Pathya and Apathya- An Ayurvedic Framework of Wholesome and Unwholesome Diet, Behavioral and Mental Health Regime for Sthaulya- A Narrative Review

The advancement of industrialization and communications has made man more sensitive and critical, resulting in a variety of health issues. Sedentary lifestyles are becoming more common as a result of the progress of industrialization and communication, resulting in chronic non-communicable diseases such as diabetes, hypertension, cancer, ischemic heart disease, cerebro-vascular accidents, atherosclerosis, varicose veins, and so on. Obesity is a risk factor for several diseases, thus preventing it will reduce the likelihood of developing them. Obesity, like other disorders, is a complex disorder caused by a combination of factors such as food, physical activity, mental health, and overall lifestyle. In Ayurveda, Sthaulya is the closest clinical entity for obesity. Sthoulya's causality is described in the Asta-Nindita-Purusha chapter. The etiopathogenesis of obesity is caused by an excessive intake of calories combined with a decrease in expenditure. A key weight-loss approach that can be used anywhere to reduce energy density. In Ayurveda, Pathya and Apathya are given specific attention in terms of Ahara, Vihara, and Manasika Entities, so that the ailment can be treated holistically. When these guidelines are followed, the treatment yields a better result in the treatment of the condition. This article attempts to review the pathya and apathy of obesity, as well as discuss the possible causes.

Does public pension impact migrant workers' nutrition: evidence from urban pension insurance in China / A previdência pública impacta a nutrição de trabalhadores migrantes: evidências do seguro de pensão urbana na China

ABSTRACT: Based on the data of "employment and food demand of urban migrant workers", this paper empirically analyzed the impact of urban pension insurance on the nutritional intake structure of migrant workers. The results showed that participating in urban pension insurance can change the nutritional intake structure of migrant workers. Additionally, fat and protein replace carbohydrate as the main nutrition sources for migrant workers. After controlling the income and labor intensity of migrant workers and other factors, urban pension insurance has a positive effect on the intake of fat and protein of migrant workers for they increase by 13.5% and 8.8% respectively. There is no significant effect on the intake of carbohydrates of migrant workers. The calorie intake of migrant workers increases by 6.8% accounting for the change of nutritional intake structure. Endogenous and robustness tests showed that the above conclusions are robust. Heterogeneity analysis showed that there is no significant difference in the effect of urban pension insurance on calorie intake of migrant workers in different income levels and age groups.

RESUMO: Este artigo usa os dados da pesquisa de "Emprego e demanda alimentar dos trabalhadores migrantes urbanos" para analisar empiricamente o impacto do seguro patrimonial urbano na estrutura de ingestão nutricional dos trabalhadores migrantes. O estudo constatou que: o seguro-pensão urbano mudou a estrutura de ingestão nutricional dos trabalhadores migrantes. Gordura e proteína substituíram os carboidratos e se tornaram a principal fonte de nutrição dos trabalhadores migrantes. Depois de controlar fatores como a renda e a intensidade do trabalho dos trabalhadores migrantes, o seguro de pensão urbana aumentou significativamente a ingestão de gordura e proteína dos trabalhadores migrantes em 13,5% e 8,8%, respectivamente, enquanto a ingestão de carboidratos dos trabalhadores migrantes não foi afetada. Significativamente afetado. A transformação da estrutura de ingestão nutricional dos trabalhadores migrantes aumentou sua ingestão calórica em 6,8%. Os testes de endogenia e robustez mostram que as conclusões acima são robustas. A análise de heterogeneidade mostra que não há diferença significativa no efeito do seguro previdenciário urbano sobre o aumento da ingestão de calorias para trabalhadores migrantes de diferentes níveis de renda e diferentes grupos etários.

Association of protein-calorie intake and clinical outcomes among critically-ill COVID-19 patients: A retrospective study

Background@#Patients admitted due to severe COVID-19 pneumonia are at high risk for malnutrition and worsening of their clinical condition. Patients with type 2 diabetes admitted for COVID-19 pneumonia have an increased risk for poor clinical outcomes. Adequate nutrition is recommended to augment a strong immune response. The American Society of Parenteral and Enteral Nutrition (ASPEN), Philippine Society of Parenteral and Enteral Nutrition (PHILSPEN), European Society of Parenteral and Enteral Nutrition (ESPEN) recommend an energy intake goal of 15-20 kcal/kg actual body weight (ABW) per day or 70-80% of caloric requirements after the acute phase of critical illness, with recommended protein intake of 1.2-2.0 g/kg ABW per day. This study aims to provide an association between calorie and protein intake with negative clinical outcomes.@*Methods@#This is a retrospective cohort study of 55 mechanically ventilated SARS COV-2 RT-PCR positive patients admitted in the critical unit of Chinese General Hospital between April 1, 2020 to December 30, 2020. Clinical profile taken include: sex, age, height weight, BMI, comorbidities, and components of the modified SOFA score and APACHE II score. Calorie and protein intake from day 3 to day 7 of ICU admission were taken. Clinical outcome data were in-hospital mortality, number of days of ICU stay, hospital admission, vasopressor use and mechanical ventilation.@*Results@#Majority of the patients included in the study were male, elderly, overweight, and with comorbidities such as hypertension, diabetes, and chronic kidney disease. Majority of the patients were on mechanical ventilation and on vasopressors for more than 1 week. In-hospital mortality accounted for 65.5% of cases. For patients without diabetes, calorie intake was 16.9 kcal/kg/day and protein intake was 0.72 g/kg/day, while patients with diabetes had a calorie intake of 20.2 kcal/kg/day and protein intake of 0.86 g/kg/day. Based on the 70% cutoff, patients with diabetes were noted to have been provided with more adequate protein (P-value= 0.027). Higher caloric intake was inversely associated with in-hospital mortality among patients younger than 75 years old (P-value=0.026) and among patients with diabetes (P-value=0.003). Higher calorie intake was also significantly associated with decreased duration of pressors among patients with diabetes (P-value=0.021). Higher protein intake positively associated with the number of days admitted among patients with lower modified SOFA scores (P-value=0.041) and among patients with diabetes (P-value=0.021). All other associations did not display significant results (all P-values>0.05).@*Conclusion@#Based on this study, increased caloric intake was associated with increased survival among patients less than 75 years, but no association was found in patients 75 years and older. Among patients with lower mortality risk, increased protein intake was associated with longer duration of hospital stay, however patients with higher risk had higher in-hospital mortality regardless of protein and calorie intake. Among patients with diabetes, higher calorie intake was associated with increased survival and decreased duration of pressor requirement, while increased protein was associated with longer length of hospital stay. Treatment for COVID-19 pneumonia, however, was not established at this time and there was significant in-hospital mortality among these mechanically ventilated patients.

Maternal Calorie Intake is a Significant Factor Associated with 6 Months of Exclusive Breastfeeding among Lactating Mothers in Depok City, Indonesia

The target of achieving exclusive breastfeeding for the first 6 months of life in Indonesia remains a challenge. Studies show a relationship between calorie intake of lactating mothers and success in 6 months of exclusive breastfeeding. This study aimed to compare the calories consumed between mothers who succeeded in 6 months of exclusive breastfeeding and those who did not and to investigate the effect of different types of supplementation. Methods: Three groups of lactating mothers (n=201) selected from cadres’ lists were followed for 6 months between June 2015 – July 2016. The first group was a control, the second group received milk (140 kcal/day), and the third group received milk and eggs (220 kcal/day). All food supplementation were given five days a week for as long as the mother was exclusively breastfeeding the infant. Cadres provided the mother supplements and ensured complete consumption. Each month, all groups were observed and measured on status of breastfeeding, anthropometry, and food consumption. Results: For all groups, calorie intake of those who succeeded in exclusive breastfeeding was significantly (p-value < 0.05) higher than those who failed. Calorie intake of lactating mothers is the most dominant factor (OR=5.6) for the success of 6 months of exclusive breastfeeding. The milk supplementation group had the highest calorie intake and highest percentage of mothers who were successful in providing 6 months of exclusive breastfeeding. Conclusion: Calories supplementation was found to be a significant factor in successfully achieving 6 months of exclusive breastfeeding. In this study, milk supplementation was more effective than milk and egg supplementation.

Effects of chronic stress and high-fat diet on metabolic and nutritional parameters in Wistar rats / Efeitos do estresse crônico e da dieta rica em gordura sobre os parâmetros metabólicos e nutricionais em ratos Wistar

OBJECTIVE: The aim of this study was assess the role of chronic stress on the metabolic and nutritional profile of rats exposed to a high-fat diet. MATERIALS AND METHODS: Thirty-day-old male Wistar rats (70-100 g) were distributed into four groups: normal-diet (NC), chronic stress (St), high-fat diet (HD), and chronic stress/high-fat diet (HD/St). Stress consisted at immobilization during 15 weeks, 5 times per week, 1h per day; and exposure to the high-fat diet lasted 15 weeks. Nutritional and metabolic parameters were assessed. The level of significance was 5%. RESULTS: The HD group had final body weight, total fat, as well as insulin and leptin increased, and they were insulin resistant. The St and HD/St had arterial hypertension and increased levels of corticosterone. Stress blocked the effects of the high-fat diet. CONCLUSION: Chronic stress prevented the appearance of obesity. Our results help to clarify the mechanisms involved in metabolic and nutritional dysfunction, and contribute to clinical cases linked to stress and high-fat diet.

OBJETIVO: Avaliar o papel do estresse crônico sobre parâmetros metabólicos e nutricionais de ratos expostos à dieta rica em gordura. MATERIAIS E MÉTODOS: Ratos Wistar machos (30 dias de idade/70-100 g) foram distribuídos em quatro grupos: dieta-normal (NC), estresse crônico (St), dieta rica em gordura (HD) e estresse crônico/dieta rica em gordura (HD/St). O estresse consistiu em imobilização durante 15 semanas, 5 vezes por semana 1h por dia e a dieta rica em gordura foi oferecida por 15 semanas. Parâmetros nutricionais e metabólicos foram avaliados. O nível de significância foi de 5%. RESULTADOS: HD tiveram peso corpóreo, gordura total e níveis de insulina e leptina aumentados e foram resistentes à insulina. Os grupos St e HD/St manifestaram hipertensão e níveis séricos de corticosterona elevados. O estresse bloqueou os efeitos da dieta. CONCLUSÃO: O estresse impediu o surgimento dela. Nossos resultados ajudam compreender os mecanismos envolvidos na disfunção metabólica e nutricional e contribuem para casos clínicos de estresse e dietas ricas em gorduras.

Association of dietary caloric intake with blood pressure, serum lipids and anthropometric indices in patients with hypertension.

The influence of dietary caloric intake was studied on blood pressure (BP), serum lipids, body mass index (BMI) and waist-hip-ratio (WHR) according to age and gender. The study population consisted of 400 healthy individuals as controls and 746 first time detected untreated hypertensive (HTN) subjects. The subjects were regrouped according to amount of calorie intake per day i.e. high and low calorie intake diet within two age-groups: 30-50 years and 51-80 yrs. Blood samples were drawn from all the subjects, following an overnight fast and serum total cholesterol (TC), triglycerides (TG) and HDL-C were measured by standard methods. Serum LDL-C was calculated by Fredrickson-Friedwald formula. BP and anthropometric measurements were measured by a standardized protocol. Highly significant increases in TC, TG, LDL-C, anthropometric and atherogenic indices were seen. While a decrease in HDL-C was observed in high calorie HTN, as compared to low calorie controls. Gender-wise, men had increased values compared to women, except, HDL-C and BMI. With increase in age, all parameters increased in both the subject categories, except atherogenic and anthropometric indices. Hypertensive subjects with high calorie intake diet showed an increase in BP, serum lipids and BMI which might be the major contributor in precipitation of hypertension and also in increasing risk of cardiovascular morbidity and mortality.

Does Dietary Intake by Tehranian Adults Align with the 2005 Dietary Guidelines for Americans: Observations from the Tehran Lipid and Glucose Study.

The aim of this study was to compare dietary intakes by Tehranian adults with recent dietary guidelines for the Americans. The study made a cross-sectional assessment of the dietary patterns of Tehranian adults using a validated food-frequency questionnaire. It included 2,510 subjects (1,121 men and 1,389 women) aged 19-70 years. They were the participants of the third follow-up survey of the Tehran Lipid and Glucose Study (2005-2008). The dietary patterns were assessed using the latest World Health Organization (WHO)’s nutritional goals and Dietary Guidelines for the Americans Adherence Index (DGAI) 2005. The mean [standard deviation (SD)] DGAI score for this population was 8.31 (1.9). Participants in the highest quartile category of DGAI were more likely to be female, older, non-smoking, and physically active than those in the lowest quartile category (p<0.001). Percentage of participants meeting the DGA recommendations was low, especially for starchy vegetables (2.3%), orange vegetables (16.2%), lean meat (9.2%), grains (12.0%), and legumes (6.4%). Over-consumption of grains was observed in almost half of the participants while approximately 20% of the subjects over-consumed milk and meat groups. Intakes of most nutrients examined were significantly associated with the DGAI 2005 score (p<0.001), except for vitamin E, vitamin B12, and vitamin D. The least adherence with the WHO goals was observed with n-3 PUFAs, sodium, fruit, and vegetable intakes. The results revealed that the dietary patterns of most Tehranian adults did not comply with the 2005 DGA and nutritional goals of WHO/Food and Agriculture Organization.

Association of Daily Sleep Duration with Obesity, Macronutrient Intake, and Physical Activity / 대한지역사회영양학회지

There are a few studies that reported the association of sleep duration with calorie intake and energy expenditure. Using cross-sectional data from a population-based prospective study, we evaluated the association of sleep duration with indicators of obesity including body mass index and waist circumference, calorie intake and its proportion of macronutrients, and physical activity. The study subjects were 4,226 male and female adults, who were aged 40 to 69 years and were free of diagnosed cardiovascular disease, diabetes mellitus, and dyslipidemia at baseline. Robust regression analysis was used to analyze associations. The study found that sleep duration is inversely associated with waist circumference, calorie intake, and percent of calories from fat intake and is positively associated with percent of calories from carbohydrate intake and physical activity. The inverse association between sleep duration and waist circumference was stronger among men than among women. The inverse association between sleep duration and calorie intake was stronger among women than among men and such association was also stronger among obese persons than those with a normal body mass index. The positive association between sleep duration and physical activity was strongly demonstrated regardless of sex or obesity. Physical activity is positively associated with sleep duration independent of potential confounding factors including age, sex, income, occupation, marital status, education, smoking status, waist circumference, calorie and macronutrient intake, and alcohol intake.

Malnutrition is not an etiological factor in the development of tropical pancreatitis – A case-control study of Southern Indian patients.

Background and Aim: Malnutrition is implicated as an etiological factor in tropical pancreatitis (TP). The aim of the present study was to elucidate whether malnutrition is the cause or the result of TP. Methods: Consecutive recently diagnosed patients with TP were evaluated for their nutritional status and dietary patterns before and after the onset of TP. The nutritional status of patients before the onset of TP was compared with that of healthy controls to demonstrate the role of malnutrition as an etiological factor for TP. Results: Of 256 consecutive patients with chronic pancreatitis, 89 were diagnosed as TP patients with disease duration of less than 1 year (mean age 32.14 ± 14 years; 60 % males) and comprised the study group. The nutritional status before the onset of TP was comparable with that of controls (n=101) with 15% of patients and 12% of the controls being malnourished (BMI <18.5kg/m2). However, after the onset of TP, 52% (n=46) of patients lost weight and the percentage of malnourished patients increased from 15% to 38% (p=<0.001) indicating that there was significant weight loss after the disease onset. When the causes of weight loss were evaluated, it was found that low calorie intake significantly contributed to weight loss (p=0.001). Conclusion: Malnutrition is not an etiological factor of TP and weight loss occurred as a result of low calorie intake after the onset of TP.

Influence of Biological, Social and Psychological Factors on Abnormal Eating Attitudes among Female University Students in Brazil.

The objective of the study was to estimate abnormal eating attitudes influenced by associated factors among female students of the Universidade Federal de Santa Catarina, Florianópolis, southern Brazil. Abnormal eating attitudes were investigated using the eating attitudes test (EAT-26), according to the presence (EAT+) and absence (EAT-) of symptoms in a sample of 220 students. The body-image was assessed by the bodyshape questionnaire (BSQ-34). Body mass index, body-fat percentage, waist-circumference, food intake (24-hour food recall), and socioeconomic characteristics (monthly household income, monthly per-capita income, and parental schooling) were also investigated. Statistical associations were tested by multivariate Poisson regression analysis. The prevalence of EAT+ and dissatisfaction with the body-image were 8.3% [confidence interval (CI) 95% 4.6-12.0] and 20.0% (CI 95% 14.7-25.3) respectively. Dissatisfaction with the body-image maintained its independent association with abnormal eating attitudes, indicating symptoms of anorexia nervosa. The results of this work highlight the importance of the planning of nutrition-education programmes in universities, aiming at assisting in the choices of food that comprise a healthful diet in a period of life of so many changes and decisions.

Effects of Glycemic Index for Boiled White Rice and Boiled White Rice Mixed with Grains on Food Consumption and Satiety Rate

In this study, we examined whether the glycemic index (GI) values of boiled white rice (GI=86) and boiled white rice mixed with grains (GI=58) could influence the total energy intake and satiety rate of a rice-based diet. Thirty adult females participated in this study, in which they ate boiled white rice, or boiled white rice mixed with grains, along with side dishes for lunch, and then ate the same white rice diet for dinner in the lab once a week for 2 weeks. There was no significant difference in the visual analogue scales for taste between the two diets. Although there were no differences between the subjects' energy intakes for side dishes, the total energy consumed from the boiled white rice mixed with grains diet (520.5 kcal) was significantly (p <0.001) lower than that consumed from the boiled white rice diet (560.2 kcal). For dinner, the subjects consumed significantly (p <0.001) lower calories when they had eaten the boiled white rice mixed with grains diet for lunch as compared to the boiled white rice diet. In addition, the subjects reported significantly (p <0.01, p <0.001) higher satiety rates after consuming the boiled white rice mixed with grains diet compared to the boiled white rice diet, despite consuming lower calories. In conclusion, these results indicate that consuming low GI rice such as boiled white rice mixed with grains substituted for boiled white rice, may be a useful strategy for weight loss and weight management since individuals will consume less energy without experiencing a reduction in satiety.

Comparison of Calorie Intake and Satiety Rate by Different Energy Density Level of Kimbab

We attempted to determine whether energy density would influence calorie intake via cognitive cues, as reflected by satiety. This experiment was designed using two different energy density levels of Kimbab: normal Kimbab (1.6 kcal/g) vs low-density Kimbab (1.0 kcal/g). 26 female college students participated in this study. The subjects ate Kimbab in the lab once a week for 2 weeks. Each week at noon, they were served 24 units of either normal or low-density Kimbab, and we determined the units, grams, and calories of the real & cognitive intake of Kimbab, and also analyzed the satiety rate after eating Kimbab. Our results demonstrated that the real calorie intake from the low-density Kimbab was significantly lower than that of the normal Kimbab (290.3 kcal vs 474.4 kcal, p<0.001), but we noted no significant differences in the units and grams of real and cognitive intake between the normal and low-density Kimbab. However, despite consuming 39% lower caloric intake, the subjects reported similar levels of satiety rates with the two different density levels of Kimbab, as they did not perceive themselves to have eaten more normal Kimbab than low-density Kimbab. Thus, this study provides evidence that the energy density of food is a crucial determinant of caloric intake, and supports the notion that the consumption of low energy-dense foods may result in a reduction of caloric intake without altering satiety.

Influence of Routine Calorie and Protein Intake on Nutritional Status in Stable Chronic Hemodialysis Patients : A 18 Months Follow-up Study / 대한신장학회잡지

BACKGROUND: Dialysis patients as a group appear to have a caloric and a protein intake less than the recommended values; because their energy expenditure is not different from that of healthy adults and because amino acid loss and increased catabolism during dialysis they should be in negative caloric & nitrogen balance and lose body mass and protein such as albumin progressively. Recently, papers dissenting about recommended protein intake in DOQI guideline were published. Because Korean people had different body size and dietary pattern from white races, recommanded protein and calorie intake may be different from that of white races. METHODS: We retrospectively analyzed our data in a group of hemodialysis patients who had dietary evaluations and kinetic measurements performed two consecutive times over a period of 18 months. RESULTS: Body weight(55.22+/-.48 kg to 57.39+/-0.29 kg, p=0.008), LBM(lean body mass, 42.79+/-.49 kg to 46.09+/-.13 kg, p=0.000), BMI(Body Mass Index, 21.89+/-.21 kg/m2 to 22.75+/-.53 kg/m2, p=0.007) and serum albumin level(3.65+/-.47 g/dL vs 3.87+/-.42 g/dL, p=0.000) were increased compared to initial values. Fat mass, TSF(Triceps Skin Fold thickness), MAC(Mid-Arm Circumference), MAMC(Mid- Arm Muscle Circumference) were remained stable over this period of time. These results suggested that these patients are not in negative energy and nitrogen balance. CONCLUSION: Albumin and body weight remained stable over a period of 18 months in spite of 27.25+/-.39 kcal/kg calorie intakes and 1.03+/-.43 g/kg protein intakes. Recommanded protein and calorie intake of Korean people may be different from that of white races.

Rapid calorie metering in ad lib rats.

Adult wistar rats of either sex housed in individual cages and fed ad lib were used to investigate the effects of calorie content and taste on ingestion. A 15 min single-choice solution (water, quinine, sucrose, saccharin) test as well as 1 h mixed diet (stock diet, sucrose-mixed, saccharin-mixed, quinine-mixed) tests were used. Calorically-rich sucrose either in solution or in mixed-diet was preferentially ingested. Taste per se has not influenced calorie intake, as intake on sweet saccharin (3·4 ± 0·4 cal) or on bitter quinine (3·3 ± 0·6 cal) was similar to intake on stock diet (4·8 ± 0·8 cal). Increased 5 min intake on sucrose solution (4·6 ±0·1 ml) over intake of other test solutions (saccharin 3·5 ± 0·2 ml, quinine, 1·2 ± 0·3 ml, water 2·1 ± 0·1 ml) and calorie intake suppression on 1 h stock diet immediately following sucrose solution intake, indicate rapid calorie metering, probably based on fast-acting specific gustatory signals.