Over half of our HD patients had sufficient RRF. RRF itself may have a beneficial effect on nutritional parameters, and it is important to determine RRF over time, even in chronic HD patients.

Objective: To determine the serum cholesterol, apolipoproteins and LDL oxidizability in young Japanese women and men during walnut consumption and to evaluate its active principle. Design: Experimental study with a randomized design. Subjects: Twenty healthy women and 20 healthy men. Interventions: Subjects were randomly assigned to consume each of two mixed natural diets for 4 weeks in a cross-over design. Reference and walnut diets were designed and the walnut diet had 12.5% of the energy derived from walnuts (44 -58 g=day). Results: The total cholesterol and serum apolipoprotein B concentrations, and the ratio of LDL cholesterol to HDL cholesterol was significantly lowered in women and men when fed on the walnut diet, than when on the reference diet (P 0.05). The LDL cholesterol concentration was significantly lowered in women on the walnut diet (0.22 mmol=l, P ¼ 0.0008), whereas this decrease was not significant in men (0.18 mmol=l, P ¼ 0.078). The most prominent change in the fatty acid composition of the cholesteryl esters from serum after the walnut diet was an elevation of a-linolenic acid in women (76%, P < 0.001) and men (107%, P < 0.001). This elevation was negatively correlated to the change in LDL cholesterol in women (r ¼ 0.496, P ¼ 0.019) and men (r ¼ 0.326, P ¼ 0.138). The LDL oxidizability in women was not influenced by the diets (P ¼ 0.19). Conclusions: a-Linolenic acid in the walnut diet appears to be responsible for the lowering of LDL cholesterol in women.

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Prolonged use of IDPN prevents muscle protein catabolism and promotes body protein and fat accumulation. IDPN appears to be effective in malnourished elderly haemodialysis patients.

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