Changes in Nutrient Intake in Patients at Nutritional Risk

The purpose of this study was to examine changes in nutrient intake in patients at nutritional risk. We included 106 malnourished patients who were admitted to Severance Hospital from March to September 2014. The average age was 59.0+/-11.6 years old and 59 patients were male (59.7%). The majority of diagnosis was cancer (94.3%). We evaluated patients' nutritional status by scored patient-generated subjective global assessment (PG-SGA), anthropometric measurement (height, weight, body composition by Bioelectrical impedance analysis), hand grip strength, biochemical and dietary assessment. The patients' daily intakes of energy and protein (1,019.5+/-706.4 kcal, 40.4+/-27.7 g) during hospitalization were significantly lower than their usual intakes (1,382.0+/-499.8 kcal, 54.4+/-25.1 g, P<0.001). Serum levels of albumin, cholesterol, and total lymphocytes were significantly reduced during hospital stay. The negatively influencing factors for reduced dietary intake were anorexia (42.5%), abdominal distention (14.2%), pain (13.2%), and others. The results of this study could be used to establish baseline data for developing new strategies for nutritional intervention in malnourished patients.

Effects of d-alpha-tocopherol supplements on lipid metabolism in a high-fat diet-fed animal model

High-fat diet up-regulates either insulin resistance or triglycerides, which is assumed to be related to the expression of peroxisome proliferator-activated receptor (PPAR)-alpha and PPAR-gamma. The beneficial effects of vitamin E on insulin resistance are well known; however, it is not clear if vitamin E with a high-fat diet alters the expression of PPAR-alpha and PPAR-gamma. We investigated the effects of d-alpha-tocopherol supplementation on insulin sensitivity, blood lipid profiles, lipid peroxidation, and the expression of PPAR-alpha and PPAR-gamma in a high-fat (HF) diet-fed male C57BL/6J model of insulin resistance. The animals were given a regular diet (CON; 10% fat), a HF diet containing 45% fat, or a HF diet plus d-alpha-tocopherol (HF-E) for a period of 20 weeks. The results showed that the HF diet induced insulin resistance and altered the lipid profile, specifically the triglyceride (TG) and total cholesterol (TC) levels (P < 0.05). In this animal model, supplementation with d-alpha-tocopherol improved insulin resistance as well as the serum levels of TG and very-low-density lipoprotein-cholesterol (VLDL-C) (P < 0.05). Moreover, the treatment decreased the levels of malondialdehyde (MDA) in the serum and liver while increasing hepatic PPAR-alpha expression and decreasing PPAR-gamma expression. In conclusion, the oral administration of d-alpha-tocopherol with a high-fat diet had positive effects on insulin resistance, lipid profiles, and oxidative stress through the expression of PPAR-alpha and PPAR-gamma in a high-fat diet-fed male mice.