LETTERS To the Editor: The recent article by Dr Gottschlichl is an excellent review and update on new advances in the use of dietary fats in enteral and parenteral nutrition. I particularly agree with Dr Gottschlich’s statement regarding the synthesis of EPA and DHA; &dquo;Eicosapentaenoic acid (EPA) and docosahexaenoic acid can be synthesized from the desaturation and elongation of alpha-linolenic acid in many species, but this conversion is somewhat inefficient in humans (ref); the conversion is further impaired by stress.&dquo; She continues in the article to discuss the recent studies that have focused on the role of fish oil (omega-3 fatty acids) in the treatment of disease and injury. Since marine sources of omega-3 fatty acids seem to play a unique role in disease, stress, and infant nutrition compared with vegetable sources of omega-3 fatty acids, I feel that Table I
of one of Dr Schmidl’s associates, Pat Groziak, RD); however I soon discovered that this information is not readily available from many manufacturers at
present. Numerous tables have previously been published reporting the omega-3 fatty acid content of various foodstuffs. Theoretically, one could use these tables to mathematically calculate the contribution of alpha-linolenic, eicosapentaenoic and docosahexaenoic acid in the products listed in Table 1, much in the same way that Swails et al derived glutamine contents of enteral diets for the NCP readership.1 While this type of exercise produces interesting data, the calculations are only approximations. I would instead like to encourage industry to actually perform more detailed nutrient analyses in the laboratory and make this information more readily
accessible to clinicians in the future.
(Fat Content of Selected Enteral and Parenteral Products) would be of greater value to clinicians if the omega-3 column were separated into these three fatty acids: alpha-linolenic (18:3), EPA (20:5), and2 DHA (22:6), as was done in one of her references.2 Following this suggestion, clinicians will readily be able to identify which enteral products contain omega-3 fatty acids from fish oil (Impact0 and Max EPA®), and those that contain omega-3 fatty acids from vegetable oil.
Shriners Burns Institute Cincinnati, Ohio
WS, Bell SJ, Borlase BC, et al. Glutamine content of proteins: Implications for enteral formulas. NCP 1992;7(3):77-80.
Mary K. Schmidl,
PhD Director of Research Clinical Products Division
Sandoz Nutrition Corporation Minneapolis, Minnesota
To the Editor: I would like to take this opportunity to thank and commend NCP for its recent review of the Immunologic Structure and Function of the Gastrointestinal Tract. The timely editorial by John Alverdy and the well-designed and executed review by Drs Langkamp-Henken, Glezer, and Kudsk were wellreceived by one who is responsible for maintaining a state-of-the-art understanding of the broad area of physiology and nutrition, with all of its clinical and practical applications.
REFERENCES 1. Gottschlich MM. Selection of optimal lipid
Gottschlich, PhD, RD, CNSD Director, Nutrition Services
parenteral nutrition. NCP 1992;7(4):152-65. Hepburn FN, Exler J, Weighrauch JL. Provisional tables on the content of omega-3 fatty acids and other fat components of selected foods. J Am Diet Assoc 1986;86:788-93.
Response from the Author: I appreciate the comments contained in Dr Schmidl’s letter. There is no denying the potential clinical usefulness of a table that compares and contrasts the numerous medical foods available for enteral and parenteral nutrition support, separating the omega-3 fatty acids into alpha-linolenic, eicosapentaenoic, and docosahexaenoic. In fact, my original intent was to do so (at the encouragement
Richard Cotter, PhD
Corporate Director, Science and Technology Gerber Products Company
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