Anne D. VanBeber

Cottonseed protein : What does the future hold ?

Cottonseed protein has the potential to increase the worlds food supply while decreasing the incidence of malnutrition among the worlds hungry. Nutritionally, cottonseed flour compares favorably to other animal and vegetable protein sources, as it is low in fat and contains a substantial amount of high biological value protein. Animal studies, as well as human research, using gossypol-free glandless cottonseed flour have shown that cottonseed protein promotes growth, increased weight gain, and a positive nitrogen balance. Cottonseed protein food products have been shown to be a healthy addition to the diets of children, college-age women, and the elderly. With its light color and bland flavor, cottonseed has many uses in the food processing arena. Baked goods, snack foods and candy, as well as pet and livestock feed are just a few successful products developed utilizing cottonseed protein.

Are Lipid Values and BMI Related to Hospitalizations in the Hemodialysis Population

OBJECTIVE To examine the relationship between lipid values and BMI (body mass index) on hospitalizations in hemodialysis (HD) patients. DESIGN Retrospective (2-year) study. SETTING Outpatient dialysis center in a large metropolitan city. PATIENTS This study used 158 HD patients stratified on the basis of ethnicity (non-Black and Black) and diabetic status (nondiabetic and diabetic). INTERVENTION Subjects were observed for 2 years. Body weight, BMI, lipid parameters, and hospitalization duration were determined 8 times (3-month intervals). MAIN OUTCOME MEASURES Body weight, BMI, lipid parameters (serum triglyceride concentration, serum total cholesterol, high-density lipoprotein [HDL]-, low-density lipoprotein [LDL]-, very low-density lipoprotein [VLDL]- cholesterol concentrations, serum Apo-protein A1 [Apo-A1] concentration, and serum Apo-protein B [Apo-B] concentration), and morbidity data were recorded. RESULTS Hemodialysis subjects were hospitalized 2.3 +/- 1.6 times over the 2-year experimental period. Length of hospital stay averaged 6.6 +/- 0.5 days/hospitalization. Length of hospital stay was inversely related to HDL concentration (r = -0.21, P <.05, n = 89), but not significantly related to BMI in HD subjects. BMI was positively associated with LDL concentration (r = +0.28, P <.01, n = 97). Cholesterol concentration was directly associated with LDL concentration (r = +0.52, P <.01, n = 138), VLDL concentration (r = +0.47, P <.01, n = 139), and triglyceride concentration (r = +0.54, P <.01, n = 155). Mean concentration of HDL-cholesterol was inversely related serum triglyceride concentration (r = -0.43, P <.01, n = 140). Although Apo-A1 concentration was directly associated with HDL level (r = +0.39, P <.01, n = 139), Apo-B was inversely related to HDL level (r = -0.37, P <.01, n = 138) and directly related to cholesterol concentration (r = +0.71, P <.01, n = 138), VLDL concentration (r = +0.87, P <.01, n = 138), and triglyceride concentration (r = +0.81, P <.01, n = 138). CONCLUSION Cardiac disease remains the primary cause of morbidity and mortality in HD patients, and results of the present study suggest that dyslipidemias present in the HD population negatively impact cardiovascular profiles which, in turn, influence the frequency/duration of hospitalizations. Among all lipid parameters analyzed in the present study, increased LDL and decreased HDL concentrations were more strongly related to length of hospital stay than was BMI.

The Effect of Dietary Omega-3, -6, and -9 Fatty Acid Supplements on Serum Fatty Acid Concentrations in Renal Dialysis Patients: Implications for Immune Response

Abstract •Objective: To alter the serum fatty acid and immunoglobulin concentrations of renal dialysis patients by supplementation of omega-3, -6, or -9 fatty acids during a 6-week period. •Design: Randomized before-and-after-supplementation trial. •Setting: Three dialysis centers in the Dallas, TX, methopolitan area. •Patients: Thirty-five maintenance hemodialysis patients were chosen. Subjects were identified for inclusion in the study by the following criteria: concentrations of triglycerides ( 1.70 mmol/L [150 mg/dL]) and cholesterol ( 4.66 mmol/L [180 mg/dL]), absence of insulin-dependent diabetes, and absence of liver disease. •Interventions: Patients were supplemented daily with either 3g of omega-3 MaxEPA (Seven Seas Health Care, Hull, England), 3g of omega-6 fatty acid cottonseed oil, or omega-9 fatty acid (10% of caloric intake) pecan oil. The control group received no treatment. •Main outcome measures: Fasting serum samples were obtained on days 0, 21, and 42 to determine serum concentrations of eicosapentanoic acid (EPA), docosahexanoic/myristic acids (DHA/MYR), arachidonic acid (AA), linolenic acid (LNA), linoleic acid (LA), oleic acid (OA), immunoglobulin G (IgG), immunoglobulin A (IgA), and immunoglobulin M (IgM). •Results: Twenty-eight subjects completed the study. Within the MaxEPA-supplemented (N = 5) and pecan oil-supplemented (N = 8) groups, serum EPA concentrations were significantly higher at days 21 and 42 than at day 0. Within the cottonseed oil-supplemented group (N = 8), serum EPA concentration was significantly higher at day 21 than at days 0 and 42. The serum concentrations of AA were significantly lower in the MaxEPA-supplemented and pecan oil-supplemented groups at day 21 and 42 than at day 0. No significant change was shown in serum DHA/MYR, LNA, LA, or OA concentrations from day 0 to day 42. There existed no significant difference in serum IgG, IgA, or IgM concentrations for the duration of the study. •Conclusions: Omega-3, -6, and -9 fatty acid supplements exert different effects on serum fatty acid concentrations in renal dialysis patients. These results support findings in the literature indicating that fatty acid metabolite profiles may be manipulated by diet. In turn, immune response may be altered through manipulation of eicosanoid production. Because of a compromised immune status, renal dialysis patients may be the best population for this type of research, and a comparison of such subjects with healthy volunteers is warranted.

Omega-3, -6, and -9 Fatty Acid Supplements Exert Different Effects on Serum Lipid Concentrations in Renal Dialysis Patients

■ Objective: To compare changes in blood lipid profiles of renal dialysis patients who consumed diets rich in either omega-3, -6, or -9 fatty acids over a 6-week period. ■ Design: Randomized before-after trial. ■ Setting: Three dialysis centers in the Dallas, TX, area. ■ Patients: Thirty-five maintenance hemodialysis patients were selected. Twenty-eight (9 men and 19 women) completed the study. Subjects were identified for inclusion for the study by the following criteria: concentrations of triglycerides (> 150 mg/dL) and cholesterol (> 180 mg/dL), absence of insulin-dependent diabetes, and absence of liver disease defined as three times greater than normal levels of serum glutamic pyruvic transaminase and serum glutamic oxaloacetic transaminase. ■ Interventions: Patients were given a daily supplement of either omega-3 fatty acid (3 g) MaxEPA (Seven Seas Health Care, Hull, England), omega-6 fatty acid (3 g) cottonseed oil, or omega-9 fatty acid (10% of caloric intake) pecan oil. ■ Main outcome measures: Fasting blood samples were obtained on days 0, 21, and 42 to determine serum total cholesterol (TChol), high-density lipoprotein cholesterol (HDL-C), HDL subfractions (HDL 2 -C and HDL 3 -C), and triglycerides (TG). ■ Results: A significant decrease in serum TChol was observed in the omega-9 fatty acid group. Significant decreases were also observed in the serum TG concentrations of the omega-3 and omega-9 fatty acid groups. Significant decreases in HDL-C were observed in the omega-3 fatty acid and control groups, whereas significant decreases in the HDL -C occurred in the control group. The HDL-C reduction in the omega-3 fatty acid group occurred primarily in the HDL -C subfraction. ■ Conclusions: Omega-3, -6, and -9 fatty acid supplements exert different effects on the serum lipid profiles of renal dialysis patients. New studies need to be initiated to determine the mechanisms responsible for this altered lipid metabolism and the clinical significance of these changes.

Nutrition Knowledge and Attitude Changes In College Students: Efficacy of One-Credit Hour Nutrition Concepts Vs. Three-Credit Hour Nutrition Courses

Abstract Nutrition knowledge and attitude changes were measured in 171 students completing a three-credit hour Nutrition course and 249 students completing a one-credit hour Nutrition Concepts course. Knowledge and attitude were measured on the first class day (pre-test) and at the end of the one semester courses (post-test). Instruments used were the previously validated Nutrition Knowledge Test (NKT) (50 multiple-choice questions) and Nutrition Attitude Scale (NAS) (25 closed-ended statements to which respondents agreed/disagreed with nutrition attitude statements). Curricula was similar in both courses, but differed in depth of content. Course topics included the Dietary Guidelines/Food Guide Pyramid, carbohydrates, fats, proteins, vitamins, minerals, and water. Results included that mean post-test NKT scores from subjects in the one-credit hour course (64±0.7% correct) were significantly higher (p

The Effect of Recombinant Hump Erythropoietin Therapy in Anemic Kidney Patients: A Nutritional Emphasis

Abstract Erythropoietin (EPO) is a hormone critical to erythroid development. Produced in the kidney, EPO stimulates erythroid precursors, regulates hemoglobin synthesis, and accelerates the production of red blood cells. During normal renal function EPO production increases with anemic conditions. In contrast, the damaged kidney of end-stage renal disease (ESRD) is unable to maintain this homeostatic balance. Thus, as kidney failure progresses, the severity of anemia increases. The recent development of recombinant human erythropoietin (r-HuEPO) brings hope to the hemodialysis population suffering from ESRD-associated anemia. Clinical trials indicate that several biochemical, hematological, and physiological parameters are improved with r-HuEPO therapy. The quality of life for patients is improved with r-HuEPO treatment; they report increased energy and appetite. The requirements of several nutrients important to erythropoiesis are increased as a result of r-HuEPO therapy. Serum concentrations of iron, folate, and vitamin B 12 should be monitored during treatment, and supplementation is often recommended. Hematocrit is increased with treatment of r-HuEPO. Amino acid concentrations may improve with r-HuEPO therapy. The blood levels of several minerals may become altered in the hemodialysis patient receiving r-HuEPO therapy. Hyperkalemia has been observed in some patients. Elevated aluminum blood levels interfere with erythropoiesis and ferrokinetics; however, desferrioxamine therapy has been used to treat this condition. Major advances have been made in treating the anemia of renal failure; however, the nutritional requirements of r-HuEPO patients warrant further investigation.