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TwoCal
HN - Vanilla
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| TWOCAL
HN 240ML |
Price:
Case of 24 $43.73 |
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| TWOCAL
HN 1000CC |
Price:
Case of 8 $69.95 |
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Features
Ross TwoCal HN - Vanilla - 8 oz cans
- For oral or tube feeding
- For patients with severe fluid restrictions
- High-nitrogen liquid formula
- Ideal for medication pass programs
Product Overview
Ross TwoCal HN - Vanilla - 8 oz cans
| Usage:
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TWOCAL HN is
a nutritionally complete, high-nitrogen liquid formula.
It is an ideal tube feeding to meet the increased protein
and calorie needs of patients with severe fluid restrictions
or for those with limited volume tolerance. With 119 Cal
per 2 fl oz, TWOCAL HN is also an excellent oral supplement
for medication pass programs.
- For patients with elevated energy
and protein requirements
- For patients requiring low-volume
feedings
- For patients with fluid restrictions
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| Features:
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- For supplemental or sole-source
nutrition
- For oral or tube feeding
- Calorically dense—2 Cal/mL,
475 Cal/8 fl oz
- High in protein—19.9
g/8 fl oz
- Lactose- and gluten-free
- Two flavors—vanilla and butter
pecan
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| Availability:
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Ready-To-Use
8-fl-oz cans, 24/case
Vanilla #00729
Product information and values listed are subject to change.
Please refer to product label or packaging for the most
current information. |
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| Administration:
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Use under medical supervision. Not for parenteral use. Pump
feeding with an 8 F tube or larger is recommended. Use TWOCAL
HN at room temperature for tube feeding. |
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| Ingredients:
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| Vanilla:
-D Water, corn syrup solids, sodium and calcium caseinates,
maltodextrin (corn), high-oleic safflower oil, sugar (sucrose),
medium-chain triglycerides (fractionated coconut oil), canola
oil, fructooligosaccharides, potassium citrate, magnesium
chloride, calcium phosphate tribasic, natural and artificial
flavors, soy lecithin, sodium citrate, ascorbic acid, choline
chloride, taurine, L-carnitine, zinc sulfate, ferrous sulfate,
alpha-tocopheryl acetate, niacinamide, calcium pantothenate,
manganese sulfate, cupric sulfate, thiamine chloride hydrochloride,
pyridoxine hydrochloride, riboflavin, vitamin A palmitate,
folic acid, biotin, chromium chloride, sodium molybdate,
potassium iodide, sodium selenate, phylloquinone, cyanocobalamin
and vitamin D3. |
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| Protein:
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| The quantity
and concentration of protein provided in TWOCAL HN are adequate
to meet the needs of most moderately to severely stressed
patients. The high-quality protein of TWOCAL HN meets or
surpasses the standard amino acid profile for protein of
high biologic value.
Protein Profile
| Percent
of total calories from protein |
16.7
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| Protein
content |
83.5
g/L |
Protein Source
| Sodium
and calcium caseinates |
100%
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| Cal/N
ratio |
150:1
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| Nonprotein
Cal/N ratio |
125:1
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| Fat:
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| The fat blend
in TWOCAL HN consists of 64% high-oleic safflower oil, 19%
MCT oil, 15% canola oil, and 2% lecithin. The high-oleic
safflower oil and canola oil blend is high in monounsaturated
fatty acids and low in cholesterol. The level of MCT oil
is designed to aid fat digestion. Effective absorption of
MCTs—unlike that of long-chain triglycerides—does not
depend on pancreatic lipase or bile salts. MCTs are thus
more rapidly absorbed by the intestinal mucosa.1
This may be particularly important for patient tolerance
of concentrated formulas that provide significant levels
of fat.
Fat Profile
| Percent
of total calories from fat |
40.1
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| Fat
Content |
90.5
g/L |
| Polyunsaturated
fatty acids |
50.7
g/L |
| Monounsaturated
fatty acids |
12.2
g/L |
| Saturated
fatty acids |
23.1
g/L |
Fat Source
| High-oleic
safflower oil |
64%
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| MCT
oil |
19%
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| Canola
oil |
15%
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| Lecithin
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2%
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| Carbohydrate:
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| TWOCAL HN contains
a combination of corn syrup solids, maltodextrin, sucrose,
and fructooligosaccharides (FOS). FOS are indigestible sugars
that occur naturally in onions, barley, bananas, and other
common foods.2 FOS are fermented by beneficial
bacteria in the colon to short-chain fatty acids (SCFAs),
the preferrred fuel of colonocytes. SCFAs increase electrolyte
and water absorption—two significant
factors in diarrhea management.3 In an in vitro
study, FOS fermentation resulted in the greatest growth
of acid-producing bacteria and the lowest pH. These factors,
in turn, did not support the growth of some pathogenic bacteria,
eg, Clostridium difficile.4 TWOCAL HN
contains 1.2 g of FOS per 8-fl-oz can, 5 g/L.
Carbohydrate Profile
| Percent
of total calories from carbohydrate |
43.2
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| Carbohydrate
content |
219 g/L
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Carbohydrate Source
| Corn
syrup solids |
50.4%
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| Maltodextrin
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33.6%
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| Sucrose
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13.3%
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| Fructooligosaccharides
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2.7%
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| Vitamins
and Minerals: |
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| TWOCAL HN provides
100% of the RDIs for 24 key vitamins and minerals in 1900
Cal (947 mL) or four 8-fl-oz servings. TWOCAL HN is supplemented
with conditionally essential nutrients L-carnitine and taurine
(38 mg/8 fl oz), which may become depleted during periods
of metabolic stress.
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| Osmotic
Concentration: |
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| The main determinants
of the osmolality of a formula are simple carbohydrates,
electrolytes, amino acids, and small peptides. Formulas
that are calorically concentrated, such as TWOCAL HN at
2 Cal/mL, have a higher osmotic concentration than standard
1 Cal/mL formulas due to the concentration of nutrients
in a limited volume.
| Osmolality*
(mosm/kg H2O) |
730
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| Osmolarity
(mosm/L) |
512
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* Measured on undiluted product using vapor pressure methodology.
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| Analysis:
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Nutrient Facts
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8
fl oz
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| FAN
(label number) |
7399-08
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| Cal/mL
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2.00
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| Energy,
Cal |
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| Protein,
g |
19.9
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%
of total Calories
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16.7
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| Fat,
g |
21.5
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%
of total Calories
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40.1
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Cholesterol,
mg
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<10
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| Carbohydrate,
g |
51.8
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%
of total Calories
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43.2
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| Water,
g* |
166
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| Dietary
Fiber, g |
0
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| L-carnitine,
mg |
38
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| Taurine,
mg |
38
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| m-Inositol,
mg |
0
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* 1 g water = 1 mL water
= 1 cc water.
Vitamins
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8
fl oz
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| Vitamin
A, IU |
1250
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| Vitamin
D, IU |
100
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| Vitamin
E, IU |
12
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| Vitamin
K, mcg |
20
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| Vitamin
C, mg |
75
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| Folic
Acid, mcg |
160
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| Thiamin
(Vitamin B1), mg |
0.6
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| Riboflavin
(Vitamin B2), mg |
0.68
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| Vitamin
B6, mg |
0.8
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| Vitamin
B12, mcg |
2.4
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| Niacin,
mg |
8
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| Choline,
mg |
150
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| Biotin,
mcg |
120
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| Pantothenic
Acid, mg |
4
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Minerals
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8
fl oz
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| Sodium,
mg (mEq) |
345
(15.0) |
| Potassium,
mg (mEq) |
580
(14.8) |
| Chloride,
mg (mEq) |
430
(12.2) |
| Calcium,
mg |
250
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| Phosphorus,
mg |
250
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| Magnesium,
mg |
100
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| Iodine,
mcg |
38
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| Manganese,
mg |
1.3
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| Copper,
mg |
0.5
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| Zinc,
mg |
5.7
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| Iron,
mg |
4.5
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| Selenium,
mcg |
18
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| Chromium,
mcg |
30
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| Molybdenum,
mcg |
38
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Amino Acids
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8
fl oz
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Essential
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| Histidine,
mg |
534.6
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| Isoleucine*,
mg |
930.6
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| Leucine*,
mg |
1782
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| Lysine,
mg |
1425.6
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| Methionine,
mg |
554.4
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| Phenylalanine,
mg |
990
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| Threonine,
mg |
792
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| Tryptophan,
mg |
217.8
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| Valine*,
mg |
1168.2
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Nonessential
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| Alanine,
mg |
574.2
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| Arginine,
mg |
653.4
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| Aspartic
Acid, mg |
1386
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| Cystine,
mg |
79.2
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| Glutamic
Acid, mg |
4237.2
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| Glycine,
mg |
356.4
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| Proline,
mg |
2098.8
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| Serine,
mg |
1089
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| Tyrosine,
mg |
970.2
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* Branched-chain amino
acids.
Fatty Acids
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8
fl oz
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| Linoleic
(18:2), mg |
2580
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| a-Linolenic
(18:3), mg |
325
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| Caprylic
(8:0), mg |
2300
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| Capric
(10:0), mg |
1720
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| Lauric
(12:0), mg |
45
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| Myristic
(14:0), mg |
45
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| Palmitic
(16:0), mg |
950
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| Stearic
(18:0), mg |
430
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| Oleic
(18:1), mg |
12040
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| Arachidic
(20:0), mg |
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Fatty
acids equal approximately 95% of total fat.
In parentheses, carbon atoms/double bonds.
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| References:
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| Clinical
Documentation Burns PE, McCall L, Wirsching R: Physical
compatibility of enteral formulas with various common medications.
J Am Diet Assoc 1988;88:1094-1096.
Meredith CN, Frontera WR, O'Reilly
KP, Evans WJ: Body composition in elderly men: Effect
of dietary modification during strength training. J
Am Geriatr Soc 1992;40:155-162.
Mitchell CO, Lipschitz DA: Evaluation
of gastrointestinal tolerance in long-term tube feeders
receiving defined formula diets. Abstracts of the 67th
annual meeting of The American Dietetic Association, 1984,
pp 283-284.
References
1.
Bach AC, Babayan VK: Medium-chain triglycerides: An update.
Am J Clin Nutr 1982;36:950-962.
2. Spiegel JE, Rose R, Karabell
P, et al: Safety and benefits of fructooligosaccharides
as food ingredients. Food Technol 1994;48:85-89.
3. Royall D, Wolever TMS, Jeejeebhoy
KN: Clinical significance of colonic fermentation. Am
J Gastroenterol 1990;85:1307-1312.
4. May T, Mackie RI, Fahey GC
Jr, et al: Effect of fiber source on short-chain fatty
acid production and on the growth and toxin production
by Clostridium difficile. Scand J Gastroenterol
1994;19:916-922.
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