A modular tube feeding recipe (MTF) was designed to meet the unique nutritional needs of burn patients, applying principles previously documented in our burned guinea pig model. MTF, a high-protein, low-fat, linoleic acid-restricted formulation is enriched with omega-3 fatty acids, arginine, cysteine, histidine, vitamin A, zinc, and ascorbic acid. Fifty patients, 3 to 76 years of age with burns ranging from 10 to 89% total body surface area were prospectively randomized into three groups which blindly compared MTF to two enteral regimens widely utilized in the nutritional support of burns. Age, percent total and third-degree burn, resting energy expenditure, and calorie and protein intake were similar in all groups. Data analysis demonstrated significant superiority of MTF in the reduction of wound infection (p less than 0.03) and length of stay/percent burn (p less than 0.02). MTF was also associated with a decreased incidence of diarrhea, improved glucose tolerance, lower serum triglycerides, reduced total number of infectious episodes and trends toward improved preservation of muscle mass, although statistical significance was not achieved. Seventy percent of deaths occurred in the group supported with an inherently large dose of fat and linoleic acid. Combining these observations, it is believed that MTF is effective in modulating an improved response to burn injury.

This randomized blind crossover study compared serum lipid and apolipoprotein concentrations in 20 men consuming 37-43% of energy as fat from diets based on corn oil, high-oleic acid sunflower oil, and butter. Each phase of the crossover design included 2 wk of butter-based diet followed by 5 wk of designated vegetable-oil-based diet with a 7-wk washout period between phases. Compared with values for the butter-based diet, the vegetable-oil-based diets reduced serum total cholesterol by 16-21% (p less than 0.001), LDL cholesterol by 21-26% (p less than 0.001), triglycerides by 10-21% (p less than 0.01 for the higher figure), and apolipoprotein B-100 by 22-29% (p less than 0.001). When values fell, they fell further on the corn-oil-based diet. There were no significant changes in serum HDL cholesterol or apolipoprotein A-1. These data suggest that when men on diets high in saturated fatty acids reduce their saturated fatty acid intake but not their total fat intake, many can still experience a significant lowering in serum total cholesterol.

No abstract

Platelet function and fatty acid composition were investigated in 30 healthy male subjects who ate a controlled-saturated-fatty-acid (baseline) diet for 3 wk and then consumed either safflower oil or canola oil as a major fat source for 8 wk. Fatty acid composition of platelet phospholipids reflected changes in dietary fatty acid composition. Compared with baseline a 35% decrease (P less than 0.05) in arachidonic acid was observed in platelet phospholipids of the canola-oil diet group while long chain n-3 fatty acids rose 7-26% (P greater than 0.05). Compared with baseline both unsaturated-fatty-acid diets reduced platelet aggregation at 3 wk of oil-based diet feeding (P less than 0.01) whereas only canola oil influenced platelet function (lowered ATP secretion) at 8 wk (P less than 0.01). No significant difference was observed in thromboxane B2 concentrations between oil-treatment groups at 8 wk. Both oil-based diets had short-term beneficial effects on platelet function but the effect of canola oil persisted longer.

Objectives: To determine relative effects of diets high in synthetic sources of myristic (14:0), palmitic (16:0) or stearic (18:0) acid on concentrations and metabolism of serum lipoproteins. Design: Eighteen healthy women participated in a three-way cross-over study for ®ve week periods separated by seven week washout periods, diets were assigned in random order. Subjects: Premenopausal women, not on medication, were from three races (Caucasian, African-American, Asian) and four apolipoprotein E phenotype groups (3a3, 3a2, 4a3, and 4a2). Intervention: During the ®rst week the subjects consumed a baseline diet providing 11 energy (en)% saturated fat, 10 en% polyunsaturated fat and 14 en% monounsaturated fat. Followed by test diets with 19 en% saturated fat (including 14 en% test saturated fatty acid), 3 en% polyunsaturated fat, and 14 en% monounsaturated fat for four weeks. Synthetic fats (trimyristin, tripalmitin, and tristearin) were used in blends with natural fats and oils. Results: Mean concentrations of serum total, esteri®ed and LDL cholesterol were signi®cantly lower after 18:0 than after 16:0 (n 16 ± 18, P`0.01 for treatment effect). Myristic acid (14:0) had an intermediate effect.Receptor-mediated degradation of 125 I-LDL in mononuclear cells obtained from the subjects was lower after 16:0 than after 14:0 and 18:0 (n 16 ± 18, P 0.05 for treatment effect). Differences in the digestibilities of the fats were not a major factor in the results. Strong cholesterolemic responses to the 16:0 diet were partly explained by apoE phenotype. Conclusions: As noted previously, stearic acid was neutral compared to 14:0 and 16:0. In contrast to studies involving natural fats, 14:0, fed as a synthetic triglyceride, was less cholesterolemic than 16:0 in a majority of subjects. ApoE phenotype in¯uenced the cholesterolemic response particularly when diets high in 16:0 were eaten.