The American journal of clinical nutrition
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Randomized Controlled Trial Clinical Trial
Effect of psyllium in hypercholesterolemia at two monounsaturated fatty acid intakes.
We performed two studies to determine whether the lipid-lowering effect of viscous soluble fiber was modified by monounsaturated fatty acid (MUFA). First, psyllium (1.4 g/MJ) was compared with wheat bran (control) in 1-mo metabolic diets by using a randomized crossover design (n = 32 hyperlipidemic subjects). The background diet contained approximately 6% of energy as MUFA (20% of total fat). ⋯ Chenodeoxycholate synthesis rate increased (30 +/- 13%, P = 0.038) with the psyllium diet in the 12 subjects in whom this was assessed. We conclude that psyllium lowered LDL- and HDL-cholesterol concentrations similarly at both MUFA intakes. However, there may be some advantage in combining soluble fiber and MUFA to reduce the ratio of LDL to HDL cholesterol.
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Randomized Controlled Trial Clinical Trial
Cornstarch regimens for nocturnal treatment of young adults with type I glycogen storage disease.
The goal of treatment of type I glycogen storage disease (GSD-I) is to prevent hypoglycemia and its biochemical consequences. In seven patients with GSD-I with a mean age of 19.5 y (range: 18.8-21.7 y), we compared the biochemical effects of isoenergetic amounts of uncooked cornstarch (UCS; 1.76 +/- 0.41 g/kg) given in random order on consecutive nights either as a single dose at 2100 (time 0) or as equally divided doses at 2100 and 0200. Over the 10-h period of observation there were significant regimen-by-time interactions for plasma glucose, serum insulin, and blood lactate concentrations. ⋯ After a single dose, plasma glucose concentrations were > or = 3.9 mmol/L for 7 h in five of seven subjects; three subjects were treated for hypoglycemia after 7-9.5 h. With divided doses, plasma glucose concentrations were > or = 3.9 mmol/L for 9 h in six of seven subjects; hypoglycemia occurred at 6 h in one subject. A single dose (1.76 +/- 0.41 g/kg) of UCS at bedtime maintains plasma glucose concentrations > or = 3.9 mmol/L for > or = 7 h in most young adults with GSD-I.
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Medical students of the American Medical Student Association established the Nutrition Curriculum Project (NCP) with the goals of ensuring that adequate nutrition information be taught to medical students; ensuring that there be a framework for integration of nutrition topics at all levels of medical education; and formulating and disseminating essential information for nutrition assessment and management in clinical practice. As a first step, the NCP assembled a ten-member advisory board to develop a comprehensive list of nutrition topics deemed essential for the adequate training of physicians. The advisory board consisted of medical and nutrition educators, physicians, and clinical specialists representing major U. ⋯ The NCP's director coordinated the decision-making process through its three iterations. Final accord on 92 topics was achieved with unanimous approval of the board in 1994. These topics, organized in five major categories, are offered as a guide to the reform of nutrition education and as the basis of a satisfactory nutrition curriculum.