0
December 12, 1980, Vol 244, No. 23 >
ARTICLE | December 12, 1980

Malnutrition in Hospitalized Patients FREE

William P. Steffee, MD, PhD
[+] Author Affiliations

Reprint requests to Clinical Nutrition Unit, University Hospital, Boston University School of Medicine, 75 E Newton St, Boston, MA 02118 (Dr Steffee).


JAMA. 1980;244(23):2630-2635. doi:10.1001/jama.1980.03310230032019
Text Size: A A A
Published online
Article
References

"MALNUTRITION" is a medically definable syndrome that is responsive to therapy. Yet most physicians accept protein malnutrition as an inevitable consequence of illness, and wasting continues in patients even though nutrition intervention techniques are available for those in whom a chance exists for recovery from their primary illness.

NUTRITIONAL HISTORY Fuel Reserves and Metabolism  To understand the development of protein-calorie malnutrition in the hospitalized patient, we first have to understand the energy reserves available to the healthy person and the interplay between various fuels, both exogenous and endogenous, as patients respond to disease and therapy. In Fig 1 the energy reserves of a 70-kg man are presented diagramatically. Even the nonobese person has approximately 135,000 calories stored as triglycerides in adipose tissue. Such fuels are useful and can be consumed during periods of stress. There is little stored carbohydrate, with perhaps 80 calories available from circulating glucose, 250 to 300

REFERENCES

1 +
Steffee WP, Goldsmith RS, Pencharz PG, et al:  Dietary protein intake and dynamic aspects of whole body nitrogen metabolism in adult humans . Metabolism 1976;;25:281-297.
2 +
Felig P, Pozefsky T, Marliss E, et al:  Alanine: Key role in gluconeogenesis . Science 1970;;167:1003.
3 +
Chen RW, Postlethwait RW:  The biochemistry of wound healing , in Anlyan WG, Sabiston DC Jr (eds): Monographs in the Surgical Sciences . Baltimore, Williams & Wilkins Co, 1964;, vol 1, pp 215-276.
4 +
Waterhouse C:  Lactase metabolism in patients with cancer . Cancer 1974;;33:66-71.
5 +
Beisel WR:  Effect of infection on human protein metabolism . Fed Proc 1966;;25:1682-1687.
6 +
Winick M: Hunger Disease . New York, John Wiley & Sons Inc, 1979;.
7 +
Schreiber SS, Oratz M, Evans C, et al:  Cardiac protein degradation in acute overload in vitro: Reutilization of amino acids . Am J Physiol 1973;;224:338.
8 +
Suskind RM (ed): Malnutrition and the Immune Response . New York, Raven Press, 1977;.
9 +
Ballinger WF, Collins JA, Drucker WR, et al (eds): Manual of Surgical Nutrition . Philadelphia, WB Saunders Co, 1975;.
10 +
Wilmore DW, Pruitt BA:  Parenteral nutrition in burn patients , in Fisher J (ed): Total Parenteral Nutrition . Boston, Little Brown & Co, 1976;.
11 +
Suskind R:  Gastrointestinal changes in protein calorie malnutrition . Pediatr Clin North Am 1975;;22:873-883.
12 +
Gamble JL: Physiological Information Gained From Studies on the Life Raft Ration . Harvey lectures 1946. Lancaster, Pa, Science Press Printing Co, 1947;, vol 42, pp 247-273.
13 +
Schoenheimer R: The Dynamic State of Body Constituents . Boston, Harvard University Press, 1942;.
14 +
Wilmore DW, Dudrick SJ:  Safe long-term venous catheterization . Arch Surg 1969;;98:256-258.
15 +
Dudrick SJ, Wilmore DW, Vars NM, et al:  Long-term total parenteral nutrition with growth, development, and positive nitrogen balance . Surgery 1968;;64:134-142.
16 +
Winitz M, Graff J, Gallagher N, et al:  Evolution of chemical diets as nutrition for man-in-space . Nature 1965;;205:741-743.

Figures

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
Steffee WP, Goldsmith RS, Pencharz PG, et al:  Dietary protein intake and dynamic aspects of whole body nitrogen metabolism in adult humans . Metabolism 1976;;25:281-297.
2 +
Felig P, Pozefsky T, Marliss E, et al:  Alanine: Key role in gluconeogenesis . Science 1970;;167:1003.
3 +
Chen RW, Postlethwait RW:  The biochemistry of wound healing , in Anlyan WG, Sabiston DC Jr (eds): Monographs in the Surgical Sciences . Baltimore, Williams & Wilkins Co, 1964;, vol 1, pp 215-276.
4 +
Waterhouse C:  Lactase metabolism in patients with cancer . Cancer 1974;;33:66-71.
5 +
Beisel WR:  Effect of infection on human protein metabolism . Fed Proc 1966;;25:1682-1687.
6 +
Winick M: Hunger Disease . New York, John Wiley & Sons Inc, 1979;.
7 +
Schreiber SS, Oratz M, Evans C, et al:  Cardiac protein degradation in acute overload in vitro: Reutilization of amino acids . Am J Physiol 1973;;224:338.
8 +
Suskind RM (ed): Malnutrition and the Immune Response . New York, Raven Press, 1977;.
9 +
Ballinger WF, Collins JA, Drucker WR, et al (eds): Manual of Surgical Nutrition . Philadelphia, WB Saunders Co, 1975;.
10 +
Wilmore DW, Pruitt BA:  Parenteral nutrition in burn patients , in Fisher J (ed): Total Parenteral Nutrition . Boston, Little Brown & Co, 1976;.
11 +
Suskind R:  Gastrointestinal changes in protein calorie malnutrition . Pediatr Clin North Am 1975;;22:873-883.
12 +
Gamble JL: Physiological Information Gained From Studies on the Life Raft Ration . Harvey lectures 1946. Lancaster, Pa, Science Press Printing Co, 1947;, vol 42, pp 247-273.
13 +
Schoenheimer R: The Dynamic State of Body Constituents . Boston, Harvard University Press, 1942;.
14 +
Wilmore DW, Dudrick SJ:  Safe long-term venous catheterization . Arch Surg 1969;;98:256-258.
15 +
Dudrick SJ, Wilmore DW, Vars NM, et al:  Long-term total parenteral nutrition with growth, development, and positive nitrogen balance . Surgery 1968;;64:134-142.
16 +
Winitz M, Graff J, Gallagher N, et al:  Evolution of chemical diets as nutrition for man-in-space . Nature 1965;;205:741-743.

Letters

Submit a Letter
CME Course for:


You need to register in order to view this quiz.


To understand the clinical management of acute heart failure syndromes.
Accreditation Information The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
To view and print your certificate and access a summary of your CME courses go to My CME.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s “Cited By” API will populate this tab (http://www.crossref.org/citedby.html).
Compression-Only CPR: Pushing the Science Forward
Cone
AAM 2010;304:1493-1495.
All you need to read in the other general journals
BMJ 2010;341:c5893-c1494.
Submit a Response

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

© 2012 American Medical Association. All Rights Reserved.
Powered bySilverchair Information Systems