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NCP In 2005, 17.5 million (30%) of all deaths globally were attributed to cardiovascular disease.1 There is a strong association between heart disease and nutrition, and we have devoted this issue to discussing this important topic. The issue begins with an Invited Commentary contributed by Dr William Roberts, the Editor-in-Chief of The American Journal of Cardiology. Dr Roberts shares his views on hypercholesterolemia as the single culprit in causing atherosclerosis. Next, Retelny, Neuendorf, and Roth summarize the role of dietary fiber, fat, sterols, stanols, soy protein, alcohol, and nuts in prevention of cardiovascular disease. The review also looks at obesity as a cardiovascular disease risk factor. In the next article, Beich and Yancy delve into the controversy of whether or not sodium restriction is necessary in the treatment of heart failure. The pathophysiology of heart failure is outlined, as well as the role of sodium in the treatment of the risk factors of heart failure, and compensated and uncompensated heart failure. Wooley then summarizes the role of thiamine in heart failure. The properties, functions, and sources of thiamine are reviewed as well as the mechanisms of thiamine deficiency in this population. The author subsequently presents a case for supplementing thiamine in individuals with heart failure. Dr DiMaria-Ghalili addresses nutrition concerns of the older patient undergoing coronary artery bypass graft. She summarizes nutrition risk factors in this population as well as metabolic effects of surgery. In a departure from the discussion of chronic heart failure, Gail Cresci addresses another nutrition concern–the dilemma of whether or not to enterally feed critically ill patients who are hemodynamically unstable. Cresci provides an excellent description of the hemodynamic changes associated with circulatory shock and how it affects the gastrointestinal tract. She reviews studies that evaluated the use of tube feeding in low flow states and summarizes the use of pharmaconutrients in this situation. Widlicka's paper on enteral nutrition in the critically ill cardiothoracic patient follows. This review covers practical tips including glycemic control, energy and protein needs, immunonutrition, and concerns of providing nutrition to cardiac patients with renal failure. Two papers address other thoracic surgery conditions. Kight presents a comprehensive review of nutrition concerns related to esophagectomy. Indications for esophagectomy are discussed, followed by details on nutrition needs following this extensive surgery. Lymphatic injury can occur during surgeries like esophagectomy or other surgeries involving the chest, abdomen, or neck. Damage of the lymphatic system can cause chyle leaks. Smoke and DeLegge address this unique complication and its potential nutrition treatments. The remainder of this issue of NCP includes 3 research studies and a review. The review by Thompson and Duffy looks at 3 contemporary nutrition practices in hematopoietic stem cell transplantation: probiotics, enteral nutrition therapy, and glycemic control. The authors review the available literature in this specific population, discussing the pros and cons of these practices. The first of the research papers compares the energy requirements of children with Stevens-Johnson Syndrome or Toxic Epidermal Necrolysis with the energy requirements of children with burn injury. Wiese et al reports on nutrition status changes in 7 patients with Crohn's disease who underwent treatment with infliximab. The third research paper by von Drygalski and Biller summarizes a retrospective study of 218 cystic fibrosis patients which evaluated relationships between pulmonary function and anemia. This issue concludes with Current Literature and Book Review sections. The Contributing Editors, Dr Praveen Goday and Dr Carol Ireton-Jones actively solicit and assign volunteers to author these reviews. If you are interested in helping to write either a Book Review or Current Literature Review, please contact the editorial office at ncp{at}aspen.nutr.org. 1 Cardiovascular disease. Available at: www.who.int/mediacentre/factsheets/fs317/en/print.html. Accessed 8/21/08.
Nutrition in Clinical Practice, Vol. 23, No. 5,
462 (2008)
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