Children burn more body fat than adults for each calorie spent, according to research in the online open access publication, Nutrition Journal, evidence that fat can be included as part of a child's healthy and balanced diet.
A US team led by John Kostyak from The Pennsylvania State University used calorimetry to measure whole body fat oxidation in 10 children (aged 6-10) and 10 adults. All had a body mass index (BMI) within the healthy, middle range. Kostyak's team checked subjects cardiovascular fitness and body fat, and all were given the same typical American diet for three days prior to testing (although adults had larger portions). Test subjects spent nine hours on three separate days at a low physical activity level, watching movies or reading, in either a room calorimeter or under a hood system, which quantify oxygen and carbon dioxide gas levels. The authors also measured the total amount of nitrogen in the subjects urine, and used these measurements to calculate how much fat they oxidised.
Although the absolute amount of fat burned in a day did not differ greatly between children and adults, children burned considerably more fat relative to the amount of energy they used. In an attempt to determine the contribution of fat oxidation to daily calorie expenditure, the researchers calculated the grams of fat oxidized per kcal of energy expenditure. This value was higher in children (0.047 0.01 g/kcal) compared to adults (0.032 0.01, p<0.02). Women and girls used fat at a higher rate than men and boys of a comparable age.
"Prepubescent children may oxidise more fat relative to total energy expenditure than adults for the purpose of supporting normal growth processes such as higher rates of protein synthesis, lipid storage and bone growth says Kostyak. 'sufficient fat must be included in the diet for children to support normal growth and development."
The findings support current dietary guidelines, suggesting that children should have a certain amount of fat in their diet, to meet their energy and nutritional needs.
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"Although genetic testing can currently identify who has these genetic variants, more studies are needed to explore the precise starting dose for these patients," said Larry Lesko, Ph.D., director of the FDA's Office of Clinical Pharmacology. "FDA has been working with other government agencies and organizations to develop such studies under the auspices of our three-year-old Critical Path Initiative, which addresses the challenges of moving promising medical products from discovery to patient use."
FDA's Critical Path Initiative has funded a research project with the University of Utah and the Critical Path Institute of Tucson, Ariz., to develop genetically based instructions for warfarin dosing. The Initiative has also facilitated meetings and planning with the National Heart, Lung and Blood Institute for a clinical trial that will study warfarin dosing based on genetic test information and is helping to pay for another clinical study being conducted by Harvard Partners that will derive personalized warfarin dosing algorithms for patients new to the drug.
The dosage and administration of warfarin must be individualized for each patient according to the particular patient's PT/INR response to the drug. The specific dose recommendations are described in the warfarin product labeling, along with the new information regarding the impact of genetic information upon the initial dose and the response to warfarin. Ongoing warfarin therapy should be guided by continued INR monitoring.
Bristol-Myers Squibb Co. of Princeton, N.J., is the manufacturer of Coumadin.
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