Increased energy expenditure in growing adolescents with Crohn's disease

Undernutrition is considered to have a central role in the pathogenesis of growth retardation in Crohn's disease. This may occur as a consequence of inadequate food intake, increased energy expenditure, or both. Ten growing adolescents with inactive Crohn's disease were assessed with respect to anthropometric parameters and resting energy expenditure, measured by indirect calorimetry during remission, repeated in relapse (N = 5), and compared to that predicted from the Harris-Benedict formula. Mean energy intake was assessed with seven-day diaries in five patients and compared to recommended intake for age, sex, weight, and physical activity. Ten healthy, growing, age- and sex-matched adolescents served as controls. Nine patients with inactive Crohn's disease, who had ceased growing, were matched for disease site and duration and acted as disease controls. Patients and disease controls had lower body mass index (19.2 ± 0.6; 20.9 ± 0.7) than healthy controls (23.7 ± 0.6; P < 0.001). Percent body fat was lower in patients (13.2 ± 1.9%) compared to healthy controls (20.5 ± 2.4%; P < 0.05) but not to disease controls (17.0 ± 2.6%). Patients had higher resting energy expenditure per kilogram of fat-free mass than disease or healthy controls (36.9 ± 5.1; 32.9 ± 2.6; 30.9 ± 2.1 kcal; P < 0.02). Measured resting energy expenditure in patients, but not in disease or healthy controls, was higher than the predicted (measured: predicted 1.15, 1.03, 0.9, respectively; P < 0.03). Energy intake in patients was 97% of recommended intake but the measured ratio of energy intake/resting energy expenditure was lower than the predicted ratio (1.49 vs 1.71; P < 0.05). During subsequent relapse in five patients resting energy expenditure was unchanged. In growing adolescents with inactive Crohn's disease, there is increased energy expenditure that is not accompanied by an increase in energy intake; Relapse of disease does not appear to increase resting energy expenditure further but may 'divert' energy from growth to disease activity. This suggests that nutritional therapy should be directed towards increasing caloric intake to maximize growth potential

Palm species richness, latitudinal gradients, sampling effort, and deforestation in the Amazon region

ABSTRACT Palms are most diverse in warm and humid regions near the equator. Though palms remain relatively well conserved, they are under increasing pressure from deforestation. Here, we analyze patterns of palm species richness relative to latitudinal gradient, sampling effort, and deforestation in the Amazon, and compare patterns of richness and floristic similarity among Amazonian sub-regions. We built a database of 17,310 records for 177 species. The areas with the greatest richness were in the western, central and northeastern Amazon, principally at latitudes 0-5ºS. Species richness and the number of records were highly correlated (R2=0.76, P2000 km2) were found in the southern and eastern Amazon of Brazil, which coincide with low richness and gaps in records. Similarity analyzes resulted in two groups of sub-regions: the first included the Amazon s.s., the Andes and the Guiana, while the second included the Plateau and Gurupi. We conclude that the highest species richness is at low latitudes, and observed richness is affected by sampling effort and is vulnerable to deforestation. Therefore, areas with low species richness, especially areas with data deficiency, need to be further studied for a better understanding of their patterns of diversity and richness