Effect of protein dose on serum glucose and insulin response to sugars.

To clarify the effects of protein on insulin and glucose response to sugars, 14 healthy normal-weight males and females were fed test meals containing 0, 15.8, 25.1, 33.6, and 49.9 g protein along with approximately 58 g carbohydrate. Serum samples were obtained at fasting time zero and 15, 30, 60, and 120 min postprandial. Mean areas of the glucose curves above fasting decreased with increasing protein dose. Protein-containing meals produced significantly lower (p less than 0.01) areas than the protein-free meal and the relationship between blood glucose area and protein dose was significant (p less than 0.001). Protein-containing meals produced significantly greater (p less than 0.01) insulin areas compared with the protein-free meal. However, no differences in insulin areas among the protein-containing meals were observed. These data support previous studies showing a blood glucose moderating and insulin-enhancing effect of protein ingestion.

Long-term effects of water-soluble dietary fiber in the management of hypercholesterolemia in healthy men and women.

Fifty-one healthy, moderately hypercholesterolemic men and women consuming their usual fat-modified diets completed a 6-month, randomized, double-blind, placebo-controlled, parallel comparison of 15 g/day supplemental water-soluble dietary fiber (WSDF; a mixture of psyllium, pectin, guar gum, and locust bean gum) and an inactive WSDF control (acacia gum). Compliance with the treatments was > 95%, adverse effects were minimal, and body weights remained constant. The WSDF mixture yielded 6.4% and 10.5% reductions in mean plasma total and low-density lipoprotein cholesterol concentrations, respectively, after 8 weeks, which were sustained at 16 and 24 weeks. Mean plasma high-density lipoprotein cholesterol and triglyceride concentrations were unchanged. No significant changes in mean plasma lipid or lipoprotein concentrations were observed in the control group. These data demonstrate that a WSDF approach to cholesterol management is effective as an adjunct to a fat-modified diet in healthy, moderately hypercholesterolemic men and women.

The effects of aerobic conditioning and/or caloric restriction in overweight men and women.

The purpose of this study was to compare the effects of exercise and/or caloric restriction for 12 wk on body composition, maximal aerobic power (VO2max), and serum lipids and lipoproteins in overweight individuals. Forty-eight males and 48 females (means age = 36.6 yr), 120-140% of ideal body weight, were randomly assigned to groups (N = 12 each) of diet-exercise (DE), diet (D), exercise (E), and sedentary control (C). The dietary regimen consisted of 1,200 kcal X d-1, while exercise consisted of 5 d X wk-1 of 30 min of walk/running. For the males, body weight (BW) and fat weight loss in the DE group (-11.8 and 23%, respectively) were significantly greater than in the D group (-9.1 and -18%), with both groups significantly greater than for E and C. In the females, BW and fat weight loss for DE (-10.4 and -24%) were significantly greater than for D (-7.8 and -20%), with both groups significantly greater than E and C. Both DE and D males and females had a decrease in fat-free weight of -4.5 and -2.4%, respectively. In both sexes, the increase in VO2max-BW (ml X kg -1 X min-1) in DE (25%) was significantly greater than for E (15%), D (11%), and C (0%), with differences between E and D nonsignificant. However, increases in absolute VO2max (1 X min-1) and VO2max-fat-free weight (ml X kg-1 X min-1) were similar (P greater than 0.05) for DE and E (14%) but significantly greater compared to D and C (2%).(ABSTRACT TRUNCATED AT 250 WORDS)

Plasma volume expansion with oral fluids in hypohydrated men at rest and during exercise.

BACKGROUND: The purpose for this study was to evaluate various carbohydrate (CHO)-electrolyte fluid formulations for consumption by astronauts to maintain or restore their plasma volume (PV) and total body water (TBW) during and after extravehicular activity (exercise experiment, EE) and for a few hours before reentry and immediately after landing (rest experiment RE). HYPOTHESIS: That fluid formulation electrolyte content would be more important than osmotic (Osm) content for increasing or maintaining PV during the RE and EE. METHODS: In the RE, 5 healthy men (23-44 yr), previously dehydrated for 24 h, drank 6 fluid formulations (Water, 19.6 Na, 157 Na, 19.6 Na + glucose, and the prepared drinks Performances and Power)--one each at weekly intervals, and then sat for 70 min. In the EE, four healthy 24-h dehydrated men (30-46 yr) exercised for 70 min supine on a cycle ergometer (load = 71 +/- 1% peak VO2). RESULTS: Rest: Subjects who consumed formulations with total Osm concentrations nearer the normal range (157 Na - 270 mOsm x kg(-1), Performance with 19.6 mEq x L(-1) Na - 380 mOsm, and to some extent Power with 23.5 mEq x L(-1) Na - 390 mOsm) had the greater increases in PV; intake of drink 157 Na, with the largest Na content, induced the greatest hypervolemia of 7.6% (p < 0.05). The various additional ions, in addition to 19.6 Na, probably contributed to the 4.6% (p < 0.05) hypervolemia with Performance. Water was not effective. Exercise: Stabilization of PV between 15-70 min was not related to drink total CHO, Na or Osm content. Performance and 157 Na were no more effective than 19.6 Na or 19.6 Na + glu for PV stabilization. Water was the least effective. Regulatory mechanisms controlling PV during exercise appear to be independent of oral fluid formulation Osm-electrolyte content. CONCLUSIONS: Drink cation (sodium) content is more important that its total osmotic content for increasing plasma volume at rest. Fluid formulations with greater hypervolemic action in resting subjects may not be as effective during exercise; therefore different formulations for use during exercise appear to be necessary.

Hypervolemia in men from fluid ingestion at rest and during exercise.

BACKGROUND: Plasma osmolality (Osm) is important for controlling and maintaining plasma volume (PV) and body water. The effect of oral rehydration fluids for ameliorating dehydration is well-established; but optimal composition and Osm of fluids for hyperhydrating normally hydrated subjects is less clear. METHODS: Six treatments were used without and with oral fluids of varying ionic and constituent concentrations for hyperhydrating six previously euhydrated men (30 +/- SD 8 yr, 76.84 +/- 16.19 kg, 73 +/- 12 ml.kg-1 PV, 40 +/- 10 ml.min-1.kg-1 peak VO2) sitting at rest for 90 min (VO2 = 0.39 +/- SE 0.02 L.min-1) and during subsequent 70 min of submaximal exercise (VO2 = 2.08 +/- SE 0.33 L.min-1, 70 +/- 7% peak VO2). The hypothesis was that the fluid composition is more important than plasma Osm for increasing PV in euhydrated subjects at rest and maintaining it during exercise. Drink formulation compositions, given at 10 ml.kg-1 body wt, (mean = 768 ml), for the sitting period were: Performance 1 (P1; 55 mEq Na+, 365 mOsm.kg H2O-1), P2 (97 mEq Na+, 791 mOsm.kg-1), P2G (113 mEq Na+, 4% glycerol, 1382 mOsm.kg-1), AstroAde (AA; 164 mEq Na+, 253 mOsm.kg-1), and 01 and 02 (no drinking). The exercise drink (10 ml.kg-1, 768 ml) was P1 for all treatments except 02 (no drinking); thus, drink designations were: P1/P1, P2/P1, P2G/P1, AA/P1, 0/P1, and 0/0. RESULTS: PV at rest increased (p < 0.05) by 4.7% with P1 and by 7.9% with AA. Percent change in PV during exercise was +1% to +3% (NS) with AA/P1; -6% to 0% (NS) with P1/P1, P2/P1, P2G/P1, and 0/P1; and -8% to -5% (p < 0.05) with 0/0. AA, with the lowest Osm of 253 mOsm.kg-1, increased PV at rest (as did P1) and maintained it during exercise, whereas the other drinks with lower Na+ and higher Osm of 365-1382 mOsm.kg-1 did not. CONCLUSION: Drink composition appears to be more important than its Osm for increasing PV at rest and for maintaining it during exercise in previously euhydrated subjects.

Pre-exercise hypervolemia and cycle ergometer endurance in men.

Time to exhaustion at 87-91% of peak VO2 was measured in 5 untrained men (age: 31 +/- 8 years, body mass: 74.20 +/- 16.50 kg, body surface area: 1.90 +/- 0.24 m2, peak VO2: 2.87 +/- 0.40 l min-1, plasma volume: 3.21 +/- 0.88 l; means +/-SD) after consuming nothing (N) or two fluid formulations (10 ml kg-1, 743 +/- 161 ml): Performance 1 (P1), a multi-ionic carbohydrate drink, containing 55 mEq l-1 Na+, 4.16 g l-1 citrate, 20.49 g l-1 glucose, and 365 mOsm kg-1 H2O, and AstroAde (AA), a sodium chloride-sodium citrate hyperhydration drink, containing 164 mEq l-1 Na+, 8.54 g l-1 citrate, <5 mg l-1 glucose, and 253 mOsm kg-1 H2O. Mean (+/-SE) endurance for N, P1 and AA was 24.68 +/- 1.50, 24.55 +/- 1.09, and 30.50 +/- 3.44 min respectively. Percent changes in plasma volume (PV) from -105 min of rest to zero min before exercise were -1.5 +/- 3.2% (N), 0.2 +/- 2.2% (P1), and 4.8 +/- 3.0% (AA; P < 0.05). The attenuated endurance for N and P1 could not be attributed to differences in exercise metabolism (VE, RE, VO2) from the carbohydrate or citrate, terminal heart rate, levels of perceived exertion, forehead or thigh skin blood flow velocity, changes or absolute termination levels of rectal temperature. Thus, the higher level of resting PV for AA just before exercise, as well as greater acid buffering and possible increased energy substrate from citrate, may have contributed to the greater endurance.

Repletion and depletion of serum alpha and beta carotene in humans with carrots and an algae-derived supplement.

A 10-day low-carotene diet phase (LCD), followed by a 7-day treatment phase (TP) and then another LCD, was adhered to by 32 adult human subjects. Serum alpha carotene (SAC) and serum beta carotene (SBC) levels were examined using HPLC and found to have decreased 44.7% and 35.8% respectively in the first LCD. Alpha and beta carotene, from algae-derived capsules and raw carrots, significantly increased SAC and SBC levels during the TP. Half-lives of SAC and SBC averaged 7.8 days and 12.4 days respectively during the two LCD. Serum vitamin A remained unchanged throughout the study.

The effect of acacia gum and a water-soluble dietary fiber mixture on blood lipids in humans.

Water-soluble dietary fibers (WSDF) are generally thought to lower cholesterol. This study compared the cholesterol-lowering effects of a medium viscosity WSDF mixture (psyllium, pectin, guar gum and locust bean gum) with an equal amount of WSDF from acacia gum, which has a lower viscosity. Hypercholesterolemic males (n = 13) and females (n = 16) were randomly assigned to one of two WSDF treatments provided in a low-calorie powder form for mixing into beverages (< 4 kcal/serving). Subjects were instructed to mix powders into their usual beverages and to consume them three times daily (5 g WSDF/serving) for 4 weeks while consuming their typical fat-modified diets. Exercise and body weights were also held constant. The WSDF mixture yielded a 10% decrease in plasma total cholesterol (from 251 +/- 20 to 225 +/- 19 mg/dL; p < 0.01), and a 14% reduction in low-density lipoprotein cholesterol (from 167 +/- 14 to 144 +/- 14 mg/dL; p < 0.001). No significant changes in plasma high-density lipoprotein cholesterol, very-low-density lipoprotein cholesterol or triglycerides were observed. In contrast, the acacia gum-treated group showed no change in any plasma lipid parameters. The WSDF treatments did not produce significant changes in mean dietary intakes within or between treatment groups. These data support previous findings that a diet rich in select WSDF can be a useful cholesterol-lowering adjunct to a fat-modified diet, but that caution should be exercised in ascribing cholesterol-lowering efficacy to dietary fibers based solely on their WSDF classification. Finally, WSDF viscosity is a potential cholesterol-lowering factor to be explored further.

Eosinophilic oesophagitis: a novel treatment using Montelukast.

BACKGROUND: Eosinophilic oesophagitis is a rarely diagnosed condition involving eosinophil infiltration of the oesophageal mucosa and creating significant symptoms of dysphagia. Failure to diagnose this disorder relates to reluctance to biopsy an apparently normal oesophagus. This is essential for histological diagnosis. To date, treatment success has been achieved only with corticosteroids. We describe here the use of an eosinophil stabilising agent Montelukast for the symptomatic relief of these patients. PATIENTS AND METHODS: Twelve patients have been identified with this condition in our unit since 1995, after thorough investigation of their dysphagia. We commenced eight of these patients on the leukotriene receptor antagonist Montelukast to symptomatically improve their swallowing while avoiding the use of long term corticosteroids. RESULTS: Many of these patients had been previously misdiagnosed, and therefore inappropriately and unsuccessfully treated for an extensive period prior to referral to our unit. All patients were unresponsive to acid suppression therapy alone but showed improvement in their swallowing on Montelukast. Six of eight reported complete subjective improvement, five patients remaining completely asymptomatic on a maintenance regimen. CONCLUSIONS: Eosinophilic oesophagitis is a disease that is often misdiagnosed due to lack of awareness and reluctance of clinicians to biopsy an apparently normal oesophagus in dysphagic patients, and therefore obtain a histological diagnosis. Investigation of these patients adds further evidence to this condition being a separate pathological state from gastro-oesophageal reflux and eosinophilic enteritis. Montelukast has been found to be of significant help in the symptomatic control of these patients while avoiding long term corticosteroids use.

Multivitamin-mineral supplementation: effects on blood chemistries of college-age women.

Forty-two female college students, age 18-29 yr. and consuming nutritionally balanced meals in the college cafeteria participated. Subjects discontinued all vitamin-mineral supplements (VMS) for 17 days and were randomly assigned to one of two treatments, either a placebo, or VMS supplying the United States Recommended Daily Allowance (USRDA) of all vitamins, zinc, iron, iodine, copper, and 60% of the USRDA of calcium, 50% of magnesium and 45% of phosphorus. Treatments were consumed for 77 days. Fasting pre-and post-treatment blood chemistries were compared. VMS yielded significant increases (p less than 0.05) in serum vitamin B-12 (+25.05 pg/ml), vitamin C (+0.35 mg/dl) and folate (+7.40 ng/ml). No significant changes (p greater than 0.05) in hematological or other blood chemistries were observed. Significant decreases in the number of below-normal serum indicators of vitamin status (p less than 0.05) and iron status (p less than 0.005) were seen with VMS. No significant changes were seen with placebo (p greater than 0.05).

Effect of increasing levels of hard wheat fiber on fecal weight, minerals and steroids and gastrointestinal transit time in healthy young women.

Hard red wheat bran (HRWB) baked in a yeast-leavened bread was fed to 36 healthy young college women consuming a basal diet of traditional foods, which contained 15 +/- 3 g/d dietary fiber (DF). Three levels of HRWB were added supplying, respectively, 5.7, 17.1 and 28.5 g/d DF; an additional treatment group did not receive any HRWB. Fecal collections were carried out in the last 5 d of treatment. Fecal wet weight, fecal dry weight and fecal ash increased significantly for each increase in HRWB (P less than 0.05). Fecal dry matter percent changed significantly only at the highest level of HRWB (P less than 0.05). After accounting for the minerals in the HRWB, there was an increased fecal loss of Ca, but not of Zn, Cu, Fe or Mg compared to the women fed no HRWB. HRWB at a level of 17.2 g/d induced faster transit times (TT) than no HRWB and 66 g/d HRWB induced faster TT than either 17.2 or 39.6 g/d HRWB (P less than 0.05). Total daily fecal steroids were not altered by changes in HRWB. Daily total bile acid excretion increased significantly (P less than 0.05) at the two higher levels of HRWB due primarily to higher excretion of chenodeoxycholic acid.