NUTRITIONAL EFFECTS 



iul 



menstrual cycles (Zuckerman, 1953; chap- 

 ter by Young on the ovary). The ovary 

 would seem to require cortical steroids for 

 the normal functioning of its own metabolic 

 processes and for those which it influences 

 peripherally. The Addisonian patient may 

 show ovarian follicular atresia and a loss of 

 secondary sex characteristics, and the un- 

 treated adrenalectomized rat exhibits a 

 decrease in ovarian size and has irregular 

 cycles (Chester Jones, 1957). The decline 

 in size of the ovary after adrenalectomy 

 is due to impaired sensitivity to follicle- 

 stimulating hormone (FSH) rather than to 

 a decreased production of FSH, and the 

 ovarian response is corrected by cortisone 

 (Mandl, 1954). 



Reproductive potential is not necessarily 

 lost when there is adrenal insufficiency, but 

 pregnancy is not well tolerated by women 

 with Addison's disease. Furthermore, adre- 

 nalectomy in rats at the time of mating or 

 4 to 6 days after mating resulted in abor- 

 tion. Improved pregnancy maintenance was 

 obtained in adrenalectomized rats given 

 saline or cortisone acetate (Davis and Plotz, 

 1954) , whereas desoxycorticosterone acetate 

 alone extended the pregnancy period beyond 

 normal time (Houssay, 1945). Essentially 

 normal pregnancies were obtained in adre- 

 nalectomized rats given both cortisone 

 acetate and desoxycorticosterone acetate 

 (Cupps, 1955). Substitution of cortisone 

 acetate for adrenal secretions may be in- 

 complete because the adrenal hormone in 

 the normal rat is primarily corticosterone 

 and because cortisone enhances the excre- 

 tion of certain amino acids and vitamins. It 

 would be interesting to test a diet with a 

 high vitamin content on the capacity of an 

 adrenalectomized rat to maintain preg- 

 nancy, because improved survival of oper- 

 ated rats is obtained by giving vitamin Bio 

 (Meites, 1953) or large doses of panto- 

 thenic acid, biotin, ascorbic acid, or folic 

 acid (Ralli and Dumm, 1952; Dumm and 

 Ralli, 1953). 



An adrenal influence over protein metab- 

 olism is well known, but protein nutrition, 

 in turn, can influence cortical steroid ef- 

 fectiveness. In fact, an extension of the life 

 span of adrenalectomized rats is not ob- 

 tained with adrenal steroids if the diet 



lacks protein (Leathern, 1958a). A low 

 protein diet alone will not improve sur- 

 vival after adrenalectomy, but better sur- 

 vival is obtained when the rats are given 

 saline. When the low protein diet was sup- 

 plemented with methionine, a definite im- 

 provement in life span was observed and the 

 possibility that cortisone exerts its effect by 

 drawing on the carcass for methionine was 

 suggested (Aschkenasy, 1955a, b). 



Reducing dietary casein to 2 per cent 

 seriously endangers pregnancy in the rat, 

 but the addition of progesterone permits 

 80 per cent of the pregnancies to be main- 

 tained. However, removal of the adrenal 

 glands counteracts the protective action of 

 the progesterone, only 10 per cent of the 

 pregnancies continuing to term. Addition 

 of methionine to the low casein diet im- 

 proved pregnancy maintenance, but 1 mg. 

 cortisone acetate plus progesterone pro- 

 vided the best results (Aschkenasy-Lelu 

 and Aschkenasy, 1957; Aschkenasy and 

 Aschkenasy-Lelu, 1957). These data em- 

 phasize the importance of nutrition in ob- 

 taining an anticipated hormone action. Fur- 

 ther investigation might be directed toward 

 the study of whole proteins other than ca- 

 sein, for the biologic value of proteins dif- 

 fers from normal when tested in adrenal- 

 ectomized rats (Leathem, 1958a) . 



As Albert has noted in his chapter, ad- 

 renalectomy has little or no effect on the 

 testis. Gaunt and Parkins (1933) found no 

 degenerative changes in the testes of adult 

 rats dying of adrenal insufficiency, although 

 an increase in the testis : body-weight ratios 

 was noted in rats fed 18 per cent and 4 per 

 cent protein (Aschkenasy, 1955c). If ad- 

 renalectomized rats are kept on a mainte- 

 nance dosage of cortisone acetate for 20 

 days and fed dietary proteins of different 

 biologic values, one finds that testis-com- 

 position of protein, lipid, and glycogen var- 

 ies in the same manner as in the normal 

 rat (Wolf and Leathem, 1955) (Table 12.3). 



When the adrenal glands are intact, the 

 influence of diet on their functional capac- 

 ity and indeed on the hypophyseal- adrenal 

 axis must be considered. Zubiran and Go- 

 mez-]\Iont (1953) showed that patients ex- 

 hibiting gonadal changes associated with 

 chronic malnutrition also exhibit adrenal 



