Barriers to and Facilitators of the Consumption of Animal-Based Protein-Rich Foods in Older Adults.

Protein intakes in the older population can be lower than recommended for good health, and while reasons for low protein intakes can be provided, little work has attempted to investigate these reasons in relation to actual intakes, and so identify those of likely greatest impact when designing interventions. Questionnaires assessing: usual consumption of meat, fish, eggs and dairy products; agreement/disagreement with reasons for the consumption/non-consumption of these foods; and several demographic and lifestyle characteristics; were sent to 1000 UK community-dwelling adults aged 65 years and over. In total, 351 returned questionnaires, representative of the UK older population for gender and age, were suitable for analysis. Different factors were important for consumption of the four food groups, but similarities were also found. These similarities likely reflect issues of particular concern to both the consumption of animal-based protein-rich foods and the consumption of these foods by older adults. Taken together, these findings suggest intakes to be explained by, and thus that strategies for increasing consumption should focus on: increasing liking/tastiness; improving convenience and the effort required for food preparation and consumption; minimizing spoilage and wastage; and improving perceptions of affordability or value for money; freshness; and the healthiness of protein-rich foods

Total free living energy expenditure in patients with severe chronic obstructive pulmonary disease.

Department of Pulmonology, University of Limburg, Maastricht, the Netherlands. Resting energy expenditure (REE) is often elevated in patients with chronic obstructive pulmonary disease (COPD), but no data are available regarding total energy expenditure in free living conditions. We compared total daily energy expenditure (TDE) in eight COPD patients (FEV1 36 +/- 13%) admitted to a pulmonary rehabilitation center and eight independently living healthy subjects, matched for sex, age, and body mass index (BMI). TDE was measured over a 2-wk interval using doubly labeled water in combination with measurement of REE and body composition. The COPD patients had a significantly higher TDE than the healthy subjects (2,499 +/- 320 kcal/d and 2,107 +/- 88 kcal/d, respectively, p < 0.01). The nonresting component of TDE (TDE-REE: physical activity and diet-induced thermogenesis [DIT]) was significantly higher in the COPD patients than in the healthy subjects, resulting in a ratio between TDE and REE of 1.7 +/- 0.2 and 1.4 +/- 0.1, respectively (p < 0.01). The results indicate that COPD patients exhibit an increased TDE in comparison with healthy subjects. The difference could by attributed to an increase in the nonresting component of TDE, since REE was comparable between the groups. Publication Types: Clinical Trial Controlled Clinical Tria

Targeting mu opioid receptors to modulate gastrointestinal function: what have we learnt so far from the studies in functional bowel disorders?

Opioids have recently received much attention because of the epidemic in their use in some countries such as the USA and the UK. Concerns have been raised about the possibility that they can increase mortality in patients when used on a long-term basis. Moreover, they are known to induce paradoxical hyperalgesia as well as alterations of gut function. The analgesic properties of opioids are mediated by receptors located in the brain, but as opioid receptors are also expressed in the gastrointestinal tract, new drugs acting on these receptors have recently been developed to treat two functional disorders, namely irritable bowel syndrome with diarrhoea and opioid-induced constipation. The aim of this article is to highlight some interesting observations resulting from the development of these drugs in the field of functional gastrointestinal disorders

Energy and nutrient dietary reference values for children in Europe: methodological approaches and current nutritional recommendations

The Expert Group on the Methodological Approaches and Current Nutritional Recommendations in Children and Adolescents was convened to consider the current situation across Europe with regard to dietary recommendations and reference values for children aged 2-18 years. Information was obtained for twenty-nine of the thirty-nine countries in Europe and a comprehensive compilation was made of the dietary recommendations current up to September 2002. This report presents a review of the concepts of dietary reference values and a comparison of the methodological approaches used in each country. Attention is drawn to the special considerations that are needed for establishing dietary reference values for children and adolescents. Tables are provided of the current dietary reference values for energy and for the macronutrients, vitamins, minerals, trace elements and water. Brief critiques are included to indicate the scientific foundations of the reference values for children and to offer, where possible, an explanation for the wide differences that exist between countries. This compilation demonstrated that there are considerable disparities in the perceived nutritional requirements of European children and adolescents. Although some of this diversity can be attributed to real physiological and environmental differences, most is due to differences in philosophy about the best methodological approach to use and in the way the theoretical approaches are applied. The report highlights the main methodological and technological issues that will need to be resolved before harmonisation can be fully considered. Solving these issues may help to improve the quality and consistency of dietary reference values across Europe. However, there are also considerable scientific and political barriers that will need to be overcome and the question of whether harmonisation of dietary reference values for children and adolescents is a desirable or achievable goal for Europe requires further consideratio

First translational consensus on terminology and definitions of colonic motility in animals and humans studied by manometric and other techniques

Alterations in colonic motility are implicated in the pathophysiology of bowel disorders, but high-resolution manometry of human colonic motor function has revealed that our knowledge of normal motor patterns is limited. Furthermore, various terminologies and definitions have been used to describe colonic motor patterns in children, adults and animals. An example is the distinction between the high-amplitude propagating contractions in humans and giant contractions in animals. Harmonized terminology and definitions are required that are applicable to the study of colonic motility performed by basic scientists and clinicians, as well as adult and paediatric gastroenterologists. As clinical studies increasingly require adequate animal models to develop and test new therapies, there is a need for rational use of terminology to describe those motor patterns that are equivalent between animals and humans. This Consensus Statement provides the first harmonized interpretation of commonly used terminology to describe colonic motor function and delineates possible similarities between motor patterns observed in animal models and humans in vitro (ex vivo) and in vivo. The consolidated terminology can be an impetus for new research that will considerably improve our understanding of colonic motor function and will facilitate the development and testing of new therapies for colonic motility disorders. This Consensus Statement provides a conceptual and methodological framework to expand research on colonic motility in experimental animals and humans. The work is intended to facilitate the development of new drugs for common colonic motility disorders and of appropriate diagnostic and therapeutic algorithms for the management of paediatric and adult patients

EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA); Scientific Opinion on Dietary Reference Values for protein

This opinion of the EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA) deals with the setting of Dietary Reference Values (DRVs) for protein. The Panel concludes that a Population Reference Intake (PRI) can be derived from nitrogen balance studies. Several health outcomes possibly associated with protein intake were also considered but data were found to be insufficient to establish DRVs. For healthy adults of both sexes, the average requirement (AR) is 0.66 g protein/kg body weight per day based on nitrogen balance data. Considering the 97.5th percentile of the distribution of the requirement and assuming an efficiency of utilisation of dietary protein for maintenance of 47 %, the PRI for adults of all ages was estimated to be 0.83 g protein/kg body weight per day and is applicable both to high quality protein and to protein in mixed diets. For children from six months onwards, age-dependent requirements for growth estimated from average daily rates of protein deposition and adjusted by a protein efficiency for growth of 58 % were added to the requirement for maintenance of 0.66 g/kg body weight per day. The PRI was estimated based on the average requirement plus 1.96 SD using a combined SD for growth and maintenance.For pregnancy, an intake of 1, 9 and 28 g/d in the first, second and third trimesters, respectively, is proposed in addition to the PRI for non-pregnant women. For lactation, a protein intake of 19 g/d during the first six months, and of 13 g/d after six months, is proposed in addition to the PRI for non-lactating women. Data are insufficient to establish a Tolerable Upper Intake Level (UL) for protein. Intakes up to twice the PRI are regularly consumed from mixed diets by some physically active and healthy adults in Europe and are considered safe

Human total, basal and activity energy expenditures are independent of ambient environmental temperature

Lower ambient temperature (Ta) requires greater energy expenditure to sustain body temperature. However, effects of Ta on human energetics may be buffered by environmental modification and behavioral compensation. We used the IAEA DLW database for adults in the USA (n = 3213) to determine the effect of Ta (−10 to +30°C) on TEE, basal (BEE) and activity energy expenditure (AEE) and physical activity level (PAL). There were no significant relationships (p > 0.05) between maximum, minimum and average Ta and TEE, BEE, AEE and PAL. After adjustment for fat-free mass, fat mass and age, statistically significant (p < 0.01) relationships between TEE, BEE and Ta emerged in females but the effect sizes were not biologically meaningful. Temperatures inside buildings are regulated at 18–25°C independent of latitude. Hence, adults in the US modify their environments to keep TEE constant across a wide range of external ambient temperatures