Nutrition
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In critically ill patients there is consistent evidence that significant benefits are achieved if nutrients are delivered within the gut compared with the parenteral route. However, in conditions related to gut hypoflux, enteral nutrition may play a double role in counterbalancing the installed low-flow state. On the one hand, enteral-induced postprandial hyperemia may preserve the mucosal barrier and ameliorate immune competence; on the other hand, feeding by the gut may pose a theoretical risk of intestinal ischemia. ⋯ Arginine may prevent intestinal injury due to hypoperfusion but may harm the gut if ischemia is established. In contrast, glutamine may promote benefits in both conditions. Further investigations by randomized trials in this field are necessary.
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We investigated if alterations in the insulin-signaling pathway could contribute to reduced hepatic glycogen levels in adult rats subjected to a protein deficiency during intrauterine life and lactation and reared through to recovery on a soybean diet. ⋯ Adult rats maintained with a soybean diet exhibited insulin resistance due, at least in part, to alterations in the early steps of the insulin signal transduction pathway.
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Hypothalamic centers integrate external signals of nutrient availability and energy status and initiate responses to maintain homeostasis. Quantifying changes in hypothalamic gene expression in the presence of nutrient excess may identify novel responsive elements. ⋯ Expression of five genes involved in availability of dopamine was increased after a high-fat diet. Failure to reduce dopamine availability sufficiently, to counter the feeding reward effect, could contribute to diet-induced obesity in these mice.