[Investigation of the nutritional status of the elderly for the development of guidelines for nutritional management in the ultra-aged society].

AIM: This study was conducted to evaluate the nutrient intake and the nutritional state of elderly people who live independently in a region with an aging rate (percentage of the elderly 65 or above to the entire population) of 50% and to develop guidelines for nutritional improvement to extend the healthy lifespan in the upcoming ultra-aged society in which, by definition, aging rate exceeds 21%. METHODS: The study investigated the diet, physical constitution and blood biochemistry of 38 elderly people living in a region with an aging rate of 50% and compared the results with 23 elderly people living in a region with an aging rate of 18%. RESULTS: In the ultra-aged region the elderly people had a tendency for serum, triglyceride to be high and calcium to be low. The rate of the elderly living alone was high and the solitary elderly tended to have poor intake of vegetable fats, albumin, iron and zinc. The elderly men in the ultra-aged region had the lowest rate of recommended dietary intakes of calcium and vitamin B1. CONCLUSIONS: The results indicated that extending a healthy lifespan in an ultra-aged society requires less intake of animal fats and more intake of vitamin B1 and calcium and a close assessment of the nutritional state of zinc, iron, and selenium. In order to prevent lifestyle-related diseases and to extend healthy life expectancy, the nutrition management of the elderly living alone is particularly important

Beneficial effects of n-9 eicosatrienoic acid on experimental bowel lesions.

PURPOSE: Dietary fortification of n-9 polyunsaturated fatty acids (PUFA) or 5,8,11-eicosatrienoic acid (ETrA) as well as n-3 PUFA might contribute to the suppression of leukotriene B4 (LTB4) synthesis and thereby reduce inflammatory bowel lesions. As a result, the effect of an ETrA-enriched diet on experimental bowel lesions was examined in this study. METHODS: In Expt. 1, rats were freely fed either an ETrA-enriched or a standard diet. After 7 days of feeding, acute bowel lesions were induced by the subcutaneous injection of 10 mg/kg indomethacin. In Expt. 2, chronic bowel lesions were made by performing subcutaneous injections of 7.5 mg/kg indomethacin twice. After the first injection, the rats were freely fed either an ETrA-enriched or a standard diet for 7 days. RESULTS: In both experiments, the rats fed an ETrA-enriched diet showed increased levels of ETrA in the plasma and intestinal mucosa, and a decreased inflammation score. However, there was no significant decrease in plasma and intestinal mucosal LTB4 in the ETrA-enriched diet-fed rats. CONCLUSION: These results suggest that the dietary supplementation of ETrA may have both prophylactic and therapeutic effects on experimentally produced bowel lesions. Further investigations are necessary to clarify the effects of ETrA on bowel lesions and its mechanisms.

Effects of isolated small bowel transplantation on liver dysfunction caused by intestinal failure and long-term total parenteral nutrition.

It has not been fully determined whether isolated small bowel transplantation (ISBTx) can reverse liver dysfunction caused by intestinal failure requiring long-term total parenteral nutrition (TPN). A boy with congenital microvillus inclusion disease presented with vomiting and severe diarrhea since the first day of life and had been managed by TPN since then. He suffered from catheter-related sepsis several times. At 14 yr of age he developed progressive hepatosplenomegaly with thrombocytopenia and coagulopathy. He underwent ISBTx with an ileal graft from his blood-identical grandmother at the age of 16 yr. Oral feeding was started on the 14th day after ISBTx and gradually increased. TPN was completely withdrawn after 5 months. Liver was palpated 5 cm below the costal margin before ISBTx, while it became non-palpable 5 months after ISBTx. Serum liver enzyme levels and prothrombin time normalized in the 5 months following ISBTx. Liver biopsy showed marked steatosis, slight cholestasis, and mild bridging fibrosis before ISBTx. Although histological examination of liver biopsy revealed complete disappearance of steatosis 7 and 11 months after ISBTx, liver fibrosis remained unchanged. This clinical experience has shown that although steatosis and cholestasis are reversible after successful ISBTx and withdrawal of TPN, liver fibrosis may remain unchanged.

Evaluation of indexes of in vivo manganese status and the optimal intravenous dose for adult patients undergoing home parenteral nutrition.

BACKGROUND: There are no accurate indexes for determining the status of manganese in humans, and there is no clear recommended daily dose of this essential trace element to be administered in total parenteral nutrition solutions. OBJECTIVE: The objectives were to evaluate accurate indexes of manganese status and elucidate the optimal manganese dose to be administered to adult patients undergoing home parenteral nutrition. DESIGN: Patients were administered total parenteral nutrition solutions providing 0, 1, 2, or 20 micromol Mn/d according to an on-off design, after which manganese concentrations in whole blood and plasma were determined. Magnetic resonance imaging (MRI) was performed to determine the intensity on T(1)-weighted images (MRI intensity) and T(1) values in the globus pallidus. Hematologic and biochemistry tests were also performed. RESULTS: High degrees of correlation were found between whole-blood manganese concentrations and both MRI intensity (r = 0.7728) and T(1) values (r = -0.7519) in the globus pallidus. A strong negative correlation was found between MRI intensity and T(1) values (r = -0.8407). The dose of 1 micromol Mn/d caused no change in MRI intensity or T(1) values, and the whole-blood manganese concentration remained within the normal range in all patients. CONCLUSIONS: Whole-blood manganese concentrations and MRI intensity and T(1) values in the globus pallidus are useful indexes of the status of manganese in humans. The optimal dose of manganese may be 1 micromol/d for adult patients undergoing home parenteral nutrition.