A double-blind controlled Ca supplementation trial was conducted for 6 months in thirty-four 7-year-old Chinese children from Hongkong and Jiangmen, China. The children were randomly allocated to the study group (n 17) or control group (n 17), and a CaCO3 tablet (300 mg Ca) or a placebo tablet was taken daily. True fractional Ca absorption (TFCA) was evaluated before and after the trial using stable isotopes: 8 mg44Ca mixed in 100 g chocolate milk was given after an intravenous injection of 0·75 mg 42Ca. There was no significant difference in baseline TFCA between the study group (60·6 (SD 11·4)%) and the controls (58·2 (SD 9.0)% P = 0·55). Serum 25-hydroxycholecalciferol levels were comparable between the two groups (P = 0·71). After 6 months, TFCA of the study group (55·6 (SD 12·7)%) was significantly lower than that of the controls (64·3 (SD 10·7)% P = 0·015). By comparing the individual changes in TFCA after the trial between the two groups there was a non-significant reduction in TFCA (5·03 (SD 12·4)% P = 0·11, Wilcoxon signed-rank test) in the study group (60·6–55·6%), whereas a significant increase in TFCA (6·17(SD 7·7)% P = 0·004, Wilcoxon signed-rank test) was observed in the controls (58·2–64·3%). The differential in TFCA between the two groups after 6 months was significantly different (P = 0·001), and remained significant after adjustment for baseline dietary intakes, weight and height by multiple-regression analysis (P = 0·003). If the mechanism of TFCA from chocolate milk in response to the treatment effects is similar to that from the total diet, then our results suggest that children with adequate vitamin D status can adapt to a change in Ca intake by adjusting the efficiency of TFCA. In corollary, children on habitually-low Ca diets have a higher TFCA than the counterparts with higher Ca diets.

The effect of early transition of the digestive system to exogenous nutrition was examined in three experiments with growing birds. A nutrient mixture (0·5 ml) of glucose, starch and oil (1:1:0·5, by vol) was orally administered immediately after hatch to turkey poults (Meleagris gallopavo) having immediate or delayed access to feed (Expt 1). Increasing amounts (0, 0·25 and 0·5 ml) of this mixture were administered immediately after hatch to turkey poults (Expt 2), or to broiler chicks (Gallus domesticus; Expt 3). The relative weights of the gastrointestinal tract (GIT) and its ingesta content, and the amylolytic capability of the pancreas were examined during the immediate post-hatch period (to 30 h). Oral administration of nutrients immediately after hatching only slightly influenced the growth of the pancreas and its amylolytic activity, but significantly increased GIT weight in both species, in a dose-dependent manne. It is suggested that early post-hatching of the digestive system by the forced administration of nutrient mixture induces anatomical and metabolic changes in the digestive system slightly earlier than in birds with late access to feed. This increases GIT content and plasma glucose levels, resulting in enhanced feed consumption and growth promotion.

Previous studies on the role of lactose malabsorption in the pathogenesis of postmenopausal osteoporosis have yielded conflicting results and further information is needed. To date, all studies have been carried out on populations with a low prevalence of lactose malabsorption and the lactose intestinal absorptive capacity was tested using a non-physiological dose of lactose. In fifty-eight Italian postmenopausal women (mean age 57 (SD 7) years), bone mineral density (BMD) at lumbar spine, H2 breath response after ingestion of 20 g lactose, intensity of symptoms of intolerance after a lactose load and daily Ca intake were evaluated. No differences were found between women with or without a positive H2, breath test with regard to BMD (−1·2 (SD 0·9) ν −0·9 (SD 0·8)) and Ca intake (509 (SD 266) ν 511 (SD 313) mg/d). On the contrary, both BMD and Ca intake were significantly lower in women with lactose malabsorption and symptoms of intolerance (−1·5 (SD 0·7) and 378 (SD 220) mg/d) than in those with malabsorption without symptoms (−0·9 (SD 0·9) and 624 (SD 254) mg/d). Moreover, in lactose malabsorbers Ca intake was correlated inversely with symptom score (rs −0·31, P<0·05) and positively with BMD (rs 0·42, P<0·005). Our results show that in Italian postmenopausal women Ca intake and BMD are not influenced directly by lactose malabsorption; the appearance of symptoms of intolerance seems to influence BMD unfavourably through a reduced Ca intake.

Studies on hospitalized elderly subjects have demonstrated that negative energy balance is common during hospitalization, but have concentrated primarily on long-stay and psychogeriatric patients. There is little information on energy balance in elderly patients admitted with acute illness from the community, despite the importance of this patient group and the presence of a number of factors likely to predispose such patients to negative energy balance. In the present study energy balance was quantified in twenty patients (eight males, mean age 82 (SD 05) years; twelve females, mean age 84 (SD 6) years) admitted from the community with acute illness, and predicted basal metabolic rate (BMR) was compared with measured resting metabolic rate (RMR). Most patients were in negative energy balance during hospitalization, and median measured energy intake (El):measured RMR ratio was 1·0 (range 0·7–1·8). The mean difference between measured El and estimated total energy expenditure was −1·3 MJ/d (range -3·4 to +2·5 MJ/d). Estimated total energy expenditure exceeded measured El in fifteen of the patients and there was a significant decline in mid-arm muscle circumference (paired t, P < 0·05) during hospitalization. We conclude that moderate negative energy balance is common in this patient group, and that these patients are at risk of undernutrition during their hospital stay.