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Background and Objective: To investigate the influence of a arginine and omega3 fatty acids enhanced supplement in nutritional variables in postsurgical ambulatory patients with head and neck tumors., Patients and Method: A population of 18 ambulatory postsurgical patients with oral and laryngeal cancer was studied. At hospital discharge, postsurgical head and neck cancer patients were asked to consume two units per day of a specially designed omega3 fatty acid enhanced supplement for a twelve week period., Results: Eighteen patients were enrolled in the study. The mean age was 62.5 (11.4) years (1 females/17 males). Duration of supplementation was 90.5 (22) days. Significant increases of serum protein levels and lymphocites were detected. PCR levels decreased after supplementation (71.96 [21.7] md/dl vs 25.9 [11.1] mg/dl; p < 0.05). No differences were detected in weight and other anthropometric parameters. A positive correlation between omega3/omega6 ratio and kg of fat mass (r = 0.59; p < 0.05) and midarm circumference (r = 0.62; p < 0.05) were detected. When the population was divided in two groups, group I (ratio omega3/omega6 < 0.51) and group II (ratio omega3/omega6 > 0.51), group II showed higher fat mass than group I (17.32 [5.3] kg vs 13.8 [5.1] kg; p < 0.05)., Conclusions: This immuno-enhanced formula could improve serum protein levels and PCR in ambulatory postoperative head and neck cancer patients. An increase in fat mass was detected in patients with a high omega3/omega6 intake of polyunsaturated fatty acids.

Objective: Phase angle alpha can be easily obtained from bioelectrical impedance analysis. In the literature, this angle is the single best predictor of survival in patients with the human immunodeficiency virus (HIV). The aim of our study was to detect nutritional and biochemical parameters that influence the phase angle., Methods: One hundred men with HIV were studied. In all patients, anthropometric and biochemical nutritional evaluations were performed. Basal concentrations of testosterone and somatomedin C (insulin-like growth factor-1) were measured. Tetrapolar bioelectrical impedance analysis was used to determine body composition. All patients received instruction on keeping 24-h written food records. Albumin, prealbumin, transferrin, CD4 count, and total lymphocytes were measured., Results: Patients' mean age was 39.1 +/- 9.9 y, mean body weight was 66.8 +/- 11.2 kg, and mean body mass index was 22.5 +/- 3.5 kg/m2. Patients' average fat-free mass was 58.05 +/- 8.7 kg and average fat mass was 9.17 +/- 4.9 kg. Average phase angle alpha was 8.21 +/- 0.88 degrees. Patients were assigned to one of two groups according to phase angle: those with a phase angle alpha smaller than 8.2 degrees (group 1) and those with a phase angle alpha of at least 8.2 degrees (group 2). Weight, body mass index, transferrin, and somatomedin C were significantly higher in group 2 (P < 0.05 for all). There were significant positive correlations between phase angle alpha and somatomedin C (r = 0.3, P < 0.05) and protein intake (r = 0.2, P < 0.05). In the multivariate analysis (adjusted for number of antiretroviral drugs prescribed, age, disease stage, and energy and protein intakes), only somatomedin C remained in the model (F = 4.5, P < 0.05), with an increase in phase angle alpha of 0.56 degrees (95% confidence interval, 0.04 to 1.08) with each 1-nM/L increase in somatomedin C., Conclusion: Somatomedin C and protein intake influenced phase angle alpha, but only somatomedin C remained as an independent factor in the multivariate analysis.

Objective: We investigated the effects of dietary fiber on symptoms of irritable bowel syndrome., Methods: A single-blind randomized clinical trial was designed. Fifty-six subjects with irritable bowel syndrome were prospectively and randomly assigned to one of two groups: group 1 received a diet containing 10.4 g/d of fiber and group 2 received a diet containing 30.5 g/d of fiber. Patients' body weights, nutritional intakes as assessed with 3-d written food records, and symptom scores were assessed at baseline and at 3 mo., Results: There were no dropouts during the study. Total energy intake and the distribution of macronutrients were not significantly different between groups. Total dietary fiber intake did not reach recommended levels in either group but was higher in group 2 than in group 1 (25.95 +/- 2.12 g/d versus 6.06 +/- 2.7 g/d, P < 0.05). Initial fiber intake did not differ significantly between groups. Pain scores, bowel scores, and general scores improved in both groups (from baseline to 3 mo), and no significant differences were detected between groups., Conclusions: A modest fiber intake in patients with irritable bowel syndrome relieved symptoms, but this therapeutic benefit of fiber may have been due to a placebo effect because the results were similar in the low-fiber group.

Objective: The aim of our work was to carry out a randomized clinical trial with two diets, one enriched in fiber (total fiber 30 g and soluble fiber 4 g) to investigate the effect on lipid and glucose levels in healthy subjects., Research Design and Methods: Fifty-three subjects were prospectively randomized to two groups (see Table 1). Group I received a diet with 10.4 g of fiber given as 1.97 g soluble fiber (pectins, gums and mucilages) and 8.13 g of insoluble fiber (hemicelullose, cellulose and lignins) and Group II received a diet with 30.5 g of fiber of which 4.11 g were soluble fiber and 25.08 g insoluble fiber. Prospective serial assessment of weight and nutritional intake (3 days written food records) were made. These determinations were performed at baseline and at 3 months. All enrolled subjects underwent the following examinations; fasting blood samples were drawn for measurement of total cholesterol, triglyceride concentrations and other lipid fractions, low density lipoprotein (LDL-cholesterol), high density lipoprotein (HDL-cholesterol), glucose, and insulin., Results: Total calorie and fat consumption were lower than recommended in both groups (calories; group I 1633+/-417 kcal per day versus group II 1707.5 +/- 579 kcal per day:ns) and (fats; group I 73.4 +/- 22.7 g per day versus group II [72.6 +/- 28 g per day:ns), without differences in fatty acid intake profile. Total fiber intake did not reach that recommended in both diets but it was higher in group II ( 9.06 +/- 2.7 g per day versus 25.95 +/- 7.12 g per day: P < 0.05). Soluble fiber intake did not reach that recommended in both diets but it was higher in group II (1.7 +/- 0.58 g per day versus 3.5 +/- 0.96 g per day: P < 0.05). Body weight did not change in both groups during treatment. During treatment, in group II a significant change was detected from baseline in LDL-cholesterol and fasting glucose levels. LDL-cholesterol decreased by 12.8% (P < 0.05) and glucose decreased by 12.3% (P < 0.05). No statistical differences were detected among triglycerides, HDL-cholesterol, and insulin levels., Conclusions: Modest increases in soluble fiber intake in healthy subjects improved LDL cholesterol and glucose levels.

Background and Objective: The aim of our work was to evaluate the dietary intake of patients with asthma., Patients and Method: A total of 54 subjects with asthma were enrolled (average age 23.59 +/- 9.6 years). In all patients, we determined weight, height and the body mass index and a three days nutritional questionnaire was administered., Results: The total calories intake was normal. Distribution of calories was: 39.7% carbohydrates, 19.4% proteins and 40.9% lipids. Low intakes of vitamin A, D, E, thiamine and folic acid were detected, and an adequate intake of vitamin K, C, niacin and B12 was observed. The mineral intake showed an increase in calcium and a decrease in magnesium, zinc, iodine and selenium. The intake of polyunsaturated omega-9 fatty acids was 34.8(12.7) g/day, that of polyunsaturated omega-6 fatty acids was 5.7(3.1) g/day, and the intake of polyunsaturated omega-3 fatty acids was 0.85(0.31) g/day. Saturated fats represented a 18.4%. The omega6/omega3 ratio was 6.63., Conclusions: Asthmatic patients have a low intake of vitamins A and E but an increase in the intake of saturated fatty acids.

Background and Objective: Nutritional intervention is a controversial area. The aim of the study was to compare the influence on nutritional status of nutritional supplementation with a standard polymeric formula as well as nutritional counselling versus isolated nutritional counselling in a group of HIV-infected patients., Patients and Method: There were 70 patients, 66 of whom were fully evaluated for each study end point after application of prospectively determined evaluability criteria. Of these, 35 were randomized to group I (standard formula) and 35 were randomized to unsupplemented group II. Group I patients received standard enteral formula (3 cans/day, 250 ml per can). Patients were submitted to a prospective serial assessment of their nutrition status (anthropometric and biochemical status) and the nutritional intake was determined by means of 24-hours written food records. Determinations were performed at baseline and at 3 months., Results: Treatment with oral supplements in group I resulted in a significant and sustained increase in weight (2.75%; p < 0.05) which was mostly due to fat mass (10.8%; p < 0.05). In contrast, no changes were detected in group II patients. The increase in body weight and tricipital skinfold was significant in group I. Total body water and fat free-mass remained without changes. CD4 counts and viral load remained stable in both groups., Conclusions: Oral nutritional supplements for a 3-months period resulted in body weight gain in HIV-infected patients, increasing the fat mass. An isolated nutritional counselling did not result in such an increase.

Background/aim: The evaluation of the significance of hyperhomocysteinemia in type 2 diabetes is further complicated by the multiple ways of considering impaired renal function, vitamin status, and lifestyle. The aim of our study was to investigate the relation between macro- and micronutrient intakes and homocysteine levels in a population having diabetes type 2., Methods: A total of 155 patients with diabetes mellitus type 2 attending our Diabetes Service (90 females and 65 males) were enrolled in a consecutive way. All patients underwent determination of fasting blood homocysteine, glycated hemoglobin, glucose, vitamin B(12), and folate levels. Microalbuminuria was evaluated on the basis of a 24-hour urine. The patients were instructed to keep 3-day written food records incorporating the use of food scales and models to enhance portion size accuracy. Alcohol drinking, physical activity, and smoking habits were also registered., Results: The mean homocysteine levels were 10.5 +/- 4.3 micromol/l. The mean glucose and Hb A(Ic) levels were 9.5 +/- 3 mmol/l and 7.8 +/- 1.4%, respectively. The vitamin status was normal: 592.6 +/- 522 pg/ml vitamin B(12) and 10.5 +/- 5.5 ng/ml folic acid. Mean microalbuminuria was 81.7 +/- 238 mg/day. The calorie intakes were normal (carbohydrates 43%, proteins 23.8%, and lipids 33.1%). A decrease in daily intakes of vitamins (A, B(1), D, and E) and trace elements (Zn, Mg, Se, and Ca) was detected. High daily intakes were detected for protein, P, and vitamins C, B(12), K and P 29.7% of the patients drank beer and 18% other alcoholic beverages. 11.7% of the patients smoked, and 77.7% maintained daily physical activity (mean/day 25.7 +/- 20.9 min). Only protein (g/day; r = 0.25; p < 0.005) and beer (ml/day; r = -0.46; p < 0.05) correlated with the total homocysteine levels. The daily intakes of vitamin B(12) and folic acid were inversely correlated with the total homocysteine levels: r = -0.29; p < 0.05) and (r = -0.12; p < 0.05), respectively. Physical activity and smoking habits were not correlated. In the multivariate analysis with a dependent variable (total homocysteine) adjusted for age, sex, microalbuminuria, and nutrient intakes (proteins, folic acid, and vitamin B(12)) and beer remained in the model., Conclusion: The present study shows that protein intake and beer could modify the levels of total homocysteine in patients with diabetes type 2., (Copyright 2003 S. Karger AG, Basel)