Purpose: Malnutrition is a common feature in critically ill children. Enteral nutrition (EN) is the main strategy to nutritionally support critical ill children, but its use can be hindered by the development of intolerance. The study aimed to assess the effectiveness and safety of amoxicillin/clavulanate (A/C) to treat EN intolerance. Methods: We retrospectively evaluated patients admitted to the pediatric intensive care unit from October 2018 to October 2019. We conducted a case-control study: in the first 6 months (October 2018-April 2019) we implemented the nutritional protocol of our Institution with no drug, whereas in the second half (May 2019-October 2019) we employed A/C for 1 week at a dose of 10 mg/kg twice daily. Results: Twelve cases were compared with 12 controls. At the final evaluation, enteral intake was significantly higher than that at baseline in the cases (from 2.1±3.7 to 66.1±27.4% of requirement, p=0.0001 by Wilcoxon matched-pairs signed rank test) but not in the controls (from 0.2±0.8 to 6.0±14.1% of the requirement, p=NS). Final gastric residual volume at the end of the observation was significantly lower in the cases than in the controls (p=0.0398). The drug was well tolerated as shown by the similar safety outcomes in both cases and controls. Conclusion: Malnutrition exposes critically ill children to several complications that affect the severity of disease course, length of stay, and mortality; all may be prevented by early EN. The development of intolerance to EN could be addressed with the use of A/C. Future prospective clinical trials are needed to confirm these conclusions.
In the 2020 Dietary Reference Intakes for Koreans, an acceptable macronutrient distribution range (AMDR), similar to the one established in 2015, was determined for carbohydrates. AMDR is the ratio that signifies energy intake from carbohydrates to the total energy intake, and is a reference that indicates a decreasing risk of chronic diseases. The AMDR of carbohydrate was determined to be optimal at 55-65% for all ages above 1 year. For the first time, in the year 2020, the estimated average requirement (EAR) and recommended nutrient intake (RNI) for carbohydrates were established. The EAR was based on the amount of glucose used per day in the brain, and was set at 100 g/day for all ages above 1 year. The RNI was set at 130 g/day, by adding a double coefficient of variation using a 15% coefficient of variation, for all ages above 1 year. In pregnant women, the amount of glucose utilized by the fetus brain was considered additionally, and for lactating women the amount of lactose secreted into maternal milk was additionally taken into consideration. Since the EAR of carbohydrate indicates the minimum amount of glucose required by the brain and is not an appropriate intake amount as an energy source, it is incorrect to compare the carbohydrate intake with the EAR or RNI. To evaluate the nutritional status of carbohydrate, it is appropriate to use the AMDR. Carbohydrate intakes within the AMDR range has the possibility in reducing the risk of chronic diseases. Hence, it is important to consider the quality as well as quantity of carbohydrates consumed.
Kim, Eunjung;Chung, Sangwon;Hwang, Jin-Taek;Park, Yoon Jung
Journal of Nutrition and Health
/
v.55
no.1
/
pp.10-20
/
2022
This article evaluated levels of Estimated Average Requirements (EARs), Reference Nutrient Intakes (RNIs), and Acceptable Macronutrient Distribution Ranges (AMDRs) of protein using the recently revised Dietary Reference Intakes (DRIs) for Koreans (2020). Dietary protein requirements are based on amounts sufficient to satisfy physiological demands to accomplish nitrogen equilibrium. The same principle was applied to estimate EARs and RNIs, for adults in DRIs conducted in 2015 and 2020 in Koreans. EAR was estimated to be 0.73 g/kg body weight/day, according to data (0.66 g/kg body weight/day) obtained using the nitrogen balance method and adjusted by efficiency of protein use (90%). RNI was calculated as EAR increased by an amount equal to twice the standard deviation of an age group so as to cover 97.5% of the group and was found to be 0.91 g/kg body weight/day. For weaned infants, children, and adolescents, growth requirement was added to estimate EAR. In particular, growth requirement was adjusted by efficiency of protein use in the revised EAR, which led to higher EARs for weaned infants, children, and adolescents of both genders as compared with 2015 DRIs. The AMDR for protein was set at 7%-20% of energy intake, which was the same as 2015 DRIs. Current, average protein intake by the Korean population is almost twice times the EAR, which suggests it might be better to increase the minimal margin for AMDR. However, it was not adjusted in this revision due to lack of evidence.
In order to investigate physiological characteristics of fusants by interspecific protoplast fusion of the genus Cellulomonas, protoplasts of Cellulomonas flavigena NCIB 12901 and Cellulomonas bibula NCIB 8142 were fused and cell wall regenerated. To give gene maker, C. bibula was treated with 500 ug/ml NTG for 1 hr and arginine requiring auxotrophic mutants were isolated. Protoplasts of the genus Cellulomonas were obtained by treatment with $600{\mu}{\textrm{g}}$/ml lysozyme, and 0.5M sorbitol was optimal for osmotic stabilizer on protoplast fromation. Protoplast fusion was enhanced by 40% PEG)M.W.6,000) containing 25 mM $CaCl_{2}$ at $30^{\circ}C$ for 30 min and fusion frequency between C. bibula and C. flavigena was $5\times 10^{-4}$. Processes of protoplast formation, cell wall regeneration and protoplast fusion were obsdrved by scanning electron microscope. By comparing enzyme activities of cellulase, exocellobiohydrolase, .betha.-glucosidase of the parent strains of Cellulomonas with those of thier mutants and fusants, fusants with increased enzyme activity were obtained. By the studies on nutritional requirement, antibiotic resistance, cellulolytic enzyme activities, type of peptidoglycan and motility of two mutants and fusants, fusants were proved to be recombinant of both mutant strains.
We report nutritional physiology and non-specific immune responses of vitamin E in parrot fish for the first time. This study aimed to investigate the essentiality and requirements in diets based on growth performances, non-specific immune responses and a challenge test against Vibrio angullarum. Six casein-gelatin based semi-purified diets were formulated to contain six graded levels of DL-${\alpha}$-tocopheryl acetate (${\alpha}$-TA) at 0, 25, 50, 75, 100 and 500 mg/kg diet (designated as E0, E25, E50, E75, E100 and E500, respectively) and fed to triplicate groups of juvenile parrot fish for 12 weeks. The analyzed dietary concentrations of vitamin E were 0, 38, 53, 87, 119 and 538 mg/kg diet for E0, E25, E50, E75, E100 and E500, respectively. At the end of the feeding trial, growth performance and feed utilization of fish fed the E25 were significantly higher compared to that of fish fed the other diets. Liver ${\alpha}$-tocopherol concentration was significantly increased with an increase in dietary ${\alpha}$-TA in a dose dependent manner. No apparent clinical signs of vitamin E deficiency and mortality were observed in fish fed the basal diet for 12 weeks. Among the immune responses assayed, phagocytic (NBT assay) and myeloperoxidase activities were significantly increased with increment of dietary ${\alpha}$-TA levels. During the challenge test with V. anguillarum, E75, E100, and E500 diets resulted in higher survivals than E0, E25 and E50 diets. The findings of this study suggest that parrot fish require exogenous vitamin E and the optimum dietary level could be approximately 38 mg ${\alpha}$-TA/kg diet for normal growth and physiology. Dietary ${\alpha}$-TA concentration over 500 mg/kg could be required to enhance the nonspecific immune responses and improve the resistance of juvenile parrot fish against V. anguillarum.
The purpose of this study is to assess folate intake, and serum and red blood cell (RBC) folate concentrations, and investigate the association between folate status and health-related behaviors among Korean college students. A total of 169 students, aged between 18 and 27 years, participated in this study. Dietary intake data were collected by trained interviewers using a 24-hour recall method for three non-consecutive days in 2009. Information on health-related behaviors was obtained by a self-administered questionnaire. Serum and RBC folate concentrations were measured by microbiological assay. The average intakes of folate were $456{\mu}gDFE$ and $347{\mu}gDFE$ in male and female students, respectively. While the average serum folate concentration was significantly lower in male students (8.9 ng/mL) compared to female students (12.5 ng/mL), RBC concentrations were not significantly different between male (398.6 ng/mL) and female students (405.3 ng/mL). In male students, low serum folate concentrations were associated with total folate intake less than the Estimated Average Requirement, non-use of folic acid supplements, smoking, alcohol drinking at least once a week and low physical activity. In female students, low serum folate concentrations were associated with smoking and alcohol drinking at least two drinks at a time and BMI ${\geq}25$. Alcohol drinking and low physical activity were also associated with low RBC folate concentrations in both male and female students. In order to improve folate nutritional status of college students, the practice of desirable health-related behaviors, such as non-smoking, moderate alcohol drinking, regular physical activity, and maintenance of healthy BMI should be encouraged along with consumption of folate-rich foods and supplements.
To determine vitamin A and E intakes and their food sources, dietary intakes were collected by three consecutive 24-hour recalls from 192 adults living in Seoul and Gyeonggi Province, Korea. The mean vitamin A, retinol and ${\beta}$-carotene intakes were $1240.1{\pm}1101.1\;{\mu}g$ retinol equivalent/day ($693.3{\pm}563.2\;{\mu}g$ retinol activity equivalent/day), $182.6{\pm}149.5\;{\mu}g$/day and $5443.3{\pm}6365.5\;{\mu}g$/day, respectively. Only 9.4% of the subjects consumed less than the Korean Estimated Average Requirement for vitamin A. The mean vitamin E intake was $6.03{\pm}2.54\;mg$${\alpha}$-tocopherol equivalent/day. The ${\alpha}$-tocopherol and ${\gamma}$-tocopherol intakes were $4.83{\pm}2.03$ and $5.57{\pm}3.41\;mg$/day, respectively. Most of the subjects (93.8%) consumed less than the Korean Adequate Intake for vitamin E. The major food sources of vitamin A were sweet potato, carrot, red pepper powder, spinach, and citrus fruit, and the top 30 foods provided 91.5% of total Plant foods provided 81.0% and animalderived foods 10.5% of the vitamin A intake from the top 30 foods. The major food sources of vitamin E were soybean oil, red pepper powder, Ramyeon (cup noodles), spinach, and egg. The top 30 foods provided 78.0% of total vitamin E intake. Plant foods provided 61.3% and animal-derived foods 15.9% of the vitamin E intake from the top 30 foods. In conclusion, the vitamin A intake of the Korean adults in this study was ge-nerally adequate, but the vitamin E intake of many subjects was inadequate. Therefore, nutritional education may be of benefit to Korean adults to increase their vitamin E intake.
BACKGROUND/OBJECTTIVES: The purposes of the study were to investigate folate intakes and plasma folate concentrations as well as estimate folate status in Korean healthy adults. SUBJECTS/METHODS: A total of 254 healthy 19- to 64-year-old adults (68 men and 186 women) living in Seoul metropolitan area, Gumi, and Kwangju, Korea participated. Three consecutive 24-hour dietary recalls, information on folate supplementation, and fasting blood samples were collected from the subjects. RESULTS: The mean dietary folate intakes were 587.4 and $499.2{\mu}g$ dietary folate equivalent (DFE)/day for men and women, respectively. The median dietary intakes of men and women were 566.6 and $474.6{\mu}g\;DFE/day$, respectively. Forty subjects (16.7% of total) less total folate than the estimated average requirement (EAR). Folate intakes of 23.3% of men and 34.8% of women aged 19-29 years did not meet the EAR for folate. Major food sources consumed for dietary folate were baechukimchi (Chinese cabbage kimchi), rice, spinach, eggs, and laver, which provided 44% of dietary folate intake for the subjects. Plasma folate concentrations were 23.4 nmol/L for men and 28.3 nmol/L for women, and this level was significantly lower in men than in women. Approximately 13% of men and 3% of women were folate-deficient, and the percentages of subjects showing folate concentrations lower than 10 nmol/L were 27.9% of men and 6.4% of women. CONCLUSIONS: Folate intakes of Korean adults in this study were generally adequate. However, one-third of young adults had inadequate folate intakes.
Fujihara, T.;Matsui, T.;Hayashi, S.;Robles, A.Y.;Serra, A.B.;Cruz, L.C.;Shimizu, H.
Asian-Australasian Journal of Animal Sciences
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v.5
no.2
/
pp.383-388
/
1992
Nutritional status of macro minerals (Ca, Mg and P) in goats grazed on the native pasture was investigated for 2 years in Luzon Island, Republic of the Philippines. Three regions in Luzon Island (Los Banos; Southern area, Munoz, Nueva Ecija; Central area and Baguio; Northern area) were objected to collect the samples of forages and blood of goats on the pasture. The average values in Ca, Mg and P contents of all the forage samples were 0.29-1.32, 0.13-0.56 and 0.15-0.45% of dry matter, respectively, and these figures almost exceeded the required dietary levels for sheep. There was no obvious changes in mineral content of forages between the seasons of rainy and dry, or among regions. In blood Ca level, more than a half of goats (57.9%) without supplement showed the level below the lower limit, and the low level was not improved even when they fed with some supplemental concentrates. The plasma levels of Mg and P were satisfactory, referring to the lower limit of normal level in goats. It is, therefore, necessary to decide the requirement and to establish a most suitable technique for supplying Ca to grazing goats in Luzon Island.
Proceedings of the Korean Nutrition Society Conference
/
2004.11a
/
pp.22-33
/
2004
It has been more than three decades since the first assay assessing circulating 25(OH)D in human subjects was performed. That publication as well as several that followed it defined 'normal' nutritional vitamin D status in human populations. Recently, the wisdom by which 'normal' circulating 25(OH)D levels in human subjects were assigned in the past has come under question. It appears that sampling human subjects, who appear to be free from disease, and assessing 'normal' circulating 25(OH)D levels by plotting a Gaussian distribution is grossly inaccurate. There are many reasons why this method is inaccurate, including race, lifestyle habits, sunscreen usage, age, latitude, and inappropriately low dietary recommendations for vitamin D. For instance, a 400IU/day. AI for vitamin D is insignificant when one considers that a 10-15 minute whole body exposure to peak summer sun will generate and release up to 20,000 IU vitamin $D_3$ into the circulation. Recent studies, which orally administered up to 10,000 IU/day vitamin $D_3$ to human subjects for several months, have successfully elevated circulating 25(OH)D levels to those observed in individuals from sun-rich environments. Further, we are now able to accurately assess sufficient circulating 25(OH)D levels utilizing specific biomarkers instead of guessing what an adequate level is. These biomarkers include intact parathyroid hormone (PTH), calcium absorption, bone mineral density (BMD), insulin resistance and pancreatic beta cell function. Using the data from these biomarkers, vitamin D deficiency should be defined as circulating levels of $25(OH)D{\leq}30ng/mL$. In certain cases, such as pregnancy and lactation, significantly higher circulating 25(OH)D levels would almost certainly be beneficial to both the mother and recipient fetus/infant.
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