Comparison of the effect of canola oil and sunflower oil on plasma lipids and lipoproteins and on in vivo thromboxane A2 and prostacyclin production in healthy young men.

The effect of dietary fatty acid composition on plasma lipids and eicosanoid production was studied in normolipidemic men. Approximately 75% of the fat in the diet was provided by a mixture of fats (MF) during the 6-d pre and postperiods and either canola oil (CO) or sunflower oil (SO) during the two 18-d experimental periods. Saturated, monounsaturated, and polyunsaturated fatty acids provided 14%, 15%, and 7%; 5%, 20%, and 10%; and 7%, 7%, and 22%, respectively, of total dietary energy in the MF, CO, and SO diets, respectively. The CO and SO diets produced similar decreases in plasma total (20% and 15%, respectively) and low-density lipoprotein (25% and 21%, respectively) cholesterol. Plasma high-density lipoprotein cholesterol and triglyceride concentrations were not altered by either fat source. Bleeding time was longer and in vivo 1-keto-PGF1 alpha production was greater (p less than 0.05) when on the CO diet than when on the MF diet. The hypocholesterolemic and antithrombotic effects of the CO diet were equivalent to those of the SO diet.

Dietary canola oil: effect on the accumulation of eicosapentaenoic acid in the alkenylacyl fraction of human platelet ethanolamine phosphoglyceride.

Volunteers consumed a mixed-fat diet for 6 d (Pre-exp) and then either a canola-oil-based diet (CAN) containing linolenic acid (18:3n-3) or a sunflower-oil-based diet (SUN) rich in linoleic acid (18:2n-6) for 18 d, followed by the alternative diet in a crossover design. Platelet phospholipids were analyzed for changes in fatty acid composition. Eicosapentaenoic acid (EPA) (20:5n-3) was significantly higher in alkenylacyl ethanolamine phosphoglyceride (PPE) and in total phosphatidylcholine (PC) after CAN compared with SUN and Pre-exp. The 22:5n-3 was increased in PPE after CAN above concentrations found after both SUN and Pre-exp. Lower concentrations of 20:4n-6 and 22:4n-6 were observed with CAN in PC and lower concentrations of 22:4n-6 in PPE. These results indicate that the consumption of canola oil moderately increases EPA concentrations and alters the concentrations of other n-6 and n-3 fatty acids in human platelet phospholipids.

Accumulation of eicosapentaenoic acid in plasma phospholipids of subjects fed canola oil.

The metabolism of alpha-linolenic acid from canola oil was studied in eight normolipidemic men. The 42-day study was divided into three periods: a 6-day pre-experimental and two 18-day experimental. Approximately 75% of the dietary fat (28% of total energy) was provided by a mixture of fats during the pre-experimental period and either canola oil (CO) or sunflower oil (SO) during the experimental periods. The CO and SO diets were fed in a cross-over design. The ratios of linoleic to linolenic acid were 2.6:1 and 73.9:1 in the CO and SO diets, respectively. Dietary fat source had an effect on plasma phospholipid fatty acids: 18:1n-9, 18:3n-3 and 20:5n-3 were higher (p less than 0.05), and 18:2n-6 was lower in the phosphatidylcholine fraction; 18:1n-9 was higher and 20:4n-6 lower in the phosphatidyl-ethanolamine fraction; and 18:1n-9 and 20:5n-3 were higher and 20:4n-6 and 22:6n-3 were lower in the alkenylacyl ethanolamine phospholipid fraction on the CO diet as compared to the SO diet. Consumption of the canola oil diet resulted in higher n-3 fatty acid levels and lower n-6 fatty acid levels in plasma phospholipids than consumption of the sunflower oil diet.

The Chelsea critical care physical assessment tool (CPAx): validation of an innovative new tool to measure physical morbidity in the general adult critical care population; an observational proof-of-concept pilot study.

OBJECTIVE: To develop a scoring system to measure physical morbidity in critical care - the Chelsea Critical Care Physical Assessment Tool (CPAx). METHOD: The development process was iterative involving content validity indices (CVI), a focus group and an observational study of 33 patients to test construct validity against the Medical Research Council score for muscle strength, peak cough flow, Australian Therapy Outcome Measures score, Glasgow Coma Scale score, Bloomsbury sedation score, Sequential Organ Failure Assessment score, Short Form 36 (SF-36) score, days of mechanical ventilation and inter-rater reliability. PARTICIPANTS: Trauma and general critical care patients from two London teaching hospitals. RESULTS: Users of the CPAx felt that it possessed content validity, giving a final CVI of 1.00 (P<0.05). Construct validation data showed moderate to strong significant correlations between the CPAx score and all secondary measures, apart from the mental component of the SF-36 which demonstrated weak correlation with the CPAx score (r=0.024, P=0.720). Reliability testing showed internal consistency of α=0.798 and inter-rater reliability of κ=0.988 (95% confidence interval 0.791 to 1.000) between five raters. CONCLUSION: This pilot work supports proof of concept of the CPAx as a measure of physical morbidity in the critical care population, and is a cogent argument for further investigation of the scoring system.

Standards of care: an innovative approach.

Clinical nutrition services at the Henderson General Division of Hamilton Civic Hospitals has taken a unique approach to standards of care. The Henderson General Division Standards of Care (HGDSC) focus on important issues in the evaluation of care including the goals, intensity and outcome of care. The HGDSC are based on populations defined by the level of nutrition care required and can easily be applied to patients with multiple medical and nutritional concerns. The standards operate under the premise that the process and intensity of care are determined by the goals of care. Thus, the standards assist in the delivery of equitable care to patients of similar nutritional risk. The goal-oriented focus of the standards is a benefit as the impact of nutrition care can be measured using the goals of care as expected outcomes. Outcome measures are considered important in the measurement of quality care since they focus on the patient's health status after intervention. The changing focus of health care in hospitals makes the identification of valid process criteria a priority for clinical dietitians. The purpose of this article is to provide insight into the unique features of the HGDSC and to explore the benefits of standards that focus on the goals and outcomes of nutrition care.