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Parenteral and Enteral Nutrition in Critical Illness
Published in Michael M. Rothkopf, Jennifer C. Johnson, Optimizing Metabolic Status for the Hospitalized Patient, 2023
Michael M. Rothkopf, Jennifer C. Johnson
Where do this literature and experience leave us? First, we accept the need for early nutritional support, generally within 24–48 hours. We also accept the goal of achieving this enterally if possible. The evidence suggests that hypocaloric feeding has risk if it results in a long-term caloric deficit. It is also clear that hypocaloric feeding offers no intrinsic benefits overall.
Obesity and Weight Management
Published in James M. Rippe, Manual of Lifestyle Medicine, 2021
Nutrition plays a critical role in the prevention and treatment of obesity. Typical nutritional interventions for weight loss in obese individuals involve sustaining an average daily caloric deficit of 500 kcals. It should be noted that energy consumption recommendations also include that caloric intake should not be lower than 1200/day for male or female adults in order to maintain adequate nutrient intake.
Nutritional Requirements in Extreme Sports
Published in Datta Sourya, Debasis Bagchi, Extreme and Rare Sports, 2019
Matthew Butawan, Jade L. Caldwell, Richard J. Bloomer
Whether attempting to lose fat, gain muscle, or a combination, the underlying theme to consider deals with EI versus EE. In order to induce any sort of weight loss including that of fat mass, a hypocaloric diet is almost always consumed. It should be mentioned that males tend to have more lean mass whereas females display more fat mass as an energetic depot to support gestation (Geer and Shen 2009). Thus, females appear to be more susceptible to metabolic dysregulations as a consequence of hypocaloric diets (Manore, Kam and Loucks 2007). This can be psychologically troublesome for female athletes, who may attempt to achieve an even more negative energy balance if not seeing the desired results. Weight loss in females may also be hindered based on the menstrual cycle, as estrogen acts as an anabolic hormone on adipose tissue (Brown and Clegg 2010). Rapid weight loss can be harmful; therefore, it is recommended athletes only lose less than 1.5% of body weight per week (Turocy et al. 2011). Furthermore, weight loss attempts should be made during the off season in order to avoid any detriments to competition. While consuming a hypocaloric diet, it is important to remember that the weight lost will likely be a combination of fat and muscle. To counteract the loss of muscle, it is recommended not to exceed a 500 Calorie deficit and to increase protein consumption to between 1.8–2.0 grams/kilogram of body weight/day (g/kg/d) (Phillips 2011). High-quality protein which is rich in leucine can be of great benefit, as leucine displays anti-catabolic effects (Xia et al. 2016).
Comparison between caloric and video-head impulse tests in Ménière’s disease and vestibular neuritis
Published in International Journal of Audiology, 2023
András Molnár, Stefani Maihoub, László Tamás, Ágnes Szirmai
Vestibular neuritis is typically thought to cause vestibular hypofunction on the affected side. In a previous study, vHIT identified acute vestibular neuritis in all cases. Follow-up examinations using vHIT and caloric tests were performed in patients with vestibular neuritis. During these follow-up examinations, 31% of cases showed a complete recovery based on the vHIT and 51.8% based on the caloric test. In that study, a correlation was detected between the follow-up caloric deficit and patient age. Based on the ROC analysis, the vHIT showed 100% sensitivity when the CP parameter was between 0 and 40, which means that the vHIT always showed normal results when the CP parameter was under 40. In contrast, when the CP was over 62.5%, the vHIT always showed pathological outcomes (Bartolomeo et al. 2014). However, in our study, no correlation was detected between caloric test and vHIT results, except for in the CP range. In another study that examined recovery after unilateral vestibular neuritis, no correlation between the vHIT parameters (i.e. G and GA) and the CP was observed. This result is important because, in that study, the GA parameter was also considered (Zellhuber, Mahringer, and Rambold 2014).
Obesity in midlife: lifestyle and dietary strategies
Published in Climacteric, 2020
The fundamental importance of caloric restriction for weight loss has been unequivocally proved. Obesity guidelines from the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society recommend that a caloric intake of 1200–1500 kcal/day (caloric deficit of 500–750 kcal/day) results in an average weight loss of 0.5–0.75 kg/week for most women46–48. Intermittent energy restriction is a novel strategy (periods of fasting alternating with feeding) that has weight-loss outcomes comparable to those with continuous caloric restriction; however, long-term studies on sustained efficacy and the effects on CVD outcomes are lacking49. Multiple dietary restrictions are difficult for patients to implement; therefore, whenever possible, meal replacement diets can be considered to provide structured portion control. With respect to macronutrient composition, low-fat, low-carbohydrate diets or high-protein diets are not superior to one another for achieving sustained weight loss. Adherence to a hypocaloric dietary plan is key, regardless of the type of diet50.
Effects of Exercise With and Without Energy Replacement on Substrate Utilization in the Fasting State
Published in Journal of the American College of Nutrition, 2020
Jie Kang, Saif B. Hasan, Nicole A. Ellis, Ira T. Vought, Nicholas A. Ratamess, Jill A. Bush, Avery D. Faigenbaum
The underlying cause that may explain why exercise increases fat utilization independent of a caloric deficit is not immediately apparent. However, the previous studies that compared metabolic effects between exercise and dietary restriction may shed some light on the potential mechanism that could explain our findings. It has long been documented that exercise of sufficient intensity can provide a potent stimulus to the sympathetic nervous system, thereby stimulating lipolysis (27), and with an increase in serum and intramuscular free fatty acids, fat oxidation in muscle also increases (28). In comparing exercise with diet, Gill et al. (29) found that the exercise-induced caloric deficit produced greater lipolysis and intramuscular triglyceride utilization than the diet-induced caloric deficit. In this same study, the authors also observed a lower insulin concentration following exercise than dietary restriction. A reduced insulin response following exercise has been linked to an increase in fat oxidation (15). When compared to dietary restriction, exercise was also found to induce larger muscle and liver glycogen use (30,31), which in turn can increase fat utilization following exercise (32). Hence, it appears that exercise can provoke more profound metabolic changes in favor of fat utilization, especially within the exercising muscle, and these changes would prevail even without a concurrent caloric deficit.