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The 2 Week Diet

The 2-week diet promises to help you shed as much as 19 pounds of body fat in just 14 days (2 weeks). In addition to this, the diet also promises to help you tone up your muscles, decrease cellulite, and improve energy levels. Once you have started the 2 Week Diet, your body responds quickly, and the pounds will start to drop off. With the 2 Week Diet, you will lose weight, but you will do it in a way that is healthy, and that will last after the weight is gone. So many people know the frustrating cycle of losing a few pounds and gaining it right back. The 2-week diet is well written, easy to follow and very informative. You will like the calculations for calorie consumption to lose weight and also how to maintain your body to your satisfaction.This productGuarantee for weight loss. Read more here...

The 2 Week Diet Summary


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The Power of the Food Guide Pyramid

The Food Guide Pyramid, the triangular symbol you see on many food packages, was developed by nutrition experts at the U.S. Department ofAgriculture (USDA) (see below). The Pyramid is an educational tool that translates nutrient requirements into the foods you need to eat and helps you put into action the advice offered by the Dietary Guidelines. In graphic form, the Pyramid displays the variety of food choices and the correct proportions needed to attain the recommended amounts of all the nutrients you need without consuming an excess of calories. The Pyramid divides all foods into six categories, based on the nutrients they contain. The Food Guide Pyramid The Food Guide Pyramid was developed by the U.S. Department ofAgriculture. The pyramid incorporates many principles that emphasize a plant-based diet that is low in fat, high in fiber, and rich in important vitamins, minerals, and other nutrients. All of these factors contribute to optimal health and help you to control your weight...

A brief overview of dietary supplement ingredient regulation in the United States

In 1994 the United States Congress passed the Dietary Supplement Health and Education Act (DSHEA, Public law 103-417, October 25, 1994, 103rd Congress). This law modified the Food, Drug, and Cosmetic Act and expanded the definition of dietary supplements to include botanical ingredients, hormones, and a diverse array of related products in addition to vitamins and minerals. The DSHEA also specified the role of the United States Food and Drug Administration (FDA) in regulating dietary supplements, mandated the creation of a Presidential Commission on Dietary Supplement Labeling, and authorized the establishment of the Office of Dietary Supplements at the National Institutes of Health (NIH). The main elements of the definition of dietary supplements from the DSHEA are listed in Box 1.1. For products that are regulated by the FDA, the 'intended use' of a product or ingredient is the turnkey that determines whether an item is broadly classified as a food or a drug. Dietary supplements, no...

Sales and use of dietary supplements in the United States

The sale and use of dietary supplements in the United States initially grew dramatically after the passage of the DSHEA. Figures of individual and mixtures of botanical supplements drove the market. The growth and demand led to a consolidation of manufacturing and retail corporations as well as new growth in botanical supplements produced by the major pharmaceutical corporations in the US. It is estimated that from 30 53 per cent of Americans or 100 million people use dietary supplements on a regular basis (several times each week) (Aarts, 1998). In 1996 sales of dietary supplements totalled 9.8 billion and represented 51 per cent of the total sales in the nutrition industry in the United States. Sales of dietary supplements in natural food stores comprised 44 per cent of the total, and mass-market retail accounted for 26 per cent of the total with the remainder in direct marketing through the mail or Internet. Overall sales for dietary supplements grew 9 per cent in 1996 (Aarts,...

Dietary Protein and Body Protein

The grains and cereals group of foods, which form the base of the Food Guide Pyramid, are excellent sources of protein, but because these proteins often lack one or more essential amino acids, they are called incomplete proteins. For example, the proteins in corn are low in the essential amino acids lysine and tryptophan, and wheat is low in lysine. In contrast, legumes tend to be rich in lysine but a bit low in methionine. Among the legumes, soybeans contain the most complete protein. Contrary to popular belief, simply eating more dietary protein, in excess of recommended amounts, will not result in bigger muscles. Our bodies do not store excess protein. If we eat more protein than our bodies need to replenish the amino acids we have used during the day, the excess amino acids are converted to, and stored as, fat. Dietary protein, like carbohydrates, supplies about 4 calories of energy per gram. Because our requirements for protein mainly depend on our body's size, our need for...

The Office of Dietary Supplements at the National Institutes of Health

The Office of Dietary Supplements (ODS) was authorized at the NIH as part of the DSHEA legislation. This office was formally started in late 1995 with the mandate to serve as a source of research support, inter-government advice, and science-based information on dietary supplements. The ODS has worked extensively with the other NIH institutes, centres and offices to partner in identifying the most fruitful areas for research in dietary supplements and to serve as a source of information for scientists, industry and the public. While the Congressional mandate for the ODS was specified broadly, the office staff needed to take this mandate and transform it into specific achievable goals and objectives. In order to do this, the office assembled over 125 scientists and professionals from academia, government, industry and public-interest groups and held a series of seven strategic planning meetings in autumn and winter 1996 1997. Different individuals were involved in each of the seven...

Recommended Dietary Allowances For Folate And Vitamin B12 Based On Genomic Stability

There is now increasing interest to redefine recommended dietary allowances (RDAs) of minerals and vitamins not only to prevent diseases of extreme deficiency but also to prevent developmental abnormalities and degenerative diseases of old age as well as optimizing cognition (75). Prevention of chromosome breakage and aneuploidy is an important parameter for the definition of new RDAs for micronutrients (9) such as folic acid and vitamin B12 because increased rates of DNA damage have been shown to be associated with increased cancer risk (76-78) and accelerated aging (79). Table 1 summarizes the information from in vitro and in vivo controlled experiments in human cells and human subjects with a view to defining, based on current knowledge, the optimal concentration and dietary intake of folic acid for minimizing genomic instability. The results from a variety of DNA damage biomarkers suggest that above RDA levels of folic acid intake are required to minimize DNA damage furthermore,...

Genetic And Dietary Factors Which Influence N3 Fatty Acid Metabolism

Because of the inability to synthesize n-3 fatty acids de novo, all animals require these fatty acids in their diet to meet their demand for maintaining a high concentration of DHA in the brain. Although little direct evidence exists in any species concerning the quantitative conversion of n-3 fatty acid precursors to DHA, it has been estimated based on rodent studies that an n-3 fatty acid intake of 0.5 of energy as a-linolenic acid (LNA) is needed in order to maintain an adequate level of DHA in the brain (Bourre et al., 1989). However, it must be recognized that the ability to biosynthesize DHA from LNA or other n-3 fatty acids varies among different animal species (Rivers et al., 1975 Hassam et al., 1977 Sinclair et al., 1979 Clandinin et al., 1985 Scott & Bazan, 1989 Salem & Pawlosky, 1994 Pawlosky et al., 1994 Fu & Sinclair, 2000). Moreover, the composition of fat in the diet has a significant influence on the liver production of long-chain PUFAs (Salem & Pawlosky,...

Retroperitoneoscopy in Obese Patients

Although the excessive retroperitoneal fat increases the degree of technical difficulty, adherence to a standardized stepwise anatomical approach (14) allows retroperitone-oscopy to be performed effectively in markedly obese or morbidly obese patients. In fact, the retroperitoneal flank approach allows the gravitational pull to shift much of the weight of the pannus anteriorly, away from the ipsilateral flank (Fig. 11). In our series, 35 of the patients had body mass index (BMI) equal or greater than 30. However, the reader should be cautioned that these challenging procedures should be performed by surgeons facile with the laparoscopic technique.

Impact Of Dietary Essential Fatty Acids On Neuronal Cell Composition And Function

Brain membranes were generally viewed as resistant to structural change by both endogenous and exogenous factors. Data have shown that brain membranes are much more sensitive to changes in composition induced by dietary fat than previously thought (Bourre et al., 1989a Foot et al., 1982 Jope & Jenden, 1979 Lee, 1985 Wurtman et al., 1981). Moreover, the extent of the changes in brain membrane composition by dietary fat varies among brain regions, cell types, and organelles (reviewed by Clandinin et al., 1997 Clandinin et al., 1991 Hargreaves & Clandinin, 1990). Earlier studies examining the role of dietary fat on brain membrane composition have used rodents that were fed 18 2n-6-deficient diets for several weeks to a few generations. Results from these studies demonstrate qualitative changes in brain membrane fatty acid composition associated with essential fatty acid deficiency (i.e., increase in 20 3n-9 and decrease in 20 4n-6 Koblin et al., 1980 Paoletti & Galli, 1972 Sun...

Dietary Modulation of Retinal Fatty Acid Composition and Function

The effect of maternal diet on the modulation of n-3 fatty acid in the retina of offspring has been studied in newly hatched chicks (Anderson et al., 1989), juvenile felines (Pawlosky et al., 1997) and piglets (Arbuckle & Innis, 1993). Docosahexaenoic acid appears to be the preferred fatty acid for raising the level of 22 6n-3 in the retina and brain among different sources of n-3 fatty acids (Anderson et al., 1990). Feeding corn oil supplemented with 22 6n-3 is able to restore the 22 6n-3 level in n-3-deficient chicks (Anderson & Connor, 1994) and felines (Pawlosky et al., 1997) probably through replacement of dipolyunsaturated molecular species (22 6n-3 - 22 6n-3) (Lin et al., 1994). These observations imply that 18 3n-3 alone in the diet as the n-3 fatty acid source may not be adequate for meeting the 22 6n-3 requirement for brain and retinal development, because 18 3n-3 is a less efficient precursor for 22 6n-3 when there is low A6desaturase activity (Anderson et al., 1990...

Effect of Dietary Fat on Very Long Chain Fatty Acids and Rhodopsin Content

Retina membrane phospholipids, particularly phosphatidylethanolamine, contain a high level of 22 6n-3 (Birch et al., 1992 Suh et al., 1994). In the rod outer segment of the retina, significant amounts of 22 6n-3 in phosphatidylserine and phosphatidylcholine also occur (Suh et al., 1994). Increased dietary intake of n-3 fatty acids increases the n-3 Fig. 2. Developmental profiles and effect of dietary 20 4n-6 and 22 6n-3 on 20 4n-6 or 22 6n-3 in phosphatidylethanolamine of photoreceptors. Fig. 2. Developmental profiles and effect of dietary 20 4n-6 and 22 6n-3 on 20 4n-6 or 22 6n-3 in phosphatidylethanolamine of photoreceptors. Fig. 3. Developmental profiles and effect of dietary 20 4n-6 and 22 6n-3 on very long chain fatty acids in phosphatidylcholine of photoreceptors. Fig. 3. Developmental profiles and effect of dietary 20 4n-6 and 22 6n-3 on very long chain fatty acids in phosphatidylcholine of photoreceptors. fatty acid content of the rod outer segment (Suh et al., 1994, 1996 Lin...

Childhood Obesity

As is the case in adults, increase in energy intake and decrease in physical activity are the primary environmental influences on childhood obesity. A number of studies have documented that the increase in obesity prevalence has paralleled the increased consumption of junk foods snacks and decreased physical activity in this age group (85-87). Incidentally, children are especially vulnerable since most decisions regarding diet and physical activity are beyond their control. For example, parental concerns over safety have tended to limit time for recreational activity and to limit activities such as walking or bicycling to school. One obvious consequence is longer periods of television viewing, which leads to prolonged unsupervised exposure to direct advertisement of foods and drinks, most of which are high in fat and or simple sugars.

The role of the dietitian

Dietary history A careful dietary history should reveal the patient's dietary habits, their intake of the suspected food and the extent to which they have to modify their diet to comply with the dietary avoidance. It can also help to identify a situation where accidental exposure is likely to occur. Likes, dislikes and cravings for foods are noted. There may be preconceived ideas about various foods and some foods may already be excluded at the patient's own initiative or following advice from other medical or non-medical practitioners. A food diary completed over a week could be analysed by a computer program to give an indication of the patient's dietary intake. An assessment is also made of the patient's ability to understand and comply with a possibly difficult avoidance diet. This information would help in the diagnosis and assessment of risk to the patient and is also valuable when an avoidance diet is suggested. The dietitian should give an explanation and provide a list of...

Your Diet for Type 2 Diabetes

People with type 2 diabetes are frequently overweight, so advice about nutrition is directed not only at controlling carbohydrate intake, but also at limiting calories. (I discuss caloric restriction and weight loss in Chapter 10.) If you have type 2 diabetes, there are several reasons why you still need to estimate the carbohydrate content of your food

Obesity and Nutritional Intake

Obesity, in general, is associated with decreased adiponectin expression in adipose tissue and plasma levels (7,13). In both men and women, overall obesity, assessed by parameters such as body mass index (BMI) and fat mass, is negatively correlated to adiponectin, although prolonged weight reduction leads to increased adiponectin levels (7,14-17). Nutritional intake does not seem to explain this relationship. Although fasting decreases adiponectin messenger ribonucleic acid (mRNA) levels in mice, serum levels remain unchanged (18). In humans, short-term fasting also does not change plasma levels of adiponectin, although prolonged caloric restriction does result in weight loss and increased adiponectin levels (14,19). Additionally, daily caloric intake, macronutrient intake, or a high-fat meal is not related to any immediate change in circulating adiponectin levels in humans except possibly in obese individuals (20-22).

Major Molecular Targets of Selected Dietary Chemopreventive Phytochemicals to Induce Apoptosis

Mechanisms underlying the elevated expression of HIF and HIF-regulated inflammatory and angiogenic gene products in tumors includes control of mRNA expression, protein stability, and activity of HIF 79 . Under hypoxic conditions, HIF-1a protein escapes prolylhydroxylase von Hippel Lindau (VHL)-dependent proteasomal degradation, thus, forming a heterodimer with HIF-1 P and subsequent binding to the hypoxia response elements (HRE) located in the promoter of target genes 79 . Under normoxic conditions, the transcriptional activity of HIF-1a is regulated by factor inhibiting HIF-1a (FIH), which prevents the binding of HIF-1a with transcriptional coactivator p300 CBP by hydroxylation of an asparagene residue located in the C-terminal domain of HIF-1a 89,90 . The activation of extracellular signal-regulated protein kinase (ERK) enhances transcrip-tional activity of HIF-1a by promoting phosphorylation and subsequent nuclear localization of HIF-1a 91,92 . Moreover, loss-of-function of tumor...

Absorption Transport And Metabolism Of Dietary Folates

If one takes into account all folyl oligo-y-glutamyl forms of the various one-carbon and unsubstituted oxidation states of the vitamin, folate metabolism becomes complex. However, it is generally agreed that food folate exists largely in 5CH3-H4folate and formyltetrahydrofolate (formyl-H4folate) forms (27). (Figure 1 gives the structure of all reduced folate derivatives.) The predominant natural dietary folate is 5CH3-H4folate (28,29), which is readily oxidized to 5-methyl-5,6-dihydrofolate (5CH3-5,6-H2folate) (27). In this oxidized form, it may add up to 50 of the total food folate (30). relatively stable. Fortunately, ascorbate secreted into the stomach lumen can salvage acid-labile 5CH3-5,6-H2folate by reducing it back to acid-stable 5CH3-H4folate and, thus, may be critical for optimizing the bioavailability of food folate (31). It has recently been shown that dietary formyl-H4folates may also utilize the natural pH of the gastrointestinal tract to isomerize and yield biologically...

Cell Signaling Molecules As Targets Of Selected Dietary Chemopreventive Phytochemicals

The National Cancer Institute (NCI) of the United States has identified about 40 plant-based foods that possess chemopreventive properties. Attention has recently been focused on a vast reservoir of nonnutri-tive phytochemicals present in fruits, vegetables, spices, and beverages as potential chemopreventive agents. It is now estimated that more than 1000 different phytochemicals possess chemopreventive activities 5 . Examples of chemopre-ventive dietary phytochemicals are epigallocatechin gallate (EGCG) from green tea, curcumin from turmeric, genistein from soybeans, sulforaphane from broccoli, proanthocyanidins from grape seeds, indole-3-carbinol from cabbage, res-veratrol from grapes, lycopene from tomatoes, organosulfur compounds from garlic, gingerol from ginger, and caffeic acid phenethyl ester (CAPE) from honey bee propolis 5 . The following section will focus on an overview of the modulation of cell signaling molecules by selected dietary...

Effect Of Dietary n3 Fatty Acids On Cognitive Function

Brain, and most other parameters remain approximately unchanged, these are not confounding factors and the effects of n-3 deficiency are generally assumed to be the result of the change in fatty acid composition of organs such as the brain. Table 2 lists oils commonly used in dietary depletion studies according to whether they are rich or poor sources of n-3 fatty acids.

Dietary n3 Deficiency in the

Perhaps the most consistent effect of n-3 deficiency is found on vision. For instance, when Wistar rats that had been fed sunflower-oil-based chow for three generations were compared to a similar soybean-oil-fed group, there were striking and highly significant differences in their electroretinograms (Bourre, et al., 1989). In 4-wk-old rats, the amplitudes of the a- and b-waves in the LNA-rich group were 39 and 80 higher, respectively, compared to the deficient group. Furthermore, for the a- and b-waves to reach the detection limit, the intensity of the light stimulus had to be 10 times higher in the LNA-deficient group than in the sufficient group. This effect diminished with time, but even between adult rats, a statistically significant difference of 20 between the a-wave amplitudes of the two dietary groups remained. Dietary Sources of Dietary Fat Commonly Used in Animal Experiments Good dietary sources of n-3 Poor dietary sources of n-3 Three generations of Wistar rats were fed...

Dietary n3 Deficiency in the Mouse 721 Mouse Visual Acuity and n3 Deficiency

In contrast, Bourre's group (Frances, et al., 1996a) compared OF1 mice fed a peanut-oil-based diet containing trace amounts of LNA with a group receiving 200 mg of LNA 100 g of feed from rape seed oil and found significant performance differences. Both groups had the same total fat and LA content in the diet and had been reared by dams receiving the same diet as their pups. There were 10 female mice in each group. The LNA-deficient group improved its performance over time, but in the Morris water maze (place-test version), it took them significantly longer to find the platform after 16 practice trials. The difference was not significant in the cued version of the test. When mice raised by the same scheme were tested (Frances, et al., 1996b) it was found that the n-3-sufficient mice but not n-3-deficient mice showed reduced exploration in a photocell Actimeter. In the forced swimming test, the n-3-sufficient mice were significantly less active, and the same was found (p < 0.061,...

High Fat Diets and Obesity Possible Influence of n3 PUFAs

Obesity is one of the major health risks for a number of diseases, particularly heart disease and diabetes. It is well known that ingestion of a diet high in saturated fats is one of the major causes of obesity. There are two explanations for this observation. First, diets high in saturated fats do not seem to be as satiating as either high-carbohydrate or highprotein diets (Doucet et al., 1998), even when the high-fat diet is less palatable (Warwick, 1996). Second, whereas increased intake of either carbohydrate or protein causes a concomitant increase in energy expenditure (e.g., nonshivering thermogenesis), increased intake of saturated fat does not cause a similar increase in energy expenditure. Individuals maintained for 1 wk on a high-carbohydrate or high-protein diet have, whereas individuals maintained on a diet high in saturated fat did not have, increased body temperature and ingested fat was mostly sequestered to adipose tissue that is, increased intake of saturated fat...

Dietary Fat and Weight Gain

Dietary restriction of cholesterol and saturated fatty acid can mitigate and in some cases prevent increases in LDL-cholesterol, VLDL-cholesterol, and hypertriglyceridemia during thiazide therapy. In addition, increases in body weight during long-term treatment with diuretics tends to increase plasma cholesterol, whereas weight loss is associated with improvement in plasma lipids. Whether the changes in weight reflect attendant alterations in insulin resistance or dietary effects on lipid synthesis is not known. However, the observations suggest that dietary fat and caloric intake are important in the pathogenesis of hyper-lipidemia during thiazide treatment.

Dietary supplements of plant origin

Epidemiology suggests that cancer is largely an unavoidable disease and that more than two-thirds of cancers might be prevented through lifestyle modification (Ferguson, 1999). According to some authors the four main causes of cancer deaths are smoking, diet, chronic infections (especially in developing countries) and hormonal factors (Ames and Gold, 1998). One of the major influences on cancer risk appears to be diet. Dietary imbalances are important especially the lack of sufficient amounts of dietary fruits and vegetables (Ames and Gold, 1997). Despite disagreement between different authors on details, there is agreement on the considerable number of modifying factors in the carcinogenic process and that there are very good prospects for dietary interventions (Ferguson, 1999). Epidemiological studies, supported by preclinical data from animal and in vitro experiments and by clinical findings, have contributed immensely in providing insights into links between diet and cancer...

Definitions of dietary supplements

The DSHEA defines dietary supplements for regulatory purpose within the United States. The Office of Dietary Supplements at the NIH needed to implement research priorities using this definition and yet in some manner group the wide array of supplement ingredients available in the marketplace into more manageable categories. A definition was needed that also could be interpreted more readily in terms of research projects. An operating definition was requested in meetings with the NIH Institute Directors and other agencies who expressed difficulty in understating whether or not specific ingredients would be supported in the research and education programmes developed by the ODS. The resulting operating definition and categorization of dietary supplement ingredients was developed in collaboration with the staff of the Office of Special Nutritionals at the Food and Drug Administration (FDA), who had oversight for dietary supplement regulatory affairs, and a large group of ad hoc advisers...

Dietary Lna And Dha As Substrates For Brain And Retina Dha Compositional Studies

Kliauea Graph

In nontracer experiments, relative contribution of dietary LNA and DHA to CNS DHA accretion have been examined in various species, including chicks, rat pups, newborn piglets, and guinea pigs. Anderson and colleagues studied the relative efficacy of LNA and DHA in restoring neural DHA levels in newly hatched chicks, as presented in Fig. 1 (Anderson, Connor, & Corliss, 1990). Laying hens were fed a n-3-deficient diet for 2 mo, and their hatched chicks were then fed a control diet or n-3-deficient diets supplemented with LNA (+LNA) or DHA (+DHA) at 3.6 wt (0.44 kcal) for 3 wk. After 3 wk, the DHA group showed brain DHA levels similar to that of controls (12.3 vs 8.3 ), whereas dietary LNA alone brought the level to only 25 of the controls. Similar results were observed for retinal DHA accretion. It was concluded that dietary DHA exerts a fourfold greater potency compared to LNA as a substrates for brain and retina DHA accretion. group. It was thus concluded that dietary LNA is 24 as...

The Dietary Reference Intakes DRIs

We all need the same nutrients, but the amounts we need depend on our age, sex, and a few other factors. For example, women who are pregnant or breastfeeding need more of most nutrients. The Food and Nutrition Board of the Institute of Medicine, National Academy of Sciences, a group of nutritional scientists from the United States and Canada, has established the Dietary Reference Intakes (DRIs), a set of recommendations for nutrient intake. The DRIs are age- and sex-specific. With the exception of fats and carbohydrates (whose requirements depend only on our calorie needs), a separate DRI is set for each of the known nutrients for each of10 different age groups. From the age of 9 years, males and females have separate DRIs, and additional DRIs are set for women who are pregnant or breastfeeding. How did the nutrient recommendations originate Concerned with the need to provide proper nutrition for newly drafted World War II soldiers, many of whom were undernourished, the Department of...

Healthy Weight

However, your health care provider does want you to be at a reasonable and healthy weight. Before you become pregnant, you should try to be at a healthy weight. Being at a healthy weight makes it easier for you to conceive, because your metabolism and hormones are more likely to be in the proper balance. So what defines a healthy weight Most health care professionals use the body mass index (BMI) as a reliable indicator of body fat. The BMI is a way of correlating your body weight to your height. (A mathematical formula divides your weight in kilograms by your height in meters squared.) Table 5.1 summarizes what you need to know about BMI. Find your height along the left column, and then find your current weight in that same row. Then look up at the top of Table 5.1 to determine your BMI category. Table 5.1. Body Mass Index Table Table 5.1. Body Mass Index Table


Obesity is excess body fat for a given age or gender and can increase the risk of coronary heart disease two-fold (BHF, 2004). Body Mass Index (BMI) is an In the last ten years the percentage of obese adults has increased by more than 50 , from 14 of the population to 22 (BHF, 2004). This has many serious implications for cardiac rehabilitation, as obesity is a significant risk to the primary cause and secondary prevention of CHD. If the goal is to use exercise as a strategy for obesity reduction, exercise programmes require prescribed energy expenditure of 3000-3500 kcal per week. This would require approximately 45-60 minutes of exercise, for example, purposeful walking performed at a moderate intensity (70 HRmax) on most days of the week (Mulvihill and Quigley, 2003). The intensity for weight management is between 50 and 75 HRmax. Type For overweight patients, avoid high-impact exercises in order to prevent excess stress on joints. Alternatively, non-weightbearing activities could...

Ideal Body Weight

To determine your ideal body weight, use the following formula If you are large-framed you can add 10 percent to the calculated weight. For example, if you are a male who is 5 feet 8 inches tall, your ideal body weight is 106 + 48 154 pounds. If you are large-framed, you might weigh as much as 169 pounds.

Obesity In Children

Childhood obesity is a serious problem in the United States because of its association with detrimental social and physical outcomes and its rising prevalence in recent years. Although several proposed methods for determining childhood obesity exist, the most widely used is to define childhood obesity as equal to or above the 95th percentile on the body mass index (BMI). Epidemiological studies employing the BMI method suggest that approximately 11 to 15 of children in the United States are obese. Estimates suggest that the prevalence of childhood obesity has risen by 4 over the previous decade (Centers for Disease Control and Prevention, 2004). Although obesity rates have increased for both sexes and all racial-ethnic groups studied, it appears that rates of obesity may be higher among minority groups, including African Americans and Mexican Americans, when compared to whites. Childhood obesity has multiple possible causes, which can be best understood by considering the combined...

The chapters that follow

In 1994 or the establishment of the European Scientific Cooperative on Phytotherapy (ESCOP) in 1989. These scientists present a comprehensive view of the earlier and current approaches to studying plant-derived compounds that are used as dietary supplements. They also have placed their research into the worldwide perspective of plant biodiversity, ecology and the increasingly politically fraught arena of genetically modified foods. Dr Can Baser approaches dietary supplements of plant origin from the perspective of the plant industry in Chapter 4. He discusses the active compounds with potential health benefits in a number of food products such as soybeans, tomatoes, etc. In Chapter 5 Giovanni Appendino and Orazio Taglialatela-Scafati take what they describe as a 'pharmaceutical point of view' towards diet. In this carefully organized chapter Drs Appendino and Taglialetela-Scafati walk the reader through major developments in the scientific understanding of active pharmaceutical...

The situation in Europe

In Europe, dietary supplements account for 15 20 per cent of the herbal market. Although regulations vary from country to country, in Europe, herbal products are generally considered as medicines. Therefore, full registration with a full dossier on quality, safety and efficacy has to be submitted for pre-market approval. Bibliographic documentation can be based on clinical trials, and the monographs of the European Pharmacopoeia (EP), World Health Organization (WHO), German Commission E and the European Scientific Cooperative on Phytotherapy (ESCOP). There is a simplified way of registering a herbal product as medicine with proof of efficacy based on long-term traditional use in countries like Germany, Austria, Belgium and France. In such a case, the medicine has to carry a disclaimer on the label stating that it is 'traditionally used' (Lawson and Bauer, 1998 Stott, 1998 Grunwald, 1999 Steinhoff, 2001). In short, the EU has, at present, no legislation like in the USA to regulate...

Druglike compounds from food plants and spices

Since nutritional research has traditionally focused on macronutrients (proteins, lipids, sugars) and essential micronutrients (vitamins, minerals), food plants have long been assumed to contain few if any secondary metabolites apart from those revealed by our senses and responsible for their taste and flavour. Over the past few decades, evidence has, however, been mounting that food plants also contain a host of secondary metabolites which, though generally undetected by our senses, can nevertheless contribute to human well-being and play a role in the maintenance of health (Pisha and Pezzuto, 1994). Evidence for the dietary intake of biologically active small molecules can be traced to two distinct lines of research, namely the study of the detrimental effects of the inordinately large consumption of single food plants, and the recognition that food and medicines can interact, sometimes with dramatic consequences. Research in these areas has always been intense, and recent...

Mainstream drugs from edible plants

The background 'pharmaceutical noise' of dietary origin Certain active pharmaceutical ingredients occur naturally in food plants and spices. With a few notable exceptions (statins, xanthines, capsaicinoids), the concentrations are very low and unlikely to exert any direct significant pharmacological activity. This background dietary 'pharmaceutical noise' can, however, become significant under particular conditions, especially in the realm of exposure to recreational drugs like tobacco and opioids. The interference of dietary nicotine (3a) in studies of exposure to environmental tobacco smoke has long been debated. Nicotine is widely distributed, and has been found in twelve plant families, with detectable amounts in many food plants. Thus, levels up to 100 (xg kg have been measured in aubergines, and also non-solanaceous vegetables like cauliflower can accumulate nicotine (Domino et al, 1993). The dietary intake of nicotine is unlikely to produce any direct pharmacological or...

Main techniques employed by plant biotechnology

Plant secondary metabolism is very important in determining flower colour, flavour of food, and plant resistance against pests and diseases. Moreover, it is the source of many useful chemicals such as drugs, dyes, flavours and fragrances (Verpoorte et al., 1999, 2000), which are the main active constituents or at least simple components of most medicinal plants and herbal dietary supplements. Therefore, it is of interest to be able to engineer the secondary metabolite production of the plant cell factory, e.g. to produce more of a useful chemical, to produce less of a toxic compound, or even to make new compounds or valuable herbal products. Our limited knowledge of secondary metabolite pathways and the genes involved is one of the main bottlenecks (Verpoorte et al, 2000).

Transgenic crops for improved medicinal plants and pharmaceutical products

As discussed earlier, secondary metabolite pathways are complicated, since they require multiple enzymatic steps to the desired end-product used as therapeutic substance or dietary supplement and since these enzymatic pathways are under the control of multifactorial regulatory processes.

The example of St Johns wort

Increasing numbers of people are seeking symptomatic relief of psychiatric disorders by using dietary supplements. Since this is generally without medical supervision (Fugh-Berman and Cott, 1999 Wong et al., 1998), it is essential that clinicians avail themselves of the extensive literature available on natural products so that potential problems can be avoided. Herb drug interactions can be of two primary types pharmacokinetic and pharmacodynamic. Dynamic interactions are those having to do with the mechanism of action, e.g. where the drug's pharmacologic actions may be in opposition to or in addition to one another. Pharmacokinetic interactions are the result of alterations in the absorption, distribution, metabolism or excretion of medications when given together with specific drugs, foods or supplements. Interactions between botanical products and prescribed medications could increase or decrease the action of the drug, though the majority of interactions are likely to go...

Official information resources

The section on official sources of information includes reviews (monographs) by officially recognized experts on botanicals such as the United States Pharmacopoeia, World Health Organization Traditional Medicine Programme and the European Scientific Cooperative on Phytotherapy. It also includes information resources from governmental organizations such as the Office of Dietary Supplements at the National Institute of Health.

Concluding remarks

Our diet contains a host of secondary metabolites which can interact with important pharmacological targets, and for which biological activity can be demonstrated in in vitro and in vivo assays. The role of these interactions for human homeostasis is unknown, and the translation of dietary constituents into pharmaceutical leads is undoubtedly fraught with difficulties. Nevertheless, it is not unconceivable that in the near future progress in biomedical sciences will put us in the position to better evaluate the physiological role and pharmacological potential of the multitude of dietary chemicals which have challenged our homeostasis over the course of evolution. People in developed countries are expecting food to make them healthier, fending off the chronic diseases of ageing. This trend has led to the explosion of the functional food market, which is expected to constitute 10 per cent of the total food market in the USA (and presumably of other developed countries as well) by 2010...


Dietary supplements in the United States include a wide array of ingredients and products that are broadly available in the marketplace. While these products are presented in formats that give the appearance of standard over-the-counter (OTC) medications such as aspirin, their manufacturers are not required to provide the same level of pre-market safety data as manufacturers of OTC products. Botanical supplements, in particular, are directly derived from wild, or in some cases, commercially grown plants and therefore are more subject to product variability due to plant contamination, and manufacturing and post-manufacturing variables that are currently not regulated. The United States and countries within Europe have widely differing approaches to regulation and marketing of dietary supplements of plant origin. While these aspects may differ, scientists worldwide share concern with the need for careful hypothesis-driven research on the efficacy and safety of dietary supplements, and,...

The European market

Due to the uncertain interpretation of rules and the lack of a harmonized legislation, anyone who has ever tried to market food supplements containing herbs, having in mind to sell the same product in the majority of EU countries, will experience the range of complications and practical difficulties which may arise. For instance, the first problem may be the legal status of the herbal product in certain countries it will be deemed as a medicine, in others as a food or a food ingredient. Talking about dietary supplements in Europe means considering both the above-mentioned categories because of the different legal basis that a single product can have in different states. As a matter of fact, we must not limit our discussion to food products. From the description of a herbal product as a medicine or as a food can derive the practical feasibility of marketing it in a number of countries. A good example of this can be marketing a Ginkgo biloba product, claiming its capability to improve...

New terminology

The expanding world of dietary supplements especially in the USA, has learned new terminology such as 'functional foods', 'novel foods', 'nutraceuticals', 'designer foods', 'pharmafood', 'phytoceuticals'. These terms are used to describe At present, in the USA, there is no legislation governing the use of nutraceuticals or functional foods. The FDA states that existing regulations for foods are sufficient and that companies must decide on intended use (conventional food or dietary supplement) early in product development (Anon., 2000).


Soybeans are a unique dietary source of the isoflavone genistein, which possesses weak oestrogenic activity and has been shown to act in animal models as an anti-oestrogen. Genistein is also a specific inhibitor of protein tyrosine kinases it also inhibits DNA topoisomerases and other critical enzymes involved in signal transduc-tion (Messina et al, 1994). Genistein is highly bioavailable in rats because its enterohepatic circulation may accumulate within the gastrointestinal tract (Sfakianos et al, 1997). The branch pathway for the formation of isoflavonoids shares several mechanistic features with the anthocyanin pathway. However, the first reaction specific for isoflavonoid biosynthesis is unique. It comprises 2-hydroxylation coupled to aryl migration of the B-ring of a flavanone (naringenin or daidzein) to yield, after a dehydration reaction that might be spontaneous or enzyme-catalysed (Hakamatsuka et al, 1998), the corresponding isoflavone (genistein or daidzein, respectively)....

Nursing Care Plans And Individual Client Care Needs

Collect assessment data from all available sources including the client, the family, other providers, and the chart. Chart data may include nurse's notes or flow sheets laboratory, diagnostic, or surgical reports progress notes from dietary, rehab, or physical therapy the physician's history and physical, and progress notes. Assess the client's current status through the interview, observation, and physical examination. After studying the health record and obtaining assessment data, organize the information into prioritized problem or client need categories.

Americas Health Goals

According to recent statistics, our eating habits the foods we eat and drink and those we avoid play a major role in preventing 4 of the 10 leading causes of death in the United States. These include heart disease, cancer, stroke, and diabetes (see sidebar Top 10 Causes of Death, this page). In

Acidbase Disorder Common Causes

Splinting, chest burns, tight chest or abdominal dressings) Abdominal distension obesity, ascites, bowel obstruction Disorders of respiratory muscles severe hypokalemia, Amyotrophic lateral sclerosis, Guillain-Barr syndrome, poliomyelitis, myasthenia gravis, drugs (curare, succinylcholine)

Genetic Considerations

Metabolic alkalosis is a common disorder of adult hospitalized patients. Elderly patients are at risk for metabolic alkalosis because of their delicate fluid and electrolyte status. Young women who practice self-induced vomiting to lose weight are also at risk for developing metabolic alka-losis. Finally, middle-aged men and women with chronic hypercapnia respiratory failure are at risk for metabolic alkalosis if their PaCO2 levels are rapidly decreased with mechanical ventilation, corticosteroids, or antacids.

Primary Nursing Diagnosis

Pharmacologic therapy may include IV saline solutions, potassium supplements, histamine antagonists, and carbonic anhydrase inhibitors. IV saline solutions (0.9 or 0.45 ) may be used to replace lost volume and chloride ions. Causes of metabolic alkalosis that respond favorably to saline therapy include vomiting, NG suctioning, post chronic hypercapnia, and diuretic therapy. The causes of metabolic alkalosis that do not respond favorably to the administration of saline include hypokalemia and mineralocorticoid excess. Potassium chloride is used to treat hypokalemia in a patient with metabolic alkalosis. Dietary supplements of potassium are not effective unless chloride levels are stabilized.

A Day for Better Health

The National Cancer Institute of the United States and the Produce for Better Health Foundation (a nonprofit consumer education foundation representing the fruit and vegetable industry) collaborated in a unique partnership in 1991 to develop the 5 a Day for Better Health program. This is a nationwide educational effort to encourage Americans to eat 5 or more servings of fruits and vegetables every day for better health. A minimum of 5 servings of fruits and vegetables a day provides the RDA for many of the vitamins and minerals (see Chapter 2, page 29). The recommendation that we eat 5 to 9 servings of fruits and vegetables each day also is based on the results of numerous studies showing the positive effects of fruits and vegetables on health as a result of their ability to reduce the risk of cancer and other diseases. Ample consumption of fruits and vegetables forms the basis of some of the Dietary Guidelines for Americans and the guidelines of the American Cancer Society and...

Preface to the First Edition

Part IV deals with the role of fats and oils in overall nutrition. The importance of antioxidants in nutrition and food preservation is presented. Excess fat intake is associated with many disease conditions. This section describes various omega fatty acids and their sources, the role of dietary fats in atherosclerosis, eicosanoids production, immune system, coronary heart disease and obesity. The various types of lipid-based synthetic fat substitutes are discussed.

Pathology and Pathogenesis

The gross pathology of ascovirus disease is very indistinct, and probably accounts for the fact that ascoviruses were discovered only recently. The most obvious sign of disease is that, within 24 hours of infection, larvae cease to gain weight or progress in development. Healthy larvae, particularly in the early stages of development, will easily quadruple their weight and size in a period of 3-4 days, whereas ascovirus-infected larvae cease to grow and may actually lose weight. This is a characteristic that is virtually impossible to detect in the field, but which is easily noticed under laboratory conditions when infected and healthy larvae are reared side-by-side over a period of a few days. A second feature easily

Other Voices Guidelines of Health Organizations

In addition to the Food Guide Pyramid and the Dietary Guidelines for Americans, several private health organizations (the American Heart Association, the American Cancer Society, and the American Institute for Cancer Research) have issued their own nutritional guidelines. Society, the American Dietetic Association, the American Academy of Pediatrics, the American Society for Clinical Nutrition, and the National Institutes of Health met in 1999 to review scientific evidence and to identify practices that are effective against major diseases. The dietary recommendations that these groups have in common include These recommendations can be achieved by following the Dietary Guidelines for Americans (page 9) and by using the Food Guide Pyramid (page 11).

The Bottom Line Optimizing Health

Nutrition experts agree that when you lower the total fat, saturated fat, and added sugar in your diet and increase the vitamins, minerals, and fiber by eating more fruits, vegetables, and grains, you can improve your quality of life and help prevent many of the diseases that are the leading causes of death. Now that you know the goals and guidelines for healthful eating, we will provide you with the nutrition and food selection knowledge you need to put those guidelines into practice. Chapter 2 explains the nutrients we all need, the roles they play in promoting health, the best food sources for these nutrients, and how your nutritional needs change throughout your life. Chapter 3 describes how your risk for serious illnesses is influenced by your diet. Chapters 4 and 5 help you learn to use the Food Guide Pyramid to choose the most nutritious foods, and they give you guidance about planning and preparing healthful, appetizing meals. Mayo Clinic Healthy Weight...

Defining the terms and scope of food and nutritional toxicology

Nutritional toxicology is the study of the nutritional aspects of toxicology. Nutritional toxicology is related to and might even overlap but is not synonymous with food toxicology. Food toxicology emphasizes toxicants or toxins found in foods, whereas nutritional toxicology targets the interrelations that toxicants or toxins have with nutrients in the diet, which affect nutritional status. Nutritional toxicology can refer to the means by which the diet or components of the diet prevent against the adverse effects of toxicants or toxins. starting when humans first realized that they had to be cautious with food selection or suffer dire consequences. Our ancestors probably learned from trial and error and by observation about which food sources satisfied hunger and which led to illness or death. As illustrated in the cartoon in Figure 1.1, early humans were quick to either learn or suffer the consequences of deciding whether to eat a plant where dead animals lay. Thus, our ancestors...

Toxicants in foods and their effects on nutrition

One usually does not relate the ingestion of a specific nutrient with concerns about the toxicity of that nutrient. However, intakes of essential dietary chemicals from zero to excessive produce responses, from lethal because of nutrient deficiency to an optimal health response and back to lethal because of intolerably high concentrations. Thus, as the solid line in Figure 1.2 illustrates, an organism cannot tolerate either of the two extremes over an extended period. The figure illustrates that there will be intakes, both low and high, associated with lethality. Also, there will be minimum low and maximum high intakes associated with good health and a valley associated with optimal health. The valley of the curve for optimal health will vary, depending on a number of physical, biochemical, or physiological effects of the nutrient. For example, the intake level of vitamin E for optimal health has a rather wide valley compared with that for intake levels of vitamin D, vitamin A, or...

The Metabolic Syndrome in HIVinfected Individuals

A constellation of laboratory and physical abnormalities, termed the metabolic syndrome, is associated with increased risk of cardiovascular morbidity and mortality (Table 2). This syndrome is seen in 24 of the US population overall its prevalence is increasing in the US. The metabolic syndrome encompasses disturbances in glucose, insulin, and lipid metabolism, associated with abdominal obesity. The presence of the metabolic syndrome roughly doubles cardiovascular disease mortality. In other studies, the risk for cardiovascular disease with metabolic syndrome is even higher.

HIVSpecific Diseases Lipodystrophy

Lipodystrophy was identified and characterized by Carr and colleagues in 1998. In addition to laboratory abnormalities associated with the metabolic syndrome, there can also be subcutaneous lipodystrophy, which can involve either fat accumulation in the abdomen, neck and upper back, (Figure 1) or lipoatrophy, involving the extremities and the face (Figure 2), and they can both be seen together. The lipoatrophy in the face is highly recognizable and can be stigmatizing. There is deepening of the nasolabial folds and loss of subcutaneous tissue in the temples and cheeks. Lipodystrophy has been associated with treatment with thymidine nucleoside analog-based (stavudine or zidovu-dine) regimens, and co-administration of a thymidine analog with some protease inhibitors may further accelerate fat loss. Studies investigating thymidine-sparing regimens typically show normal limb fat mass and lower incidence of clinical lipoatrophy, even over prolonged follow-up.

Substrate Specificity

NAT1 and NAT2 have different but overlapping substrate specificities, although no substrate is exclusively acetylat-ed by one isozyme or the other, and no clear structural motif that determines substrate specificity for the different isoforms has been identified. Substrates preferentially N-acetylated by human NAT1 are p-aminobenzoic acid, p-aminosalicylic acid, sulfamethoxazole, and the folate catabolite p-aminobenzoyl glutamate. Substrates primarily N-acetylated by human NAT2 include a number of sul-fonamides (sulfamethazine, sulfapyridine, sulfadiazine, sulfameridine, and sulfadoxine), isoniazid, aminoglutethi-mide, amonafide, procainamide, dapsone, dipyrone, endra-lazine, hydralazine, prizidilol, batracylin, and metabolites of clonazepam and caffeine. Some compounds, such as the carcinogenic aromatic amines 2-aminofluorene, ben-zidine, 4-aminobiphenyl, 4,4-dichloroaniline and 2-naph-thylamine, and the food-derived heterocyclic amines and are N-acetylated to varying degrees by both...

Mechanisms of food intolerance and food allergy

What role do food allergens themselves play We know generally that the most common foods implicated in food allergy and food intolerance are egg, milk, peanuts, nuts, fish and soya.5-7 On average, an individual's gastrointestinal tract will process about 100 tonnes of food during a lifetime. Everything we eat is foreign to our body and potentially immunogenic. What is so special about some food allergens Why do only a proportion of people have the ability to sensitise and cause an allergic reaction What is the natural history of food allergy and food intolerance We do not know why with some foods, such as milk, sensitivity is lost with time, while with others, such as peanut, the reaction seems to be long-lasting. What influences do our eating habits have on our allergy and intolerance profile For example, soybean and rice allergy is more common in Japan, and fish allergy is more prevalent in Scandinavian countries. Who in the UK had heard of kiwifruit allergy 20 years ago

The Bottom Line on Fats

Dietary fat is a source of energy, but high-fat diets, especially diets high in saturated fat, increase the risk of gaining excessive amounts of weight and of developing diabetes, coronary artery disease, high blood pressure, and several types of cancer. This increased risk is the reason that health experts encourage us to reduce our intake of total and saturated fats by

Serological Relationship and Variability

Serologically, no distinction can be made between different virus isolates by using polyclonal antibodies. Variable detectability of viral antigens in brain specimens by monoclonal antibodies indicates, however, that some strain variation may exist. No conclusive data are available on the occurrence of biologically different virus strains in natural hosts. It remains to be seen whether inapparent infections in horses and sheep might be due to variant strains. All virus strains used for infection of experimental animals originate from brain tissue of naturally infected diseased horses. These isolates mostly underwent serial passages in rabbits and were adapted thereafter to different animals. Different biological properties of virus isolated at various times after infection from rats could also point to the existence of variants. In this context it should be emphasized that virus isolates exist that cause extreme obesity syndrome or behavioral alterations in infected rats.

Fetal Maternal Relationships

Pregnancy affects thyroid homeostasis. An increased excretion of iodine in the urine accounts for the increase in thyroid volume even in areas of moderate dietary iodine intake 4 . Some studies, however, do not show an increase in urinary iodine during pregnancy. In either case the increase in thyroid volume is the result of imbalance between the intake and increased requirements of iodine during pregnancy 5 . Iodine deficiency during pregnancy is associated with maternal goitre and reduced maternal thyroxine (T4) level. While thyroid size increases in areas of iodine deficiency it does not do so in those regions that are iodine sufficient even in moderate iodine-deficient regions urinary iodine excretion is higher in all trimesters than in non-pregnant women and may be

Pleiotropic Effects Of Creatine

As evidence for the above, in vitro treatment of cells as well as dietary supplementation of animals with Cr are highly beneficial with regard to protection from injury and enhancement of survival following noxious treatment (Brewer and Wallimann, 2000 Brustovetsky et al., 2001 Sullivan et al., 2000). Since Cr supplementation leads to an increase in intracellular PCr levels, a higher PCr ATP ratio (Vandenberghe et al., 1997) and thereby to a higher buffering capacity for intracellular ATP and ADP concentrations, one could explain at least part of the Cr-dependent protection of cells from various stressors, especially the neuroprotective effects of Cr (see chapters 8-11 Stockler et al., 2007 Schulze and Battini, 2007 Tarnopolsky, 2007 Klein and Ferrante, 2007), by the classical beneficial effects of Cr in improving the cellular energy state. Cr supplementation mediates remarkable neuroprotection in experimental animal models of amyotrophic lateral sclerosis (ALS), Huntington's disease...

Life Span and the Aging Process

The aging process causes many changes, both visible and invisible. In humans, these changes take several forms. In the first two decades of life, from birth to adulthood, aging involves physical growth and maturation and intellectual development. These changes are fairly noticeable and relatively swift compared to the rest of the life span. After reaching physical maturity, humans begin to show subtle signs of physical aging that grow more pronounced over time. Long-term exposure to sunlight and the outdoors may begin to toughen the skin and produce wrinkles on the face and body. The senses change Sight, hearing, taste, and smell become less acute. Gradual changes in the eye cause many older adults to need glasses to read. Hair begins to thin and turn gray. Individuals with less active lifestyles often begin to gain weight, particularly around the waist and hips. Beginning in their 40s (or, rarely, in their late 30s), many women experience menopause, which marks the end of...

Discharge And Home Healthcare Guidelines

Teach the patient factors that may precipitate anginal episodes and the appropriate measures to control episodes. Teach the patient the modifiable cardiovascular risk factors and ways to reduce them. Manage risk factors, including hypertension, diabetes mellitus, obesity, and hyperlipidemia.

Anorexia Nervosa DRG Categr 428

Anorexia nervosa is an eating disorder of complex and life-threatening proportions. It is an illness of starvation that is brought on by a severe disturbance of body image and a morbid fear of obesity. One in 250 adolescents are affected, and tragically, about 5 of those affected die. Anorexia nervosa is characterized by a person's refusal to maintain a minimally normal body weight for her or his height and age. This is done through inadequate food intake with no medical reason to account for weight loss. A distorted body image, dominated by an intense fear of obesity, leads to a relentless pursuit of an unreasonable and unhealthy thinness. Anorexia has four primary characteristics fear of becoming obese despite weight loss a distorted body image body weight 15 less than normal because of a refusal to eat and in females past puberty, the absence of three consecutive menstrual periods.

Supplements Foods or Functional Foods

Others, like the well-known multivitamins, may contain an entire panel of vitamins and minerals in amounts close to the Dietary Reference Intakes (DRIs). Still other supplements may not contain any substances yet identified as nutrients or even demonstrated as beneficial to health. With few exceptions, foods are better sources than supplements for the nutrients we need. A diet based on the Food Guide Pyramid, especially one that is rich in fruits, vegetables, whole-grain foods, and legumes, will provide most of the nutrients we know we need and the ones we have not yet identified. When we build our diet on a foundation of whole foods, we reap the added benefit of phytochemicals (known and unknown) and all the types of fiber we have begun to realize are important for health. Dietary supplements can be enticing. However, because of a law passed in 1994, the Dietary Supplement Health and Education Act, the Food and Drug Administration (FDA) is more limited in what it can do to regulate...

Clinical and Subclinical Infection

VCJD presents clinically with psychiatric symptoms, including depression and withdrawal, followed after a mean of 6 months by progressive ataxia and cognitive impairment, associated with involuntary limb movements. The mean survival is 14 months. vCJD affects younger age groups than in sporadic Creutzfeldt-Jakob disease (sCJD) with a mean age at death of 29 years (range 16-74 years), and it has been proposed that this may be related to either age-related susceptibility or variation in dietary exposure by age. All tested clinical cases have been methionine homozygotes at codon 129 of the human prion protein gene (PRNP).

Diet and biotransformation

The biotransformation of a toxic compound usually, but not always, results in detoxification. It can, however, lead to the metabolic activation of foreign compounds. The effect of dietary constituents on the metabolism of foreign compounds has been the subject of intensive study for many years. More than two decades ago, the term toxicodietetics was coined for the study of dietary factors in the alterations of toxicity a term that was perhaps ahead of its time. There are a multitude of dietary factors that can affect toxicity. Dietary factors can be associated with the exposure situation, ranging from factors such as palat-ability of the food to the physical volume or rate of food ingestion. Dietary factors can be responsible for producing changes in the body composition, physiological and biochemical functions, and nutritional status of subjects. These factors, and others, can have marked influences on the toxicity of substances. For example, it is customary to fast laboratory...

Common symptoms in pregnancy

Constipation complicates approximately one-third of pregnancies usually decreasing in severity with advancing gestation. It is thought to be related in part to poor dietary fibre intake and reduction in gut motility caused by rising levels of progesterone. Diet modification with bran and wheat fibre supplementation helps, as well as increasing daily fluid intake.

Nutrition and Your Stage of Life

Choosing to eat wisely throughout life is one of the most important components of living a healthful lifestyle. Using the Dietary Guidelines for Americans and Food Guide Pyramid as standards for your food choices and amounts, you will be well on your way to establishing healthful eating habits for your entire life. Unfortunately, many people become discouraged by nutrition advice because they mistakenly think they cannot eat their favorite foods.

Preschool Years Ages 1 to

As babies become toddlers, they make the transition into eating food the rest of the family eats. The rapid weight gain characterized during the first year levels off during the second, with an average gain of 5 to 6 pounds. Because a child is not growing at the same rate as during infancy, he or she may not want the same quantities of food that were once enjoyed. Some preschoolers may be uninterested in eating, whereas others seem finicky. Sometimes preschoolers are reluctant to try new foods or expand their food repertoire beyond three or four favorites. There are several things you can do to help overcome these challenges without forcing a child to eat (see sidebar Tips for Feeding Toddlers, page 42). By this time, a child should be eating foods from each of the food groups represented in the Food Guide Pyramid. However, do not expect a preschooler to eat a completely balanced diet every day. When allowed to choose from a selection of nutritionally sound foods, most children tend...

DHA and Membrane Fluidity

It is often erroneously assumed that more fatty acyl double bonds automatically means a more fluid membrane. By differential scanning calorimetry, however, it has been reported that for a series of PCs where the sn-1 chain is stearic acid and the sn-2 chain has zero, one, two, three, four, or six (DHA) double bonds, the phase transition temperature (Tm) decreases upon the addition of a first and second double bond (Coolbear et al., 1983 Dratz & Deese, 1986). However, further double bonds actually increases Tm so that 18 0,22 6 PC has a slightly higher Tm than does 18 0,18 3 PC or 18 0,20 4 PC. There are many reports in the literature indicating that the addition of DHA to already fluid biological membranes does not further enhance their fluidity as measured by steady-state polarization of fluorescent membrane probes. Dietary fish-oil studies on hepatocytes (Clamp et al., 1997), intestinal microvillus (Wahnon et al., 1992), erythrocytes (Popp-Snigders et al., 1986 Popp-Snijders et...

Biomedical and Behavioral Science

To evaluate the effectiveness of animal models, consider an example in the behavioral sciences. Bulimia is a disorder in which an individual's eating behavior becomes bizarre and his or her body image becomes distorted. In her overconcern about her body image, an adolescent female might eat large quantities of junk food and then vomit (binge-purge behavior). In the animal model of this disorder, a hole is made in the stomach wall when the animal eats, the food is siphoned off. Through this model of the condition of eating without calories,'' scientists attempt to identify and understand various environmental, dietary, and physiological causes of bulimia.

Human Behavioral Changes

Another notable change is in the general population's eating habits. The growing number of two-income families and the trend of eating away from home contribute fewer opportunities to discuss food safety information and follow best practices among family members. The percentage of income spent on food eaten away from home has significantly increased during recent decades. Fast food restaurants and salad bars are turning into primary sites for food consumption in today's fast-paced society 23 . The number of home-delivered meals considered as the ultimate convenience food has dramatically increased chiefly due to the rapid delivery mechanisms. Furthermore, aging has a profound effect on food safety considerations as the elderly are more susceptible to food-borne illnesses 24 . Developing nations are also experiencing food safety issues due to changes in food consumption practices. The booming economies of countries such as India and China, towing to the explosive growth in information...

Teenage Years Ages 13 to

Most of the calories a teenager consumes should take the form of the complex carbohydrates found at the bottom of the Food Guide Pyramid. It is also a good idea for teens to have 3 servings of calcium-rich foods a day (milk, yogurt, cheese, certain vegetables) to make certain that needs are met for growing bones. Iron is also important to the expanding volume of blood in the body and for increasing muscle mass. Teenage girls can be at risk for a shortage of iron as a result of iron loss through menstruation. To ensure ample dietary iron, encourage teens to eat fish, poultry (especially dark meat), red meat, eggs, legumes, potatoes, broccoli, rice, and iron-enriched grain products. When weight gain accompanies these habits, many teenagers turn to fad diets for quick weight loss. All of these pressures may lead to nutritional excesses, deficiencies, and, at the extreme, eating disorders. Excessive weight concerns can have more serious implications. Extremes in eating patterns, either...

Central Nervous System Cerebrovascular Accidents

A stroke has reported delay in colonic transit to be more generalised in the stroke group-rather than residing in a rectal evacuatory disorder-and rectal sensation to be normal in the stroke group 28 . Risk factors for constipation (and presumably overflow) include decreased mobility, dehydration, dietary factors and the use of drugs, which exert anticholinergic actions on the gut.

Why clinical trials have a limited value for detection of unexpected adverse events

Dexfenfluramine (Redux) was approved by the FDA as a promising drug for the treatment of obesity. However, bad news soon surfaced. The first cases of heart valve abnormalities were observed a year later, primarily in subjects exposed to the combination of fenfluramine and phentermine or fen-phen. Following the publication of a large case series3 and reports to the FDA from several obesity clinics, dexfenfluramine was withdrawn from the market. The clinical experience suggested that use of dexfenfluramine for six months or longer caused an unknown type of valvulopathy in a small but significant proportion of subjects. It is notable that the clinical trial experience prior to drug approval, which included 1,000 subjects treated for one year, did not raise any suspicion about drug-induced valvular disease. How could this problem have been anticipated It is no surprise that echocardiography was not a routine procedure in the clinical trials.

The Battle of the Bulge

With countless diet programs and products promising to help you shed pounds, losing weight should be easy. Simply eating too much and not being active enough are the causes of most overweight problems. But you also know it is hard to lose weight and even harder to keep it off. The cause of overweight and obesity is a chronic imbalance of calories ingested and calories burned. Genetic and environmental factors also contribute to obesity. Americans spend more than 33 billion a year on weight-loss products and services, but they are losing the battle of the bulge. Despite the great desire of Americans to be thinner, they have become more obese. Some have even declared that the United States has an obesity epidemic. It is estimated that more than 50 percent of adult Americans are overweight. The prevalence of obesity also is increasing in several other countries.

Get the Terms Straight

Overweight and obesity are terms that often are used interchangeably, but they have different meanings. Overweight refers to having excess body weight compared with the norm for a person's height, but the term does not account for what tissue is making up the weight. For example, athletes are often overweight according to weight-for-height tables because they have increased muscle mass. However, for most people, overweight means having too much fat. Obesity refers to body fat in excess of what is healthful for an individual. In healthy women, an acceptable level of body fat ranges from 25 to 35 percent. In contrast, an acceptable range of body fat in men is from 10 to 23 percent.

Pinpointing Your Risk

There are risk factors that indicate a predisposition for obesity. Among these risk factors are the following Body mass index (BMI) BMI is defined as your weight (in kilograms) divided by the square of your height (in meters). Simpler still, look it up in the Body Mass Index Table on page 49. The advantage of BMI over bathroom scales and weight-for-height tables is that it normalizes weight for height and helps determine whether you have a healthful or unhealthful percentage of total body fat. A BMI from 19 to 24.9 is associated with a minimal to low health risk. A BMI from 25 to 29.9 is considered overweight and is associated with moderate health risks. A BMI of 30 or higher is considered obese and is associated with a substantially greater risk for development of various diseases. Extreme obesity is a BMI of more than 40. Body Mass Index Table* To use the table, find your height in the left-hand column. Move across to find your weight. The number at the top of the column is your BMI.

Informed consent for anaesthetic procedures

Through the 1990s, in developed countries, the number of women receiving an anaesthetic procedure in association with a pregnancy increased to more than 60 17 in line with the increasing popularity of, and demand for, neuraxial analgesia - older mothers, obesity, increased Caesarean delivery rates, in vitro fertilization procedures and the like.

Clinical manifestation

Skin changes facial plethora striae ecchymoses and purpura telangiectasias skin atrophy hirsutism and male pattern balding in women increased lanugo facial hair steroid acne acanthosis nigricans Central obesity increased adipose tissue in the face (moon facies), upper back at the base of neck (buffalo hump), and above the clavicles

The practical application of due diligence to food allergenicity

The key to practical implementation of the 'due diligence' defence is knowing your product. Modern foods are complex and will rarely be manufactured from a handful of fresh ingredients derived from known sources. Frequently, complex flavouring compounds and other bought-in functional ingredients will be used in order to provide the specific manufacturing properties and product attributes which are necessary to make a product successful in today's competitive world. It is therefore important to hold detailed specifications for these ingredients in order to be confident that they do not contain potential allergens or, at least, that adequate warning can be given if necessary. Herein lies a problem, because many manufacturers of such ingredients will be shy about revealing the exact nature of their product. A request for a product specification may result in a polite refusal as the ingredient manufacturer plays the confidentiality card. In this situation there are a number of options...

Dha And Adhesion Molecules

CD8 and CD4, present on mature T-cell subsets, are not adhesion molecules per se but, rather, provide additional signals during antigen recognition, thereby enhancing the likelihood of T-cell activation. Oth et al. (Oth et al., 1990) observed that a fish-oil diet reduced CD4 expression on lymphoma cells (grown as ascites) without affecting expression of CD8, CD11a CD18, and MHC I. The dietary fatty acids may have affected CD4 gene expression or modified the membrane so as to deform or mask the epitope detected by the anti-CD4 monoclonal antibody. With regard to the latter, we demonstrated that cells modified with DHA presented as a fatty acid in culture medium or in phospholipids fused into the plasma membrane of lymphocytes displayed altered expression of two of three CD8 epitopes (one epitope decreased, another increased, the last was unchanged) (Jenski et al., 1995a), arguing for a direct effect of DHA on CD8 conformation or the lateral distribution of CD8 and its interaction with...

Dha And Major Histocompatibility Complex Proteins

In general, DHA or mixtures of omega-3 fatty acids decrease the expression of MHC II molecules. As designed, most experiments detect changes in MHC II production rather than direct modification of plasma membrane structure. For example, human volunteers fed a fish-oil supplement displayed reduced expression of MHC II on peripheral blood monocytes before and after treatment with the cytokine y-interferon (Hughes et al., 1996a), and dietary fish oil decreased MHC II expression on rat lymphatic dendritic cells (Sanderson et al., 1997) and murine peritoneal exudate cells (primarily B-cells and macrophages) (Huang et al., 1992). The nature of the stimulus used to induce MHC II expression is an important consideration in evaluating DHA's effects. Macrophages (thioglycollate-elicited peritoneal exudate cells) from n3-rich fish-oil-fed mice expressed more MHC II after a brief treatment with platelet-activating factor contrast than did macrophages from n6-rich safflower oil (Erickson et al.,...

Natural Product Research And Developmentan Update

While recombinant proteins and peptides are gaining market share, low-molecular-weight compounds still remain the predominant pharmacologic choice for therapeutic intervention 60 . Just a small sampling of the many available examples of the commercialization of modern drugs from natural products along with their year of introduction, indication, and company are Orlistat, 1999, obesity, Roche Miglitol, 1996, antidiabetic (Type II), Bayer Topotecan, 1996, antineoplastic, SmithKline Beecham Docetaxel, 1995, antineoplastic, Rh ne-Poulenc Rorer Tacrolimus, 1993, immunosuppressant, Fujisawa Paclitaxel, 1993, antineoplastic, Bristol-Myers Squibb.

Thrombosis and embolism

The Confidential Enquiry into Maternal and Child Health 2000-2002 7 shows that pulmonary embolism is still a major cause of death in the puerperium. Of a total of 25 deaths that occurred in the triennium, 16 occurred in the post-natal period. Table10.3 illustrates how therateof pulmonary embolism as a cause of death has remained static since 1985. The report identifies that there are three major areas that give rise to this increased risk of pulmonary embolism. These were increased maternal age, a family history of thromboembolism and obesity with its associated lack of mobility. Of the 16 deaths that occurred, 7 occurred within 7 days of delivery and 6 in the subsequent 2 weeks. The other 3 deaths occurred after this time. Currently, the use of prophylactic, subcutaneous, low molecular weight heparin as prophylaxis in the puer-perium is given only to women who are having Caesarean sections but attention should be given to this increased risk group for prophylactic heparin in the...

Counselling of patients after perinatal death

When a woman and her family experience a loss associated with pregnancy, special attention must be given to the grieving that they are going to undergo. Mourning is an extremely important part of coping and the clinical signs and symptoms of grief are important to recognize so that the healthcare workers can be sympathetic to this grieving process. These symptoms include sleeplessness, fatigue, poor eating habits, preoccupation with pictures of the baby, feelings of guilt, hostility and anger and a general disruption in the normal pattern of daily life. Unless the clinicians are aware of these changes, misunderstanding may occur and the ability to help the process of grieving will be lost. These families require a sympathetic person so that they have the opportunity to express and discuss their feelings in an open way. The establishment of identified individuals who are trained to deal with perinatal death is extremely important and centres should have doctors, midwives and...

Genenutrient Interactions In The Maternal Risk Of Down Syndrome Link To Abnormal Folate Metabolism

Multifactorial gene-environment interactions that compromise maternal folate status may promote chromosomal meiotic nondisjunction and risk of Down syndrome. The 677C T polymorphism of the MTHFR gene causes an alanine to valine substitution that decreases enzyme activity by 35 with the heterozygous (C T) genotype and 70 with the homozygous (T T) genotype (101). The reduction in enzyme activity associated with the MTHFR polymorphism raises the dietary requirement for folic acid to maintain normal remethylation of homocysteine to methionine (102). Consequently, inadequate folate intake in individuals with the MTHFR polymorphism could lead to an increase in homocysteine and a decrease in methionine levels (103). As shown in Fig. 1, chronic elevation in intracellular homocysteine can lead to a pathologic increase SAH that is associated with inhibition of the DNA methyltransferase and DNA hypomethylation (19,104).

Exogenous Sources of Advanced Glycoxidation End Products

Animal studies have demonstrated the close relationship between increased dietary AGE intake and development and or progression of many diabetes-related complications. Nephropathy, postinjury restenosis, accelerated atherosclerosis, and delayed wound healing were significantly inhibited by lowering dietary AGE intake (27-30). Sebekova and associates demonstrated in the remnant-kidney rat model that feeding an AGE-rich diet for 6 weeks increases kidney weight and causes proteinuria, independent of changes in glomerular filtration rate, pointing to the detrimental effect of such diet on the kidney (31). Of particular interest are studies showing that a low-glycotoxin environment can prevent or delay significantly autoimmune diabetes in successive generations of nonobese diabetic (NOD) mice (32) and to improve the insulin-resistant state in db db (+ +) mice (33). Reduction in exposure to exogenous AGEs of db db (+ +) mice, lacking in leptin receptor and thus prone to insulin resistance...

Oxidation of Fats and Amino Acids

Proteins are first hydrolyzed into their component amino acids, followed by deamina-tion, removal of the amino group. Finally, each of the 20 amino acids is converted to either pyruvate, acetyl-CoA, or one of the other intermediates in the Krebs cycle, for further oxidation. Free amino acids are not stored in the body. Excess proteins in the diet thus must be eliminated by the mechanism just described. Deamination releases ammonia to the blood, which can be toxic and must be rapidly removed. This can be accomplished by incorporation into new amino acids or by excretion either directly as ammonia (fish), uric acid (birds and reptiles), or urea (mammals).

Advanced glycoxidation endproducts metabolism

Other intracellular protective systems also help to limit the accumulation of reactive AGE intermediates. Methylglyoxal is first converted by glyoxalase-I to S-D-lacto-ylglutathione in the presence of reduced glutathione as an essential cofactor, and then converted to D-lactate by glyoxalase-II. The significance of such systems is supported by studies in which overexpression of glyoxalase-I prevented hyperglycemia-induced AGE formation and increased macromolecular endocytosis (47). These systems, however, could still be overwhelmed by high AGE conditions such as diabetes, renal failure, or sustained excess dietary AGE intake.

Body composition fluids and electrolyte metabolism

The glomerular filtration rate is low in newborn infants and only reaches mature levels by the end of the first year. Thus infants initially require little water, and 40-60 ml kg per 24 h is adequate. Infants have a concomitant obligatory sodium loss and do not require dietary sodium until weight loss is complete. In a sick or preterm infant, fluid and electrolyte administration must be carried out with great care as well as frequent measuring of weight and blood electrolyte concentrations.

Aging Exercise and Antioxidant Defense System

As acute strenuous exercise and chronic exercise training increase the requirement for various antioxidants, it is conceivable that dietary supplementation of specific antioxidants would be beneficial. Older subjects may be more susceptible to oxidative stress and may benefit from the antioxidant protection provided by vitamin E. During severe oxidative stress such as strenuous exercise, the enzymatic and nonenzymatic antioxidant systems of skeletal muscle are not able to cope with the massive free-radical formation, which results in an increase in lipid peroxidation. Vitamin E decreases exercise-induced lipid peroxidation. The exercise may increase superoxide anion generation in the heart, and the increase in the activity of superoxide dismutase (SOD) in skeletal muscle may be An acute bout of exercise can increase the activity of certain antioxidant enzymes in various tissues. The mechanism of this activation is unclear. Exercise training has little effect on hepatic or myocardial...

Therapeutic Approaches

Aging is associated with the decline in multiple areas of immune function, but, to date, no single mechanism has emerged as responsible for all of the observed changes. It is being increasingly acknowledged that autoimmune processes play a proinflammatory role in the development of many pathological conditions, such as atherosclerosis. It is likely that the mechanisms underlying age-related changes in immunity are multifactorial, with both genetic and environmental factors playing a significant role (Burns et al., 1997). The progression of and recovery from infectious diseases depends, at least in part, on immune responses and nutritional status in the elderly. Nutrition therapy may improve the immune responses of elderly people, particularly those with total-, protein-, fat-, or micronutrient-energy balances on prescribed low protein or fat diets (Lesourd, 1997). Micronutrient supplementation improves the immune status in the aged individuals. Episodes of disease in the aged leads to...

Nutrition Intervention

Immune system in the elderly, even in the apparently healthy independent-living elderly (Lesourd, 1999). Protein-energy malnutrition is associated with decreased lymphocyte proliferation, reduced cytokine release, and decreased antibody responses to vaccines. Deficits in zinc, selenium, and vitamin B6 in the elderly compound the depression of the immune system. The elderly do not have an adequate supply of fats for proliferation of lymphocyte and macrophage populations, antibody production, and hepatic synthesis of acute-phase proteins. Fat oxidation is reduced in the elderly at rest, during exercise, and in response to meal ingestion, as a result, in part, to the loss of fat-free mass, decreased intrinsic fat oxidation in muscle, and hormonal factors. These changes in fat oxidation are only partially corrected with training (Calles-Escandon and Poehlman, 1997). Lipids are known to have modulatory effects on the cellular immune system at the biochemical and molecular levels, including...

Gender Ethnicracial And Life Span Considerations

Because early cervical cancer is usually asymptomatic, establish a thorough history with particular attention to the presence of the risk factors and the woman's menstrual history. Establish a history of later symptoms of cervical cancer, including abnormal bleeding or spotting (between periods or after menopause) metrorrhagia (bleeding between normal menstrual periods) or menorrhagia (increased amount and duration of menstrual bleeding) dysparuenia and postcoital bleeding leukorrhea in increasing amounts and changing over time from watery to dark and foul and a history of chronic cervical infections. Determine if the patient has experienced weight gain or loss abdominal or pelvic pain, often unilateral, radiating to the buttocks and legs or other symptoms associated with neoplasms, such as fatigue.

Optimal Iodine Intake

The recommended daily iodine intake is variable depending the age of the subject (table 1). The recommended intake of iodine in neonates reflects the observed mean iodine intake of young infants exclusively fed human milk in iodine-replete areas 4, 5 . However, it is well established that the iodine content of breast milk is critically influenced by the dietary intake of the pregnant and lactating mother 4, 5 . The iodine intake required in order to achieve a positive iodine balance and to insure a progressively increasing intrathyroidal iodine pool in the growing infant is at least 15 xg kg day in full-term and 30 xg kg day in preterm infants this corresponds approximately to 90 xg day 6 .

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