Effect of a Protein-Energy Supplement of Low Consumption with Coconut Pulp Expeller (<i>Acrocomia aculeata</i>) of Beef Cattle at Pasture

The purpose of this study is to evaluate the effect of a low consumption protein-energy supplement that incorporates 15% of coconut pulp expeller in bovine animals. These pasture fattening cattle were checked on daily weight gain, supplement consumption and efficiency of pasture use. This study was carried out in a livestock establishment in the Department of Concepción, Paraguay. A total of 108 animals were selected;castrated male bovines, 342 ± 30.2 of body weight (BW), age average 28 months, Nelore breed distributed in 2 treatments (T1 and T2): T1 = 42 animals;control group (pasture + conventional mineral salt) and T2 = 66 animals;treatment group with a protein-energy supplement (pasture + protein-energy supplement with minerals). In both treatments, the animals grazed on pasture of Brachiaria brizantha cv. Marandú and Panincum maximaun cv. Tanzania used a system of pasture rotation of 1 - 3 days of occupation and 35 - 40 days of rest. The average daily weight gain (DG) was 0.82 and 0.83 kg/day (p > 0.05), the supplement consumption was 0.1 and 0.28 kg/day per animal and the % disappearance of the biomass of 18 and 23% for T1 and T2, respectively. In conclusion, there was no evident effect on DG of protein-energy

Usefulness of a Simple Protein-Energy Wasting Score for Predicting Hospitalization in Maintenance Hemodialysis Patients: A Prospective Cohort Study

Background: Malnutrition is a strong predictor of prognosis in maintenance hemodialysis patients (MHD). We previously proposed a new and simple protein-energy wasting (PEW) score that appears to be useful for assessing the risk of mortality in patients on MHD. Objectives: In the present study, we evaluated the reliability of this PEW score as a predictor of hospitalization in Japanese patients on MHD. Methods: In this single-center, prospective cohort study conducted in Japan, PEW score was calculated for 180 MHD patients. PEW score ranged from 0 (best: S1) to 4 (worst: S4) and was calculated based on nutritional indicators including serum albumin, body mass index, serum creatinine level, and protein intake. The outcome was the number of hospitalizations during the 2-year study period. Results: Thirty-six patients were hospitalized during the study period. Kaplan-Meier curves showed there were fewer hospitalizations in the group with a PEW score of 0/1 than in the group with a score of 3/4. Multivariate analysis revealed a hazard ratio for hospitalization of 3.109 for S3/4 versus S0, 2.777 for S3/4 versus S1, and 2.048 for S3/4 versus S2. Conclusion: The new and simple PEW score is a useful predictor of hospitalization in MHD patients and is also useful for identifying subgroups of MHD patients with a high risk of mortality.

Nutrition and exercise in the management of liver cirrhosis

Liver cirrhosis(LC)patients often have protein-energy malnutrition(PEM)and decreased physical activity.These conditions often lead to sarcopenia,which is the loss of skeletal muscle volume and increased muscle weakness.Recent studies have demonstrated that PEM and sarcopenia are predictors for poor survival in LC patients.Nutrition and exercise management can improve PEM and sarcopenia in those patients.Nutrition management includes sufficient dietary intake and improved nutrient metabolism.With the current high prevalence of obesity,the number of obese LC patients has increased,and restriction of excessive caloric intake without the exacerbation of impaired nutrient metabolism is required for such patients.Branched chain amino acids are good candidates for supplemental nutrients for both obese and non-obese LC patients.Exercise management can increase skeletal muscle volume and strength and improve insulin resistance;however,nutritional status and LC complications should be assessed before an exercise management regimen is implemented in LC patients.The establishment of optimal exercise regimens for LC patients is currently required.In this review,we describe nutritional status and its clinical impact on the outcomes of LC patients and discuss general nutrition and exercise management in LC patients.

Nutritional status in chronically hospitalized stroke patients complicated with pulmonary infection

Complicated pulmonary infection following stroke has traditionally been considered an aspirated infection by many physicians, and little attention has been paid to concomitant protein-energy malnutrition. In the present study, we hypothesized that protein-energy malnutrition may be present in hospitalized chronic stroke patients complicated with pulmonary infection. The results revealed that body protein and fat stores were significantly depleted in stroke patients with pulmonary infection. Protein-energy malnutrition was present in 12 of 27 patients with pulmonary infection. In comparison, only eight of 42 stroke patients without pulmonary infection exhibited protein-energy malnutrition. A significantly higher prevalence of protein-energy malnutrition was found in the pulmonary infection group, suggesting that protein-energy malnutrition is more likely to be present in hospitalized chronic stroke patients with pulmonary infection.

Comparative Influence of Dehulling on the Composition, Antioxidative and Functional Properties of Sorrel (<i>Hibiscus sabdariffa</i>L.) Seed

Although animal proteins provide indispensable amino acids that the body requires for normal growth, maintenance and function, their expensiveness makes them unaffordable especially for most families in the developing countries. This has given impetus to extensive research into under-utilized protein-rich oilseeds such as sorrel as possible alternate sources of good quality protein for tackling the challenge of protein-energy malnutrition which is fast becoming a global challenge. Sorrel seed may hold great potentials as a source of good quality protein, however the presence of hard seed coat, bitter after-taste and associated antinutritional factors have limited its use as protein supplement for humans and food ingredient. This study therefore compared the effect of dehulling sorrel seed to boiling, germination and roasting. This was with the aim of enhancing its utilization as protein source for human nutrition and functional ingredient in food product development. Flours obtained were analyzed for their proximate, mineral, antinutrient, amino and fatty acids composition;in vitro starch and protein digestibility, and functional and antioxidative properties. Protein content (ranged from 24.93% - 32.91%) significantly increased due to processing;dehulling alone accounted for a percentage increase of 32.01%. Similarly, dehulling increased all essential amino acids (except isoleucine and valine) at percentage which ranged from 3.63% - 61.17% whereas other processing methods caused significant reductions. Lysine, leucine, valine, arginine and phenylalanine were the most abundant essential amino acids, while methionine and cystine were the first and second limiting amino acids. Palmitic, linoleic, oleic and stearic acids were the most abundant fatty acids. Mineral composition was K > Ca > Mg > Na > Fe > Zn > Mn. Dehulled seed flour had highest in vitro protein digestibility (75.87%). Improved amino acid composition, antioxidative and functional properties of sorrel seed flour due to dehulling may indicate the potential of this flour to serve as a protein supplement and functional ingredient for food product development.

Muscle mass loss and intermuscular lipid accumulation were associated with insulin resistance in patients receiving hemodialysis

Background An accelerated muscle wasting was the pivotal factor for protein-energy wasting in end stage renal disease. However, very few researches have examined the skeletal muscle quantity and quality in clinical patients. This study investigated the muscle morphologic changes by magnetic resonance imaging （MRI） and analyzed the related factors in hemodialysis patients. Methods Fifty-eight patients receiving maintenance hemodialysis （HD） were investigated and 28 healthy adults with gender and age matched were used as controls （Control）. Anthropometry, cytokine factors, and laboratory data were measured. The muscle and intermuscular adipose tissues （IMAT） were analyzed via a Thigh MRI. The bicep samples were observed after HE staining. Homeostatic model assessment of insulin resistance （HOMA-IR） was measured and their association with muscle wasting was analyzed. Results HD patients tended to have a lower protein diet, anthropometry data, and serum albumin, but the C reactive protein and interleukin-6 increased significantly. The MRI showed that HD patients had less muscle mass and a lower muscle/total ratio, but the fat/muscle and IMAT was higher when compared to the Control group. The muscle fiber showed atrophy and fat accumulation in the biceps samples come from the HD patients. Moreover, we found that the HD patients presented with a high level of plasma fasting insulin and increased HOMA-IR which negatively correlated with the muscle/ total ratio, but positively with the fat/muscle ratio. Conclusions Muscle wasting presented early before an obvious malnutrition condition emerged in HD patients. The main morphological change was muscle atrophy along with intermuscular lipid accumulation. Insulin resistance was associated with muscle wasting in dialysis patients.