicates a contribution of endogenous and/or microbial material to the dietary fiber value in ileostomy effluents. However, significantly less excretion of some dietary fiber polysaccharide residues, especially glucose residues, during the oat-bran bread-based dietary period was also noted. This was presumably caused by a degradation of mixed-linked (1,3),(1,4)-beta-D-glucans.     

Acidosis in cattle: a review

Acute and chronic acidosis, conditions that follow ingestion of excessive amounts of readily fermented carbohydrate, are prominent production problems for ruminants fed diets rich in concentrate. Often occurring during adaptation to concentrate-rich diets in feedyards, chronic acidosis may continue during the feeding period. With acute acidosis, ruminal acidity and osmolality increase markedly as acids and glucose accumulate; these can damage the ruminal and intestinal wall, decrease blood pH, and cause dehydration that proves fatal. Laminitis, polioencephalomalacia, and liver abscesses often accompany acidosis. Even after animals recover from a bout of acidosis, nutrient absorption may be retarded. With chronic acidosis, feed intake typically is reduced but variable, and performance is depressed, probably due to hypertonicity of digesta. Acidosis control measures include feed additives that inhibit microbial strains that produce lactate, that stimulate activity of lactate-using bacteria or starch-engulfing ruminal protozoa, and that reduce meal size. Inoculation with microbial strains capable of preventing glucose or lactate accumulation or metabolizing lactate at a low pH should help prevent acidosis. Feeding higher amounts of dietary roughage, processing grains less thoroughly, and limiting the quantity of feed should reduce the incidence of acidosis, but these practices often depress performance and economic efficiency. Continued research concerning grain processing, dietary cation-anion balance, narrow-spectrum antibiotics, glucose or lactate utilizing microbes, and feeding management (limit or program feeding) should yield new methods for reducing the incidence of acute and chronic acidosis.     

Identification of a gene essential for O-acetylation of the Staphylococcus aureus type 5 capsular polysaccharide

It has been hypothesized that the developmental toxicity of certain compounds is, in part, due to maternal toxicity resulting in alterations in zinc (Zn) metabolism that affects the developing conceptus. In the present work the effects of developmentally toxic doses of 2-ethylhexanoic acid (EHXA), 2-ethylhexanol (EHXO), and valproic acid (VPA) on Zn metabolism were investigated in the pregnant rat. In experiment 1, dams were intubated with EHXA (3.13, 6.25, 9.38 or 12.5 mmol/kg), EHXO (6.25, 9.38 or 12.5 mmol/kg), VPA (1.56, 3.13, 6.25 or 9.38 mmol/kg), or corn oil (control; 1.0 ml/kg) at 14:00 h on gestation day (GD) 11.5, intubated with 32 microCi 65Zn at 22:00 h, and then killed at 08:00 h on GD 12.5. At the higher dose levels of EHXA and EHXO, and at all dosages of VPA, the percentage of 65Zn retained in maternal liver was higher, while that in the embryos was lower, than in controls. Chemical-associated changes in 65Zn distribution were associated with increased maternal liver metallothionein (MT) concentrations. In experiment 2, dams were fed diets containing 1, 25 or 97 microg Zn/g from GD 0-16 and intubated with 3.5 mmol EHXA or 1.0 ml corn oil/kg/d from GD 8-15. Dams were killed on GD 16 or 19. High incidences of encephalocele and tail defects were noted in the GD 16 fetuses of EHXA-treated dams fed either the low or adequate Zn diet, the highest incidences being in the low Zn group. On GD 19 the incidence of tail defects tended to be higher in the EHXA groups than in oil-treated controls, the highest incidence occurring in the low Zn EHXA group. Encephalocele was only observed in the low Zn EHXA-treated group. Fetal weight and crown-rump lengths were decreased by EHXA treatment and low dietary Zn. The incidence of rib anomalies was higher in the EHXA-exposed groups than in their respective oil controls. In experiment 3, GD 10.5 embryos collected from control dams were cultured for 48 h in serum from control or EHXA-treated male rats fed 4.5 or 25.0 microg Zn/g diets. Embryos cultured in either EHXA or low Zn sera exhibited delayed development; the addition of Zn to these sera eliminated their developmental toxicity. These results support the hypothesis that certain chemicals which induce maternal toxicity act, in part, to influence embryonic Zn metabolism and trigger abnormal development. Importantly, the teratogenic effects of these chemicals can be modulated by dietary Zn intake.     

The nutritional status of patients with an alcohol problem

73 patients with an alcohol problem seen in a hospital medical unit over a two year period were examined specifically for signs suggestive of nutritional deficiency and of organ or system damage due to alcohol. A seven day dietary recall was carried out on most of them. Clinical signs of nutritional deficiency were relatively uncommon but nine patients had Wernicke-Korsakoff syndrome and ten had peripheral neuropathy. Thiamine was present in less than recommended amounts in 81.5% of the diets. Vitamin D and vitamin C were the next most common dietary deficiencies. 66.1% were deficient in energy intake and about a third of patients derived more than 40% of their energy from alcohol.     

Influence of short-term dietary measures on dioxin concentrations in human milk

Breast-feeding may expose infants to high levels of toxic chlorinated dioxins. To diminish intake of these lipophilic compounds by the baby, two diets were tested for their ability to reduce concentrations of dioxins in human milk. The diets were a low-fat/high- carbohydrate/low-dioxin diet. (about 20% of energy intake derived from fat) and a high fat /low-carbohydrate/low-dioxin diet. These diets were tested in 16 and 18 breast-feeding women, respectively. The test diets were followed for 5 consecutive days in the fourth week after delivery. Milk was sampled before and at the end of the dietary regimen, and dioxin concentrations and fatty acid concentrations were determined. Despite significant influences of these diets on the fatty acid profiles, no significant influence on the dioxin concentrations in breast milk could be found. We conclude that short-term dietary measures will not reduce dioxin concentration in human milk.