The American journal of clinical nutrition
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Clinical Trial
Energy utilization and growth in breast-fed and formula-fed infants measured prospectively during the first year of life.
This study is the first to report approximations of energy requirements for male and female breast-fed and formula-fed infants based on individual estimates of total daily energy expenditure (TDEE) and energy deposition derived from total body fat (TBF) and fat-free mass (FFM) gain as determined by total-body electrical conductivity. In 46 healthy, full-term infants the effect of > or = 4 mo of exclusive breast-feeding compared with formula feeding on macronutrient and energy intake, TDEE, energy deposition, and growth were investigated prospectively. Metabolizable energy intake (MEI) was assessed from macronutrient intake by test weighing (MEI-TW) and from the sum of TDEE and energy deposition (MEI-Pred). ⋯ This feeding effect, however, was not significant for MEI-Pred (MJ/d). MEI-TW differed from MEI-Pred only in breast-fed infants at 1-4 mo (P < 0.05 at 2-4 mo). The data from this study indicate that energy requirements in infants are lower than the recommendations in guidelines currently in use.
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Comparative Study
Resting energy expenditure in children in a pediatric intensive care unit: comparison of Harris-Benedict and Talbot predictions with indirect calorimetry values.
The use of prediction equations has been recommended for calculating energy expenditure. We evaluated two equations that predict energy expenditure, each of which were corrected for two different stress factors, and compared the values obtained with those calculated by indirect calorimetry. The subjects were 55 critically ill children on mechanical ventilation. ⋯ These limits of agreement indicate large differences in energy expenditure between the measured value and the prediction estimated for some patients. Therefore, neither the Harris-Benedict nor the Talbot method will predict resting energy expenditure with acceptable precision for clinical use. Indirect calorimetry appears to be the only useful way of determining resting energy expenditure in these patients.
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Multicenter Study Comparative Study Clinical Trial
Predicting energy needs in ventilator-dependent critically ill patients: effect of adjusting weight for edema or adiposity.
Predicting energy needs in critical illness can be difficult because of uncertainties about the influence of multiple factors on energy expenditure. Understanding these components is important to avoid limiting optimal outcome by underfeeding and to avoid complications of overfeeding. Prediction strategies often use a patient's weight to estimate needs. ⋯ Adjusted-weight strategies could explain > 45% of the variability of resting energy expenditure in subjects 130-159% of ideal body weight. Results of this study suggest that using adjusted weights with the KPK prediction strategy may be preferable for this population, particularly for patients > or = 130% of ideal body weight. This study also indicated that multiple diagnoses may not lead to increased energy requirements.
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Randomized Controlled Trial Comparative Study Clinical Trial
The response to treatment of subclinical thiamine deficiency in the elderly.
The significance of subclinical thiamine deficiency in the elderly was determined by assessing response to thiamine supplementation in a randomized double-blind, placebo-controlled trial. Thirty-five of 222 people aged > or = 65 y had two concentrations of erythrocyte thiamine pyrophosphate (TPP) < 140 nmol/L 3 mo apart and 41 other people had the first, but not the second, TPP concentration below this value. Both groups were randomly assigned in a double-blind trial to oral thiamine (10 mg/d) or a placebo. ⋯ We conclude that a low TPP concentration on two occasions is a better predictor of response to treatment than an isolated measurement. Quality of life was enhanced by providing thiamine supplements. Blood pressure and weight were lower after thiamine supplementation.