At a mean follow-up of 19 months, this same investigator observed that older patients undergoing elective CABG usually did not regain the weight they lost between the preoperative period and after hospital discharge. Furthermore, patients who lost more weight in the postoperative period were more likely to require subsequent hospital readmission.414 In an observational study of 100 consecutive patients under- going cardiac surgery, van Venrooij et al415 noted that low pre- operative protein intake ( 0.98 g kg 1 ) did not result in more complications or a longer hospital stay compared with a high preoperative protein intake (>0.98 g kg 1 ). On the other hand, a high-energy preoperative diet (>22 kcal kg 1 ) resulted in more postoperative complications. Racca and evaluated nutrition biomarkers in 50 nondiabetic patients on admission to a rehabilitation facility after cardiac surgery and 16 days later. Patients received a standard car- diac diet with controlled caloric support (30 kcal kg 1 ) providing 15% to 20% dietary protein, 30% fat, and 50% to 55% carbohydrates rich in fruits and vegetables. After 16 days on this standard dietary regimen, low plasma albumin levels increased, anemia improved, and markers of inflammation declined. From the above data, it would appear that controlled, com- prehensive dietary intake is effective in restoring the nutri- tional insults brought about by major surgery such as CABG but that oversupplementation may be detrimental. Although it seems justified to modulate nutritional intake to promote a quicker recovery from CABG, to date, there are no prospec- tive, randomized trials documenting a benefit associated with perioperative nutritional modification. Vitamins and Supplements The use of vitamin supplementation is a widespread prac- tice in the general population that amounts to tremendous expenditure. 