Feeding tube

Impediments to Adequate Nutrition

Nutrition Therapy in the Adult Hospitalized Patient
The dosage of available atropine is 0. Multiply total volume to be infused by the drop factor; divide by the total time of infusion in minutes. Fatty acids, the immune response, and autoimmunity: Plain water can irritate the mucous membranes. Swallowing is usually not affected nor is the ability to control oral secretions. Driving up the quality and relevance of research through the use of agreed core outcomes.

Consensus Recommendations

Clinical Practice Library

Arteriosclerosis Jan-Feb;9 1: Controlled trial of a diet high in unsaturated fat for prevention of atherosclerotic complications. The Lancet Nov 16;2 Incidence of cancer in men on a diet high in polyunsaturated fat.

The Lancet Mar 6;1 The Oslo diet-heart study: Circulation 42 —, http: The effect of plasma cholesterol lowering diet in male survivors of myocardial infarction: Acta Medica Scandinavica, Supplementum ; The Lancet Sep 28;2 Turpeinen O et al. Dietary prevention of coronary heart disease: International Journal of Epidemiology Jun;8 2: Miettinen M et al. Dietary prevention of coronary heart disease in women: International Journal of Epidemiology Mar;12 1: The Finnish mental hospital trial, July 9, , http: Dietary reference intakes for energy, carbohydrate, fiber, fat, fatty acids, cholesterol, protein, and amino acids.

Excess omega-3 fatty acid consumption by mothers during pregnancy and lactation caused shorter life span and abnormal ABRs in old adult offspring. Neurotoxicology and Teratology March—April;32 2: Long-term intake of fish oil increases oxidative stress and decreases lifespan in senescence-accelerated mice.

Nutrition Mar;27 3: Lack of benefit of dietary advice to men with angina: European Journal of Clinical Nutrition Feb;57 2: Dietary fat and health: Lands WE, Lifestyle diversity, http: Omega fats and cardiovascular disease, September 6, , http: Healthy intakes of n-3 and n-6 fatty acids: The Journal of Nutritional Biochemistry Apr;17 4: Watkins BA et al.

Journal of Nutrition Sep; 9: Addition of omega-3 fatty acid to maintenance medication treatment for recurrent unipolar depressive disorder.

The American Journal of Psychiatry Mar; 3: Su KP et al. Omega-3 fatty acids for major depressive disorder during pregnancy: Journal of Clinical Psychiatry Apr;69 4: Omega-3 fatty acids in major depressive disorder. A preliminary double-blind, placebo-controlled trial.

European Neuropsychopharmacology Aug;13 4: Stoll AL et al. Omega 3 fatty acids in bipolar disorder: Archives of General Psychiatry May;56 5: Associations between increases in plasma n-3 polyunsaturated fatty acids following supplementation and decreases in anger and anxiety in substance abusers.

Hamazaki T et al. The effect of docosahexaenoic acid on aggression in young adults. A placebo-controlled double-blind study. Journal of Clinical Investigation Feb 15;97 4: Omega-3 fatty acid treatment of women with borderline personality disorder: The American Journal of Psychiatry Jan; 1: Hallahan B et al. Omega-3 fatty acid supplementation in patients with recurrent self-harm. Single-centre double-blind randomised controlled trial.

The British Journal of Psychiatry Feb; Omega-3 fatty acids improve the diagnosis-related clinical outcome. Critical Care Medicine Apr;34 4: Experimental Medicine and Biology Maywood Jun; 6: Improved outcome after peripheral nerve injury in mice with increased levels of endogenous? The Journal of Neuroscience Jan 11;32 2: Fat—1 transgenic mice with elevated omega-3 fatty acids are protected from allergic airway responses. Biochimica et Biophysica Acta Sep; 9: High pancreatic n-3 fatty acids prevent STZ-induced diabetes in fat-1 mice: Diabetes Apr;60 4: Increased dietary intake of omegapolyunsaturated fatty acids reduces pathological retinal angiogenesis.

Nature Medicine Jul;13 7: Transgenic mice rich in endogenous omega-3 fatty acids are protected from colitis. Melanoma growth is reduced in fat-1 transgenic mice: Berquin IM et al. Modulation of prostate cancer genetic risk by omega-3 and omega-6 fatty acids. Journal of Clinical Investigation Jul; 7: Habbel P et al.

Docosahexaenoic acid suppresses arachidonic acid-induced proliferation of LST human colon carcinoma cells. World Journal of Gastroenterology Mar 7;15 9: Griffitts J et al.

Non-mammalian fat-1 gene prevents neoplasia when introduced to a mouse hepatocarcinogenesis model: Omega-3 fatty acids prevent liver neoplasia.

Biochimica et Biophysica Acta Oct; Mediterranean diet, traditional risk factors, and the rate of cardiovascular complications after myocardial infarction: Circulation Feb 16;99 6: Mediterranean dietary pattern in a randomized trial: Archives of Internal Medicine Jun 8; Effects of changes in fat, fish, and fibre intakes on death and myocardial reinfarction: The Lancet Sep 30;2 Maintenance of lower proportions of n — 6 eicosanoid precursors in phospholipids of human plasma in response to added dietary n — 3 fatty acids.

Biochimica et Biophysica Acta Dec 10; 2: Circulating nonesterified fatty acid level as a predictive risk factor for sudden death in the population. Circulation Aug 14; 7: Comparison of monounsaturated fat with carbohydrates as a replacement for saturated fat in subjects with a high metabolic risk profile: The effects of supraphysiologic doses of testosterone on muscle size and strength in normal men.

Low-fat high-fiber diet decreased serum and urine androgens in men. Growth hormone effect on the role of fat in nitrogen metabolism. American Journal of Physiology Nov; 5: Growth hormone and protein metabolism. Clinical Nutrition Dec;28 6: From GH to Billy Ghrelin. Cell Metabolism Aug;10 2: Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease.

Saturated fat, carbohydrate, and cardiovascular disease. Dietary intake of saturated fatty acids and mortality from cardiovascular disease in Japanese: Inverse association of dietary fat with development of ischemic stroke in men. Dietary fats, carbohydrate, and progression of coronary atherosclerosis in postmenopausal women. Hat tip to Richard D Feinman: What if saturated fat is not the problem? Ketogenicity of soybean oil, coconut oil and their respective fatty acids for the chick. Journal of Nutrition Dec; Medium-chain triglyceride MCT ketogenic therapy.

Epilepsia Nov;49 suppl 8: In vitro killing of Candida albicans by fatty acids and monoglycerides. Antimicrobial Agents and Chemotherapy Nov;45 Liu S et al. Biological control of phytopathogenic fungi by fatty acids. Mycopathologia Aug; 2: The effects of saturated fatty acids on Giardia duodenalis trophozoites in vitro.

Parasitology Research Oct;97 3: Medium-chain fatty acids decrease colonization and invasion through hilA suppression shortly after infection of chickens with Salmonella enterica serovar Enteritidis. Applied and Environmental Microbiology Jun;70 6: Gantois I et al. Butyrate specifically down-regulates salmonella pathogenicity island 1 gene expression. Applied and Environmental Microbiology Jan;72 1: Antimicrobial property of lauric acid against Propionibacterium acnes: Journal of Investigative Dermatology Oct; Antibacterial interactions of monolaurin with commonly used antimicrobials and food components.

Journal of Food Science Sep;74 7: In vitro inactivation of Chlamydia trachomatis by fatty acids and monoglycerides. Antimicrobial Agents and Chemotherapy Sep;42 9: Antibacterial actions of fatty acids and monoglycerides against Helicobacter pylori. Inactivation of enveloped viruses and killing of cells by fatty acids and monoglycerides.

Antimicrobial Agents and Chemotherapy Jan;31 1: The antimicrobial function of milk lipids. Advances in Nutritional Research ; Studies on fatty acid composition of adipose tissue and blood lipids of Polynesians. I have heard that coconut is bad for the heart and that it is good for the heart.

Harvard Heart Letter Sep;17 1: Low-density lipoprotein subclass patterns and risk of myocardial infarction. Value of low-density lipoprotein particle number and size as predictors of coronary artery disease in apparently healthy men and women: Journal of the American College of Cardiology Feb 6;49 5: Diabetes Care Nov;23 Consumption of medium- and long-chain triacylglycerols decreases body fat and blood triglyceride in Chinese hypertriglyceridemic subjects.

European Journal of Clinical Nutrition Jul;63 7: The therapeutic implications of ketone bodies: Medium chain triglycerides MCT in aging and arteriosclerosis.

The Tokelau Island migrant study. International Journal of Epidemiology Sep;3 3: Stanhope JM et al. The Tokelau Island Migrant Study: Journal of Chronic Diseases ;34 2—3: Niacin stimulates adiponectin secretion through the GPRA receptor. Ahmed K et al. Trends in Pharmacological Sciences Nov;30 Effects of dietary coconut oil on the biochemical and anthropometric profiles of women presenting abdominal obesity.

Lipids Jul;44 7: Safe and effective use of the ketogenic diet in children with epilepsy and mitochondrial respiratory chain complex defects. Epilepsia Jan;48 1: Sudden cardiac death in association with the ketogenic diet. Pediatric Neurology Dec;39 6: European Archives of Paediatric Dentistry Sep;9 3: Formulation, stability, and administration of parenteral nutrition with new lipid emulsions.

Nutrition in Clinical Practice Oct-Nov;24 5: Japanese Journal of Pharmacology Oct;87 2: White H, Venkatesh B. Critical Care Apr 6;15 2: Neuroprotective and disease-modifying effects of the ketogenic diet.

Behavioural Pharmacology Sep;17 5—6: Chronic in vitro ketosis is neuroprotective but not anticonvulsant. Journal of Neurochemistry May; 4: The neuroprotective properties of calorie restriction, the ketogenic diet, and ketone bodies.

Brain Research Reviews Mar;59 2: ScienceDaily, October 22, , www. Ketogenic diet prevents cardiac arrest-induced cerebral ischemic neurodegeneration. Journal of Neural Transmission Jul; 7: More fat and fewer seizures: The Lancet Neurology Jul;3 7: Brain Research Aug 25; Costantini LC et al. BMC Neuroscience Dec 3;9 suppl 2: A ketogenic diet as a potential novel therapeutic intervention in amyotrophic lateral sclerosis. BMC Neuroscience Apr 3;7: Current Treatment Options in Neurology Nov;10 6: Factors influencing the evolution of West syndrome to Lennox-Gastaut syndrome.

Pediatric Neurology Aug;41 2: Application of a ketogenic diet in children with autistic behavior: Journal of Child Neurology Feb;18 2: The antidepressant properties of the ketogenic diet. Biological Psychiatry Dec 15;56 The ketogenic diet may have mood-stabilizing properties. Medical Hypotheses Dec;57 6: Schizophrenia, gluten, and low-carbohydrate, ketogenic diets: Cancer as a metabolic disease. Implementing a ketogenic diet based on medium-chain triglyceride oil in pediatric patients with cancer.

Journal of the American Dietetic Association Jun;95 6: Targeting energy metabolism in brain cancer through calorie restriction and the ketogenic diet. Journal of Cancer Research and Therapeutics Sep;5 suppl 1: Effects of a ketogenic diet on tumor metabolism and nutritional status in pediatric oncology patients: Journal of the American College of Nutrition Apr;14 2: Effects of a ketogenic diet on the quality of life in 16 patients with advanced cancer: Fasting vs dietary restriction in cellular protection and cancer treatment: Oncogene Jul 28;30 Raffaghello L et al.

Fasting and differential chemotherapy protection in patients. Cell Cycle Nov 15;9 Johnson JB et al. Pretreatment with alternate day modified fast will permit higher dose and frequency of cancer chemotherapy and better cure rates.

Medical Hypotheses Apr;72 4: Hat tip to Mario Renato Iwakura. Long-term use of the ketogenic diet in the treatment of epilepsy. Hat tip Evelyn Kocur aka CarbSane. A blinded, crossover study of the efficacy of the ketogenic diet. Epilepsia Feb;50 2: Branched chain amino acids as adjunctive therapy to ketogenic diet in epilepsy: Journal of Child Neurology Oct;24 A human gut microbial gene catalogue established by metagenomic sequencing. Nature Mar 4; Bowel disease, part IV: More on fecal transplants, November 3, , http: Hat tip to Dr.

A cautionary tale of mucus fore and aft, August 30, , www. Role of dietary fiber and short-chain fatty acids in the colon. Current Pharmaceutical Design ;9 4: Butyrate improves insulin sensitivity and increases energy expenditure in mice. Diabetes Jul;58 7: Scheppach W et al. Effect of butyrate enemas on the colonic mucosa in distal ulcerative colitis. Gastroenterology Jul; 1: Physiological concentrations of short-chain fatty acids immediately suppress colonic epithelial permeability.

British Journal of Nutrition Aug; 2: Constipation is relieved more by rye bread than wheat bread or laxatives without increased adverse gastrointestinal effects. Effects of short chain fatty acids on a new human colon carcinoma cell line LIM Gut Dec;27 Mechanisms of primary cancer prevention by butyrate and other products formed during gut flora—mediated fermentation of dietary fibre.

Mutation Research Jul-Aug; 1: Cancer Research Jun 1;67 The Journal of Neuroscience Oct 15;23 Modulatory effect of butyric acid—a product of dietary fiber fermentation in experimentally induced diabetic rats. The Journal of Nutritional Biochemistry Sep;13 9: Anti-inflammatory effects of sodium butyrate on human monocytes: Hyaluronan mixed esters of butyric and retinoic acid affording myocardial survival and repair without stem cell transplantation. The Journal of Biological Chemistry Mar 26; Butyric acid from the diet: Rarity of colon cancer in Africans is associated with low animal product consumption, not fiber.

The American Journal of Gastroenterology May;94 5: Dietary fiber and progression of atherosclerosis: Blueberry husks, rye bran and multi-strain probiotics affect the severity of colitis induced by dextran sulphate sodium. Scandinavian Journal of Gastroenterology ;44 Vancomycin-resistant enterococci exploit antibiotic-induced innate immune deficits. Nature Oct 9; Fats and absorbing endotoxin, February 23, , http: Potential prebiotic properties of almond Amygdalus communis L.

Applied and Environmental Microbiology Jul;74 Mucin degradation by Bifidobacterium strains isolated from the human intestinal microbiota. Applied and Environmental Microbiology Mar;74 6: Colonization of mucin by human intestinal bacteria and establishment of biofilm communities in a two-stage continuous culture system.

Applied and Environmental Microbiology Nov;71 Increased consumption of refined carbohydrates and the epidemic of type 2 diabetes in the United States: Low-fat dietary pattern and risk of colorectal cancer: Hat tip Melissa McEwen, The human colon in evolution: Archives of Internal Medicine Jun 27; Late-life alcohol consumption and year mortality. Clinical and Experimental Research Nov;34 Hat tip to Robin Hanson: Alcohol is healthy, September 2, , www.

Alcohol dosing and total mortality in men and women: Archives of Internal Medicine Dec 11—25; Camargo CA et al. Prospective study of moderate alcohol consumption and mortality in US male physicians. Archives of Internal Medicine Jan 13; 1: Yuan JM et al. Follow up study of moderate alcohol intake and mortality among middle aged men in Shanghai, China. BMJ Jan 4; Doll R et al. Mortality in relation to consumption of alcohol: BMJ Oct 8; Hat tip to David J.

Alcohol problems and solutions, www2. Alcohol consumption and mortality. Characteristics of drinking groups. Addiction Feb;93 2: Wine consumption and year mortality among late-life moderate drinkers. Journal of Studies on Alcohol and Drugs Jan;73 1: The health and health behaviors of people who do not drink alcohol.

American Journal of Preventive Medicine Nov;21 4: Alcohol consumption and mortality in individuals with diabetes mellitus. British Journal of Nutrition Oct; 7: You M et al. Ronis MJ et al. Clinical and Experimental Research Oct;33 Changes in gut microbiota control metabolic endotoxemia-induced inflammation in high-fat diet-induced obesity and diabetes in mice. Diabetes Jun;57 6: Effect of methionine on the fatty acid composition of cellular membranes in rats with chronic ethanol consumption and jejunoileal bypass.

Alcohol and Alcoholism Sep;31 5: Relationships between nutrition, alcohol use, and liver disease. Sprince H et al. Protective action of ascorbic acid and sulfur compounds against acetaldehyde toxicity: Watanabe A et al.

Lowering of blood acetaldehyde but not ethanol concentrations by pantethine following alcohol ingestion: Clinical and Experimental Research May—Jun;9 3: Hat tip to Wyatt: Hippocrates on diet and hygiene. The diet trap revisited: Long-term persistence of hormonal adaptations to weight loss. Pathways from weight fluctuations to metabolic diseases: Naturalistic weight-reduction efforts prospectively predict growth in relative weight and onset of obesity among female adolescents.

Journal of Consulting and Clinical Psychology Dec;67 6: High prevalence of vitamin D insufficiency and its association with obesity and metabolic syndrome among Malay adults in Kuala Lumpur, Malaysia. Diabetes Feb;57 2: Intracellular magnesium of obese and type 2 diabetes mellitus children.

Diabetes Therapy Aug;1 1: Association of total body and visceral fat mass with iron deficiency in preadolescents: British Journal of Nutrition Aug; 4: Zinc and copper serum levels of morbidly obese patients before and after biliopancreatic diversion: Journal of Gastrointestinal Surgery Dec;15 Selenium is significantly depleted among morbidly obese female patients seeking bariatric surgery. Obesity Surgery Nov;21 Mursu J et al. Dietary supplements and mortality rate in older women: Archives of Internal Medicine Oct 10; Effects of multivitamin and mineralsupplementation on adiposity, energy expenditure and lipid profiles in obese Chinese women.

International Journal of Obesity Jun;34 6: Dietary supplements and weight control in a middle-age population. Multivitamin and dietary supplements, body weight and appetite: British Journal of Nutrition May;99 5: Mutation Research Jan 17; 1: From poison to remedy: Journal of Neural Transmission ; 4: The frequency of U-shaped dose responses in the toxicological literature.

Toxicological Sciences Aug;62 2: Annals of Medicine ;41 5: Myxedema coma induced by ingestion of raw bok choy. World Review of Nutrition and Dietetics ; The effect of dietary fibre on fecal weight and composition. In Handbook of dietary fibre in human nutrition, 2nd ed. CRC Press, , — Gliadin, glutenin or both? The search for the Holy Grail in coeliac disease. In vitro cytotoxic effect of wheat gliadin-derived peptides on the Caco-2 intestinal cell line is associated with intracellular oxidative imbalance: ASPEN envisions an environment in which every patient receives safe, efficacious, and high-quality patient care.

ASPEN has developed parenteral nutrition PN shortage considerations to assist its members and other clinicians in coping with PN shortages for their patients. For the most up-to-date product shortage information, see these websites: These recommendations do not constitute medical or professional advice, and should not be taken as such. To the extent the information published herein may be used to assist in the care of patients, this is the result of the sole professional judgment of the attending health professional whose judgment is the primary component of quality medical care.

The information presented herein is not a substitute for the exercise of such judgment by the health professional. Purchase only as much ILE supply as needed. In the interest of fair allocation to all patients nationally, please do not stockpile. These products may have different oil emulsion components, fatty acid sources and amounts, and packaging and labeling compared to products available in the United States. The Dear Healthcare Professional Letter accompanying imported products should be carefully reviewed before implementing clinical use.

Members of the healthcare team should be educated on any differences between imported ILE products and ILE products approved for use in the U. Compound PN in a single, central location either in a centralized pharmacy or as outsourced preparation to decrease inventory waste. Consider a supply outreach to other facilities in your geographic location. These procedures should include a process: Prioritize supply of soybean oil-based ILE as follows: Neonatal and pediatric hospitalized patients should continue the same ILE therapy as before the shortage to minimize risk of adverse effects associated with essential fatty acid deficiency EFAD in this high-risk patient population.

Priority for ILE during critical shortages should be given to neonates followed by pediatric patients and finally, adolescent patients. Adult, mild-to-moderately malnourished hospitalized patients receiving PN less than 2 weeks may have ILE withheld during a shortage unless it is considered essential in the judgment of the healthcare professional. The remainder of non-protein energy may be provided by dextrose unless not indicated clinically, such as hyperglycemia, hypertriglyceridemia, and obesity.

ILE should be provided as a component of daily energy based on current practice recommendations prior to the shortage for some specific adult hospitalized patients eg, patients with glucose intolerance, severely malnourished patients, patients at risk for re-feeding syndrome, during pregnancy. A good study on brain benefit from autologous stem cells. Repair of your own damaged tissue with your own cells. Parkinson's effects millions of people in the US and does not respond well or for long term for the majority of patients.

It is extremely debilitating and costly. In a review of different studies stem cells protect and stimulate the neurons that make dopamine, and rep. This paper reviews a variety of clinical trials and studies in reference to Alzheimer's disease and stroke. It describes that stem cells act in various ways.

These include decreases in inflammation , cell replacement and trophic actions. The state of the art technique. They downregulate inflammatory mediators. The technique that I feel is the state of the art is both intravenous and nebulized inhaled mist.

In my practice the great majority of patients start to see benefit. A large multi center meta analysis describes the benefits of your own stem cells for peripheral vascular disease.

Bone marrow stem cells were used and injected into muscles and intravenously. This is an excellent article outlining how stem cells from your own bone marrow can help with neurorestoration of various cells in the brain.

My technique involves using intravenous and nasal nebulizer therapy. Kidney disease is a common and difficult to treat series of conditions.

They typically stem from age related degeneration of the tissues. A variety of medications are used to try to halt or slow damage , but are often ineffective. Stem Cell therapy , as has been shown.

Diabetes is a devastating degeneration of virtually all tissues of the body.

B. Nutritional assessment