The Impact of Bariatric Surgery on Nitrogen Balance at Six months Post-surgery.

PURPOSE: Obesity, defined as abnormal or excessive fat accumulation that presents a risk to health, rose from 8.6 to 10.5% in Singapore's residents. Bariatric surgery, the primary treatment for severe obesity, induces fat and muscle loss. Adequate protein intake is vital for preventing muscle loss. This study examines nitrogen balance in individuals with obesity pre- and post-surgery. MATERIALS AND METHODS: Sixteen participants with severe obesity (BMI ≥ 32.5 kg/m2) undergoing bariatric surgery (14 sleeve gastrectomy, 2 Roux-en-Y gastric bypass) and 20 normal-weight controls (BMI < 25 kg/m2) were recruited. Nitrogen balance, calculated from dietary protein intake and urine nitrogen excretion, was assessed. Participants with obesity were re-evaluated 6 months post-surgery. Data were analyzed using parametric methods. RESULTS: At baseline, controls had a BMI of 20.8 ± 2.1 kg/m2; those with obesity had 40.9 ± 7.3. Daily calorie and protein intake for participants with obesity were not statistically significantly different from controls (calorie intake at 1467 ± 430 vs. 1462 ± 391 kcal, p = 0.9701, protein intake 74.2 ± 28.7 vs. 64.6 ± 18.3 g, p = 0.2289). Post-surgery, BMI, fat-free mass, fat mass, total energy intake, carbohydrate, and protein intake decreased significantly (p < 0.01). Protein oxidation and urine nitrogen excretion did not change after bariatric surgery. However, nitrogen balance significantly reduced from 2.62 ± 5.07 to - 1.69 ± 5.07 g/day (p = 0.025). CONCLUSION: Dietary protein intake is inadequate in individuals with obesity at 6 months post-bariatric surgery and contributes to a state of negative nitrogen balance.

Decreased renal function increases the nighttime urine volume rate by carryover of salt excretion to the nighttime.

To determine the pathophysiology of nocturnal polyuria associated with renal dysfunction, patients who underwent laparoscopic nephrectomy were prospectively studied. The diurnal variation in urine volume, osmolality, and salt excretion were measured on preoperative day 2 and postoperative day 7. The factors associated with an increase in the nighttime urine volume rate with decreased renal function were evaluated using multiple linear regression analysis. Forty-nine patients were included. The estimated glomerular filtration rate decreased from 73.3 ± 2.0 to 47.2 ± 1.6 mL/min/1.73 m2 (P < 0.01) and the nighttime urine volume rate increased from 40.6% ± 2.0% to 45.3% ± 1.5% (P = 0.04) with nephrectomy. The nighttime urine osmolality decreased from 273 ± 15 to 212 ± 10 mOsm/kg and the nighttime salt excretion rate increased from 38.7% ± 2.1% to 48.8% ± 1.7% (both P < 0.01) with nephrectomy. Multiple linear regression analysis showed that the increase in the nighttime urine volume rate was strongly affected by the increase in the nighttime salt excretion rate. A decrease in renal function causes an increase in the nighttime urine volume rate, mainly because of an increase in nighttime salt excretion.Trial registration number: UMIN000036760 (University Hospital Medical Information Network Clinical Trials Registry).Date of registration: From 1 June 2019 to 31 October 2020.

Validity Coefficient of Repeated Measurements of Urinary Marker of Sugar Intake Is Comparable to Urinary Nitrogen as Marker of Protein Intake in Free-living Subjects.

BACKGROUND: Studies do not show consistent relationships between self-reported intake of sugar and outcome of disease. To overcome the drawbacks of self-reported intake methods, we investigated whether there is an agreement in ranking of individuals between their self-reported sugar intake and urinary sucrose and fructose. METHODS: We used data of 198 Dutch adults (106 women) from the DUPLO study. Sugar intake of all foods and drinks consumed over 24-hour period was estimated by collecting duplicate portions (DP) and 24-hour recalls (24hR), telephone (24hRT) and Web-based (24hRW), while sugar excretion was based on 24-hour urine samples. Sugar content of 24hR was calculated using a newly developed sugar database and sugar content of DPs and urine samples was calculated using high-performance liquid chromatography-atomic emission spectrometry and LC/MS-MS, respectively. Measurement error models assessed validity coefficients (VC) and attenuation factors (AF). Coefficients were compared with those of protein biomarker. RESULTS: The VC for the marker, using DP as reference, showed comparability with substantially better ranking of participants (0.72 for women and 0.93 for men), than 24hRT (0.57 and 0.78) or 24hRW (0.70 and 0.78) as reference in the sucrose models. The VC of the sucrose models was within 10% of the protein models, except for the model with 24hRT as reference, among women. The AF started at higher values and increased by a greater factor compared with the VC. CONCLUSIONS: Repeated measurements of urinary sucrose and fructose as a marker of daily sucrose intake had a ranking performance comparable to urinary nitrogen as marker of protein intake in free-living Dutch adults. IMPACT: The validation of the sugar biomarker in a free-living population with three different dietary assessment methods and its comparable ranking ability with a good recovery biomarker (i.e., protein biomarker) have important research applications. The biomarker may be used for validating dietary assessment methods, for monitoring compliance in human feeding studies, for monitoring the effect of public health interventions, and as a surrogate for ranking subjects according to sucrose intake when information on sucrose in food composition databases is lacking.

Trichostrongylus colubriformis infection in Santa Inês lambs: impact on feed digestibility, blood markers, and nitrogen balance / Infecção por Trichostrongylus colubriformis em cordeiros Santa Inês: impacto na digestibilidade dos alimentos, marcadores sanguíneos e balanço de nitrogênio

Abstract This study aimed to evaluate the effects of Trichostrongylus colubriformis infection on the hemato-biochemical parameters, feed digestibility, and nitrogen balance in Santa Inês lambs. Eighteen three-month-old Santa Ines castrated male lambs (16.9 ± 1.43 kg of body weight) were randomly distributed in two experimental treatments: infected with T. colubriformis (I, n = 9) and uninfected (U, n = 9). The I group received a total of 45,000 L3 larvae of T. colubriformis (5,000 infective larvae, three times per week, for three weeks). During the experimental period, blood, feed digestibility, and nitrogen balance were evaluated. The I lambs showed a reduction in erythrocytes, hemoglobin, hematocrit, mean corpuscular volume, and total proteins, as well as an increase in platelets and eosinophils compared to those in the U group (p < 0.05). With the exception of total protein content, these values were within the normal range for the species. Furthermore, lower dry matter and organic matter digestibility were observed in the I lambs (p = 0.08). The present findings highlight that T. colubriformis infection has the potential to impair some hemato-biochemical parameters as well as feed digestibility in lambs, which could affect their productivity.

Resumo O objetivo deste estudo foi avaliar os efeitos da infecção por Trichostrongylus colubriformis nos parâmetros hemato-bioquímicos, digestibilidade aparente dos nutrientes e balanço de nitrogênio de cordeiros Santa Inês. Dezoito cordeiros Santa Inês, de três meses de idade e castrados (16,9 ± 1,43 kg de peso corporal), foram distribuídos aleatoriamente em dois tratamentos experimentais: infectados com T. colubriformis (I, n = 9) e não infectados (U, n = 9). O grupo I recebeu um total de 45.000 larvas L3 de T. colubriformis (5.000 larvas infectantes, três vezes por semana, durante três semanas). Durante o período experimental, foram avaliadas as variáveis sanguíneas, digestibilidade e balanço de nitrogênio. Os cordeiros I apresentaram redução de eritrócitos, hemoglobina, hematócrito, volume corpuscular médio e proteínas totais, além de aumento de plaquetas e eosinófilos, quando comparados ao grupo U (p< 0,05). Contudo, exceto para proteínas totais, os valores estavam dentro do intervalo normal para a espécie. Além disso, a digestibilidade da matéria seca e da matéria orgânica foi menor no grupo I de cordeiros (p = 0,08). Os presentes achados destacam que a infecção por T. colubriformis teve potencial para prejudicar alguns parâmetros hemato-bioquímicos, bem como a digestibilidade aparente da dieta, o que poderia afetar a produtividade dos cordeiros.

Nitrogen balance after a single oral consumption of sacha inchi (Plukenetia volúbilis L.) protein compared to soy protein: a randomized study in humans.

Sacha inchi is a seed produced in the Peruvian Amazonian and its oil is recognized by the lowering lipids effect in humans. The remaining material transformed to flour has a higher amount of protein, but, the nitrogen balance once ingested orally has not been studied. The present study was designed to evaluate the nitrogen balance after single consumption of 30 g of sacha inchi flour and compared with that obtained after consumption of 30 g soybean flour in adult men and women. This was a double-blind cohort study in 15 men and 15 women between 18 and 55 years old. Fifteen subjects received soy meal and 15 subjects received sacha inchi meal. Group receiving sacha inchi flour has comparable initial parameters as those receiving soybean flour (p > 0.05). Blood samples at different times were obtained. Urine for 24 h was collected to calculate nitrogen balance, p < 0.05 was considered significant. Plasma insulin levels increased post-prandial with a peak at 30 min. Thereafter, a reduction occurred. The magnitude of changes in insulin levels was similar in sacha inchi and soybean groups (p < 0.05). Lipid profile and inflammatory marker, C-reactive protein (CRP) and interleukin 6 (IL6) was not different at 0 or 24 h after sacha inchi or soy flour administration. The nitrogen balance was negative in the study but similar between both groups (p > 0.05). In conclusion, protein consumption of sacha inchi flour has the same nitrogen balance as soybean flour, shows acceptability for a single consumption and does not present serious adverse effects.

Influence of milk processing temperature on growth performance, nitrogen retention, and hindgut's inflammatory status and bacterial populations in a calf model.

This research communication describes a study aimed at evaluating the effects of heat treatment of milk on growth performance, N retention, and hindgut's inflammatory status and bacterial populations using young dairy calves as a model. Twenty-one Holstein calves were randomly allocated to one of three treatments: raw milk (RM), pasteurised milk (PAST), or UHT milk (UHT). Calves were submitted to a N balance study, and a biopsy from the distal colon and a faecal sample were obtained from 5 animals per treatment to determine expression of several genes and potential changes in the hindgut's bacterial population. Milk furosine content was 33-fold greater in UHT than in RM and PAST milks. Calves receiving RM grew more than those fed UHT, and urinary N excretion was greatest in calves fed UHT. Quantification of Lactobacillus was lower in calves consuming PAST or UHT, and Gram negative bacteria were greater in UHT than in PAST calves. The expression of IL-8 in the hindgut's mucosa was lowest and that of IL-10 tended to be lowest in RM calves, and expression of claudin-4 tended to be greatest in UHT calves. In conclusion, the nutritional value of UHT-treated milk may be hampered because it compromises growth and increases N excretion in young calves and may have deleterious effects on the gut's bacterial population and inflammation status.

Potential therapeutic interventions for chronic kidney disease-associated sarcopenia via indoxyl sulfate-induced mitochondrial dysfunction.

BACKGROUND: Chronic kidney disease (CKD) patients experience skeletal muscle wasting and decreased exercise endurance. Our previous study demonstrated that indoxyl sulfate (IS), a uremic toxin, accelerates skeletal muscle atrophy. The purpose of this study was to examine the issue of whether IS causes mitochondria dysfunction and IS-targeted intervention using AST-120, which inhibits IS accumulation, or mitochondria-targeted intervention using L-carnitine or teneligliptin, a dipeptidyl peptidase-4 inhibitor which retains mitochondria function and alleviates skeletal muscle atrophy and muscle endurance in chronic kidney disease mice. METHODS: The in vitro effect of IS on mitochondrial status was evaluated using mouse myofibroblast cells (C2C12 cell). The mice were divided into sham or 5/6-nephrectomized (CKD) mice group. Chronic kidney disease mice were also randomly assigned to non-treatment group and AST-120, L-carnitine, or teneligliptin treatment groups. RESULTS: In C2C12 cells, IS induced mitochondrial dysfunction by decreasing the expression of PGC-1α and inducing autophagy in addition to decreasing mitochondrial membrane potential. Co-incubation with an anti-oxidant, ascorbic acid, L-carnitine, or teneligliptine restored the values to their original state. In CKD mice, the body and skeletal muscle weights were decreased compared with sham mice. Compared with sham mice, the expression of interleukin-6 and atrophy-related factors such as myostatin and atrogin-1 was increased in the skeletal muscle of CKD mice, whereas muscular Akt phosphorylation was decreased. In addition, a reduced exercise capacity was observed for the CKD mice, which was accompanied by a decreased expression of muscular PCG-1α and increased muscular autophagy, as reflected by decreased mitochondria-rich type I fibres. An AST-120 treatment significantly restored these changes including skeletal muscle weight observed in CKD mice to the sham levels accompanied by a reduction in IS levels. An L-carnitine or teneligliptin treatment also restored them to the sham levels without changing IS level. CONCLUSIONS: Our results indicate that IS induces mitochondrial dysfunction in skeletal muscle cells and provides a potential therapeutic strategy such as IS-targeted and mitochondria-targeted interventions for treating CKD-induced muscle atrophy and decreased exercise endurance.

Estimation of Benchmark Dose of Lifetime Cadmium Intake for Adverse Renal Effects Using Hybrid Approach in Inhabitants of an Environmentally Exposed River Basin in Japan.

The aim of this study is to estimate the reference level of lifetime cadmium intake (LCd) as the benchmark doses (BMDs) and their 95% lower confidence limits (BMDLs) for various renal effects by applying a hybrid approach. The participants comprised 3,013 (1,362 men and 1,651 women) and 278 (129 men and 149 women) inhabitants of the Cd-polluted and nonpolluted areas, respectively, in the environmentally exposed Kakehashi River basin. Glucose, protein, aminonitrogen, metallothionein, and ß2 -microglobulin in urine were measured as indicators of renal dysfunction. The BMD and BMDL that corresponded to an additional risk of 5% were calculated with background risk at zero exposure set at 5%. The obtained BMDLs of LCd were 3.7 g (glucose), 3.2 g (protein), 3.7 g (aminonitrogen), 1.7 g (metallothionein), and 1.8 g (ß2 -microglobulin) in men and 2.9 g (glucose), 2.5 g (protein), 2.0 g (aminonitrogen), 1.6 g (metallothionein), and 1.3 g (ß2 -microglobulin) in women. The lowest BMDL was 1.7 g (metallothionein) and 1.3 g (ß2 -microglobulin) in men and women, respectively. The lowest BMDL of LCd (1.3 g) was somewhat lower than the representative threshold LCd (2.0 g) calculated in the previous studies. The obtained BMDLs may contribute to further discussion on the health risk assessment of cadmium exposure.

Renal Protective Effect of Probucol in Rats with Contrast-Induced Nephropathy and its Underlying Mechanism.

BACKGROUND: Contrast-induced nephropathy (CIN) refers to acute renal damage that occurs after the use of contrast agents. This study investigated the renal protective effect of probucol in a rat model of contrast-induced nephropathy and the mechanism of its effect. MATERIAL AND METHODS: Twenty-eight Wistar rats were randomly divided into the control group, model group, N-acetylcysteine(NAC) group, and probucol group. We used a rat model of iopromide-induced CIN. One day prior to modeling, the rats received gavage. At 24 h after the modeling, blood biochemistry and urine protein were assessed. Malondialdehyde (MDA) and superoxide dismutase (SOD) were measured in renal tissue. Kidney sections were created for histopathological examination. RESULTS: The model group of rats showed significantly elevated levels of blood creatinine, urea nitrogen, 24-h urine protein, histopathological scores, and parameters of oxidative stress (P<0.05). Both the NAC and probucol groups demonstrated significantly lower Scr, BUN, and urine protein levels compared to the model group (P<0.05), with no significant difference between these 2 groups. The NAC group and the probucol group had significantly lower MDA and higher SOD than the model group at 24 h after modeling (P<0.05). The 8-OHdG-positive tubule of the probucol group and NAC group were significantly lower than those of the model group (p=0.046, P=0.0008), with significant difference between these 2 groups (P=0.024). CONCLUSIONS: Probucol can effectively reduce kidney damage caused by contrast agent. The underlying mechanism may be that probucol accelerates the recovery of renal function and renal pathology by reducing local renal oxidative stress.

Irbesartan can improve blood lipid and the kidney function of diabetic nephropathy.

AIM: Diabetic nephropathy (DN) is the most frequent cause of end-stage renal disease. The activation of the renin-angiotensin system (RAS) and lipid disorders are major risk factors in progressive chronic kidney disease. Inhibition of the RAS is one of the most widely used therapies to treat chronic kidney disease. But its effect is not sufficient, and lowered hyperlipidemia is required. Most of medications for hypertension have effects only on the blood pressure in DN. This study is to evaluate the influence of irbesartan on blood lipid, kidney function, and the pathological change of kidney, liver, and adipose tissue. METHODS: Six-week old db/db mice were randomly assigned to control group and irbesartan group. Mice in irbesartan group were fed 40 mg/kg irbesartan each day. Eight weeks later, blood lipid, kidney function, and the pathological change of kidney, liver, and adipose tissue were measured. RESULTS: The results indicated that the blood lipid, uric acid, urea nitrogen, and creatinine of db/db mice increased significantly. There are obvious vacuolar degeneration and ballooned hepatocytes around the central vein of db/db mouse liver. Kidney biopsy found glomerular hypertrophy of glomerular, mesangial thickening, and vacuolar degeneration. Irbesartan can decrease the blood pressure, blood lipid, and kidney lipid. But it has no effects on blood glucose and liver lipid. It can improve the function and pathological change of kidney of db/db mice. But it has no effects on pathological change of adipose tissue and liver. CONCLUSIONS: Irbesartan can decrease blood lipid and protect the kidney of db/db mice, and is a good choice of treatment for diabetic nephropathy.

Effects of dietary Capsicum oleoresin on productivity and immune responses in lactating dairy cows.

This study investigated the effect of Capsicum oleoresin in granular form (CAP) on nutrient digestibility, immune responses, oxidative stress markers, blood chemistry, rumen fermentation, rumen bacterial populations, and productivity of lactating dairy cows. Eight multiparous Holstein cows, including 3 ruminally cannulated, were used in a replicated 4×4 Latin square design experiment. Experimental periods were 25 d in duration, including a 14-d adaptation and an 11-d data collection and sampling period. Treatments included control (no CAP) and daily supplementation of 250, 500, or 1,000 mg of CAP/cow. Dry matter intake was not affected by CAP (average 27.0±0.64 kg/d), but milk yield tended to quadratically increase with CAP supplementation (50.3 to 51.9±0.86 kg/d). Capsicum oleoresin quadratically increased energy-corrected milk yield, but had no effect on milk fat concentration. Rumen fermentation variables, apparent total-tract digestibility of nutrients, and N excretion in feces and urine were not affected by CAP. Blood serum ß-hydroxybutyrate was quadratically increased by CAP, whereas the concentration of nonesterified fatty acids was similar among treatments. Rumen populations of Bacteroidales, Prevotella, and Roseburia decreased and Butyrivibrio increased quadratically with CAP supplementation. T cell phenotypes were not affected by treatment. Mean fluorescence intensity for phagocytic activity of neutrophils tended to be quadratically increased by CAP. Numbers of neutrophils and eosinophils and the ratio of neutrophils to lymphocytes in peripheral blood linearly increased with increasing CAP. Oxidative stress markers were not affected by CAP. Overall, in the conditions of this experiment, CAP did not affect feed intake, rumen fermentation, nutrient digestibility, T cell phenotypes, and oxidative stress markers. However, energy-corrected milk yield was quadratically increased by CAP, possibly as a result of enhanced mobilization of body fat reserves. In addition, CAP increased neutrophil activity and immune cells related to acute phase immune response.

Substituição do resíduo da produção de palmito da Palmeira Real Australiana (Archontophoenix alexandrae) na silagem de cana-de-açúcar em dietas de ovinos / Replacing of residue from production of palm Palm Royal Australian (Archontophoenix alexandrae) in silage of sugar cane in diets of sheep

Objetivou-se avaliar a composição química, consumo voluntário e digestibilidade aparente de dietas contendo resíduo oriundo da produção de palmito da palmeira Real Australiana (Archontophoenix alexandrae) em substituição à cana-de-açúcarem ovinos. Foram utilizados 12 ovinos com peso vivo médio de 23,3 ± 2,8 kg, mantidos em gaiolas metabólicas distribuídos em seis quadrados latinos 2x2 implementado em esquema fatorial 3 x 2 (três tipos de resíduo - folha, bainha e composta - e dois níveis de substituição do resíduo, 5% e 15%). Verificou-se maior consumo de matéria seca (MS), matéria orgânica (MO), carboidratos não fibrosos (CNF) na substituição pelo resíduo composta. Os valores médios de digestibilidade aparente da MS, MO, Proteína bruta (PB), fibra insolúvel em detergente neutro corrigido para cinzas e proteína(FDNcp) e nível dietético de NDT foram maiores para o resíduo folha. Constatou- se efeito de interação entre resíduo e o nível de substituição sobre as excreções urinárias de nitrogênio total (EUN), balanço nitrogenado aparente (BNA) e compostos nitrogenados microbianos (NMIC). Resíduos da produção de palmito oriundos da palmeira Real Australiana podem ser utilizados como alimentos volumosos na dieta de animais ruminantes, sendo destes, o resíduo folha e composta os que apresentaram melhores respostas nas características avaliadas.

The aim of this study was to evaluate the chemical composition, voluntary intake and apparent digestibility of the diets containing residue from palm heart of Australian Royal Palm (Archontophoenix alexandrae) to replace sugar cane on sheep. Twelve sheep were used with average live weight of 23,3 ± 2,8 Kg and they placed in metabolism cages and distributed in six latin square 2 x 2 in a factorial design 3 x 2 (three types of residue -sheet, bark and composed - and two levels of residue’s replacement, 5% and 15%). It was observed higher intake of dry matter (DM), organic matter (OM), nonfiber carbohydrates (NFC) by substitution of composed residue. The average values of apparent digestibility of DM, OM, crude protein (CP), neutral detergent fibre correct for ash and protein (NDFap) and total digestible nutrients (TDN) were higher for sheet residue. There was interaction between type of residue and level of residue’s replacement on the urinary excretion of total nitrogen (NUE), apparent nitrogen balance (BNA) and microbial nitrogen compost (NMIC). Residues from palm heart of Australian Royal Palm can be used as roughage in the ruminants’diet, and of these residues, the sheet and composed residue showed better response in the evaluated characteristics.

Protein supplementation during resistance-type exercise training in the elderly.

INTRODUCTION: Resistance training has been well established as an effective treatment strategy to increase skeletal muscle mass and strength in the elderly. We assessed whether dietary protein supplementation can further augment the adaptive response to prolonged resistance-type exercise training in healthy elderly men and women. METHODS: Healthy elderly men (n = 31, 70 ± 1 yr) and women (n = 29, 70 ± 1 yr) were randomly assigned to a progressive, 24-wk resistance-type exercise training program with or without additional protein supplementation (15 g·d-1). Muscle hypertrophy was assessed on a whole-body Dual-energy X-ray absorptiometry (DXA), limb (computed tomography), and muscle fiber (biopsy) level. Strength was assessed regularly by 1-repetition maximum (RM) strength testing. Functional capacity was assessed with a sit-to-stand and handgrip test. RESULTS: One-RM strength increased by 45% ± 6% versus 40% ± 3% (women) and 41% ± 4% versus 44% ± 3% (men) in the placebo versus protein group, respectively (P < 0.001), with no differences between groups. Leg muscle mass (women, 4% ± 1% vs 3% ± 1%; men, 3% ± 1% vs 3% ± 1%) and quadriceps cross-sectional area (women, 9% ± 1% vs 9% ± 1%; men, 9% ± 1% vs 10% ± 1%) increased similarly in the placebo versus protein groups (P < 0.001). Type II muscle fiber size increased over time in both placebo and protein groups (25% ± 13% vs 30% ± 9% and 23% ± 12% vs 22% ± 10% in the women and men, respectively). Sit-to-stand improved by 18% ± 2% and 19% ± 2% in women and men, respectively (P < 0.001). CONCLUSION: Prolonged resistance-type exercise training increases skeletal muscle mass and strength, augments functional capacity, improves glycemia and lipidemia, and reduces blood pressure in healthy elderly men and women. Additional protein supplementation (15 g·d-1) does not further increase muscle mass, strength, and/or functional capacity.

[Protein malnutrition in patient in the early postoperative period after uncomplicated removal of the brain tumors].

Malnutrition leads to adverse effects and may worsen clinical outcome. Surgery as a stress factor activates pathological reactions changing metabolism structure. The aim of this study was to evaluate changes of protein metabolism in patients after elective neurosurgical operation. 24 patients were prepared for elective surgery and were enrolled in this study. Evaluation of each patient included: measurement of anthropometric indices--height, weight, arm circumference and the triceps skinfold thickness, the definition of protein loss by determining the loss of nitrogen in the urine, assessment of protein catabolism, determining the violations of nutritional status upon the base of laboratory parameters. During the course of the conducted investigation significant (p < 0.05) decrease in the indices of total protein, albumin, transferrin and the absolute numbers of lymphocytes in the postoperative period was revealed. All the patients developed severe protein catabolism. It became clear that uncomplicated elective surgical intervention, together with the adopted scheme of the nutritional therapy leads to severe protein catabolism in all patients.

Resveratrol supplementation improves glycemic control in type 2 diabetes mellitus.

Resveratrol is a naturally occurring polyphenolic compound. Numerous animal studies have been reported on its wide-ranging beneficial effects in the biological system including diabetes mellitus (DM). We hypothesized, therefore, that oral supplementation of resveratrol would improve the glycemic control and the associated risk factors in patients with type 2 diabetes mellitus (T2DM). The present clinical study was therefore carried out to test the hypothesis. Sixty-two patients with T2DM were enrolled from Government Headquarters Hospital, Ootacamund, India, in a prospective, open-label, randomized, controlled trial. Patients were randomized into control and intervention groups. The control group received only oral hypoglycemic agents, whereas the intervention group received resveratrol (250 mg/d) along with their oral hypoglycemic agents for a period of 3 months. Hemoglobin A(1c), lipid profile, urea nitrogen, creatinine, and protein were measured at the baseline and at the end of 3 months. The results reveal that supplementation of resveratrol for 3 months significantly improves the mean hemoglobin A(1c) (means ± SD, 9.99 ± 1.50 vs 9.65 ± 1.54; P < .05), systolic blood pressure (mean ± SD, 139.71 ± 16.10 vs 127.92 ± 15.37; P < .05), total cholesterol (mean ± SD, 4.70 ± 0.90 vs 4.33 ± 0.76; P < .05), and total protein (mean ± SD, 75.6 ± 4.6 vs 72.3 ± 6.2; P < .05) in T2DM. No significant changes in body weight and high-density lipoprotein and low-density lipoprotein cholesterols were observed. Oral supplementation of resveratrol is thus found to be effective in improving glycemic control and may possibly provide a potential adjuvant for the treatment and management of diabetes.

Effects of surplus dietary L-tryptophan on stress, immunology, behavior, and nitrogen retention in endotoxemic pigs.

The possible beneficial effects of surplus dietary Trp (+5 g of Trp/kg of diet) on factors related to stress, immunology, behavior, and N retention were investigated in postweaning piglets (approximately 15 kg of BW) challenged for 10 d with intravenous bacterial lipopolysaccharide (from Escherichia coli). Two diets fed restrictively (732 kJ of NE/kg of BW(0.75)/d) were compared, 1) a basal diet (apparent ileal digestible Trp = 1.9 g/kg; the recommended amount of Trp to warrant near-optimal growth in nonendotoxemic piglets), and 2) a Trp-enriched basal diet (+5 g of free l-Trp/kg), with 8 individually housed piglets per diet. Pooled salivary cortisol, but not plasma cortisol sampled at euthanasia, showed a tendency (P = 0.07) toward reduced concentrations in the Trp group (1.1 vs. 1.4 ng/mL; pooled SE = 0.1 ng/mL). Plasma C-reactive protein was reduced (P = 0.04) in the Trp group (0.9 vs. 5.0 mg/L; pooled SE = 1.3 mg/L), but haptoglobin, IL-6, tumor necrosis factor α, and lipopolysaccharide-induced fever were similar between the 2 dietary treatments. Physical activity related to approaching a human showed a tendency (P = 0.08) toward increased latency time in the Trp group (101 vs. 60 s; pooled SE = 16 s), but the times spent standing, sitting, and lying were similar between dietary treatments. The ADFI, ADG (346 vs. 302 g/d; pooled SE = 14 g/d; P = 0.11), body N retention (11.6 vs. 11.0 g/d; pooled SE = 0.2 g/d; P = 0.18), and G:F (0.55 vs. 0.49; pooled SE = 0.03; P = 0.17) were not different between the groups fed Trp and the basal diet. In conclusion, surplus dietary Trp had limited effects on stress, immunology, behavior, and N retention in a pig model of systemic endotoxemia.

Enteral nutrition is superior to total parenteral nutrition for pancreatic cancer patients who underwent pancreaticoduodenectomy.

OBJECTIVE: To determine the effects of total parenteral nutrition (TPN) and enteral nutrition (EN) on biochemical and clinical outcomes in pancreatic cancer patients who underwent pancreaticoduodenectomy. METHODS: From the year 2006 to 2008, 60 patients who underwent pancreaticoduodenectomy in Tianjin Third Central Hospital were enrolled in this study. They were randomly divided into the EN group and the TPN group. The biochemical and clinical parameters were recorded and analyzed between the two groups. RESULTS: There was no significant difference in the nutritional status, liver and kidney function, and blood glucose levels between the TPN and EN groups on the preoperative day, the 1st and 3 rd postoperative days. However, on the 7th postoperative day, there was significant difference between the two groups in 24 h urinary nitrogen, serum levels of, total protein (TP), transferrin (TF), alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), and γ-glutamyl transpeptadase (GGT), blood urea nitrogen (BUN) and creatinine (Cr). On the 14th postoperative day, there was a significant difference between the two groups in terms of urinary levels of 24 h nitrogen, TP, TF, retinol binding protein, ALT, AST, ALP, GGT, total bilirubin, direct bilirubin, BUN, Cr, and glucose. The incidence of delayed gastric emptying in the EN and TPN groups was 0% and 20%, respectively. Moreover, the incidence of pancreatic fistulas and hemorrhages in the EN group were 3.6% and 3.6%, versus 26.7% and 30% in the TPN group, respectively. CONCLUSIONS: EN is better than TPN for pancreatic cancer patients who received pancreaticoduodenectomy.

Rhein protects against acetaminophen-induced hepatic and renal toxicity.

This study investigated the possible protective effects and mechanism of rhein on Acetaminophen (APAP)-induced hepatotoxicity and nephrotoxicity in rats. Treatment of rats with APAP resulted in severe liver and kidney injuries, as demonstrated by drastic elevation of serum glutamate-pyruvate transaminase (GPT), glutamate-oxaloacetic transaminase (GOT), total bilirubin (TBIL), creatinine (CREA), urea nitrogen (UREA) levels and typical histopathological changes including necrosis, phlogocyte infiltration and fatty degeneration in liver, tubules epithelium swelling and severe vacuolar degeneration in kidney. APAP caused oxidative stress, as evidenced by increased reactive oxygen species (ROS) production, nitric oxide (NO) and malondiadehyde (MDA) levels, together with depleted glutathione (GSH) concentration in the liver and kidney of rats. However, rhein can attenuate APAP-induced hepatotoxicity and nephrotoxicity in a dose-dependent manner. Our results showed that GPT, GOT, UREA and CREA levels and ROS production were reduced dramatically, NO, MDA, GSH contents were restored remarkedly by rhein administration, as compared to the APAP alone treated rats. Moreover, the histopathological damage of liver and kidney were also significantly ameliorated by rhein treatment. These findings suggested that the protective effects of rhein against APAP-induced liver and kidney injuries might result from the amelioration of APAP-induced oxidative stress.

Comparative effect of green tea, chokeberry and honeysuckle polyphenols on nutrients and mineral absorption and digestibility in rats.

BACKGROUND/AIMS: Natural polyphenols are chemically and biologically active. This study aimed at examining the physiological effects of high doses of polyphenol extracts from green tea and new polyphenol-rich sources (chokeberry and honeysuckle fruits) on nutrient absorption. METHODS: 32 male Wistar rats were divided into four groups and fed a diet supplemented with one of the three polyphenolic extracts (at 0.4%) or a control diet for 4 weeks. A perfusion technique was used to study the effects at intestinal level. Pure polyphenols from the three sources were introduced into perfusion fluid at a concentration of 0.4% and allowed to cross the intestinal tract in 1.5 h. RESULTS: In the perfusion experiment, addition of the extracts caused a strong and statistically significant reduction in absorption of the selected nutrients (water, glucose, cholesterol, amino acids and minerals) compared to control animals. In the nutritional experiment, we recorded a slight decrease in diet utilization and growth in rats on polyphenolic diets relative to control group. In the same experiment, we observed a reduction of Zn and Cu absorption, but this was not accompanied by diminished concentrations in the bone femur. CONCLUSIONS: The presence of the polyphenolic extracts in the perfusion liquids significantly reduced absorption from the small intestine, but the nutritional experiment did not confirm deleterious consequences of the consumption of high extract doses.