Journal of the American College of Nutrition
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The report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults published in 1988 evoked great interest from the medical profession, the public, and food manufacturers. The merits of different dietary interventions to lower plasma cholesterol are debated in advertising, popular publications, and research publications. The present paper is a review of the contributions of saturated and trans fatty acids (FA) to the US diet, their metabolism, and effects upon plasma cholesterol. ⋯ These modifications may decrease the palatability of the food, thereby presenting a challenge to the food industry. Substitution of fats hydrogenated to contain trans FA for fats high in SFA may not be beneficial to health. Labeling of foods would improve the ability of the consumer to make appropriate choices.
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This review of corn oil provides a scientific assessment of the current knowledge of its contribution to the American diet. Refined corn oil is composed of 99% triacylglycerols with polyunsaturated fatty acid (PUFA) 59%, monounsaturated fatty acid 24%, and saturated fatty acid (SFA) 13%. The PUFA is linoleic acid (C18:2n-6) primarily, with a small amount of linolenic acid (C18:3n-3) giving a n-6/n-3 ratio of 83. ⋯ The use of corn oil to contribute to a PUFA intake of 10 en% in the diet would be beneficial to heart health. No single source of salad or cooking oil provides an optimum fatty acid (FA) composition. Many questions remain to be answered about the relation of FA composition of the diet to various physiological functions and disease processes.
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Essentiality of zinc in nutrition of higher animals was established in 1934. Dietary zinc deficiency in humans was recognized in 1961. Dietary requirements for zinc have been estimated factorially and by balance studies. ⋯ Of some interest was the finding that the mean intake of none of the groups was equivalent to the Recommended Dietary Allowance. The mean intake of males ranged from 9.32 mg in men 75y and older to 13.53 mg in persons 15-18y. The mean intake of the females ranged from 7.04 mg in women 75y and older to 9.22 mg in persons 12-14 y.
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With both enteral and parenteral feedings, the amount of nutrients required depends on the degree of nutritional depletion, level of hypermetabolism, and the phase of the patient's response to illness or injury. Protein requirements are significantly increased in the critically ill. In skeletal trauma, energy needs are increased approximately 25%, in sepsis, 50%, and in severe burns, 75-100%. ⋯ In the hypoalbunemic patient with concomitant stress, nitrogen retention will be limited until the stress, i.e. acute injury or infection, is relieved. Nitrogen (g):calorie (kcal) intake will average 1:80. During therapy, nutritional assessment parameters must be measured periodically to evaluate the effectiveness of the nutritional regime.
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Respiratory function in mechanically ventilated patients (VP) is adversely affected by starvation and hypermetabolic stress. These patients are more successfully managed and extubated if proper nutritional support is provided. The features of metabolism and respiratory function in VP require moderation in glucose, fat, and protein administration. In delivering energy to VP, attention must be given to nearby tracheostomy sites complicating the parenteral route and airway-cuff problems that may inhibit effective enteral feeding.