The physiology of nutritional assessment and therapy in protein-calorie malnutrition

摘要: Abstract Protein-calorie malnutrition (PCM), in the purest sense, is result of depleted body protein stores due to semistarvation. A review hormonal response simple semistarvation illustrates elegant adaptive ability respond an inadequate diet. By contrast, body's metabolic injury or illness stimulus a dynamic process orchestrated by monokines and hormones. Although response, strictly speaking, not synonymous with PCM, resultant increased energy expenditure, anorexia, potential for skeletal muscle breakdown can even more rapid depletion stores. Ultimately, need nutritional support depends on amount recent weight loss, anticipated time insufficient oral intake, degree stress. discussion basic concepts anthropometry precedes examples advantages disadvantages given anthropometric parameter selected disease states. The effects PCM visceral structure function are discussed detail so that reader appreciate why may have very different impact nourished compared malnourished patient. Particular attention paid adverse immune its antithesis, beneficial repletion system. An approach refeeding discusses indications initiation support, choice route, design macronutrient micronutrient regimen, guidelines monitoring. Familiarity alterations key mitigation potentially life-threatening complications sudden refeeding. Appreciation nutrition important, as will vary nearly optimal be expected appropriate nonstressed semistarved patient, whereas inefficient severely stressed concludes role modifier injury.