Dietary recommendations protein

Low-nitrogen (protein) diets have been advocated from the early years of treatment of severe chronic uremia. The very-low-protein diets tested in the MDRD Study were of marginal benefit in these well-supervised patients with very low renal function, but are not well adhered to in practice, may lead to negative nitrogen balance, and are not recommended. Protein intake is restricted spontaneously to approximately 0.6 to 0.8g/kg/day by uremic patients not receiving dietary advice. To prevent malnutrition, patients receive professional dietary advice, with diets containing an increased proportion of first class protein and increased calorie content of up to 35 kcal/kg/day. The NHANES III has confirmed an association with reduced GFR and malnutrition in noninstitutionalized individuals studied in a cross-sectional survey of more than 5000 participants stratified according to GFR. ... 

The Dietary Recommended Intake (DRI) for protein in pregnancy is 71 g/day [3]. This recommendation provides an additional 21 g over nonpregnancy protein recommendations in order to support the growth of the placenta and fetal tissue. Medical food is the major source of protein for individuals with PKU. When protein is supplied as medical food containing L-amino acids, it is oxidized more rapidly than whole protein, and therefore the amount of protein needed is greater than normal (1.2 times the DRI or 85 g/day). In severe PKU, medical food provides about 80 % of the protein or about 68 g protein per day. A simple way to assure that adequate protein is being provided is to meet the DRI for protein from amino acid-based medical food alone. 

Reduction in dietary protein intake has been shown to slow the progression of kidney disease.8 However, protein restriction must be balanced with the risk of malnutrition in patients with CKD. Patients with a GFR less than 25 mL/minute/ 1.73 m2 received the most benefit from protein restriction 8 therefore, patients with a GFR above this level should not restrict protein intake. The NKF recommends that patients who have a GFR less than 25 mL/minute/1.73 m2 who are not receiving dialysis, however, should restrict protein intake to 0.6 g/kg per day. If patients are not able to maintain adequate dietary energy intake, protein intake maybe increased up to 0.75 g/kg per day.15 Malnutrition is common in patients with ESRD for various reasons, including decreased appetite, hypercatabolism, and nutrient losses through dialysis. For this reason, patients receiving dialysis should maintain protein intake of 1.2 g/kg per day to 1.3 g/kg per day. 

Dietary consumption should be balanced in carbohydrates, protein, and fat. Several diet plans exist that promote weight loss through strict limitation or overabundance of only one macronutrient (e.g., low-fat, low-carbohydrate, or high-protein diets) however, overall energy consumption and expenditure will determine the amount of weight alteration. Consultation with a dietician is recommended when... 

It has been well established that the ingestion of high dietary protein levels results in hypercalciuria in man, and that hypercalciuria is frequently accompanied by negative calcium balance (1-3). In a summary of data from nutritional surveys in the U.S., Pao (4J showed that dietary protein intake was well above the Recommended Dietary Allowances (RDA) for both men and women regardless of age (1). Although dietary calcium intakes are generally at the RDA for men, women below the age of 50 yr consume only 75% of the RDA (4J. Women above the age of 50 yr consume only two-thirds of the RDA for calcium (4). These low consumptions become critical when we consider the reduced ability for calcium absorption demonstrated in both men and women over the age of 60 yr (6). 

Since ferrets eat only their caloric requirements, and since their gastrointestinal transit time is short (3-5 h), it is recommended that they receive diet ad libitum. Dry cat food was previously recommended for ferrets however, there are now at least two standardized ferret chows commercially available. The most important dietary variable is the quality of the protein, and ferrets appear to do best with a high percentage of animal protein in their diet (Morton and Morton, 1985). Feed consumption will be higher in the fall and winter and lower in the spring and... 

The presence of proteins in the diet is essential for health. An important question, therefore, is what is the minimal amount of protein that must be provided to maintain health It is not an easy question to answer. Even when no protein or amino acid is consumed, in an otherwise adequate diet, urea is lost from the body due to body protein break down. The daily loss of protein is about 0.34 g per kg or about 24 g protein each day for a 70 kg person (i.e. when no protein is consumed). However, this amount does not represent the minimal intake required, since other factors, (such as the amount of energy consumed, other components in the diet, and trauma physical activity can affect this amount.) The recommended dietary allowance (RDA) for a young adult is 0.8 g per kg per day (Table 8.6). 

Age (years) Body weight (kg) Recommended Dietary Allowance of protein (g/kg per day) ... 

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... 

The beneficial effects of dielary fiber, including both soluble and insoluble fiber, are generally recognized. Current recommendations arc for daily intakes of 20-35 g in a balanced diet of cereal products, fruits, vegetables, and legumes. However, the specific preventive role of dietary fiber in certain diseases has been difficult to establish, in pan because dielary risk factors such as high saturated fat and high protein levels are reduced as fiber levels increase. 

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