Preoperative Oral Carbohydrate Loading in Pancreaticoduodenectomy

Overnight fasting before elective surgery has been the routine to reduce the risk of pulmonary aspiration. Recently, several international guidelines for preoperative fasting recommend to intake carbohydrate-containing fluids up to 2 to 3 hours before the induction of anesthesia to improve postoperative recovery. Based on the recommendations, we developed a "preoperative carbohydrate diet" provided for the preoperative patients. The purpose of this case report is to share our experience of applying preoperative carbohydrate loading prior to surgery.

A Study for Comparison of Dietary Quality and Vitamin K Intake of Vegetarians with Carnivores

The prevalence of chronic diseases have been rising in the developing countries because of their increased animal foods consumption and Western lifestyle. Lately, vegetarian diet that exclude animal products get public attention. The purpose of this study was to evaluate the nutritional status and dietary quality of vegetarians, and their consumption of vitamin K and was also assessed. Vegetarians including strict vegan and lacto-ovo-vegetarian consumed their diet at least over 6 months. Carnivores were gender and age matched with vegetarians and they consumed over 50% of protein and fat from animal sources. Current nutrient intakes and dietary quality were assessed using 3-day food records and intake of vitamin K was calculated from the data base of "Provisional Table on the vitamin K contents of foods, USA". Blood sample were collected and biochemical parameters and plasma phylloquinone concentrations were analyzed. Anthropometric data from vegetarian and carnivore were not significantly different. The intake of calories, protein, vitamin B2, Ca and Zn of the vegetarians were remarkably lower than RDA for each nutrient. Moreover, index of nutritional quality and nutrient adequacy ratio of vegetarians were lower than those of carnivore. Vegetarian consumed less fat and the ratio of n-6/n-3 fatty acid was lower in vegetarian. The intake of essential amino acids in vegetarian was significantly lower than that of carnivore. The vitamin K consumption and plasma phylloquinone concentration of vegetarian were significantly higher than those of carnivore (p < 0.05). The dietary vitamin K consumption was positively correlated with plasma phylloquinone levels in vegetarian (p < 0.01).