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Nutrition and Metabolic Factors
Published in Michael H. Stone, Timothy J. Suchomel, W. Guy Hornsby, John P. Wagle, Aaron J. Cunanan, Strength and Conditioning in Sports, 2023
Michael H. Stone, Timothy J. Suchomel, W. Guy Hornsby, John P. Wagle, Aaron J. Cunanan
Nitrogen balance can be modified several factors including the physiological state and health of the individual, energy intake, and essential and nonessential amino acid intake. Regarding the latter, very low dietary intake of an EAA may reduce the rate of protein synthesis and impair the use of other amino acids for protein synthesis. As a result, if protein synthesis is reduced sufficiently, a catabolic environment may predominate, ultimately producing an increased excretion of nitrogen. This negative nitrogen balance may occur if the proportions of EAA in the diet are unbalanced or if protein intake is insufficient. Furthermore, the catabolic environment and negative nitrogen balance can occur even if only one EAA is limited as a result of inadequate diet (163).
Writing the Initial Parenteral Nutrition Order
Published in Michael M. Rothkopf, Jennifer C. Johnson, Optimizing Metabolic Status for the Hospitalized Patient, 2023
Michael M. Rothkopf, Jennifer C. Johnson
We can gain more precision on protein requirements by measuring protein balance and breakdown. The classic method for this is the nitrogen balance in which protein intake is subtracted by protein output in the urine, skin and stool. The nitrogen balance then becomes a simple calculation of nitrogen in minus nitrogen out.
Nutrition Screening and ADIME
Published in Praveen S. Goday, Cassandra L. S. Walia, Pediatric Nutrition for Dietitians, 2022
Jennifer L. Smith, Teresa A. Capello
Nitrogen balance is calculated as nitrogen intake minus nitrogen loss from the body. Nitrogen balance is useful when evaluating protein metabolism, as nitrogen is a crucial part of protein building blocks or amino acids. Negative nitrogen balance is defined as more loss than intake, which is then used as a marker for nutrition risk. Nitrogen balance is evaluated by calculating the concentration of urea in the urine. This requires a 24-hour urine collection which can be burdensome.
Longitudinal association between dietary protein intake and survival in peritoneal dialysis patients
Published in Renal Failure, 2023
Shu-Hong Bi, Xiaoxiao Wang, Wen Tang, Tao Wang, Baohua Li, Chunyan Su
Classical method for assessing dietary protein requirements is nitrogen balance [27]. Protein equivalent of total nitrogen appearance (PNA) is a common tool used to estimate protein intake and is calculated using urea clearance from 24-h urine and dialysate collection in PD patients. Therefore, the calculation of nitrogen balance and the formulae which were used were of great importance. Bergstrom formula originated from the data of European PD patients and may have overestimated DPI in Asian CAPD patients [18,28]. Recently, new formulae for calculating PNA were generated based on nitrogen balance studies of stable Chinese CAPD patients [25]. Since the study population had a fairly typical Asian body type and the dialysis regimen was consistent with the characteristics of CAPD clinical practice in Asia, the new formulae might be more suitable for DPI estimation in the study population [25]. Therefore, in this study, we also used new formulae to calculate nitrogen balance. Results from new formulae suggested that patients with DPI 0.80–0.99g/kg/day and DPI ≥ 1.0g/kg/day both presented positive nitrogen balance. Therefore, taking into account these results, DPI ≥ 0.8 g/kg/day was supposed to be more appropriate for the long-term outcome in the Asian CAPD population.
Hyperkalemia in chronic peritoneal dialysis patients
Published in Renal Failure, 2022
Andrew B. Elliott, Karim M. M. Soliman, Michael E. Ullian
We found that serum samples with higher [K+]s also contained higher creatinine concentrations and urea nitrogen concentrations. Similar to our findings were those from Liu et al., who observed a positive correlation between azotemia (creatinine and urea nitrogen levels) and [K+]s [17]. It is possible that noncompliance with PD therapy, which would be reflected by more azotemia, caused hyperkalemia. It is also possible that larger muscle mass or greater protein intake contributed to hyperkalemia. It has been demonstrated that skeletal muscle content of potassium is greater in PD patients than in control patients with normal renal function [21]. A carefully performed metabolic study in 8 chronic PD patients demonstrated that increasing daily dietary protein intake from 0.98 to 1.44 g/kg resulted in positive nitrogen balance and positive potassium balance [22]. We did not find that hyperkalemia-only patients were younger than hypokalemia-only patients, with youth a putative marker of larger muscle mass.
Food and beverages promoting elderly health: six food-based dietary guidelines to plan good mixed meals for elderly South Africans
Published in South African Journal of Clinical Nutrition, 2021
Sanjoy Saha, Upasana Mukherjee, Makenzie Miller, Li-Ling Peng, Carin Napier, Heleen Grobbelaar, Wilna Oldewage-Theron
The current recommended daily allowance (RDA) for protein, according to the WHO, is 0.8 g protein per kilogram of bodyweight each day (g/kg BW/d), regardless of age or gender.110,112,116 This corresponds to about 56 g/day for men and 46 g/day for women and comprises 10% of total energy intake, when based on a 8 400–9 200 kJ diet.116 Emerging evidence, however, has led many to argue that this recommendation does not consider age-related changes in metabolism, immunity, hormone levels, muscle and fat mass, food intake, physical activity or progressing frailty.107,110,122,125 Furthermore, the nitrogen-balance studies from which the current RDA is derived have been criticised for their inability to accurately quantify all routes of nitrogen intake and loss, and lack of measurement of physiological endpoints associated with healthy ageing, among other limitations.110,122 The technical drawbacks of the nitrogen balance technique may result in requirement values that are too low.109