Energy intake in short bowel syndrome: assessment by 24-h dietary recalls compared with the doubly labelled water method.

Short bowel syndrome (SBS) represents a serious intestinal absorption disorder, and patients may be prone to severe malnutrition. Dietetic therapy is critically important both for immediate prognosis and successful long-term rehabilitation. To maintain energy balance, an accurate assessment of energy intake is required. Our objective was to compare energy intake (EI) assessed by 24-h dietary recalls (EIrecall), a standard clinical assessment, with the total energy expenditure measured by the doubly labelled water (TEEdlw) method in SBS patients and matched controls. A total of twenty-two participants (eleven each in the SBS and control groups (CG), six female and five male) were evaluated; CG were matched to SBS patients on the basis of age, BMI and sex. TEE was measured by DLW and compared with EI determined by four 24-h dietary recalls using the USDA Automated Multiple-Pass Method. Bland-Altman plots and paired Student's t test were used to compare EIrecall with TEEdlw (P<0·05). Participants' mean age was 53 (sd 8) years. TEEdlw (7·85 (SD 1·16) MJ/d, 0·14 (SD 0·02) MJ/kg per d) was significantly lower (P=0·014) compared with EIrecall (11·07 (SD 3·45) MJ/d, 0·21 (SD 0·08) MJ/kg per d) in the SBS group. On the other hand, in the CG group TEEdlw (10·02 (SD 1·86) MJ/d, 0·18 (SD 0·03) MJ/kg per d) was significantly higher (P=0·001) compared with EIrecall (7·19 (SD 1·68) MJ/d, 0·13 (SD 0·03) MJ/kg per d). In SBS patients, reported EI is higher than DLW-measured EI. Therefore, providing or prescribing energetic intake based on EIrecall without accounting for potential malabsorption-related losses can compromise the energy needs in SBS patients and affect nutritional status in the long term.

Exploring the Influence of Gut Microbiome on Energy Metabolism in Humans.

The gut microbiome has a profound influence on host physiology, including energy metabolism, which is the process by which energy from nutrients is transformed into other forms of energy to be used by the body. However, mechanistic evidence for how the microbiome influences energy metabolism is derived from animal models. In this narrative review, we included human studies investigating the relationship between gut microbiome and energy metabolism -i.e., energy expenditure in humans and energy harvest by the gut microbiome. Studies have found no consistent gut microbiome patterns associated with energy metabolism, and most interventions were not effective in modulating the gut microbiome to influence energy metabolism. To date, cause-and-effect relationships and mechanistic evidence on the impact of the gut microbiome on energy expenditure have not been established in humans. Future longitudinal observational studies and randomized controlled trials utilizing robust methodologies and advanced statistical analysis are needed. Such knowledge would potentially inform the design of therapeutic avenues and specific dietary recommendations to improve energy metabolism through gut microbiome modulation.

Soybean glycinin improves HDL-C and suppresses the effects of rosuvastatin on hypercholesterolemic rats.

BACKGROUND: This study was an investigation of the effects of ingesting a daily dose of isolated glycinin soy protein (11S globulin), in association with rosuvastatin, on the control of hypercholesterolemia in experimental animals. METHODS: Male Wistar rats were kept in individual cages under appropriate controlled conditions of temperature, light and humidity. The animals were divided into five groups (n = 9): 1) standard (STD): fed on casein as protein source; 2) hypercholesterolemic (HC): STD plus 1% cholesterol and 0.5% cholic acid; 3) HC+11S: hypercholesterolemic + glycinin (300 mg/kg/day); 4) HC+ROS: hypercholesterolemic + rosuvastatin (10 mg/kg/day); 5) HC+11S+ROS: HC diet, the 11S protein and the drug in the doses given in (3) and (4). The protein and the drug were administered by gavage for 28 days. The results indicated that the addition of 1% cholesterol and 0.5% cholic acid induced hypercholesterolemia in the animals without interfering with their weight gain. RESULTS: A single daily dose of glycinin contributed an additional 2.8% of dietary protein intake and demonstrated its functional role, particularly in raising HDL-C, decreasing triglycerides in the liver and improving the atherogenic index in animals exposed to a hypercholesterolemic diet. CONCLUSION: Most of the beneficial effects of the isolated treatments disappeared when the drug (rosuvastatin) and the protein (glycinin) were taken simultaneously. The association was shown not to interact additively, as noted in the plasma levels of total cholesterol and non-HDL cholesterol, and in the significant increase of cholesterol in the liver. Studies are in progress to identify the effects of peptides derived from the 11S globulin and their role in cholesterol metabolism.

Disease activity index is associated with subclinical atherosclerosis in childhood-onset systemic lupus erythematosus.

BACKGROUND: Systemic lupus erythematosus (SLE) is an independent risk factor for cardiovascular events. The present study determined the prevalence of subclinical atherosclerosis in childhood-onset SLE using the carotid intima-media thickness (CIMT) measurement and investigated associations between traditional and nontraditional risk factors for atherosclerosis, such as medications, SLE Disease Activity Index - SLEDAI-2 K and SLICC-ACR damage index and CIMT. METHODS: Cross-sectional prospective study between 2017 and 2018. CIMT was assessed by ultrasonography. Data were collected by chart review, nutritional evaluation and laboratory tests and analyzed by Fisher, Wilcoxon-Mann-Whitney tests, multiple linear and log binomial regression. RESULTS: Twenty-eight patients (mean age 13.9 years, SD 3) were enrolled. The prevalence of subclinical atherosclerosis was 32% (95% CI 14.8, 49.4). The mean CIMT was 0.43 ± 0.035 mm. The most common traditional risk factors observed were dyslipidemia (82.1%), uncontrolled hypertension (14.2%), obesity (14.3%), and poor diet (78.6%). Uncontrolled hypertension (p = 0.04), proteinuria (p = 0.02), estimated glomerular filtration rate < 75 ml /min/1.73 m2 (p = 0.02) and SLEDAI-2 K > 5 (P = 0.04) were associated with subclinical atherosclerosis. SLEDAI-2 K > 5 maintained association with CIMT after adjusting for control variables. CONCLUSION: Subclinical atherosclerosis is frequently observed in cSLE, mainly in patients with moderate to severe disease activity.