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Query: UMLS:C0028754 (obesity)
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Recent epidemiologic studies show that diabetes mellitus is almost as prevalent in undernourished populations as it is in well-nourished ones, despite the virtual absence of obesity as an etiologic determinant in the former. Undernutrition itself may be the risk factor that replaces obesity in predisposing such populations to diabetes. The glucose intolerance of protein-energy malnutrition is known to be associated with structural changes in the beta cell, and in a significant proportion of undernourished subjects it is irreversible despite prolonged and vigorous nutritional rehabilitation. Chronic undernutrition over a lifetime may, therefore, be an important determinant of diabetes in an individual, either by progressively impairing beta cell function or by increasing the susceptibility of the individual to other genetic and environmental diabetogenic influences.
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PMID:The role of undernutrition in the pathogenesis of diabetes mellitus. 643 34

Many authors have pointed that precocious weaning expose infants to serious risks as hypernutrition, obesity, adverse reactions to foods, hypernatremia, dental caries, emotional problems as anorexia or bulimia, so that actually weaning is delayed after 6th month of age. Going on with the "adapted" formula is a relative nonsense because "adapted" milks have low protein and calcium contents so that they are not adequate to cover estimated and advisable intakes of 4-6 month baby unless feeding unusual higher volumes. On the other side "fresh milk" can not be considered a nutritional "chance", owing its low values of EFA, iron, vitamins, getting worse when fresh milk is diluted. So, recently was born a new milk formula "the follow up milk", on covering nutritional requirement for infants after 4 months of age. Someone is still critical about a follow up milk, also if ESPGAN in 1981 has confirmed its value in the infant feeding. Our work dealed on physical and biochemical nutritional assessment of 100 infants fed a new "liquid follow up formula" (Transilat). Nutritional assessment was performed with the following parameters: daily changes in weight according Fomon standards, plasmatic iron, cholesterol, transferrin, calcium, total proteins, hemoglobin concentration; all data are related to literature values for age. Results show that infants fed (Transilat) are growing well; nutritional data from biochemical point of view discovered any form of minimal or sporadic malnutrition. The follow up milk is a good nutritional "chance" after 4th month of age, instead of fresh cow milk; some infant with clinical problem needing a delayed introduction of cow milk can benefit of follow up milk also in older ages.
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PMID:["Follow-up milk": general principles and evaluation of the nutritional status of 100 subjects fed a liquid transitional formula]. 664 69

Anorexia nervosa (AN) can be considered a result of complex instrumental conditioning. It is postulated that in healthy nonsatiated individuals, the sight and smell of the preferred food, acting as a conditioned stimulus (food CS), activates a memory pattern of associations "eating--desirable sensory input" (approach pattern). This leads to the instrumental reaction of eating which is reinforced by sensory satisfaction. In victims of AN, in addition to the approach pattern the food CS activates another pattern of associations consisting of such components as "eating--obesity--failure" and " noneating --thinness--success" (avoidance pattern). The establishment of the avoidance pattern depends on such factors as social preferences and pressures to be slim, inborn dispositions, and personal psychological problems. If the activation of the avoidance pattern prevails over the activation of the approach pattern, the individual refrains from eating. The refusal to eat is here an instrumental avoidance reaction; its performance is reinforced by satisfaction derived from successful self-control and losing weight. A prolonged activation of the avoidance pattern leads to malnutrition and ultimately to death. In cases in which the approach pattern and the avoidance pattern are frequently activated simultaneously to the same degree, a neural conflict may develop. In a variation called "bulimia nervosa," an activation of the approach pattern alternates with the activation of the avoidance pattern. First, overeating takes place; it is reinforced by oral-gastric satisfaction. Then, the avoidance reaction of self-induced vomiting or purging follows; it is reinforced by satisfaction derived from preventing weight gain.
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PMID:Anorexia nervosa as a case of complex instrumental conditioning. 672 79

Egg binding most often affects budgerigars, cockatiels, finches and canaries. Causes include oversized or malpositioned eggs, lack of exercise, nesting too early or late, excessive egg laying, uterine damage or infection, obesity, malnutrition, sudden drops in ambient temperature and genetic factors. Clinical signs are perching unsteadily with ruffled feathers and half-closed eyelids, frequent tail-wagging or straining, swelling over the tail base, and sitting on the cage bottom. Diagnosis is by physical examination and radiography. Treatment may involve increasing the ambient temperature to 85-90 F, lubricating the vent, IM injections of Ca solution and/or oxytocin, egg aspiration and laparotomy.
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PMID:Egg binding in caged and aviary birds. 673 18

Marked perturbations of cell-mediated immunity are observed in nutritional imbalance, both undernutrition and overnutrition. Individuals with protein-energy malnutrition show consistent impairment of cutaneous delayed hypersensitivity and a reduced number of circulating T lymphocytes. Variable changes in lymphocyte stimulation response in vitro to mitogens and antigens are seen. There is a relative increase in the number of "null" cells and high levels of leukocyte terminal deoxynucleotidyl transferase activity. These findings suggest impaired differentiation of T cell precursors, which may be the direct result of reduced thymic hormone activity. Alterations in the production of lymphokines are not consistent. Infants with intrauterine growth retardation show a marked and long-lasting deficit in cell-mediated immunity. Specific nutrient deficiencies vary in their ability to influence cell-mediated immunity and the mechanisms underlying the immunologic abnormalities. Among others, zinc and pyridoxine deficiencies are associated with marked immunodepression. Obesity also is associated with alterations in cell-mediated immune responses. This has been observed in man, in genetically obese mice, and in states of excess intake of lipids, vitamins, minerals, and a trace elements. Nutritional modulation of cellular immunity is an important determinant of morbidity in several systemic disorders.
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PMID:Cell-mediated immunity in nutritional imbalance. 677 81

Children recovering from severe malnutrition on a milk based diet have low plasma zinc concentrations: children recovering on a soya based diet have much lower plasma zinc concentrations, lower rates of weight gain, and higher energy costs of tissue deposition. However, they do not demonstrate the clinical features of anorexia, diarrhea, and skin lesions usually associated with zinc deficiency. We therefore supplemented 16 children with zinc acetate on the basis that a therapeutic response to zinc constitutes the best evidence of a preexisting zinc deficiency. Fourteen of the 16 children had an immediate and definite increase in their rate of weight gain with zinc supplementation. This was associated with a decrease in the energy cost of tissue deposition, regrowth of the thymus, and activation of the sodium pump. We conclude that the children were indeed zinc deficient. We suggest that the anorexia of zinc deficiency is related to an inability to metabolize nitrogen in the zinc deficient state, and that our children did not show an appetitive response because of the relatively low protein content of the diets we used. Based on the premise that the abnormalities seen in our children may have been secondary to mild zinc deficiency, we suggest that limitation of lean tissue synthesis, with resultant obesity, and a propensity to infection are the major features of a mild zinc deficiency. Children undergoing a period of "catch up" weight gain or growth should have supplemental zinc, particularly if they have had diarrhea or if the use of a soya based formula is contemplated.
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PMID:Effect of zinc supplementation on the dietary intake, rate of weight gain, and energy cost of tissue deposition in children recovering from severe malnutrition. 678 72

The protein-energy malnutrition classification schemes of Waterlow and McLaren, although similar in other respects, assess the weight-for-height of children in quite different ways. The drawbacks of their two methods are described, and an alternative method is presented which overcomes them. The new index is called weight/height2-for-age, and consists of the ratio weight/height2 expressed as a percentage of the same ratio for a reference child of the same age. Although the index is not age independent, it is insensitive to all but the grossest errors in age for children over 12 months old. The index is equally appropriate for the assessment of obesity. A slide-rule based on the Tanner standard is available to do the calculation.
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PMID:Weight-for-height indices to assess nutritional status--a new index on a slide-rule. 679 99

Development of gut IgA plasma cells was studied in early postnatal under- and overnutrition. Female mice were allowed to suckle in litters of 4, 9 or 20 pups to produce a state of obesity (litter of 4) or protein-energy malnutrition (litters of 20). Litters of nine were considered as control groups. Overfeeding during the suckling period did not change the development and the number of IgA plasma cells of the small intestine. By contrast, the weanling protein-energy malnourished mice had shorter intestines, reduced weight of gut mucosal, muscular and serosal layers and reduced length of villi. However, protein-energy malnutrition, when limited to the suckling period, had no marked effect on the development of IgA plasma cells. A diminished number of these cells was observed only when a more severe and prolonged state of malnutrition was induced.
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PMID:Effect of early postnatal under- and overnutrition on the development of IgA plasma cells in mouse gut. 680 53

Clinical and epidemiologic data suggest a causal relationship between nutritional deficiency and infection. Among other factors, impaired immune responses secondary to malnutrition increase susceptibility to infectious illness. Protein-energy undernutrition and deficiencies of iron, zinc, pyridoxine, and other nutrients depress a variety of immunity functions. Cell-mediated immunity, complement system, microbicidal activity of phagocytes, secretory antibody response, and antibody affinity are often decreased. Recent studies have revealed many metabolic and hormone alterations as well as changes in the number and function of lymphocyte subpopulations. Obesity also is associated with impaired cellular immune functions. Dietary factors may play a critical role in host resistance to disease.
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PMID:Nutrition and immune responses. 683 21

The nutritional status of and disease patterns in 449 healthy and 803 hospitalized urbanized Blacks in Durban were surveyed. While unemployed males were generally less fat than controls, obesity (i.e. weight 40% over that expected) was extremely common among female factory (33%) and female hospital 'domestic' (65%) employees. Undernutrition was significantly more common amont patients and more marked in males, 82% having significantly reduced fat stores. Disease patterns were similar in malnourished male and female patients, with infective and respiratory diseases predominating. However, the pattern was different in overweight male and female patients, non-ischaemic cardiovascular diseases, particularly hypertension, predominating. The most common cause of death in males was respiratory disease, and in females cardiovascular disease. Overall, malnutrition was most common in the subgroup (N = 212) of patients who died. The results confirm the known associations between undernutrition and increased susceptibility to infection and mortality, and also between overnutrition and hypertensive cardiovascular disease. The observation that malnutrition and obesity can coexist within rapidly urbanized communities stresses the need for concurrent education on nutrition. The high incidence of 'hospital malnutrition' observed emphasizes the need for nutritional support in acutely ill patients.
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PMID:The fat and the thin--a survey of nutritional status and disease patterns among urbanized Black South Africans. 684 76


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