The American journal of clinical nutrition
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Clinical Trial Controlled Clinical Trial
Maldigestion and colonic fermentation of wheat bread in humans and the influence of dietary fat.
A fraction of wheat bread is malabsorbed in healthy humans. The malabsorbed fraction is bigger than what can be accounted for by in vitro measurements of dietary fibers and resistant starch. To determine whether it is a specific fraction defined by the structure of the starch molecule or a variable amount--which depends on the individual, the amount ingested, and other components of the meal--we performed a dose-response study on wheat bread in healthy human volunteers. ⋯ We conclude that the malabsorbed fraction of wheat bread was dependent on the amount ingested, the composition of the meal, and individual gastrointestinal handling. Fermentation of wheat bran resulted in a very low breath-hydrogen response compared with lactulose or wheat bread. Addition of 11 g butter to the bread seemed to increase the malabsorbed fraction of the starch, an effect that was abolished when the amount of butter was increased to 26 g.
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Randomized Controlled Trial Comparative Study Clinical Trial
Effects of milk viscosity on gastric emptying and lactose intolerance in lactose maldigesters.
The possibility of delaying gastric emptying and improving lactose digestion and tolerance by increasing milk viscosity was studied in 13 lactose maldigesters who ingested three test milks with different viscosities (range: 33-1892 mPa.s) in random order at intervals of 1 wk. Each test portion was 500 mL and provided approximately equal to 1900 kJ and 18 g lactose. The different viscosities were obtained by adding varying proportions of rice starch and maltodextrin to a basic milk formula. ⋯ The milks were well tolerated; > 50% of the subjects reported nondisturbing symptoms or none. We conclude that gastric emptying, orocecal transit time, and lactose digestion and tolerance were not affected by altering milk viscosity. This may have been due to the high energy content of the test milks, which in itself led to slow gastric emptying.
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Comparative Study
Nutrition practices of family physicians after education by a physician nutrition specialist.
Although nutrition is an important part of medical care, nutrition education is not provided in most training programs for physicians in the United States, resulting in limited nutrition knowledge among physicians and limited nutritional care of patients. A nutrition education program was provided by a physician nutrition specialist in a family practice residency program. ⋯ The nutrition education program resulted in an increase in physicians' nutrition knowledge scores (P < 0.01) and an increase in the frequency with which physicians discussed nutrition and recommended diets for their patients (P < 0.05). This suggests that nutrition education by a physician nutrition specialist within a family practice residency program can be effective in increasing nutritional care provided to patients.
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Comparative Study
Maternal anthropometry and infant feeding practices in Israel in relation to growth in infancy: the North African Infant Feeding Study.
Relations between maternal anthropometric status during pregnancy and infant feeding practices and growth from birth through the first 6 mo of life were examined in a cohort of 351 Israeli mother-infant pairs of North African descent. Maternal weight, height, and triceps skinfold thicknesses were determined at 6 and 9 mo of pregnancy, while infants' weights and lengths were measured at birth and at 1, 2, 3, and 6 mo of age with concurrent collection of age-specific maternal-reported infant feeding data. On the basis of multiple-linear-regression analysis that adjusted for potential covariates, mean maternal weight at the first prenatal visit and at 6 and 9 mo of pregnancy were positively associated with birth length (P for trend in all cases < 0.0001) and with linear growth between birth and 1, 3, and 6 mo of age. ⋯ Moreover, maternal height, weight, and skinfold thickness at 6 and 9 mo of pregnancy were positively associated with mean birth weight. After adjustment for morbidity in the past month and other covariates, infants breast-fed exclusively had greater attained weight and weight gain in the first 3 mo compared with infants who were bottle-fed exclusively, breast-fed and bottle-fed, or solid-fed exclusively. These findings underscore the need for programs that improve the nutritional status of women before, during, and after pregnancy, and encourage exclusive breast-feeding of infants for at least the first 3 mo of life.
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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.