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PubMed1997

Enteral nutrition therapy.

Nursing care is key to positive outcomes in patients who require enteral nutrition. Understanding the decision-making process for the use of this therapy along with the steps of feeding initiation, advancement, monitoring, and complication prevention, gives nursing personnel the tools they need to deliver nutrition in a safe, cost-effective manner. This article presents this essential information to help nurses care for patients who are receiving enteral nutrition.

Contraindications↗
PubMed1976

Egg substitutes: chemical and biologic evaluations.

The total lipid, cholesterol, phospholipid, and fatty acid content of dried whole egg (DWE), a refrigerated liquid egg substitute, a powdered egg substitute, and a commercial egg yolk replacer (EYR) were compared. All substitutes contained less total lipid, cholesterol, and phospholipid than DWE. The powdered substitute contained only half the total lipid content reported by the producers and only a fifth of the cholesterol of DWE, while the percentage distribution of fatty acids was similar to that of DWE. The liquid substitute and EYR had fatty acid distributions similar to soybean oil. Rat growth and lipid response were compared for diets containing either DWE or a mixture of EYR and egg white. Both diets were fed with and without vitamin and mineral supplements. Rat growth response was greatest on the DWE diets, either with or without the supplements, was intermediate on the supplemented EYR diets, and was least on the unsupplemented EYR diets. The consumption of DWE-containing diets, when compared with the EYR-containing diets, caused greater liver weight, greater liver total lipid and total cholesterol content, and slightly higher serum cholesterol.

Animals↗
PubMed2002

The effect of consumption of foods that differ in energy density and/or sodium bicarbonate supplementation on subsequent diet selection in sheep.

The short-term consumption of foods that differed in energy density (ED) and/or NaHCO3 supplementation, on subsequent food intake and diet selection in sheep were measured. Thirty sheep weighing 35.9 (sd 2.89) kg were used. Two foods were formulated: H had 11 and L had 8 MJ metabolizable energy/kg fresh matter. Four further foods were formulated by adding either 40 g NaHCO3/kg or 16.5 g NaCl/kg to foods H and L. NaCl was added to give the same Na concentration as with 40 g NaHCO3/kg to control for any effects of Na per se. In a preliminary test, it was found that a 2 h consumption of food H supplemented with NaHCO3 could buffer potential impact on the rumen environment of subsequent consumption of food H alone (as judged by rumen pH and acid-buffering capacity); however, it was not as effective as the consumption of food L alone in doing so. Each food treatment was offered to one of six groups (n 5) for 2 h following 16 h of food deprivation. Sheep were then offered a choice between H and L for a further 6 h. Supplementing H or L with either NaHCO3 or NaCl had no significant effect on either intake or diet selection. ED significantly (P<0.01) affected intake during the 2 h single feeding period, with sheep offered H or L consuming 540 and 663 (sed 37) g respectively, but had no effect on subsequent intake during the choice period. During the choice period all sheep showed a preference for food H, but sheep previously offered L selected significantly more H (0.873 g/g) than sheep previously offered H (0.544 (sed 0.028) g/g; P<0.001). It is concluded that short-term consumption of foods that differ in ED, and hence in their potential impact on the rumen environment, significantly affects subsequent diet selection. This is in agreement with the hypothesis that ruminant animals select a diet to help maintain the rumen environment within a certain physiological range. Food H with 40 g NaHCO3 added/kg may not have been sufficient to affect subsequent diet selection. It is suggested that larger, rather than smaller, changes in the rumen environment achieved through previous feeding should be expected to alter subsequent diet selection.

Animals↗
PubMed1999

Abacavir: absolute bioavailability, bioequivalence of three oral formulations, and effect of food.

STUDY OBJECTIVES: Study A: to determine the absolute bioavailability of a single 300-mg abacavir hemisulfate tablet. Study B: to determine the bioequivalence of two oral abacavir formulations (300-mg hemisulfate tablet, 100-mg succinate caplet), the effect of food on the bioavailability of the 300-mg hemisulfate tablet, and the bioavailability of the hemisulfate tablet relative to the hemisulfate solution. DESIGN: Phase I, randomized, open-label, balanced two- (study A) and three- or four-period (study B), crossover studies. SETTING: Two clinical research centers. SUBJECTS: Six men infected with the human immunodeficiency virus (HIV), aged 27-39 years (study A), and 18 HIV-infected men and women, aged 21-50 years (study B). INTERVENTIONS: In study A, all subjects received a single, oral 300-mg tablet of abacavir hemisulfate or a single, intravenous infusion of abacavir hemisulfate 150 mg over 60 minutes. In study B, all subjects received each of three single-dose treatments: three 100-mg abacavir succinate caplets in a fasted state, one 300-mg abacavir hemisulfate tablet in a fasted state, and one 300-mg abacavir hemisulfate tablet with a high-fat breakfast. Twelve subjects in study B also received a fourth treatment of abacavir hemisulfate 300 mg as an oral solution in a fasted state. Plasma samples collected for 24 hours (study A) or 12 hours (study B), and urine samples collected for 12 hours (study A) were analyzed by validated high-performance liquid chromatographic methods. MEASUREMENTS AND MAIN RESULTS: Abacavir pharmacokinetic parameters were calculated using standard, noncompartmental methods. In study A, the geometric least square (GLS) mean absolute bioavailability of oral abacavir was 83% (range 65-107%). In study B, the hemisulfate tablet was bioequivalent to the succinate caplet, but its time to maximum concentration (Tmax) occurred 30 minutes earlier. Administration of the abacavir hemisulfate tablet with food had no effect on area under the curve from time zero to infinity (AUC0-infinity), decreased maximum concentration (Cmax) by 26%, and delayed Tmax by 38 minutes. The relative bioavailability (GLS mean AUC0-infinity ratio) of the 300-mg abacavir hemisulfate tablet to solution was 101%, Cmax was 11% lower, and Tmax was unchanged. The most common drug-related adverse events associated with abacavir were nausea, vomiting, abdominal pain, and headache, all of which were mild. CONCLUSION: Based on our results, abacavir is safe and well tolerated and can be administered with or without meals.

Administration, Oral↗
PubMed1990

Absorption of doxycycline from a controlled release pellet formulation: the influence of food on bioavailability.

A three-way crossover study was performed to compare the bioavailability of a new pelletised doxycycline product administered either with food or without food and a reference product taken without food. Four different methods were used to calculate pharmacokinetic parameters from the data. The sums of squares, Akaike's Information Criterion (AIC), and the ranges for the parameters obtained were used for comparison. Good fits to the data were obtained when all four methods were used, each with a lag time. The two compartment open model was the most efficient method for describing the data. The one compartment open model was the least efficient, particularly with respect to predicting the peak concentration of doxycycline in plasma. All the models gave similar rank order results with respect to bioavailability differences between the three treatments. Analysis of the data by different methods suggests that pelletised doxycycline is bioequivalent to the reference product when taken in the absence of food. A standardized feeding regimen affected the rate, but not extent of absorption of doxycycline from the pelletised formulation.

Absorption↗
PubMed1987

Influence of a standard meal on the absorption of controlled-release pseudoephedrine capsules.

The influence of a standard meal on the extent and rate of absorption of pseudoephedrine from a controlled-release (CR) capsule formulation (Pennkinetic System) was studied in 16 normal male volunteers. Equivalent single doses of an immediate-release (IR) pseudoephedrine reference syrup and the CR capsules were each studied under both fasted and postprandial conditions. Pharmacokinetic analysis evaluated the fraction of drug absorbed over time as determined by the Wagner-Nelson method. The area under the drug concentration versus time curve (AUC) results were not influenced by food or formulation, indicating that the CR formulation was absorbed to the same extent as the IR syrup. The maximum plasma concentration (Cmax) and the time to maximum concentration (tmax) tabulations under fasted conditions indicated that the CR preparation peaked at a lower level and a later time than the IR syrup. Food minimally affected the Cmax of the IR formulation, but did not affect that of the CR formulation. Food delayed the tmax of both the IR and CR preparations by less than 1 h, but only the delay of the CR formulation was statistically significant. Neither delay was considered clinically meaningful. The results of this study strongly suggest that the pharmacokinetic profile of the CR pseudoephedrine capsules was minimally affected by the presence of food.

Adolescent↗
PubMed2003

A different approach to breast-feeding of the infant with phenylketonuria.

UNLABELLED: We studied the possibility and safety of a new approach to breast-feeding infants with phenylketonuria (PKU). We compared a group of PKU infants being breast-fed according to our new protocol with a group of PKU infants receiving formula only. The breast-fed group consisted of nine infants born between 1994 and 1999 being breast-fed at the time of diagnosis. The formula-fed group consisted of nine PKU infants, born between 1988 and 1997. In the breast-fed group, feedings alternated between breast-feeding and phenylalanine (Phe)-free bottle-feeding. The numbers of breast-feedings were adapted to the plasma Phe concentrations. At each feeding, either bottle- or breast-feeding, the child was allowed to drink until satiety. Data on metabolic control and growth during the first 6 months showed no statistically different results. The mean Phe concentration in the breast- fed group was 170 micro mol/l (range 137-243 micro mol/l) and in the formula- fed group 181 micro mol/l (range 114-257 micro mol/l). Compared to a routine where both bottle and breast are offered at each feeding, this new approach is more convenient for the parents and the child will be able to empty the breast, therefore drinking not only foremilk but also hindmilk. CONCLUSION: the results suggest that this feeding protocol is safe in the strict treatment of otherwise healthy infants with phenylketonuria.

Bottle Feeding↗
PubMed1983

Fat composition of the infant diet does not influence subsequent serum lipid levels in man.

The serum lipid concentrations have been followed until 5 years of age in children fed for between 1 and 6 months with breast milk (n = 35), a home-prepared cow's milk formula (n = 17) or proprietary formula with a low content of cholesterol and high content of linoleic acid (n = 32). The serum cholesterol concentrations were significantly lower in the proprietary formula-fed infants than in the infants fed with breast milk or cow's milk formula between 2 and 6 months of age, i.e. during the period of formula feeding. No differences were observed between the 3 groups in serum lipid values after 9 months of age. A statistically significant correlation was observed between cholesterol concentrations recorded before 6 months and after 3 years of age in children fed initially with the proprietary low-cholesterol formula, but not in the two other groups. It is concluded that the fat composition of the infant diet commonly used in the developed countries affects the contemporary serum cholesterol concentration, but does not influence the serum lipid or lipoprotein levels later in life.

Animals↗
PubMed1982

Carotenoids as food colorants.

The carotenoids are a chemically related group of pigments which occur widely and abundantly in nature. Fruits, vegetables and vegetable oils, dairy products, leaves, shrimp, lobster, the plumage of exotic birds, all contain carotenoids. Chemically, the carotenoids may be divided into carotenes, made up of carbon and hydrogen only, and oxycarotenoids containing oxygen in addition to carbon and hydrogen. The use of carotenoid-containing plant extracts for coloring foods has been practiced for centuries and continues today. Advances in chemical synthesis resulted in the complete laboratory synthesis of beta carotene in 1950. Since then the commercial synthesis of several carotenoids has been accomplished. In the U.S. three of these commercially synthesized carotenoids, beta-carotene, beta-apo-8'-carotenal, and canthaxanthin, are accepted color additives for use in foods and are exempt from certification. These three carotenoids are also widely accepted for food use in other countries. This paper deals with the chemistry and synthesis of these three carotenoids, with special emphasis on their numerous commercially available market forms and their characteristics, and on the application of these carotenoids in the coloring of food products.

Beverages↗
PubMed1991

Retina fatty acid composition of piglets fed from birth with a linoleic acid-rich vegetable-oil formula for infants.

The effects of a vegetable-oil-based formula containing 30% 18:2n-6 (18:2 omega-6), 0.8% 18:3n-3, and no n-6 or n-3 long-chain polyunsaturated fatty acids (LCPs) on retina total lipid, ethanolamine phosphoglyceride (EPG), and phosphatidylcholine (PC) fatty acid composition were studied in neonatal piglets. Term-gestation piglets were fed sow milk (SMF) or the formula (FF) from birth for 5, 10, 15, or 25 d. After 25 d feeding, the 22:6n-3 was reduced by 24% in total lipid, 20% in EPG, and 28% in PC of retinas of FF relative to SMF piglets. A compensatory increase in 22:4n-6 and 22:5n-6 concentrations occurred in retina total lipid, EPG, and PC of FF animals. The data suggest that the exclusive feeding of formulas devoid of LCPs and high in 18:2n-6 and/or 18:2n-6 and 18:3n-3 compromises normal accretion of 22:6n-3 in neonatal piglet retina. The potential reversibility of these changes or their effects on vision are not known.

Animal Feed↗
PubMed1993

Effects of supplementation with omega 3 long-chain polyunsaturated fatty acids on retinal and cortical development in premature infants.

Deficiency of omega 3 long-chain polyunsaturated fatty acids (LCPUFAs) in vertebrates produces subtle adverse effects on visual and neural function. Preterm infants 1) are deprived of vital intrauterine fat accretion during late pregnancy, 2) must rely solely on formula for fatty acid supplies if not breastfed, and 3) may have limited postnatal desaturase activity. In a study to evaluate the necessity of dietary omega 3 LCPUFAs, preterm infants were fed human milk, corn-oil-based formula (omega 3 fatty acid deficient), soy-oil-based formula (rich in precursor fatty acids), or marine-oil-supplemented formula (containing docosahexaenoic acid). At 36 and 57 wk postconception, the LCPUFA profiles in red blood cell lipids were nearly equivalent in the human-milk and marine-oil groups whereas the corn-oil group had markedly lower values for omega 3 fatty acids. Rod photoreceptor function was significantly less mature in the corn-oil group compared with the human-milk and marine-oil-enriched groups in early postnatal development (36 wk). The corn-oil group also had impaired visual acuity at both 36 and 57 wk. The potential benefit of omega 3 LCPUFA-enriched full-term formula is discussed. The study supports a role for omega 3 LCPUFAs as required nutrients for the optimal maturation of visual and cortical function in preterm infants.

Breast Feeding↗
PubMed2005

Visual maturation of term infants fed long-chain polyunsaturated fatty acid-supplemented or control formula for 12 mo.

BACKGROUND: Several studies found a benefit of long-chain polyunsaturated fatty acid (LCP) supplementation for visual or mental development, but others found no benefit. Likely contributors to differences among studies are the amount of LCP supplementation, functional outcomes, and sample size. OBJECTIVE: We evaluated LCP supplementation in amounts typical for human milk (based on local and worldwide surveys) in a large cohort of infants by using sweep visual evoked potential (VEP) acuity as the functional outcome. DESIGN: The study was a double-masked, randomized, controlled clinical trial in 103 term infants. By age 5 d, infants were randomly assigned to receive either formula with no docosahexaenoic acid (DHA) or arachidonic acid (ARA) or formula supplemented with DHA and ARA as 0.36% and 0.72%, respectively, of total fatty acids. Sweep VEP acuity was the primary outcome. Random dot stereoacuity, blood lipid profile, growth, and tolerance were secondary outcomes. RESULTS: VEP acuity in the LCP-supplemented group was significantly better than that in the control group at ages 6, 17, 26, and 52 wk. Stereoacuity in the LCP-supplemented group was significantly better than that in the control group at age 17 wk but not at ages 39 and 52 wk. By ages 17 and 39 wk, the red blood cell DHA concentration in the LCP-supplemented group was more than double and more than triple, respectively, that in the control group. Growth of infants fed LCP-supplemented and control formulas did not differ significantly, and both diets were well tolerated. CONCLUSION: LCP supplementation of term infant formula during the first year of life yields clear differences in visual function and in total red blood cell lipid composition.

Arachidonic Acid↗
PubMed1998

Long-chain polyunsaturated fatty acid levels in formulae influence deposition of docosahexaenoic acid and arachidonic acid in brain and red blood cells of artificially reared neonatal rats.

We studied the effects of dietary long-chain polyunsaturated fatty acids (PUFA) on the fatty acid composition of the brain and red blood cells in gastrostomized rat pups reared artificially from postnatal Days 5-18. These pups were fed rat milk substitutes in which the fat comprised 10% linoleic acid and 1% alpha-linolenic acid and, using a 3 x 3 factorial design, one of three levels of both arachidonic acid (AA) and docosahexaenoic acid (DHA) supplied as single cell microbial oils (0.0, 0.4 and 2.4% fatty acids). A tenth group was reared by nursing dams. The fatty acid composition of the phosphatidylethanolamine (PE) and phosphatidylserine/phosphatidylinositol (PS/PI) phospholipids in the brain and red blood cells on Day 18 reflected the dietary composition in that pups receiving long-chain supplementation of each had higher levels of the supplemented PUFA, but lower levels of the other, relative to unsupplemented groups. In contrast to these results, there were few changes in the brain in phosphatidylcholine (PC) phospholipids whereas, in the red blood cells, changes in PC were similar to those in PE and PS/PI. Regression analyses showed that DHA levels in the brain correlated more closely with those of the red blood cells than did AA levels. The results of this study indicate that, although supplementation of formula with AA or DHA during the period of rapid brain development in rats increases deposition of the long-chain PUFA in the developing tissues, each also affects the levels of the other.

Animals↗
PubMed1990

Routine L-ascorbic acid supplementation does not alter iron, copper, and zinc balance in low-birth-weight infants fed a cows'-milk formula.

The effect of ascorbic acid (AA) [284 mumol (50 mg) twice daily] on the net intestinal absorption and maximum apparent retention of Fe, Cu, and Zn was investigated by metabolic balance studies in a randomised crossover study of six low-birth-weight (LBW) neonates fed a cows'-milk-based formula containing (mumol/L) Fe, 126; Cu, 11; Zn, 87; and AA, 400. Absorption +/- SD (Fe, -5.0 +/- 7.5; Cu, 0 +/- 0.4; Zn, -0.8 +/- 3.4) (mumol kg-1 day-1) was not altered by AA (Fe, -4.1 +/- 4.6; Cu, 0.3 +/- 0.6; Zn, -1.1 +/- 2.7) neither was retention (without AA: Fe, -6.0 +/- 8.4; Cu, -0.1 +/- 0.3; Zn, -2.4 +/- 4.2; with AA: Fe, -4.9 +/- 4.7; Cu, 0.1 +/- 0.6; and Zn, -2.7 +/- 3.1). Supplements of AA administered as in the circumstances of routine care of LBW neonates do not enhance the absorption and retention of Fe, nor do they impair these aspects of the metabolism of Cu and Zn.

Animals↗