Moderate-intensity exercise sustained for 16 months is effective for weight management in young adults.

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Parenteral nutrition lipid emulsions made from various plant oils contain steroidal compounds, called phytosterols. During parenteral administration of lipid emulsions, phytosterols can reach levels in the blood that are many fold higher than during enteral administration. The elevated phytosterol levels have been associated with the development of liver dysfunction and the rare development of liver failure. There is limited information available in the literature related to phytosterol concentrations in lipid emulsions. The objective of the current study was to validate an assay for steroidal compounds found in lipid emulsions and to compare their concentrations in the most commonly used parenteral nutrition lipid emulsions: Liposyn® II, Liposyn® III, Lipofundin® MCT, Lipofundin® N, Structolipid®, Intralipid®, Ivelip® and ClinOleic®. Our data demonstrates that concentrations of the various steroidal compounds varied greatly between the eight lipid emulsions, with the olive oil-based lipid emulsion containing the lowest levels of phytosterols and cholesterol, and the highest concentration of squalene. The clinical impression of greater incidences of liver dysfunction with soybean versus MCT/LCT and olive/soy lipid emulsions may be reflective of the levels of phytosterols in these emulsions. This information may help guide future studies and clinical care of patients with lipid emulsion-associated liver dysfunction.

Objective: The primary aims of this trial were to evaluate the reproducibility of a portable handheld calorimeter (Medgem) in a clinical population, and to compare its measures with a calorimeter in typical use with these patients. Design: Cross-sectional clinical validation study. Setting: Outpatient Clinical Research Center. Subjects: A total of 24 stable home nutrition support patients. Interventions: In random order three measures of resting metabolic rate (RMR) were taken after a 4-h fast, 15 min rest and 2-h abstention from exercise. Two measures were taken with the same Medgem (MG) and one with the traditional calorimeter (Deltatrac). Reproducibility of MG measures and their comparability to a Deltatrac measure were assessed by Bland-Altman analysis, with 47250 kcal/day established a priori as a clinically unacceptable error. In addition, disagreement between the two types of measures was defined as greater than 10% difference. Results: The mean difference between two MG measures was À6.8 kcal/day, with limits of agreement between 233 and À247 kcal/day and clinically acceptable. The mean difference between the Deltatrac and mean of two MG measures was À162 kcal/day, with limits of agreement between 577 and À253 kcal/day and clinically unacceptable. In all, 80% of the repeated MG RMR measures agreed within 10%, and the mean MG reading agreed with the Deltatrac in 60% of cases. Conclusions: RMR obtained using the MG calorimeter has an acceptable degree of reproducibility, and is acceptable to patients. The MG measures, however, are frequently lower than traditional measures and require further validation prior to application to practice in this vulnerable patient group.

Background: Measurements of dietary intake in obese and overweight populations are often inaccurate because food intakes are underestimated. Objective: The purpose of this study was to evaluate the validity of the combined use of observer-recorded weighed-food records and 24-h snack recalls in estimating energy intakes in overweight and obese individuals. Design: Subjects were 32 healthy women and 22 healthy men with mean body mass indexes (in kg/m 2 ) of 29.5 and 30.3, respectively. Energy intake (EI) was measured over 2 wk in a university cafeteria. No restrictions were made on meal frequency or EI. To document food consumed outside the cafeteria, 24-h snack recalls were conducted before meals. Energy expenditure (EE) was measured with the doubly labeled water (DLW) method (EE DLW ). Energy balance was determined by measuring body weight at the beginning and end of the 2-wk period. Results: The mean EI in the women (10.40 ± 1.94 MJ/d) and men (14.37 ± 3.21 MJ/d) was not significantly lower than the EE DLW in the women (10.86 ± 1.76 MJ/d) and men (14.14 ± 2.83 MJ/d). The mean EI represented 96.9 ± 17.0% and 103 ± 18.9% of the measured EE for women and men, respectively. There were no significant changes in weight in the group as a whole or by sex at the end of the testing period; the men lost 0.23 ± 1.58 kg and the women lost 0.25 ± 1.09 kg. Conclusion:The combination of observer-recorded food records and 24-h snack recalls is a valid method for measuring EI in overweight and obese individuals.

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