Clients should be taught to change positions slowly. Antimicrobial property of lauric acid against Propionibacterium acnes: The client should be encouraged to eat food high in folic acid such as green leafy vegetables, meat, fish, legumes, and whole grains. The objective of this exercise was to identify approximately 30 high priority research questions under ten themes that could be addressed by systematic reviews in the area of planning for or response to natural disasters, humanitarian crises or other major healthcare emergencies. A stool softener would be prescribed before resorting to an enema.
Notes to the Book
Cancer Research Aug 1;70 Leucine, glucose, and energy metabolism after 3 days of fasting in healthy human subjects. European Journal of Cell Biology Aug;83 7: The adherent gastrointestinal mucus gel layer: Faure M et al. Development of a rapid and convenient method to purify mucins and determine their in vivo synthesis rate in rats. Analytical Biochemistry Aug 15; 2: Ainsworth BE et al. Relationship between fatty acid delivery and fatty acid oxidation during strenuous exercise.
Journal of Applied Physiology Dec;79 6: Effect of fat adaptation and carbohydrate restoration on metabolism and performance during prolonged cycling. Journal of Applied Physiology Dec;89 6: High rates of muscle glycogen resynthesis after exhaustive exercise when carbohydrate is coingested with caffeine. Journal of Applied Physiology Jul; 1: Is there a glycemic threshold for mortality risk? Diabetes Care May;22 5: Dr Ron Rosedale, November 1, , http: The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus.
Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes UKPDS The Lancet Sep 12; Clinical and Investigative Medicine Aug;18 4: Clinics in Geriatric Medicine May;15 2: Association of hemoglobin A1c with cardiovascular disease and mortality in adults: Annals of Internal Medicine Sep 21; 6: Prevalence of polyneuropathy in pre-diabetes and diabetes is associated with abdominal obesity and macroangiopathy: Diabetes Care Mar;31 3: Post-challenge blood glucose concentration and stroke mortality rates in non-diabetic men in London: Diabetologia Jul;51 7: Prospective study of hyperglycemia and cancer risk.
Diabetes Care Mar;30 3: Increased prevalence of impaired glucose tolerance in patients with painful sensory neuropathy. Diabetes Care Aug;24 8: Hat tip to Jenny Ruhl: Starches, sugars and obesity. Nutrients Mar;3 3: ScienceDaily, December 11, , www. Segal MS et al. Is the fructose index more relevant with regards to cardiovascular disease than the glycemic index?
European Journal of Nutrition Oct;46 7: Food processing and the glycemic index. Relationship between the rate of gastric emptying and glucose and insulin responses to starchy foods in young healthy adults.
Glycemic index of single and mixed meal foods among common Japanese foods with white rice as a reference food.
European Journal of Clinical Nutrition Jun;57 6: Gastric emptying of a solid meal is accelerated by the removal of dietary fibre naturally present in food.
Gut Jun;36 6: Jenkins AL et al. Nutrition Journal Nov 22;9: Perissinotto E et al. Alcohol consumption and cardiovascular risk factors in older lifelong wine drinkers: Low-carbohydrate-diet score and the risk of coronary heart disease in women. Atherogenic lipoprotein phenotype and diet-gene interactions. Hepatic and whole-body fat synthesis in humans during carbohydrate overfeeding.
Hat tip to geoff Adipose tissue triglyceride turnover, de novo lipogenesis, and cell proliferation in humans measured with 2H2O. On the importance of fatty acid composition of membranes for aging. Journal of Theoretical Biology May 21; 2: Autoxidation of fats and related substances.
Pergamon Press, London, , 51— Physiological Reviews Oct;87 4: Integretive and Comparative Biology Nov;50 5: The role of impaired mitochondrial lipid oxidation in obesity. Biological Research for Nursing Apr;10 4: The adipostat balloon, October 12, , http: Contribution of mitochondria to oxidative stress associated with alcoholic liver disease.
Crescenzo R et al. Increased hepatic de novo lipogenesis and mitochondrial efficiency in a model of obesity induced by diets rich in fructose. European Journal of Nutrition Apr 28, [epub ahead of print] http: The long life of birds: Oxidation and activation of unsaturated fatty acids. Archives of Biochemistry and Biophysics Apr;81 2: The debate about n-6 polyunsaturated fatty acid recommendations for cardiovascular health.
Journal of the American Dietetic Association Feb; 2: Problems with essential fatty acids: Progress in Lipid Research Nov;42 6: The slow discovery of the importance of omega 3 essential fatty acids in human health. Journal of Nutrition Feb; 2 suppl: Essential fatty acid deficiency in patients receiving home parenteral nutrition.
The American Journal of Clinical Nutrition ;68 1: Why is carbon from some polyunsaturates extensively recycled into lipid synthesis? Lipids Apr;38 4: Dietary linoleic acid has no effect on arachidonic acid, but increases n-6 eicosadienoic acid, and lowers dihomo-gamma-linolenic and eicosapentaenoic acid in plasma of adult men.
Linoleic acid is associated with lower long-chain n-6 and n-3 fatty acids in red blood cell lipids of Canadian pregnant women. High dietary omega-6 fatty acids contribute to reduced docosahexaenoic acid in the developing brain and inhibit secondary neurite growth. Brain Research Oct 27; Effect of cholesterol-lowering diet on mortality from coronary heart-disease and other causes. A twelve-year clinical trial in men and women.
The Lancet Oct 21;2 A controlled clinical trial of a diet high in unsaturated fat. Circulation ; 40 suppl: Stephan Guyenet, personal communication. Dayton S et al. Composition of lipids in human serum and adipose tissue during prolonged feeding of a diet high in unsaturated fat. The Journal of Lipid Research Jan;7 1: Baylin A et al. Adipose tissue biomarkers of fatty acid intake. Witting LA, Lee L. Recommended dietary allowance for vitamin E: Berry EM et al. The relationship of dietary fat to plasma lipid levels as studied by factor analysis of adipose tissue fatty acid composition in a free-living population of middle-aged American men.
London SJ et al. Fatty acid composition of subcutaneous adipose tissue and diet in postmenopausal US women. Garland M et al. The relation between dietary intake and adipose tissue composition of selected fatty acids in US women.
Knutsen SF et al. Comparison of adipose tissue fatty acids with dietary fatty acids as measured by hour recall and food frequency questionnaire in black and white Adventists: Annals of Epidemiology Feb;13 2: Ren J et al. The Journal of Lipid Research Sep;49 9: Toll-like receptor-2 deficiency enhances non-alcoholic steatohepatitis.
BMC Gastroenterology May 28;10 1: Dietary saturated fatty acids: Gastroenterology Aug; 2: Dietary saturated fat reduces alcoholic hepatotoxicity in rats by altering fatty acid metabolism and membrane composition.
Role of adiponectin in the protective action of dietary saturated fat against alcoholic fatty liver in mice. Hepatology Sep;42 3: Effect of dietary fat saturation on ldl oxidation and monocyte adhesion to human endothelial cells in vitro.
Arteriosclerosis, Thrombosis, and Vascular Biology Nov;16 Mata P et al. Monounsaturated and polyunsaturated n—6 fatty acid-enriched diets modify LDL oxidation and decrease human coronary smooth muscle cell DNA synthesis. Arteriosclerosis, Thrombosis, and Vascular Biology Oct;17 Dietary lipid profile is a determinant of tissue phospholipid fatty acid composition and rate of weight gain in rats.
Journal of Nutrition Mar; 3: Hat tip to George Henderson: Data from tables 1 and 3. The Journal of Biological Chemistry Mar 14; Hat tip to Jamie Scott: Fatty acids, the immune response, and autoimmunity: Mechanisms by which botanical lipids affect inflammatory disorders. Associations between fatty acids in colostrum and breast milk and risk of allergic disease.
Wijga AH et al. Breast milk fatty acids and allergic disease in preschool children: Journal of Allergy and Clinical Immunology Feb; 2: Increasing homicide rates and linoleic acid consumption among five Western countries, — Lipids Dec;39 The omega ratio, September 2, , http: Linoleic acid, a dietary n—6 polyunsaturated fatty acid, and the aetiology of ulcerative colitis: Gut Dec;58 Effect of isocaloric low fat diet on prostate cancer xenograft progression in a hormone deprivation model.
Journal of Urology Apr; 4: Coherent anti-Stokes Raman scattering imaging of lipids in cancer metastasis. BMC Cancer Jan 30;9: Corn oil in the treatment of ischaemic heart disease. British Medical Journal Jun 12;1 Effect of the Anti-Coronary Club program on coronary heart disease. Low fat, low cholesterol diet in secondary prevention of coronary heart disease. The data were subsequently re-analyzed and omega-6 fats appeared even more harmful.
Ramsden CE et al. Use of dietary linoleic acid for secondary prevention of coronary heart disease and death: Test of effect of lipid lowering by diet on cardiovascular risk. The Minnesota Coronary Survey. Arteriosclerosis Jan-Feb;9 1: Controlled trial of a diet high in unsaturated fat for prevention of atherosclerotic complications. The Lancet Nov 16;2 Incidence of cancer in men on a diet high in polyunsaturated fat.
The Lancet Mar 6;1 The Oslo diet-heart study: Circulation 42 —, http: The effect of plasma cholesterol lowering diet in male survivors of myocardial infarction: Acta Medica Scandinavica, Supplementum ; The Lancet Sep 28;2 Turpeinen O et al. Dietary prevention of coronary heart disease: International Journal of Epidemiology Jun;8 2: Miettinen M et al.
Dietary prevention of coronary heart disease in women: International Journal of Epidemiology Mar;12 1: The Finnish mental hospital trial, July 9, , http: Dietary reference intakes for energy, carbohydrate, fiber, fat, fatty acids, cholesterol, protein, and amino acids.
Excess omega-3 fatty acid consumption by mothers during pregnancy and lactation caused shorter life span and abnormal ABRs in old adult offspring. Neurotoxicology and Teratology March—April;32 2: Long-term intake of fish oil increases oxidative stress and decreases lifespan in senescence-accelerated mice.
Nutrition Mar;27 3: Lack of benefit of dietary advice to men with angina: European Journal of Clinical Nutrition Feb;57 2: Dietary fat and health: Lands WE, Lifestyle diversity, http: Omega fats and cardiovascular disease, September 6, , http: Healthy intakes of n-3 and n-6 fatty acids: The Journal of Nutritional Biochemistry Apr;17 4: Watkins BA et al.
Journal of Nutrition Sep; 9: Addition of omega-3 fatty acid to maintenance medication treatment for recurrent unipolar depressive disorder. The American Journal of Psychiatry Mar; 3: Su KP et al. Omega-3 fatty acids for major depressive disorder during pregnancy: Journal of Clinical Psychiatry Apr;69 4: Omega-3 fatty acids in major depressive disorder.
A preliminary double-blind, placebo-controlled trial. European Neuropsychopharmacology Aug;13 4: Stoll AL et al. Omega 3 fatty acids in bipolar disorder: Archives of General Psychiatry May;56 5: Associations between increases in plasma n-3 polyunsaturated fatty acids following supplementation and decreases in anger and anxiety in substance abusers. Hamazaki T et al. The effect of docosahexaenoic acid on aggression in young adults. A placebo-controlled double-blind study. Journal of Clinical Investigation Feb 15;97 4: Omega-3 fatty acid treatment of women with borderline personality disorder: The American Journal of Psychiatry Jan; 1: Hallahan B et al.
Omega-3 fatty acid supplementation in patients with recurrent self-harm. Single-centre double-blind randomised controlled trial. The British Journal of Psychiatry Feb; Omega-3 fatty acids improve the diagnosis-related clinical outcome. Critical Care Medicine Apr;34 4: Experimental Medicine and Biology Maywood Jun; 6: Improved outcome after peripheral nerve injury in mice with increased levels of endogenous?
The Journal of Neuroscience Jan 11;32 2: Fat—1 transgenic mice with elevated omega-3 fatty acids are protected from allergic airway responses. Biochimica et Biophysica Acta Sep; 9: High pancreatic n-3 fatty acids prevent STZ-induced diabetes in fat-1 mice: Diabetes Apr;60 4: Increased dietary intake of omegapolyunsaturated fatty acids reduces pathological retinal angiogenesis. Nature Medicine Jul;13 7: Transgenic mice rich in endogenous omega-3 fatty acids are protected from colitis.
Melanoma growth is reduced in fat-1 transgenic mice: Berquin IM et al. Modulation of prostate cancer genetic risk by omega-3 and omega-6 fatty acids. Journal of Clinical Investigation Jul; 7: Habbel P et al. Docosahexaenoic acid suppresses arachidonic acid-induced proliferation of LST human colon carcinoma cells.
World Journal of Gastroenterology Mar 7;15 9: Griffitts J et al. Non-mammalian fat-1 gene prevents neoplasia when introduced to a mouse hepatocarcinogenesis model: Omega-3 fatty acids prevent liver neoplasia. Biochimica et Biophysica Acta Oct; Mediterranean diet, traditional risk factors, and the rate of cardiovascular complications after myocardial infarction: Circulation Feb 16;99 6: Mediterranean dietary pattern in a randomized trial: Archives of Internal Medicine Jun 8; Effects of changes in fat, fish, and fibre intakes on death and myocardial reinfarction: The Lancet Sep 30;2 Maintenance of lower proportions of n — 6 eicosanoid precursors in phospholipids of human plasma in response to added dietary n — 3 fatty acids.
Biochimica et Biophysica Acta Dec 10; 2: Circulating nonesterified fatty acid level as a predictive risk factor for sudden death in the population. Circulation Aug 14; 7: Comparison of monounsaturated fat with carbohydrates as a replacement for saturated fat in subjects with a high metabolic risk profile: The effects of supraphysiologic doses of testosterone on muscle size and strength in normal men. Low-fat high-fiber diet decreased serum and urine androgens in men.
Growth hormone effect on the role of fat in nitrogen metabolism. American Journal of Physiology Nov; 5: Growth hormone and protein metabolism. Clinical Nutrition Dec;28 6: From GH to Billy Ghrelin. Cell Metabolism Aug;10 2: Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease.
Saturated fat, carbohydrate, and cardiovascular disease. Dietary intake of saturated fatty acids and mortality from cardiovascular disease in Japanese: Inverse association of dietary fat with development of ischemic stroke in men. Dietary fats, carbohydrate, and progression of coronary atherosclerosis in postmenopausal women.
Hat tip to Richard D Feinman: What if saturated fat is not the problem? Ketogenicity of soybean oil, coconut oil and their respective fatty acids for the chick. Journal of Nutrition Dec; Medium-chain triglyceride MCT ketogenic therapy. Epilepsia Nov;49 suppl 8: In vitro killing of Candida albicans by fatty acids and monoglycerides. Antimicrobial Agents and Chemotherapy Nov;45 Liu S et al.
Biological control of phytopathogenic fungi by fatty acids. Mycopathologia Aug; 2: The effects of saturated fatty acids on Giardia duodenalis trophozoites in vitro. Parasitology Research Oct;97 3: Medium-chain fatty acids decrease colonization and invasion through hilA suppression shortly after infection of chickens with Salmonella enterica serovar Enteritidis.
Applied and Environmental Microbiology Jun;70 6: Gantois I et al. Butyrate specifically down-regulates salmonella pathogenicity island 1 gene expression. Applied and Environmental Microbiology Jan;72 1: Antimicrobial property of lauric acid against Propionibacterium acnes: Journal of Investigative Dermatology Oct; Antibacterial interactions of monolaurin with commonly used antimicrobials and food components.
Journal of Food Science Sep;74 7: In vitro inactivation of Chlamydia trachomatis by fatty acids and monoglycerides. Antimicrobial Agents and Chemotherapy Sep;42 9: Antibacterial actions of fatty acids and monoglycerides against Helicobacter pylori. Inactivation of enveloped viruses and killing of cells by fatty acids and monoglycerides. Antimicrobial Agents and Chemotherapy Jan;31 1: The antimicrobial function of milk lipids.
Advances in Nutritional Research ; Studies on fatty acid composition of adipose tissue and blood lipids of Polynesians. I have heard that coconut is bad for the heart and that it is good for the heart. Harvard Heart Letter Sep;17 1: Low-density lipoprotein subclass patterns and risk of myocardial infarction. Value of low-density lipoprotein particle number and size as predictors of coronary artery disease in apparently healthy men and women: Journal of the American College of Cardiology Feb 6;49 5: Diabetes Care Nov;23 Consumption of medium- and long-chain triacylglycerols decreases body fat and blood triglyceride in Chinese hypertriglyceridemic subjects.
European Journal of Clinical Nutrition Jul;63 7: The therapeutic implications of ketone bodies: Medium chain triglycerides MCT in aging and arteriosclerosis.
The Tokelau Island migrant study. International Journal of Epidemiology Sep;3 3: Stanhope JM et al. The Tokelau Island Migrant Study: Journal of Chronic Diseases ;34 2—3: Niacin stimulates adiponectin secretion through the GPRA receptor. Ahmed K et al. Trends in Pharmacological Sciences Nov;30 Effects of dietary coconut oil on the biochemical and anthropometric profiles of women presenting abdominal obesity.
Lipids Jul;44 7: Safe and effective use of the ketogenic diet in children with epilepsy and mitochondrial respiratory chain complex defects. Epilepsia Jan;48 1: Sudden cardiac death in association with the ketogenic diet. Pediatric Neurology Dec;39 6: European Archives of Paediatric Dentistry Sep;9 3: Formulation, stability, and administration of parenteral nutrition with new lipid emulsions.
Nutrition in Clinical Practice Oct-Nov;24 5: Japanese Journal of Pharmacology Oct;87 2: White H, Venkatesh B. Critical Care Apr 6;15 2: Neuroprotective and disease-modifying effects of the ketogenic diet.
Behavioural Pharmacology Sep;17 5—6: Chronic in vitro ketosis is neuroprotective but not anticonvulsant. Journal of Neurochemistry May; 4: The neuroprotective properties of calorie restriction, the ketogenic diet, and ketone bodies. Brain Research Reviews Mar;59 2: ScienceDaily, October 22, , www. Ketogenic diet prevents cardiac arrest-induced cerebral ischemic neurodegeneration. Journal of Neural Transmission Jul; 7: More fat and fewer seizures: The Lancet Neurology Jul;3 7: Brain Research Aug 25; Costantini LC et al.
BMC Neuroscience Dec 3;9 suppl 2: A ketogenic diet as a potential novel therapeutic intervention in amyotrophic lateral sclerosis. BMC Neuroscience Apr 3;7: Current Treatment Options in Neurology Nov;10 6: Factors influencing the evolution of West syndrome to Lennox-Gastaut syndrome.
Pediatric Neurology Aug;41 2: Application of a ketogenic diet in children with autistic behavior: Journal of Child Neurology Feb;18 2: The antidepressant properties of the ketogenic diet. Biological Psychiatry Dec 15;56 The ketogenic diet may have mood-stabilizing properties. Medical Hypotheses Dec;57 6: Schizophrenia, gluten, and low-carbohydrate, ketogenic diets: Cancer as a metabolic disease. Implementing a ketogenic diet based on medium-chain triglyceride oil in pediatric patients with cancer.
Journal of the American Dietetic Association Jun;95 6: Targeting energy metabolism in brain cancer through calorie restriction and the ketogenic diet. Journal of Cancer Research and Therapeutics Sep;5 suppl 1: Effects of a ketogenic diet on tumor metabolism and nutritional status in pediatric oncology patients: Journal of the American College of Nutrition Apr;14 2: Effects of a ketogenic diet on the quality of life in 16 patients with advanced cancer: Fasting vs dietary restriction in cellular protection and cancer treatment: Oncogene Jul 28;30 Raffaghello L et al.
Fasting and differential chemotherapy protection in patients. Cell Cycle Nov 15;9 Johnson JB et al. Pretreatment with alternate day modified fast will permit higher dose and frequency of cancer chemotherapy and better cure rates. Medical Hypotheses Apr;72 4: Hat tip to Mario Renato Iwakura. Long-term use of the ketogenic diet in the treatment of epilepsy. Hat tip Evelyn Kocur aka CarbSane. A blinded, crossover study of the efficacy of the ketogenic diet.
Epilepsia Feb;50 2: Branched chain amino acids as adjunctive therapy to ketogenic diet in epilepsy: Journal of Child Neurology Oct;24 A human gut microbial gene catalogue established by metagenomic sequencing. Nature Mar 4; Bowel disease, part IV: More on fecal transplants, November 3, , http: Hat tip to Dr.
A cautionary tale of mucus fore and aft, August 30, , www. Role of dietary fiber and short-chain fatty acids in the colon. Current Pharmaceutical Design ;9 4: Butyrate improves insulin sensitivity and increases energy expenditure in mice.
Diabetes Jul;58 7: Scheppach W et al. Effect of butyrate enemas on the colonic mucosa in distal ulcerative colitis. Gastroenterology Jul; 1: Physiological concentrations of short-chain fatty acids immediately suppress colonic epithelial permeability. British Journal of Nutrition Aug; 2: Constipation is relieved more by rye bread than wheat bread or laxatives without increased adverse gastrointestinal effects.
Effects of short chain fatty acids on a new human colon carcinoma cell line LIM Gut Dec;27 Mechanisms of primary cancer prevention by butyrate and other products formed during gut flora—mediated fermentation of dietary fibre. Mutation Research Jul-Aug; 1: Cancer Research Jun 1;67 The Journal of Neuroscience Oct 15;23 Modulatory effect of butyric acid—a product of dietary fiber fermentation in experimentally induced diabetic rats.
The Journal of Nutritional Biochemistry Sep;13 9: Anti-inflammatory effects of sodium butyrate on human monocytes: Hyaluronan mixed esters of butyric and retinoic acid affording myocardial survival and repair without stem cell transplantation. The Journal of Biological Chemistry Mar 26; Butyric acid from the diet: Rarity of colon cancer in Africans is associated with low animal product consumption, not fiber.
The American Journal of Gastroenterology May;94 5: Dietary fiber and progression of atherosclerosis: Blueberry husks, rye bran and multi-strain probiotics affect the severity of colitis induced by dextran sulphate sodium.
Scandinavian Journal of Gastroenterology ;44 Vancomycin-resistant enterococci exploit antibiotic-induced innate immune deficits. Nature Oct 9; Fats and absorbing endotoxin, February 23, , http: Potential prebiotic properties of almond Amygdalus communis L. Applied and Environmental Microbiology Jul;74 Mucin degradation by Bifidobacterium strains isolated from the human intestinal microbiota. Applied and Environmental Microbiology Mar;74 6: Colonization of mucin by human intestinal bacteria and establishment of biofilm communities in a two-stage continuous culture system.
Applied and Environmental Microbiology Nov;71 Increased consumption of refined carbohydrates and the epidemic of type 2 diabetes in the United States: Low-fat dietary pattern and risk of colorectal cancer: Hat tip Melissa McEwen, The human colon in evolution: Archives of Internal Medicine Jun 27; Late-life alcohol consumption and year mortality. Clinical and Experimental Research Nov;34 Hat tip to Robin Hanson: Alcohol is healthy, September 2, , www. Alcohol dosing and total mortality in men and women: Archives of Internal Medicine Dec 11—25; Camargo CA et al.
Prospective study of moderate alcohol consumption and mortality in US male physicians. Archives of Internal Medicine Jan 13; 1: Yuan JM et al. Follow up study of moderate alcohol intake and mortality among middle aged men in Shanghai, China.
BMJ Jan 4; Doll R et al. Mortality in relation to consumption of alcohol: BMJ Oct 8; Hat tip to David J. Alcohol problems and solutions, www2. Alcohol consumption and mortality. Characteristics of drinking groups. Addiction Feb;93 2: Wine consumption and year mortality among late-life moderate drinkers. Journal of Studies on Alcohol and Drugs Jan;73 1: The health and health behaviors of people who do not drink alcohol. American Journal of Preventive Medicine Nov;21 4: Alcohol consumption and mortality in individuals with diabetes mellitus.
British Journal of Nutrition Oct; 7: You M et al. Ronis MJ et al. Clinical and Experimental Research Oct;33 Changes in gut microbiota control metabolic endotoxemia-induced inflammation in high-fat diet-induced obesity and diabetes in mice.
Diabetes Jun;57 6: Effect of methionine on the fatty acid composition of cellular membranes in rats with chronic ethanol consumption and jejunoileal bypass. Alcohol and Alcoholism Sep;31 5: Relationships between nutrition, alcohol use, and liver disease.
Sprince H et al. Protective action of ascorbic acid and sulfur compounds against acetaldehyde toxicity: Watanabe A et al. Lowering of blood acetaldehyde but not ethanol concentrations by pantethine following alcohol ingestion: Clinical and Experimental Research May—Jun;9 3: Hat tip to Wyatt: Hippocrates on diet and hygiene.
The diet trap revisited: Long-term persistence of hormonal adaptations to weight loss. Pathways from weight fluctuations to metabolic diseases: Naturalistic weight-reduction efforts prospectively predict growth in relative weight and onset of obesity among female adolescents. Journal of Consulting and Clinical Psychology Dec;67 6: High prevalence of vitamin D insufficiency and its association with obesity and metabolic syndrome among Malay adults in Kuala Lumpur, Malaysia.
Diabetes Feb;57 2: Intracellular magnesium of obese and type 2 diabetes mellitus children. Diabetes Therapy Aug;1 1: Association of total body and visceral fat mass with iron deficiency in preadolescents: British Journal of Nutrition Aug; 4: Zinc and copper serum levels of morbidly obese patients before and after biliopancreatic diversion: Journal of Gastrointestinal Surgery Dec;15 Selenium is significantly depleted among morbidly obese female patients seeking bariatric surgery.
Obesity Surgery Nov;21 Mursu J et al. Dietary supplements and mortality rate in older women: Archives of Internal Medicine Oct 10; Effects of multivitamin and mineralsupplementation on adiposity, energy expenditure and lipid profiles in obese Chinese women.
International Journal of Obesity Jun;34 6: Dietary supplements and weight control in a middle-age population. Multivitamin and dietary supplements, body weight and appetite: British Journal of Nutrition May;99 5: Mutation Research Jan 17; 1: From poison to remedy: Journal of Neural Transmission ; 4: The frequency of U-shaped dose responses in the toxicological literature.
Toxicological Sciences Aug;62 2: Annals of Medicine ;41 5: Myxedema coma induced by ingestion of raw bok choy. World Review of Nutrition and Dietetics ; The effect of dietary fibre on fecal weight and composition. In Handbook of dietary fibre in human nutrition, 2nd ed. CRC Press, , — Gliadin, glutenin or both? The search for the Holy Grail in coeliac disease. In vitro cytotoxic effect of wheat gliadin-derived peptides on the Caco-2 intestinal cell line is associated with intracellular oxidative imbalance: Biochimica et Biophysica Acta Jan 6; 1: Gliadin cytotoxicity and in vitro cell cultures.
Toxicology Letters Dec 15; 1: In vivo gluten ingestion in coeliac disease. Digestive Diseases Nov-Dec;16 6: Is gliadin really safe for non-coeliac individuals? Production of interleukin 15 in biopsy culture from non-coeliac individuals challenged with gliadin peptides. Gut Jun;56 6: Gluten links from Bloggeier, May 22, , http: Kenneth Fine of EnteroLab; see the transcript of Dr. Is celiac disease an autoimmune disorder?
Current Opinion in Immunology Dec;17 6: Celiac disease and autoimmune thyroid disease. Naiyer AJ et al. Tissue transglutaminase antibodies in individuals with celiac disease bind to thyroid follicles and extracellular matrix and may contribute to thyroid dysfunction. Thyroid Nov;18 A type 1 diabetes-related protein from wheat Triticum aestivum. The more common conditions that necessitate feeding tubes include prematurity, failure to thrive or malnutrition , neurologic and neuromuscular disorders, inability to swallow, anatomical and post-surgical malformations of the mouth and esophagus, cancer, Sanfilippo syndrome , and digestive disorders.
Feeding tubes are used widely in children with excellent success for a wide variety of conditions. Some children use them temporarily until they are able to eat on their own, while other children require them longterm. Some children only use feeding tubes to supplement their oral diet, while others rely on them exclusively. People with advanced dementia who get feeding assistance rather than feeding tubes have better outcomes. Feeding tubes are often used in the intensive care unit ICU to provide nutrition to people who are critically ill while their medical conditions are addressed; as of there was no consensus as to whether nasogastric or gastric tubes led to better outcomes.
There is at least moderate evidence for feeding tubes improving outcomes for chronic malnutrition in people with cancers of the head and neck that obstruct the esophagus and would limit oral intake,   people with advanced gastroparesis ,  and ALS. People who have surgery on their throat or stomach often have a feeding tube while recovering from surgery; a tube leading through the nose and down to the middle part of the small intestine is used, or a tube is directly placed through the abdomen to the small intestine.
As of it appeared that people with tube through the nose were able to start eating normally sooner. Medical nutrition companies make flavored products for drinking and unflavored for tube feeding. These are regulated as medical foods , which are defined in section 5 b of the Orphan Drug Act 21 U. Nasogastric and nasojejeunal tubes are meant to convey liquid food to the stomach or intestines.
When inserted incorrectly, the tip may rest in the respiratory system instead of the stomach or intestines; in this case, the liquid food will enter the lungs, resulting in pneumonia and can, in rare cases, lead to death. Complications associated with gastrostomy tubes inserted through the abdomen and into the stomach or intestines include leakage of gastric contents containing hydrochloric acid around the tube into the abdominal peritoneal cavity resulting in peritonitis, a serious complication which will cause death if it is not properly treated.
Septic shock is another possible complication. Barrier creams, to protect the skin from the corrosive acid, are used to manage this. A phenomenon called "tube dependency" has been discussed in the medical literature, in which a child refuses to eat after being on a feeding tube, but it is not recognized as a disorder in the ICD or DSM and its epidemiology is unknown. The most common types of tubes include those placed through the nose, including nasogastric, nasoduodenal, and nasojejunal tubes, and those placed directly into the abdomen, such as a gastrostomy, gastrojejunostomy, or jejunostomy feeding tube.
A nasogastric feeding tube or NG-tube is passed through the nares nostril , down the esophagus and into the stomach. This type of feeding tube is generally used for short term feeding, usually less than a month, though some infants and children may use an NG-tube longterm.
Individuals who need tube feeding for a longer period of time are typically transitioned to a more permanent gastric feeding tube.
The primary advantage of the NG-tube is that it is temporary and relatively non-invasive to place, meaning it can be removed or replaced at any time without surgery.
NG-tubes can have complications, particularly related to accidental removal of the tube and nasal irritation. A nasojejunal or NJ-tube is similar to an NG-tube except that it is threaded through the stomach and into the jejunum, the middle section of the small intestine. In some cases, a nasoduodenal or ND-tube may be placed into the duodenum, the first part of the small intestine.
These types of tubes are used for individuals who are unable to tolerate feeding into the stomach, due to dysfunction of the stomach, impaired gastric motility, severe reflux or vomiting. These types of tubes must be placed in a hospital setting.
A gastric feeding tube G-tube or "button" is a tube inserted through a small incision in the abdomen into the stomach and is used for long-term enteral nutrition. One type is the percutaneous endoscopic gastrostomy PEG tube which is placed endoscopically. The position of the endoscope can be visualized on the outside of the person's abdomen because it contains a powerful light source. A needle is inserted through the abdomen, visualized within the stomach by the endoscope, and a suture passed through the needle is grasped by the endoscope and pulled up through the esophagus.
The suture is then tied to the end of the PEG tube that will be external, and pulled back down through the esophagus, stomach, and out through the abdominal wall.
The insertion takes about 20 minutes. The tube is kept within the stomach either by a balloon on its tip which can be deflated or by a retention dome which is wider than the tract of the tube. G-tubes may also be placed surgically, using either an open or laparoscopic technique.
Gastric feeding tubes are suitable for long-term use, though they sometimes need to be replaced if used long term. The G-tube can be useful where there is difficulty with swallowing because of neurologic or anatomic disorders stroke, esophageal atresia , tracheoesophageal fistula, radiotherapy for head and neck cancer , and to decrease the risk of aspiration pneumonia.
There is moderate quality evidence suggesting that the risk of aspiration pneumonia may be reduced by inserting the feeding tube into the duodenum or the jejunum post-pyloric feeding , when compared to inserting the feeding tube into the stomach.
A G-tube may instead be used for gastric drainage as a longer term solution to the condition where blockage in the proximal small intestine causes bile and acid to accumulate in the stomach, typically leading to periodic vomiting, or if the vagus nerve is damaged. Where such conditions are only short term, as in a hospital setting, a nasal tube connected to suction is usually used.
A blockage lower in the intestinal tract may be addressed with a surgical procedure known as a colostomy , and either type of blockage may be corrected with a bowel resection under appropriate circumstances. If such correction is not possible or practical, nutrition may be supplied by parenteral nutrition. A gastrojejunostomy or GJ feeding tube is a combination device that includes access to both the stomach and the jejunum, or middle part of the small intestine.
Typical tubes are placed in a G-tube site or stoma, with a narrower long tube continuing through the stomach and into the small intestine.