Nestle Nutrition workshop series. Clinical & performance programme最新文献

{"title":"Diet modifications to control hypertension: the multifactorial approach.","authors":"Cheryl L Rock","doi":"10.1159/000080661","DOIUrl":"https://doi.org/10.1159/000080661","url":null,"abstract":"","PeriodicalId":18989,"journal":{"name":"Nestle Nutrition workshop series. Clinical & performance programme","volume":"9 ","pages":"155-167"},"PeriodicalIF":0.0,"publicationDate":"2004-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000080661","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24676327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fluid and electrolytes in the clinical setting.","authors":"Dileep N Lobo","doi":"10.1159/000080665","DOIUrl":"https://doi.org/10.1159/000080665","url":null,"abstract":"The understanding of fluid and electrolyte balance in the clinical setting is often poor and prescribing is usually left to the most junior member of the team [1, 2]. Fluid prescriptions, especially in the perioperative period, can be very variable, with patients sometimes receiving in excess of 5 liters water and 500 mmol sodium/day [1, 3]. The 1999 UK National Confidential Enquiry into Perioperative Deaths reported that 20% of the patients sampled had either poor documentation of fluid balance or had unrecognized or untreated fluid imbalance [4], leading to increased postoperative morbidity and mortality [4]. In this review some of the pathophysiological aspects of fluid balance will be discussed and some recent and a few classic studies described, particularly in the context of nutritional and metabolic care.","PeriodicalId":18989,"journal":{"name":"Nestle Nutrition workshop series. Clinical & performance programme","volume":"9 ","pages":"187-203"},"PeriodicalIF":0.0,"publicationDate":"2004-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000080665","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24677924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The metabolic syndrome as a clinical problem.","authors":"Peter Kopelman","doi":"10.1159/000080646","DOIUrl":"https://doi.org/10.1159/000080646","url":null,"abstract":"Insulin resistance is a common metabolic problem characterized by an impaired physiological response to insulin. It is a key factor in the pathogenesis of type-2 diabetes and is present in more than 50% of patients with the condition [1]. Importantly, it may predate the development of hyperglycemia by several years. The clustering of insulin resistance and several other metabolic and vascular disorders is known as the metabolic syndrome or insulin resistance syndrome. Both insulin resistance and the metabolic syndrome are associated with an increased risk of cardiovascular disease. The characteristic features of the metabolic syndrome include upper body (central) obesity, hypertension, dyslipidemia, glucose intolerance and specific abnormalities of coagulation and endothelial function. In addition, it is frequently associated with fatty infiltration of the liver and the development of non-alcoholic steatohepatitis (NASH). The precise origins of the metabolic syndrome remain poorly understood. However, they are unquestionably related to increasing body fatness. Clinicians should be made familiar with the risks associated with insulin resistance and the metabolic syndrome just as they are aware of the established interventions that reduce the risk of heart disease. Early intervention that targets the metabolic syndrome will, if successful, prevent the progression to type-2 diabetes, diminish the risk of coronary heart disease and reduce the future burden to health care. Despite this, many clinicians continue to consider obesity to be self-inflicted and fail to recognize the metabolic syndrome and its medical significance and, as a consequence, do not seize the early opportunity to intervene. Allison SP, Go VLW (eds): Metabolic Issues of Clinical Nutrition. Nestlé Nutrition Workshop Series Clinical & Performance Program, vol 9, pp 77–92, Nestec Ltd., Vevey/S. Karger AG, Basel, © 2004.","PeriodicalId":18989,"journal":{"name":"Nestle Nutrition workshop series. Clinical & performance programme","volume":"9 ","pages":"77-92"},"PeriodicalIF":0.0,"publicationDate":"2004-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000080646","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24676322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pathogenic role of inflammatory cytokines in obesity: from insulin resistance to diabetes mellitus.","authors":"André Marette","doi":"10.1159/000080650","DOIUrl":"https://doi.org/10.1159/000080650","url":null,"abstract":"It is now well established that an inflammatory component contributes to the pathogenesis of obesity-linked diabetes and cardiovascular diseases. First proposed by Hotamisligil et al. [1] more than a decade ago, there is now convincing experimental evidence for the existence of an inflammatory link between obesity and the occurrence of the insulin resistance dyslipidemic syndrome commonly known as the ‘metabolic syndrome’. Indeed, several molecules that are best known for their role in immune and inflammatory cells are now considered as key modulators of energy metabolism in insulin target tissues and are secreted by fat cells in the expanded adipose tissue of obese subjects. These include proinflammatory cytokines, e.g. tumor necrosis factor(TNF ), interleukin (IL)-6, IL-1, and interferon, as well as adipose-specific cytokines or ‘adipokines’ such as leptin and resistin. These inflammatory mediators exert their actions via a complex interplay of signal transduction mechanisms that we are just beginning to fully appreciate. Several molecular targets have been proposed to mediate the insulin-resistant effects of cytokines in insulin target tissues. The principal goal of this chapter is to briefly review current knowledge on the mechanisms by which cytokines promote insulin resistance in obesity. Particular emphasis will be placed on inducible nitric oxide (NO) synthase (iNOS), an inducible isoform of the NO synthase (NOS) family that is overexpressed in the skeletal muscle and adipose tissues of several animal models of obesity. Allison SP, Go VLW (eds): Metabolic Issues of Clinical Nutrition. Nestlé Nutrition Workshop Series Clinical & Performance Program, vol 9, pp 141–153, Nestec Ltd., Vevey/S. Karger AG, Basel, © 2004.","PeriodicalId":18989,"journal":{"name":"Nestle Nutrition workshop series. Clinical & performance programme","volume":"9 ","pages":"141-153"},"PeriodicalIF":0.0,"publicationDate":"2004-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000080650","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24676326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Insulin sensitivity: normal and abnormal.","authors":"A Basu","doi":"10.1159/000080622","DOIUrl":"https://doi.org/10.1159/000080622","url":null,"abstract":"Insulin is the major anabolic hormone in the human body. Secreted by the cells of the pancreatic islets, typically in response to a meal, it is fundamental in maintaining normal glucose homeostasis. Its main effect on glucose metabolism is to suppress hepatic glucose production and to stimulate whole body glucose uptake in insulin sensitive tissues, i.e., muscle, liver and fat. Abnormal/impaired insulin sensitivity or ‘insulin resistance’ therefore signifies a state of reduced peripheral and hepatic responsiveness to the biological actions of insulin. In addition insulin has multiple and vital effects on protein (suppresses proteolysis) and fat (suppresses lipolysis) metabolism. Other recently appreciated effects include those on cellular growth, prevention of apoptosis, stimulation of the sodium-potassium pump and on vascular endothelial function.","PeriodicalId":18989,"journal":{"name":"Nestle Nutrition workshop series. Clinical & performance programme","volume":"9 ","pages":"37-52"},"PeriodicalIF":0.0,"publicationDate":"2004-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000080622","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24676319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Environmental influences on diseases in later life.","authors":"L Tappy, G Seematter, J-L Martin","doi":"10.1159/000080621","DOIUrl":"https://doi.org/10.1159/000080621","url":null,"abstract":"Over the last century, there has been a rapid decrease in the incidence of many infectious diseases. Over the same period, the prevalence of several noninfectious diseases, e.g. obesity, type-2 diabetes, and coronary heart disease, has increased dramatically to the point that we are facing an epidemic of noncommunicable diseases. These diseases are clearly observed more frequently in ‘rich’ countries: they are favored by the availability of abundant foods, motorized transportation and other riches and can be denominated ‘diseases of affluence’ [1]. Prominent among these diseases of affluence is a constellation of pathological findings, including obesity, type-2 diabetes mellitus, dyslipidemia, high blood pressure and other related metabolic or vascular abnormalities, which has been called successively the syndrome X, the insulin resistance syndrome or, more recently, the metabolic syndrome [2]. Although the pathogenesis of this syndrome remains debated, it is recognized that insulin resistance is one of its central components and might indeed be instrumental in the development of several of the associated metabolic alterations [3]. Genetic factors are generally thought to be involved in the pathogenesis of obesity, type-2 diabetes, and dyslipidemia. Genetic factors may directly intervene in the pathogenesis of insulin resistance. The recent epidemiological development of these disorders, which showed a several-fold increase in their rates of prevalence over only a few decades, i.e. during which it is unlikely that major changes in the genetic background occurred, clearly indicates that other factors play a prominent role. It is likely that these factors are to be searched for in the important environmental changes which have occurred in the recent history of the world. Allison SP, Go VLW (eds): Metabolic Issues of Clinical Nutrition. Nestlé Nutrition Workshop Series Clinical & Performance Program, vol 9, pp 19–35, Nestec Ltd., Vevey/S. Karger AG, Basel, © 2004.","PeriodicalId":18989,"journal":{"name":"Nestle Nutrition workshop series. Clinical & performance programme","volume":"9 ","pages":"19-35"},"PeriodicalIF":0.0,"publicationDate":"2004-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000080621","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24676318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Muscle mass and protein metabolism.","authors":"Gianni Biolo, Marcello De De Cicco","doi":"10.1159/000080648","DOIUrl":"https://doi.org/10.1159/000080648","url":null,"abstract":"Muscle protein content is regulated acutely (minutes to hours) by modulation of the rates of protein synthesis and degradation. In physiological conditions, a small fraction of muscle protein content is lost in the postabsorptive state, whereas it is immediately regained with the following meal. Thus, the efficiency of the mechanisms responsible for the regulation of protein synthesis and degradation in the postabsorptive and fed states appears to be crucial for maintaining skeletal muscle mass throughout the day, thereby avoiding protein wasting. The hydrolysis protein to their constituent amino acids is a highly regulated process. The adenosine triphosphate (ATP)independent lysosomal proteases, Ca2 -dependent proteases and an ATPdependent pathway involving the ubiquitin-proteasome complex have been identified in skeletal muscle. Under normal physiological conditions, the lysosomes are predominantly involved in the degradation of extracellular and membrane-associated proteins. In contrast, the ubiquitin-dependent system is quantitatively the most important degradative system of myofibrillar proteins in skeletal muscle. Anabolic and catabolic hormones, such as insulin and cortisol, may inhibit or stimulate the activity of the ubiquitin-proteasome system. The synthesis of myofibrillar proteins in skeletal muscle requires the presence of physiological levels of insulin [1]. Nonetheless the importance of amino acid availability in the postprandial stimulation of muscle protein synthesis should be emphasized. Following amino acid administration, muscle protein synthesis increases proportionally to the amount of amino acids administered, up to 3 times the basal postabsorptive value. Amino acids are more efficiently utilized when given in divided doses (as occurs with meal feeding) rather than with continuous administration (as often occurs in artificial nutrition). The Allison SP, Go VLW (eds): Metabolic Issues of Clinical Nutrition. Nestlé Nutrition Workshop Series Clinical & Performance Program, vol 9, pp 111–124, Nestec Ltd., Vevey/S. Karger AG, Basel, © 2004.","PeriodicalId":18989,"journal":{"name":"Nestle Nutrition workshop series. Clinical & performance programme","volume":"9 ","pages":"111-124"},"PeriodicalIF":0.0,"publicationDate":"2004-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000080648","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24676324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Water and sodium balance: a nutritional goal.","authors":"Antonio Sitges-Serra","doi":"10.1159/000080666","DOIUrl":"https://doi.org/10.1159/000080666","url":null,"abstract":"Back in the 5th century BC, Empedocles suggested that the biosphere was composed of four elements: earth, wind, fire and water. These four components of life are currently known under names different from those dear to the early philosophers. ‘Earth’ contains the nutritional substrates including vitamins and trace elements. ‘Wind’ refers to the respiratory gases supporting cell life or produced as byproducts of metabolic processes occurring within the cell. ‘Fire’ is the energy resulting from substrate oxidation. ‘Water’ is the only element that is still called by its original name owing to it being the original ‘milieu’ in which life was made possible. In this chapter we will review some basic aspects of water and electrolyte metabolism emphasizing those that bear a relation to major areas of clinical nutrition such as body composition, undernutrition, nutrition assessment and refeeding.","PeriodicalId":18989,"journal":{"name":"Nestle Nutrition workshop series. Clinical & performance programme","volume":"9 ","pages":"205-225"},"PeriodicalIF":0.0,"publicationDate":"2004-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000080666","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24677925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuro-hormonal integration of metabolism: challenges and opportunities in the postgenomic era.","authors":"Vay Liang W W Go, Yu Wang, Hong Yang","doi":"10.1159/000080667","DOIUrl":"https://doi.org/10.1159/000080667","url":null,"abstract":"Humans are multicellular organisms designed to provide continuous nutrition to all constituent cells by means of nutrient homeostasis through genomicnutrient-metabolic interaction. This process is highly regulated and integrated through neuro-hormonal control processes at various levels of organization. Metabolism at the cellular level is primarily regulated by cell-signaling pathways and substrate environments for specific metabolic events. This is achieved through the regulation of futile substrate cycles within the cell by substrates and signal-sensitive gene expressions. Metabolism at the intercellular level is primarily regulated by paracrine, autocrine, hormones, and other neurotransmitters that alter the functional state of metabolic networks within individual cells and the cell-to-cell relationship. At the organism’s physiological level, metabolic regulation is achieved through complex neuro-endocrine circuitry, and its integration with nutritional signals that translate these interrelationships into nutrients and energy homeostasis [1]. Over the last century, tremendous progress has been made at the physiological level in the following areas: feeding behavior; major function of the digestive processes in the gut and gut-brain-endocrine axis; hypothalamic and autonomic pathways and neurotransmitters in regulating hunger, satiety, and energy metabolism; endocrine control of metabolic function of organs involved in energy homeostasis (brain, gut, liver, muscle, and adipose tissue), and altered metabolic pathways and/or control system failure that can lead to diseases such as obesity, metabolic syndrome, diabetes mellitus, cancer, and other disorders. This has been the subject of various recent workshops sponsored by Nestlé [2–5]. Allison SP, Go VLW (eds): Metabolic Issues of Clinical Nutrition. Nestlé Nutrition Workshop Series Clinical & Performance Program, vol 9, pp 227–242, Nestec Ltd., Vevey/S. Karger AG, Basel, © 2004.","PeriodicalId":18989,"journal":{"name":"Nestle Nutrition workshop series. Clinical & performance programme","volume":"9 ","pages":"227-242"},"PeriodicalIF":0.0,"publicationDate":"2004-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000080667","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24677926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nutrition and genomics.","authors":"Bruce German","doi":"10.1159/000080668","DOIUrl":"https://doi.org/10.1159/000080668","url":null,"abstract":"The decoding of the human genome is already being heralded as one of science’s greatest achievements and is viewed as the point of departure for the next generation of life science research to understand human health and cure human disease [1]. However, genomics as a scientific endeavor is not simply the list of nucleotides in the genomes of humans and various other organisms. This new field is bringing a new knowledge base on genes, their functions and regulation. This is promoted by new, multiple and truly remarkable biomolecule-based analytical technologies that are capable of interrogating the functioning of living organisms with a breadth and depth not previously imagined. Additionally, computer-based technologies are spawning an entirely new computation discipline directed towards the mining of biological databases, termed bioinformatics. The various scientific disciplines that seek to develop cures for human diseases are already fully engaged in genomic research. Nutrition, with its goals to improve human health and prevent disease, stands to achieve tremendous advances during this post-genome era. Nutrition enjoyed conspicuous success during the first half of the 20th century, establishing all the major essential nutrients – the vitamins, minerals, amino acids and fatty acids – that are necessary for growth, development and reproduction. The diseases that are associated with a deficiency of each of these nutrients and the quantities of each nutrient necessary to prevent them have been reasonably well described using a variety of animal models and experimental strategies. As Carpenter [2] pointed out in his fascinating series on a short history of nutritional science, many have looked on the developments in the mid 20th century as the ‘golden age of nutrition’, but during the dawn of this 21st century nutrition science now faces a new set of challenges for which the knowledge, tools and strategies of the ‘omics’ will be indispensable. The challenges are not small Allison SP, Go VLW (eds): Metabolic Issues of Clinical Nutrition. Nestlé Nutrition Workshop Series Clinical & Performance Program, vol 9, pp 243–263, Nestec Ltd., Vevey/S. Karger AG, Basel, © 2004.","PeriodicalId":18989,"journal":{"name":"Nestle Nutrition workshop series. Clinical & performance programme","volume":"9 ","pages":"243-263"},"PeriodicalIF":0.0,"publicationDate":"2004-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000080668","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24677927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}