Basal energy expenditure and diet- induced modifications to thermogenesis in short bowel syndrome.

BACKGROUND & AIM: The influence of food intake on diet-induced thermogenesis, in the absence of parenteral nutrition, has not been assessed in short bowel syndrome (SBS) patients. We studied basal energy expenditure (BEE) and diet-induced thermogenesis in SBS patients (n=8) and paired healthy adult volunteer controls (n=8). METHODS: Energy expenditure was measured by indirect calorimetry (IC) before and after control diet intake. All study participants received oral control diet randomly given in 3 doses (A=1.0, B=1.5 and C=2.0)x1/6 of BEE calories. Bioelectric impedance was assessed. Pairing criteria for controls were: age, sex, body mass index. RESULTS: No significant differences were found between SBS and paired healthy control groups in relation to absolute BEE (P=0.146) and when it was adjusted for body mass index, lean and fat body mass (P=0.861, 0.208 and 0.574, respectively). All diets promoted thermogenesis in both groups. The interaction between the control diet (A, B and C) and SBS and healthy control groups for diet induced thermogenesis presented a significant difference (P=0.026). When comparing groups (SBS vs healthy controls) in relation to the control diet (B and C) we observed: P=0.030 and 0.004, respectively. CONCLUSION: In patients with SBS it was observed that: (1) BEE measured by IC in absolute values or adjusted by lean body mass is similar to healthy control group; (2) Diet-induced thermogenesis was lower than the healthy control group for higher caloric diets (B and C).

[Protective factors for iron deficiency anemia: prospective study in low-income infants]. / Factores de protección para la anemia ferropriva: estudio prospectivo en niños de bajo nivel socioeconómico.

This study was performed to assess both risk and protective factors associated with iron deficiency anemia in 130 infants with age below 24 months, with low socio-economic status and followed since their births by a primary health care program in the city of São Paulo, Brazil. Growth, morbidity and dietary factors were analysed as well as hemoglobin levels (Hb) at regular intervals (6, 9, 12, 18 and 24 months). The portable Hemocue photometer was employed to measure hemoglobin levels and anemia was considered when Hb values were below 11 g/dL. Simple logistic regression was used with socio-economic variables, age group, nutritional status, morbidity, breastfeeding and food intake. Risk factors for anemia in the studied group were intake of cow's milk at 4 months and who has 3 or more old brothers (OR approximately = 2). The protective factors for anemia were age between 18 and 24 months and intake of infant formula, vitamin C, meat and beans at 6 months (OR approximately = 0.5). The prevention of iron deficiency anemia includes encouraging healthy feeding practices starting at 6 months of life.