In this prospective study of elderly people, nutritional status (body mass index, triceps skinfold thickness, arm-muscle circumference, and serum albumin) was assessed in a group of recently hospitalized (< 48 h) patients (n = 311), and compared with a home-living group (n = 106). Undernutrition was present in 52.9% of males and 60.6% of females by the time of admission to the hospital. Further, 65% of the males and 69% of the females had an insufficient energy intake the month before hospitalization [males < 8372 kJ (2000 kcal) and females < 7116 kJ (1700 kcal)]. Intake of vitamins and trace elements below two-thirds of the US recommended dietary allowances was more common in the hospital group. This group was more often unable to buy food and cook dinner, had more chewing problems, and had reduced appetite for food. Reduced nutrient and energy intakes may increase the occurrence of undernutrition, with increased risk for hospitalization in vulnerable groups as a consequence.

Two groups of children with phenylketonuria were followed from birth for several years. The Recommended Dietary Allowance group received a protein intake as recommended by the Food and Nutrition Board. The Food and Agricultural Organization (FAO) group received a protein intake as recommended by FAO. The children were followed very closely for the biochemical control of the disease. The children were also followed very closely to evaluate the adequacy of the protein intake using length, weight, routine hematology, chemical analysis, and x-ray of the hand. The results indicated two groups of healthy children. However, a decline in length growth percentile was found in some of the FAO children. A possible osteoporosis developed in two of the FAO children. The possible conclusion that the FAO "safe level of intakes of egg or milk protein" is marginal is discussed.

A group of 24 men was studied during a period of heavy, sustained work lasting for 107 hours, during which time they had less than 2 hours sleep. Nine men received a diet providing 3 3.49 M J (8000 kcal) and 1 5 a diet providing 6.30 MJ (1 500 kcal) per day. The subjects were assessed by objective measurements of simulated military tasks and by subjective assessments using self-rated (Borg perceived exertion and Standford sleepiness scales) and observer-rated scales. Although the high energy group tended to feel slightly more alert there were no differences between the group in the tests of military performance. After 4 days of sustained activity all subjects were judged to be ineffective as soldiers. The high-energy diet was well tolerated.The average loss of body-fat in the high-energy group was 1-3 kg compared with 3.1 kg in the other group, suggesting that even the high-energy group was in energy deficit. These results suggest that the major factor influencing performance in these experiments was sleep deprivation, and that the decline in performance as assessed by observers, could not be prevented by giving a highenergy diet. alone.

The diet of children with blocks in the metabolism of five amino acids has been investigated to evaluate the need for these amino acids in the maintenance of normal growth and development. Two children with phenylketonuria, one child with tyrosine aminotransferase defect and one child with maple syrup urine disease are included in the study. The growth and development of the children have been within the normal range except for language development, which was retarded in the maple syrup urine disease child. The need for phenylalanine, phenylalanine and tyrosine combined and isoleucine, leucine, and valine for protein synthesis in growing children was investigated by registering the intake of phenylalanine in the phenylketonuria children, the intake of phenylalanine and tyrosine in the tyrosine amino transferase defect child and isoleucine, leucine and valine in the maple syrup urine disease child. The significance of this intake, defined as the sufficient intake, is discussed, as well as the difference between the sufficient intake and requirement. The sufficient intake is compared with former studies on requirement. There is good agreement between the sufficient intake and requirement of phenylalanine and tyrosine. The sufficient intake of isoleucine, leucine, and valine as judged from our study is lower than in former studies on requirement.

1. Two groups of children with phenylketonuria (PKU) received protein at two different levels. The protein scource was a protein hydrolysate, devoid of phenylalanine, and intact protein from milk, vegetables and fruit. One group (RDA group) was given protein at a level based on the recommendations of the (US) Food and Nutrition Board (1974, 1980). The other group (FAO group) was given protein at the level of intake corresponding to the Joint FAO/WHO ad hoc Expert Committee (1973) safe levels of intake of egg or milk protein. The children were monitored very closely for several years. From an earlier study evaluating the protein intake of the two groups it was suspected that the Joint FAO/WHO ad hoc Expert Committee (1973) recommendations were marginal.2. In the present study the phenylalanine intake of the two groups required to maintain the plasma phenylalanine concentration at the required level was established. The results showed that the RDA group required more phenylalanine than the FAO group. This difference was statistically significant from the age of 5–15 months.3. We have interpreted the greater requirement for phenylalanine in the RDA group as a result of a greater nitrogen intake and thus a more rapid chemical maturation of N (increase in protein concentration of the body with age). It is known that up to the age of 6 months the chemical maturation of N is related to the N intake. In the present study we have found that this difference in chemical maturation lasted up to the age of 15 months. The conclusion drawn from the study was that a protein intake slightly higher than the Joint FAO/WHO ad hoc Expert Committee (1973) recommendations might be desirable.