Comparison of postprandial oleic acid, 9c,11t CLA and 10t,12c CLA oxidation in healthy moderately overweight subjects.

Few studies report the individual effect of 9c,11t- and 10t,12c-CLA on human energy metabolism. We compared the postprandial oxidative metabolism of 9c,11t- and 10t,12c-CLA and oleic acid (9c-18:1) in 22 healthy moderately overweight volunteers. After 24 weeks supplementation with 9c,11t-, 10t,12c-CLA or 9c-18:1 (3 g/day), subjects consumed a single oral bolus of the appropriate [1-(13)C]-labeled fatty acid. 8 h post-dose, cumulative oxidation was similar for 9c-18:1 and 10t,12c (P = 0.66), but significantly higher for 9c,11t (P < 0.01).

Short-term administration of a combination of recombinant growth hormone and insulin-like growth factor-I induces anabolism in maintenance hemodialysis.

CONTEXT: Resistance to GH and IGF-I is a significant complication of severe chronic kidney disease, which contributes to muscle wasting. Pharmacological doses of recombinant human (rh) GH or rhIGF-I have been proposed to treat this catabolic condition. OBJECTIVE: This study was undertaken to examine the potential additive anabolic effects of rhGH + rhIGF-I compared with rhIGF-I. DESIGN: We studied eight well-nourished hemodialysis patients in a random crossover design and compared the metabolic effects of a 3-d administration of moderate dose of rhIGF-I (40 microg/kg per 12h) with an association of rhIGF-I + rhGH (50 microg/kg/d). Leucine kinetics, plasma amino acids (AAs), serum insulin, and IGF binding proteins (IGFBP)-1 and -3 were measured. RESULTS: The net protein balance was not affected by rhIGF-I alone, whereas serum insulin and IGFBP-3 decreased (P < 0.05) and IGFBP-1 increased (P < 0.01). With the combination rhGH + rhIGF-I, an increase of IGFBP-3 (P < 0.01) and insulin (P < 0.01) as well as a decrease of IGFBP-1 (P < 0.01) occurred. Plasma essential AAs (P = 0.01) as well as the essential to nonessential AA ratio (P < 0.001) decreased. Whole-body protein net balance increased significantly (P < 0.05) with a 22% decrease in leucine oxidation and a 15% increase in nonoxidative leucine disposal. CONCLUSIONS: In dialysis patients, rhIGF-I administration at a moderate dose has no protein metabolic effect, but the association with a moderate dose of rhGH is followed by a significant anabolic response.

Effect of an enteral diet supplemented with a specific blend of amino acid on plasma and muscle protein synthesis in ICU patients.

BACKGROUND & AIM: Polytrauma patients are characterized by a negative nitrogen balance and muscle wasting. Standard nutrition is relatively inefficient to improve muscle protein turnover. The aim of this study was to investigate the effect of enteral nutrition (EN) supplemented with specific amino acids on protein metabolism in polytrauma patients. METHODS: In a double blind study, 12 polytrauma patients were randomized to receive EN supplemented with either a mixture of cysteine, threonine, serine and aspartate (AA patients) or alanine at isonitrogenous levels (Ala patients). An intravenous infusion of l-[1-(13)C]-leucine was performed in the fed state between day 9 and 12 post-injury (Df) in patients and in a group of healthy volunteers (n=8) (EN+Ala) to measure whole body leucine kinetics, plasma and muscle protein synthesis rates. Nitrogen balance, 3-methyl histidine excretion were measured from day 3 to Df. RESULTS: The contribution of total plasma proteins to whole body protein synthesis was greatly increased, from 11% in healthy volunteers to about 25% in polytrauma patients. AA supplementation had no effect on nitrogen balance, leucine kinetics or plasma protein synthesis in patients. In contrast, the urinary excretion of 3-methyl histidine tended to decrease along the study in the AA supplemented group compared to an increase in the Ala group. Muscle protein synthesis tended to be higher in the AA group than in the Ala group (46%, P=0.065). CONCLUSION: During injury, an increased supply of cysteine, threonine, serine and aspartate could be able to better cover the specific amino requirements, thus resulting in improved muscle protein synthesis without impairment of acute phase protein synthesis.

Higher calcium urinary loss induced by a calcium sulphate-rich mineral water intake than by milk in young women.

It is well known that the intestinal availability of Ca from Ca-rich mineral waters is equivalent to that of milk Ca. However, the effect of associated anions on Ca urinary loss needs to be addressed. The aim of the current study was to compare, under ordinary conditions of consumption, milk and a SO4-rich mineral water as the Ca provider in a large number of subjects consuming the same quantity of Ca from the two sources in a crossover study lasting for an extended period. Thirty-seven healthy women completed a 12-week protocol, divided into four periods of 3 weeks (W). In the first (W1-3) and third (W6-9) periods, dietary Ca intake was restricted to 600 mg/d. In the second (W4-6) and final (W10-12) periods, either 400 ml/d medium-fat milk or 1 litre of a Ca- and SO4-rich mineral water, each providing about 480 mg Ca/d, was added to the diet in a random manner. Dietary evaluation, blood and urinary measures were performed during the last week (W6 and W12) of each Ca supplementation period. The urinary excretion of Ca was higher (0.5 mmol/d more) with water than with milk (P<0.001). An examination of all the dietary factors known to influence calciuria suggested that the acidogenic action of SO4 was responsible for this increased calciuria. Thus, despite an equal Ca intake and assuming an unchanged intestinal absorption, these results suggest that Ca balance is better with milk consumption than with CaSO4-rich water.

Pre- and postoperative aminoacidemia in breast cancer: a study vs. matched healthy subjects.

Various alterations of aminoacidemia have been described during breast cancer. The aim of this study was first to establish the specific modifications of plasma-free amino acid concentrations by a comparative study of 19 patients with mammary tumors and 18 healthy volunteers, and, second, to determine the evolution of aminoacidemia after surgical tumor removal. Aminoacidemia was determined the day before (D0), and then five days, one month (M1), and six months after surgical removal of the tumor, and a single determination was performed in control subjects. Plasma levels (mumol/L) of serine and glutamate were higher in cancer-bearing women at D0 (respectively, 124 +/- 3 and 68 +/- 7) than in healthy volunteers (respectively, 110 +/- 6 and 48 +/- 5). Surgical tumor removal induced a normalization of aminoacidemia (in mumol/L at D5: serine: 114 +/- 4; at M1: glutamate: 55 +/- 6 Non Significant (NS) from values of healthy subjects). Among the various patterns reported for breast cancer, we confirm one of those described by Cascino in 1995, and we show that these levels revert to normal after tumor surgical removal.

Effects of two conjugated linoleic Acid isomers on body fat mass in overweight humans.

OBJECTIVE: To examine the effects of two different conjugated linoleic acid (CLA) isomers at two different intakes on body composition in overweight humans. RESEARCH METHODS AND PROCEDURES: Eighty-one middle-aged, overweight, healthy men and women participated in this bicentric, placebo-controlled, double-blind, randomized study. For 6 weeks (run-in period), all subjects consumed daily a drinkable dairy product containing 3 g of high oleic acid sunflower oil. Volunteers were then randomized over five groups receiving daily either 3 g of high oleic acid sunflower oil, 1.5 g of cis-9,trans-11 (c9t11) CLA, 3 g of c9t11 CLA, 1.5 g of trans-10,cis-12 (t10c12) CLA, or 3 g of t10c12 CLA administrated as triacylglycerol in a drinkable dairy product for 18 weeks. Percentage body fat mass and fat and lean body mass were assessed at the end of the run-in and experimental periods by DXA. Dietary intake was also recorded. RESULTS: Body fat mass changes averaged 0.1 +/- 0.9 kg (mean +/- SD) in the placebo group and -0.3 +/- 1.4, -0.8 +/- 2.1, 0.0 +/- 2.3, and -0.9 +/- 1.7 kg in the 1.5-g c9t11, 3-g c9t11, 1.5-g t10c12, and 3-g t10c12 groups, respectively. Changes among the groups were not significantly different (p = 0.444). Also, lean body mass and dietary intake were not significantly different among the treatments. DISCUSSION: A daily consumption of a drinkable dairy product containing up to 3 g of CLA isomers for 18 weeks had no statistically significant effect on body composition in overweight, middle-aged men and women.

The rate of protein digestion affects protein gain differently during aging in humans.

In young men ingesting protein meals, slowly digested proteins (caseins: CAS) induce a higher protein gain than those that are rapidly digested (whey proteins: WP). Our aim was to assess whether or not this is true in elderly men receiving mixed meals. The effects of meals containing either CAS or two different amounts of WP (WP-iN: isonitrogenous with CAS, or WP-iL: providing the same amount of leucine as CAS) on protein metabolism (assessed by combining oral and intravenous leucine tracers) were compared in nine healthy, elderly (mean +/- S.E.M. age 72 +/- 1 years) and six young men (24 +/- 1 years). In both age groups, WP-iL and WP-iN were digested faster than CAS (P < 0.001, ANOVA). Proteolysis was inhibited similarly whatever the meal and age groups (P = NS). Protein synthesis was higher with WP-iN than with CAS or WP-iL (P < 0.01), irrespective of age (P = NS). An age-related effect (P < 0.05) was found with postprandial leucine balance. Leucine balance was higher with CAS than with WP-iL (P < 0.01) in young men, but not in elderly subjects (P = NS). In isonitrogenous conditions, leucine balance was higher with WP-iN than with CAS (P < 0.001) in both age groups, but the magnitude of the differences was higher in the elderly men (P = 0.05). In conclusion, during aging, protein gain was greater with WP (rapidly digested protein), and lower with CAS (slowly digested protein). This suggests that a 'fast' protein might be more beneficial than a 'slow' one to limit protein losses during aging.

Validation of bioelectrical impedance analysis in patients with amyotrophic lateral sclerosis.

BACKGROUND: Amyotrophic lateral sclerosis (ALS) is a neurologic disease with an unfavorable prognosis that may be accompanied by malnutrition or overweight. Nutritional status is difficult to evaluate in these patients because of their physical limitations and the asymmetry of their disease involvement. Bioelectrical impedance analysis (BIA), which enables bedside analysis of body compartments, has not been adequately validated for use in patients with ALS. OBJECTIVE: We compared reference measures of fat-free mass (FFM(a)), obtained by dual-energy X-ray absorptiometry, with FFM obtained by BIA and by the skinfold-thickness technique. DESIGN: We measured FFM(a) in 32 ALS patients. Anthropometric measures included weight, height, skinfold thickness, and arm and wrist circumferences. The fat mass obtained from the skinfold-thickness measures enabled us to calculate FFM. BIA was performed by measuring the bioimpedances at 5, 50, and 100 kHz of each side of the body and from one side to the other. FFM was calculated by using the instrument's internal software and by using 3 standard equations. The concordance between the methods was evaluated by the Bland-Altman test. RESULTS: Two of the 16 measured FFM values were not significantly different from FFM(a). However, the risk of dispersion was too high to be acceptable in practice. An equation was then developed by using multivariate analysis, with impedance at 50 kHz. This equation was validated in a second population of 15 ALS patients and with the use of 2 successive measurements performed on 18 patients. CONCLUSION: BIA is a simple technique that is valid for use in ALS patients, both for a single exam measure and for longitudinal monitoring, with the use of an adapted equation and a frequency of 50 kHz.

Influence of the protein digestion rate on protein turnover in young and elderly subjects.

It has long been recognized that numerous dietary parameters, such as the amount and type of protein and nonprotein energy sources, affect protein metabolism. More recently, we demonstrated that the protein digestion rate is an independent factor regulating postprandial protein gain. Indeed, in young men, using a non-steady-state approach and intrinsically labeled milk protein fractions [whey protein (WP) and casein (CAS)] we showed that a slow digested dietary protein (CAS) induced a greater protein gain than a fast one (WP). The mechanisms of this gain also differed according to the protein rate of digestion. WP stimulated amino acid oxidation and protein synthesis without modifying proteolysis, whereas CAS increased amino acid oxidation and protein synthesis to a lesser extent and strongly inhibited proteolysis. These results led to the concept of "slow" and "fast" protein and were confirmed by further experiments during which the meals tested presented different digestion rates but were otherwise identical in terms of amino acid profile. We also analyzed the effects of fat and carbohydrates added to CAS and WP. Our preliminary results suggest that added nonprotein energy sources to CAS and WP attenuated the differences in both the protein digestion rate and protein gain. Finally, and in contrast to young subjects, a "fast" protein may be more beneficial than a "slow" one in elderly subjects, to limit body protein loss. However, long-term studies are needed to confirm this age-related effect.

[Microgravity and weightlessness: experimental model accelerates nutritional pathology]. / Microgravité et apesanteur: modèle expérimental accéléré des pathologies nutritionnelles.

Short space flights affect nutritional intakes, body composition and functional parameters. Prolonged space flights (SF) over weeks or months further worsen these alterations and result in acute or chronic physical deterioration at earth return. Current planning of SF to Mars, with microgravity conditions for more than 2 years, stresses the need for developing and optimising a nutritional program and physical countermeasures to prevent body mass atrophy and functional body alterations. This review presents the models of microgravity simulation on earth and the main effects of weightlessness on body composition, protein metabolism, hormonal profile and muscle function. It summarizes contradictory findings related to the oxidative stress related to SF. It discusses potential countermeasures (nutrition, physical activity) to the negative effects of microgravity on human body. Future research possibilities in ground and space medicine are evoked.

Alterations of sensory perceptions in healthy elderly subjects during fasting and refeeding. A pilot study.

BACKGROUND: Sensory perception losses may contribute to age-related malnutrition by affecting food selection and consumption. OBJECTIVE: To determine the effects of a 36-hour fast followed by a 6-hour refeeding period on sensory perceptions in 7 healthy elderly subjects (65-80 years of age) and 6 healthy young subjects (18-35 years of age). METHODS: Self-perceived hunger and olfactory ratings were recorded on visual analogue scales in response to three different classes of odorant stimuli (salt, sweet and sour). Odorant stimuli were administered three times during the study, twice during the fasting period (12 and 24 h fasted) and once at the end of the re-nutrition period. RESULTS: A significant difference was found between the two groups for the self-perceived hunger ratings in response to the sour stimuli. A significant difference was observed between the two groups for olfactory ratings as regards the salt and sour odorant stimuli. Among the metabolic changes associated with fasting and refeeding, blood glucose was significantly related (r(2) = 0.97, p = 0.001) to the perception of hunger in the control group subjects, but no such relationship was found for the elderly subjects (r(2) = 0.16, p = NS). CONCLUSION: (1) Self-perceived hunger and olfactory ratings are specifically affected in healthy elderly. (2) Nutritional status can modulate sensory perceptions in elderly and young during the transition from fasting to refeeding.

Effect of high altitude on protein metabolism in Bolivian children.

In Bolivia, malnutrition in children is a major health problem that may be caused by inadequate protein, energy, and micronutrient intake; exposure to bacterial and parasitic infections; and life in a multistress environment (high altitude, cold, cosmic radiation, low ambient humidity). However, no data on protein absorption and utilization at high altitude were available. Therefore, we evaluated the effect of altitude on protein metabolism in Bolivian children. We measured protein utilization using leucine labeled with a stable isotope ((13)C) in two groups of healthy prepubertal children matched for age. Group 1 (n = 10) was examined at high altitude (HA) in La Paz (3600 m), and group 2 (n = 10) at low altitude (LA) in Santa Cruz (420 m). The nutritional status did not differ between groups but, as was to be expected, the HA group had higher hemoglobin concentration than the LA group. The children consumed casein that was intrinsically labeled with L-(1-(13)C) leucine and expired (13)CO(2) was analyzed. Samples of expired air were measured by isotope ratio mass spectrometer in Clermont-Ferrand. It was found that cumulative leucine oxidation ((13)CO(2)) at 300 min after ingestion was 19.7 +/- 4.9% at HA and 25.2 +/- 3.2% at LA. These results showed that protein absorption and/or utilization is significantly affected by altitude.

Adaptive response to a low-protein diet in predialysis chronic renal failure patients.

Arandomized, controlled study of 12 patients with mild chronic renal failure was designed to assess the metabolic effects of a low-protein diet supplemented (n = 6) or not (n = 6) with ketoanalogs of amino acids. The protein intake was prescribed so that both groups were isonitrogenous. The dietary survey each month included a 3-d food record and a 24-h urine collection for urea measurement. After a 4- to 6-wk equilibrium period (standard occidental diet, 1.11 g of protein and 32 kcal/kg per d), patients reduced their protein intake to reach 0.71 g of protein/kg per d during the third month. Energy intake was kept constant (31 kcal/kg per d) during the 3-mo period. Compliance to the diet was achieved after 2 mo of training. Leucine turnover measurement was performed before and at the end of the 3-mo low-protein period. There was no clinical change, whereas total body flux decreased by 8% (P < 0.05) and leucine oxidation by 18% (P < 0.05). No difference could be attributed to the ketoanalogs themselves. Thus, under sufficient energy intake, a low-protein diet is nutritionally and metabolically safe during chronic renal failure. The nitrogen-sparing effect of a low-protein diet is still present during mild chronic renal insufficiency.