The effect of a wide range of daily vitamin C intake (350-2250 mg, mean 975 mg) on the serum and urine vitamin C levels was studied in 20 adult hospitalized patients receiving total parenteral nutrition for a period greater than 15 days. Serum vitamin C levels increased with vitamin C administration, but remained within the normal range. Urine vitamin C levels were above normal during total parenteral nutrition in all but one patient. A positive vitamin C "balance" was achieved in all patients. The vitamin C intake positively correlated with the vitamin C urine concentration and vitamin C "balance." Maximal vitamin C retention was 800 mg/day. It is concluded that administration of vitamin C in doses greater than 1000 mg/day is unjustified in those patients receiving total parenteral nutrition who are not hypermetabolic.
The rate of fat emulsion clearance from the blood of 10 healthy adult male volunteers administered 0.1 gram of fat per kilogram body weight as 10% or 20% safflower oil emulsion (Liposyn) was studied. The subjects were hospitalized for 2 days and each was given the predetermined amount of one of the two fat emulsions (10% or 20%) by rapid injection into a peripheral vein and the rate of clearance of the emulsion determined over a 60-minute period, beginning when half of the emulsion had been injected. There was no significant difference in the clearance rate between the two emulsions. It is concluded that 20% fat emulsion is a safe as 10% fat emulsion for use in intravenous nutritional support.
Studies show that bile acids and long-chain fatty acids are responsible for diarrhea in certain malabsorption syndromes. Recent reports indicate that substances such as dietary cholesterol, when moderately consumed, can reduce bile-induced excessive mucosal fluid and electrolyte output. This study explores the antidiarrheal effect and dosage of dietary cholesterol in rats following massive bowel resection, co-fed elemental diet. Thirty-five male Sprague-Dawley rats weighing 248–253 g underwent 75% resection of the small bowel and were fed ad libitum for 21 days with 1 of 5 diets (n = 7) of Vivonex HN, supplemented by 0, 2.5, 5, 10 or 15 mM cholesterol/l,000 g of the powdered elemental diet. Parameters measured included daily food and water consumption, daily changes in weight, volume of excrement and stool consistency graded by the same individual (water, semiformed or formed). It was found that 5 mM dietary cholesterol in 1,000 g of the elemental diet produced the most formed stool and significantly improved weight gain in rats with short-bowel syndrome.
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