Adequate intake carbohydrate

Propofol infusion syndrome mimics the mitochondrial myopathies, in which there are specific defects in the mitochondrial respiratory chain. The clinical features of mitochondrial myopathy result from a disturbance in lipid metabolism in cardiac and skeletal muscle. These patients generally remain well until stressed by infection or starvation, although subclinical biochemical abnormalities of mitochondrial transport can be demonstrated. It has been suggested that early management of critically iU children may not include adequate calorific intake to balance the increase in metabolic demands, and that in susceptible children the diversion of metabolism to fat substrates may cause the propofol infusion sjmdrome. It is unclear if the dose or duration of propofol infusion alters this effect. As adults have larger carbohydrate stores and require lower doses of propofol for sedation, this may account for the relative rarity of the sjmdrome in adults. The authors suggested that adequate early carbohydrate intake may prevent the propofol infusion syndrome (71). 

Protein is an essential nutrient for human growth, development, and homeostasis. The nutritive value of dietary proteins depends on its amino acid composition and digestibility. Dietary proteins supply essential amino acids, which are not synthesized in the body. Nonessential amino acids can be synthesized from appropriate precursor substances (Chapter 17). In human adults, essential amino acids are valine, leucine, isoleucine, lysine, methionine, phenylalanine, tryptophan, and threonine. Histidine (and possibly arginine) appears to also be required for support of normal growth in children. In the absence from the diet of an essential amino acid, cellular protein synthesis does not occur. The diet must contain these amino acids in the proper proportions. Thus, quality and quantity of dietary protein consumption and adequate intake of energy (carbohydrates and lipids) are essential. Protein constitutes about 10-15% of the average total energy intake. 

Provision of biosynthetic precursors. In the absence of adequate dietary carbohydrate intake, gluconeogenesis supplies precursors for the synthesis of glycoproteins, glycolipids, and stmctural carbohydrates. 

Many studies report beneficial effects of trivalent chromium. The element is described by WHO [24.5] as essential owing to its ability to strengthen the activity of in-suHn and its influence on carbohydrate and Upid metaboHsm. Biological systems commonly contain chromium as Cr in small concentrations [24.6]. It is thought, but disputed, that chromium is essential for life and involved in human glucose metaboHsm [24.7]. Chromium intake has been shown to be positive for humans and decreases the symptoms of diabetes in people with glucose intolerance [24.8]. An adequate intake of chromium for an adult is 50-200 pg/day and the content of chromium in tissues is 100-1000 pg/kg dry weight. 

Hypoglycaemic coma occurs if the plasma concentration of glucose falls below about 2 mmol/L, as a result of administration of insulin or oral hypoglycaemic agents without an adequate intake of carbohydrate. Strenuous exercise without additional food intake can also cause hypoglycaemia. In such cases oral or intravenous glucose is required. 

Diet and water balance—Adjustments in diet to meet the energy demands of cold work activities include increased caloric intake (carbohydrates and fat) to compensate for the body s energy demands. Water deficits contribute to dehydration and increased risk to cold injuries. Efforts should be made to avoid water loss and maintain an adequate water balance. 

DRIs, dietary reference intakes EAR, estimated average requirement RDA, recommended dietary allowance AI, adequate intake.-Data from Institute of Medicine of the National Academies (2002) Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, Amino Acids. Washington, DC The National Academies Press. 

Every patient with diabetes requires some form of dietary assessment, and often therapy. This is important to allocate the relative amounts of energy derived from carbohydrate, protein and fat of total recommended daily calories in proportion to the patient s body weight and height and daily requirements, while avoiding atherogenic diets. Diets with high carbohydrate content (50-60%), low fat (30-35%) and adequate protein (10-15%) is recommended. Fibre-rich foods are preferable. The use of non-nutritive sweeteners (saccharin, aspartame, ace-sulfame K and sucralose) are acceptable. Alcohol intake should be assessed since excess consumption... 

Acceptable Macronutrient Distribution Ranges (AMDR) are defined as a range of intakes for a particular macronutrient that is associated with reduced risk of chronic disease while providing adequate amounts of essential nutrients. Adults should consume 45 to 65 percent of their total calories from carbohydrates, 20 to 35 percent from frit, and 10 to 35 percent from protein. 

A calorie intake of 1,800-2,500 kcal/day (ca. 30 kcal/ kg BW/day) is guaranteed by the adequate administration of fats (70-140 g) and carbohydrates (280-325 g). Consideration should be given to the fact that cirrhotic patients show a resistance to insulin and a glucose intolerance, with a tendency to develop a diabetic metabolic condition. For this reason, it might well be necessary to administer insulin. Carbohydrates reduce the plasma levels of ammonia and free tryptophan. 

Vitamins In particular, water-soluble vitamins have to be provided in adequate quantities. With a carbohydrate diet and alcoholic liver disease, the daily requirement is higher. A daily intake of multivitamins, best combined with trace elements and minerals, is recommended. As a rule, liposoluble vitamins are best administered by parenteral route due to inadequate absorption. The therapeutic significance of zinc (s. pp 50, 99) should always be borne in mind. (34, 153, 155,169)... 

Our dietary intake comprises three macronutrients (protein, carbohydrate and lipid) and a large but unknown number of micronutrients (vitamins, minerals, antioxidants, etc.). Good health rests, in part, on an adequate and balanced supply of these components. This book is concerned with the major sources of lipids and the micronutrients that they contain. 

Dextrose, a carbohydrate, is used in fluid replacement and caloric supplementation in patients who cannot maintain adequate oral intake or are restricted from doing so. 

More recently, novel erythropoiesis-stimulating protein (NESP) or darbapoetin alfa (Aranesp) has been approved for clinical use in patients with indications similar to those for epoetin alfa. It is a genetically modified form of erythropoietin in which four amino acids have been mutated such that additional carbohydrate side chains are added during its synthesis, prolonging the circulatory survival of the dmg to 24 to 26 hours. Recombinant erythropoietin therapy, in conjunction with adequate iron intake, can be highly effective... 

In humans, the catabolism of macronutrients (carbohydrates, fats, and proteins) to supply energy is an important aspect of nutrition. In the United States, most diets provide more than an adequate number of nutritional calories. The typical American diet is high enough in fat that essential fatty acids (Section 21.6) are seldom, if ever, deficient. The only concern is that the diet contains an adequate supply of protein. If the intake of protein is sufficient, the supply of essential amino acids (Section 23.5) is normally also sufficient. Packaging on food items... 

IV.A), this ion is currently officially recognized as an essential micronutrient for humans (577, 578). The recently published values of Dietary Reference Intakes of Crflll) in the United States and Canada (ranging from 0.2 to 5.5 pg day for infants or from 20 to 45 pg day for adults) (578) are significantly lower than the previously accepted values of Recommended Dietary Allowances (RDA) (from 10 pg day for infants to 200 pg day for adults) (577). Measurements of Cr(III) contents in food sources suggested that up to 90% of the population in industrialized countries receive less than adequate amounts of dietary Cr(III). These amounts can be further decreased by carbohydrate- and fat-based diets, which promote Cr(III) excretion (3). As the biological activity of Cr(III) has been related to improvements in glucose and fat metabolism (579), the use of... 

Nut seeds are also high in protein and low in carbohydrates. Diets high in protein and low carbohydrate have been shown to decrease hunger, reduce body fat, lower blood pressure, and improve blood lipid levels by decreasing TAG and LDL cholesterol levels [43,93,134-137]. Thus, inclusion of moderate amounts of nut seeds as a part of a well-balanced food intake, ideally when substituted for other fat or protein sources in the diet, may be useful in designing adequate diets intended for weight loss and weight control. 

Changes in dietary carbohydrate that reduce milk fat content tend to increase protein content if dietary protein supply is adequate. The effect may require 2 3 weeks to manifest itself and be of the order of 8 g protein/kg nulk. It is probable that the increased propionic acid production on such diets has a sparing effect on certain glucogenic amino acids such as glutamate, and more of these are then available to the mammary gland for protein synthesis. Alternatively, such diets are often associated with an increase in microbial protein synthesis in the rumen, which will increase amino acid supply to the mammary gland. The increased intake of energy per se, which usually occurs on such diets, would have the same effect. 

A varied diet should provide an adequate level of thiamine to prevent deficiency. The thiamine requirement of an individual is influenced by age, energy and carbohydrate intake, and body mass. On the basis of considerable evidence, the Food and Nutrition Board of the US Institute of Medicine recommends thiamine intake at a level of 0.5mg/1000kcal (4184KJ) (National... 

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