A Cross-sectional Study of Nutritional Status, Diet, and Dietary Restrictions Among Persons With an Ileostomy or Colostomy.

Little is known about the nutritional status and dietary habits of persons with an intestinal stoma, and no specific dietary guidelines have been established. A cross-sectional study was conducted among patients of a Stoma Patient Health Care Service in Juiz de Fora, Brazil, to compare the nutritional status of persons with an ileostomy or colostomy and to evaluate which foods are avoided most frequently and why. Anthropometric measurements (weight, height, arm circumference, and triceps and subscapular skinfold thickness) and body fat were assessed. Habitual dietary intake (energy, protein, carbohydrate, fiber, fat, calcium, iron, sodium, potassium, thiamin, riboflavin, vitamin B6, vitamin B3 [niacin], and vitamin B12) was assessed using a validated quantitative food frequency questionnaire. Foods avoided and reasons for avoidance (increased odor, increased gas, increased output, constipation, appliance leakage, and feelings regarding leaving home) were assessed. All data were collected without personal identifiers and stored in electronic files. Data were analyzed descriptively, and the Student's t test or Mann-Whitney test was used to compare the groups. Chi-squared analysis with Yates' continuity correction or Fisher's exact test was employed to examine the differences in the frequency of avoided foods by reasons for avoidance between the 2 groups. Of the 103 participants (52 [50.5%] men, 51 [49.5%] women; mean age 60.5 ± 12.9 years); 63 (61.2%) had a colostomy and 40 (38.8%) had an ileostomy. For both groups combined, time since surgery ranged from 1 to 360 months. Anthropometric measurements and body composition did not suggest nutritional deficiencies and did not differ significantly between groups. Persons with an ileostomy had a significantly lower fat and niacin intake than persons with a colostomy (P <.05). No other dietary intake differences were observed. Avoiding foods due to appliance leakage was more common among participants with an ileostomy (8, 20%) than a colostomy (3, 4.8%), and vegetables and fruits were reported as the most problematic foods. None of the other cited reasons was significantly different. The results of this study confirm that many persons with a stoma adjust their dietary intake and avoid certain foods which, especially in persons with an ileostomy, may increase their risk for nutritional deficiencies. Additional research to assess dietary intake and nutritional status variables as well as patient needs is needed to facilitate the development of specific nutritional status monitoring and dietary recommendations for persons with an ileostomy or colostomy.

High-oleic peanuts: new perspective to attenuate glucose homeostasis disruption and inflammation related obesity.

OBJECTIVE: To evaluate the effects of acute and daily consumption of high-oleic peanuts (HOP) on inflammation and glucose homeostasis in overweight/obese men. METHODS: In a 4-week randomized clinical trial, males with body mass index of 29.8 ± 2.3 kg/m(2) and aged 18-50 years were assigned to the groups: control (CT, n = 22); conventional peanuts (CVP, n = 22); or HOP (n = 21). They followed a hypocaloric-diet with or without 56 g/day of CVP or HOP. Main outcomes were changes in fasting blood biomarkers and postprandial insulin, glucose, tumor necrosis factor-alfa (TNF-α), and interleukin-10 (IL-10) responses after acute peanut intake. RESULTS: At baseline, HOP showed significantly lower postprandial responses of glucose, insulin, and TNF-α than CVP and CT. Changes in fasting blood biomarkers did not differ between groups after the 4-week intervention. However, within groups, total cholesterol decreased in CT, and all groups reduced High-density lipoprotein (HDL-c). Triglycerides were reduced in HOP and CVP. IL-10 increased significantly in all groups while only the CT and CVP showed increased TNF-α after intervention. CONCLUSION: Acute high-oleic peanut consumption leads to stronger moderation of postprandial glucose, insulin, and TNF-α concentrations than CVP and control meal intake. Whether daily intake of high-oleic peanuts has additional benefits to CVP remains uncertain.

High-oleic peanuts increase diet-induced thermogenesis in overweight and obese men.

BACKGROUND: Evidences suggest that nuts consumption can improve energy metabolism. PURPOSE: This study aimed to compare the effects of acute ingestion of high-oleic and conventional peanuts on appetite, food intake, and energy metabolism in overweight and obese men. METHODS: Seventy one subjects (29.8 ± 2.4 kg/m2) were assigned to the groups: control (CT, n = 24); conventional peanuts (CVP, n = 23); high-oleic peanuts (HOP, n = 24). Subjects consumed 56 g of peanuts (CVP and HOP) or control biscuits (CT) after overnight fasting. Thereafter, energy metabolism was evaluated over 200 minutes, during which diet-induced thermogenesis (DIT) and substrate oxidation were analyzed. Appetite sensation was recorded for 3 hours. Statistical analyses were performed using the SAS software considering 5% as the significance level. RESULTS: Postprandial energy expenditure and DIT were significantly higher in HOP than in CVP. Substrate oxidation did not differ between groups. Only HOP presented score below 100 indicating incomplete compensation. CT and CVP showed a complete caloric compensation (scores > 100). Regarding appetite sensation, CVP group felt less "full" than HOP and CT. After 3 hours, satiety score of CVP returned to baseline, whereas HOP and CT remained significantly higher. Hunger scores returned to baseline in CVP and CT and they were maintained significantly lowered in HOP. CONCLUSION: High-oleic peanuts contributed to higher DIT, higher sensation of fullness and incomplete compensation for energy intake compared to conventional peanuts and may be useful to dietary intervention to reduce body weight.

Antecedentes: Las pruebas sugieren que el consumo de frutos secos puede mejorar el metabolismo energético. Propósito: Este estudio tenía por finalidad comparar los efectos de la ingesta aguda de cacahuetes con alto contenido en oleico y cacahuetes convencionales sobre el apetito, el consumo de alimentos y el metabolismo energético in hombres con sobrepeso y obesos. Métodos: Se distribuyó a 71 individuos (29,8 ± 2,4 kg/m2) a los grupos: control (CT, n = 24); cacahuetes convencionales (CVP, n = 23); cacahuetes con alto contenido en oleico (HOP, n = 24). Los individuos consumieron 56 g de cacahuetes (CVP y HOP) o control (CT) tras un ayuno nocturno. Posteriormente, se evaluó el metabolismo energético a lo largo de 200 minutes, durante los cuales se analizaron la termogénesis inducida por la dieta (TID) y la oxidación de sustratos. La sensación de apetito se registró durante 3 horas. Se realizaron los análisis estadísticos con el programa SAS considerando un nivel de significación del 5%. Resultados: El consumo de energía posprandial y la TID fueron significativamente superiores en el HOP que el CVP. La oxidación de sustratos no difirió entre los grupos. Sólo el HOP presentó una puntuación por debajo de 100, lo que indicaba una compensación incompleta. El CT y el CVP mostraron una compensación calórica completa (puntuaciones > 100). Con respecto a la sensación de apetito, el grupo CVP se mostró menos "lleno" que los grupos HOP y CT. A las 3 horas, la puntuación de saciedad del CVP volvió a la situación basal, mientras que en los grupos HOP y CT permanecía significativamente superior. Las puntuaciones de hambre volvieron a la situación basal in los grupos CVP y CT y se mantuvieron significativamente por debajo a las del grupo HOP. Conclusión: Los cacahuetes con alto contenido en oleico contribuyen a una mayor TID, mayor sensación de plenitud y una compensation incompleta del consumo de energía en comparación con los cacahuetes convencionales y pueden ser de ayuda como intervention dietética para disminuir el peso corporal.

Intestinal permeability measurements: general aspects and possible pitfalls.

INTRODUCTION: Disturbances of the gut barrier function have been related to a variety of diseases, including intestinal and extra-intestinal diseases. The intestinal permeability tests are considered useful tools for evaluating disease severity and to follow-up patients after a therapeutic intervention and indirectly assess barrier function. OBJECTIVE: The aims of this review were to highlight the possible factors underlying higher intestinal permeability and the clinical conditions that have been associated with this in different age range; and also provide some insight into methodological aspects. RESULTS AND DISCUSSION: Abnormal regulation of tight junction function is the main cause of altered intestinal barrier. The impaired barrier function results in higher permeation rates of administered probes through the intestinal mucosa. Lactulose and mannitol are one of the most commonly used probes. The innocuousness and easiness of intestinal permeability tests can be explored to expand the knowledge about the clinical situations in which intestinal barrier dysfunction can be an important feature. Many factors may influence the results of the test. Researchers and healthcare professionals should try to circumvent the possible pitfalls of the intestinal permeability tests to produce consistent evidences. The use of others markers of intestinal physiology may also contribute to understand the role of barrier function in different diseases.

Introducción: Alteraciones funcionales de la barrera intestinal se han relacionado con una variedad de enfermedades intestinales y también con enfermedades no intestinales. Las pruebas de permeabilidad intestinal son consideradas herramientas útiles para evaluar la gravedad de la enfermedad para el posterior seguimiento de los pacientes después de una intervención terapéutica. Objetivo: El objeto de esta revisión ha sido destacar los posibles factores que pueden estar asociados a una mayor permeabilidad intestinal y revisar condiciones clínicas que han sido asociadas en individuos de diferentes edades. También revisar ciertos aspectos metodológicos de las pruebas de permeabilidad intestinal. Resultados y discusión: Las uniones estrechas entre los enterocitos son las principales estructuras encargadas de la regulación de la barrera intestinal. Una alteración de éstas, resulta en una deficiencia en la permeabilidad intestinal y una mayor penetración de las sustancias marcadoras de permeabilidad intestinal. La lactulosa y el manitol son las sustancias marcadoras más utilizadas. La inocuidad y facilidad de los test de permeabilidad han sido de ayuda para explorar y ampliar el conocimiento de muchas condiciones clínicas en las que la disfunción de la barrera intestinal ha sido un sello distintivo. Muchos factores pueden influir en los resultados de los test de permeabilidad. Sin embargo, los investigadores y los clínicos han de tratar de eludir los posibles inconvenientes de las pruebas de permeabilidad intestinal para poder producir evidencias más consistentes. El uso de otras sustancias marcadoras de la fisiología intestinal también puede contribuir a comprender mejor el papel de la barrera intestinal en diferentes enfermedades.