Glycemic Index List of Fruits and Vegetables

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When the coring device is used, at least 10 samples should be taken per stack. The curvilinear relationship between intestinal calcium absorption and calcium intake can be made linear by using the logarithm of calcium intake to yield the equation: Vitamin D supplementation and fracture incidence in elderly persons: Ethnicity Comparisons between racial groups within countries suggest substantial racial differences in the prevalence of osteoporosis. Gastric banding patients may or may not feel physically hungry after surgery, but typically they become hungry within a few weeks, since ghrelin levels may increase due to lower oral intake. The following are some of the most common micronutrient deficiencies and symptoms patients experience after bariatric surgery and strategies for treatment.

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The methods using faecal indices to estimate digestibility are based on established regression relationships between faecal indices and the digestibility of dry or organic matter Van Soest, The general model for these relationships is: The two variables merely happen to go together i.

The estimation of digestibility via faecal indices involves the following steps: The main advantages of this method are that it is relatively low-cost and results can be obtained fairly quickly. Its chief disadvantage is that it is site-specific, and the derived parameters and relations In vitro analysis of consumed feed.

When digestibility is analysed by in vitro methods, samples of feed ingested are subjected to artificial tests which simulate digestibility under controlled conditions. The more commonly applied methods involve the use of rumen fluids, chemical fermenters and nylon bags see Church and Pond, Rumen fluids are extracted from rumen-fistulated animals and used in combination with buffers to simulate the action of saliva. The Tilley-Terry method, which is widely used, involves an additional stage in which the feed is further digested with acid pepsin for another 48 hours.

The residual represents the indigestible portion of the feed. Chemical fermenters added to the feed have been used to predict digestibility. The method is also used to study rumen function and the metabolism of certain compounds, e. The advantage of the two methods is that the analysis is not expensive if laboratory facilities are available and that it can be performed fairly quickly.

The methods can also be used to assess the digestibility of grab samples of grass or of cut samples of stover and straws taken after crop harvesting.

These are inserted into the rumen of test animals and removed after a prescribed period. The loss of material from the bag as a result of fermentation is then calculated. The method is more applicable to on-station research, but it can be used together with the rumen cannula method to determine intake. Nutritive value of feed This part of the module focuses on the methods and techniques used in estimating the supply of different nutrients to animals in particular situations or systems, in relation to their need for these nutrients.

It starts with a general section on estimating the main feed components. It then goes straight to fibre analysis because of the difficulties involved in estimating feed values in very fibrous diets. Finally, it looks at some of the techniques in use for the physical sampling, from stands of different kinds of feed, for laboratory analysis.

Methods to estimate feed components The feed value of a source of feed can be assessed on the basis of its energy value, crude protein content and mineral content, using methods specifically designed to estimate these components of feed. The energy yield of a source of feed such as natural pasture can be estimated from its dry-matter weight per unit area. Module 6 discusses the various methods used to estimate biomass or dry-matter weight under rangeland conditions.

Many of these methods rely on the use of predictive equations based on the relationship between biomass and the vegetation characteristics e. Samples can be taken to establish similar predictive relationships for the estimation of dry-matter weight of crop residues.

Powell , for instance, used grain yield to predict total stover dry-matter weight and stalk and leaf dry-matter weights for millet and sorghum. The relationships, which were based on data obtained from randomly chosen sites in Kaduna State, Nigeria, were highly significant Figure 5.

Van Raay and de Leeuw adopted a similar procedure to determine the DM weight of crop residues in Katsina, Nigeria. They established predictive relationships on the basis of stalk and stand density, plant height and plant edibility subjectively estimated. Relationships between sorghum and millet grain yields and stover dry-matter DM yields.

Having obtained an estimate of dry-matter yield, an estimate of digestibility is then required before the desired approximation of the energy yield can be calculated.

The fibrous portions of a feed must, therefore, be considered before more accurate estimates of nutritive value can be made. Feeds with a high biomass per unit area are often low in energy since they also contain a high proportion of indigestible fibrous matter.

Methods of fibre analysis have been devised to separate those portions of fibre which can be utilised by the ruminant from those which are essentially indigestible. Fibre analysis is thus particularly important in the assessment of the nutritive value of these feeds.

For the purposes of illustration, however, the following average relationships can be used: Let us calculate the feed energy requirements of a kg liveweight ox for maintenance, foraging and production, and compare these with the availability of energy to that animal from its feed supply. The maintenance fasting metabolism requirement is determined as follows: Km tends to lie in the range 0.

We can call this 'foraging'. The energy requirement for foraging Ef are given by the formula: To gain weight, an animal needs between 12 and 27 MJ of ME per kg liveweight, depending on the percentage that fat constitutes in the meat accumulated. We can now compare supply and requirements of feed energy per ox for the 90 days of the dry season as follows: The standard laboratory method for the estimation of crude protein is the Kjeldahl method which is described in most texts on animal nutrition e.

McDonald et al, ; Church and Pond, The analysis is used to determine the crude protein content of a sample of grass or stover, and the results can then be used to establish predictive regression equations similar to those illustrated in Figure 5. When estimating the crude protein content of browse plants and crop residues, it should be borne in mind that the presence of certain phenolics tannins in these feeds can affect the availability of nitrogen to the ruminant.

This is particularly true of feeds high in insoluble polyphenolics, for which the calculated crude protein content may overestimate the amount of nitrogen which can actually be synthesised into protein e. Woodward and Reed, Analysis should only be attempted if mineral deficiencies are clearly evident. Even then, if other nutrients such as energy or crude protein are more limiting as is likely to be the case on African rangelands , the mineral constraint should be dealt with only after the primary deficiencies have been rectified Little, The methods used by ILCA researchers to diagnose the more common deficiencies involve blood, bone, liver, milk and faecal samples and are discussed in general terms below.

All the methods outlined rely on adequate laboratory facilities. For a more detailed account of symptoms of mineral deficiency and the role of minerals in animal nutrition, the user is referred to basic nutrition texts, e.

Cullison and Church and Pond Whole blood, blood serum and blood plasma samples have been used to diagnose mineral deficiencies particularly phosphorous and magnesium in livestock. Values significantly below 'normal' concentrations or ranges indicate the nutritional status of an animal with respect to a particular mineral, but the evidence is not always conclusive McDowell et al, Precautions must, for instance, be taken when samples are taken in less than optimum conditions since exercise, stress, temperature and other factors can alter mineral concentrations.

Such factors are often difficult to control in African conditions Mtimuni, and have resulted in high concentrations of phosphorous in serum when the concentration in forages consumed was, in fact, extremely low.

Little et al described a method for obtaining accurate estimates of blood inorganic P concentrations, but the difficulties of interpretation of such data were noted by Gartner et al Basically, only low blood inorganic P values have any diagnostic value. Because of the problems just described, tests using bone samples have been developed to test for phosphorus deficiency in livestock.

Samples of rib bone can be obtained by simple surgery. For FSR diagnostic work, simple measurements that can be made on certain long bones at slaughter can provide results which are generally more reliable than those obtained from blood samples.

These methods have been described by Little Liver samples have been used to diagnose for copper, cobalt and vitamin A deficiencies in African livestock Tartour, ; van Niekerk, ILCA has used samples of milk to diagnose mineral deficiencies in cattle in Ethiopia.

However, since milk composition is influenced by such factors as cow age, stage of lactation and genetic potential, milk sampling tends to be unreliable. The 'let-down' problem associated with zebu cattle Module 5 also means that it is cliff cut to obtain representative samples in field studies. Large variations in butterfat content between successive milkings of the same cow reflect this problem Lambourne et al, However, milk samples are very useful in the diagnosis of iodine deficiency Committee on Mineral Nutrition, Apart from their use in digestibility and intake studies, faecal samples have been used to diagnose for phosphorus and sodium deficiencies Little, Sodium problems are diagnosed more accurately, but with more difficulty, from saliva samples.

However, the analysis of mineral deficiencies is probably best done by feed analysis at the diagnostic phase of farming systems research. The methods described above are more applicable to specific problems requiring more sensitive analysis Little, A knowledge of the symptoms involved will provide further confirmatory evidence e.

The opinions of traditional herders will also be useful in identifying mineral deficiencies particularly the need for salt , as will be the movement of stock over large distances to natural sources of minerals. Fibre analysis The crude-fibre Weende method is described in most texts on animal nutrition. The method has been widely used to determine the fibre content of feed, but it has two serious shortcomings, particularly with respect to highly fibrous feeds such as crop residues, straws etc.

Ruminants can, however, utilise some cellulose and hemicelluose though lignin is essentially indigestible. The digestibility of a feed therefore tends to be underestimated. As a result, a portion of these components is included in the nitrogen-tree extract sugars and starches and is, therefore, assumed to be highly digestible.

The digestibility of a feed therefore tends to be overestimated. Because of these shortcomings, Van Soest devised a method which separates feed dry matter into two fractions - one of high or uniform digestibility and the other of low or non-uniform digestibility. Feed samples are boiled in a neutral-detergent solution and components are separated as follows: This fraction more closely corresponds to the true fibre fraction than the estimate of the Weende crude-fibre analysis.

However, NDF is not a uniform chemical entity, its overall nutritive value is considerably influenced by the amount of lignin present. To determine this amount, the feed is treated by acid detergent, and the procedure is known as the acid-detergent fibre ADF analysis. By heating the NDF in acid detergent, the presence of tannins can also be detected.

The detergent analysis and its different procedures are discussed in greater detail by Van Soest and Reed and Van Soest Because of the high costs of reagents and apparatus used in detergent analysis, developing countries have been slow to adopt the method.

ILCA's Animal Nutrition Section has recently developed a low-cost micro-fibre apparatus which uses one tenth of the amount of reagent used in conventional detergent analysis experiments. Feed sampling for laboratory analysis The types of feed usually sampled for laboratory analysis are crop residues and hays, grains and fresh forage or silage. Crop residues and hays. Most African farmers store crop residues and hays in stacks, and the nutritive value of the feed tends to be highly variable both within and between stacks.

This increases sampling requirements and complicates the procedures involved. Because of the variability in the nutritive value of crop residues and hay commonly encountered, it is useful to make a visual estimate of the variation in a selected stack before sampling begins, and to interview the farmer about the time of harvesting, the methods of stacking used and the composition of the stack i. Sampling may be done with a coring device or by hand. Samples should always be taken from a cross-section of each chosen stack.

When large stacks are encountered, dismantling may be necessary to ensure that samples from the less accessible parts are obtained. When the coring device is used, at least 10 samples should be taken per stack. The material gathered should be properly mixed, weighed and stored in a dry place before dispatching it to the laboratory.

The combined dry weight of corings taken per stack should not be less than 2 kg. The samples should be clean and stored in a porous paper or a piece of cloth to avoid moisture contamination. Relevant information date, feed type, sample weight, identification should be recorded in duplicate. When samples are taken by hand, several visits are normally required to ensure that the nutritive value of the stack is properly assessed.

At each visit, grab samples should be taken from the face of the stack and mixed. They should be taken at every an, as the farmer makes use of the stack. If the farmer finishes one stack and starts another, or alternates between different stacks, new samples should be taken following the same procedure. Although hand-sampling is tedious, changes in feed quality over time e.

With coring, several return trips would be required if specific information on quality change over time was needed.

Grain samples are usually taken with a grain probe. Between cores should be taken at random from the storage bin. The samples should then be mixed and separated into subsamples of about g. Each sub-sample should be placed in a porous paper or cloth sack and properly labelled before dispatch or storage.

These are usually fresh forage or silage. If it is not possible to weigh the sample when it is taken, one half should be placed in a sealed plastic bag to retain moisture and then weighed after returning from the field. This fresh weight is needed to calculate dry-matter content after drying.

The other half of the sample should be kept in a porous paper or cloth sack for other analyses than dry-matter content. In the event that samples cannot be transported to the laboratory the same day, they should be dried either by hanging under cover or by spreading them out on paper in a dry and protected place.

Alternatively, samples can be hung in sacks above the coil of a kerosene refrigerator. If drying is delayed, samples should be kept in plastic bags out of direct sunlight to avoid spoilage, or they should be stored frozen.

Cored samples should be taken from the pit using the procedure outlined above for stacked hay and crop residues. If sampling is done by hand, about 20 grab samples should be taken from the freshly cut face and mixed thoroughly. A subsample of 2 kg is required for analysis. The procedure should be repeated every third or fourth face cut to account for within-pit variability. If oven-drying is not possible, one of the drying methods given for fresh forage will suffice.

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Which form of calcium is recommended after VSG? According to the most recently proposed dietary guidelines, how many meals per day are recommended for VSG patients? World Health Organization website. Accessed May 15, Centers for Disease Control and Prevention website.

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Nutrition care for patients undergoing laparoscopic sleeve gastrectomy for weight loss. J Am Diet Assoc. Clinical practice guidelines for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric patient— update: Calorie intake and meal patterns up to 4 years after roux-en-y gastric bypass surgery. Recommended Diet Progression Stage Foods Duration 1 Clear liquids, sugar and caffeine free 24 to 48 hours 2 Full liquid diet, lactose free 10 to 14 days 3 Puréed protein foods, incorporate puréed fruit, vegetables, and starch as recommended by dietitian 10 to 14 days 4 Mechanically altered soft foods Variable 5 Regular diet that incorporates a variety of nutrient-dense foods; focus on protein intake first to meet daily needs Lifelong Patients who have undergone VSG should be encouraged to participate in regular follow-up visits with their interdisciplinary bariatric team.

Learning Objectives After completing this continuing education course, nutrition professionals should be better able to: Identify potential nutritional deficiencies that result from undergoing the procedure. Apply current practice nutrition guidelines to direct dietary counseling. CPE Monthly Examination 1.

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