Problem Arthur N

Arthur is a 75-year-old man, 170 cm tall and weighing 50 kg. He has advanced cancer, and has lost 2 kg body weight over the last 4 weeks. What is his body mass index? Is it within the desirable range? His mean skinfold thickness is 1.9 mm, suggesting that he has negligible reserves of adipose tissue, and he shows considerable wasting of muscle, so we can assume that most of his weight loss is muscle. The composition of muscle is: 79% water, 17% protein (at 17 kJ/g) and 3% fat (at 37 kJ/g).

What was his overall energy deficit over the last 4 weeks (total energy deficit and average/day)?

For his age and body weight, BMR would be expected to be between 4.7 and 4.9 MJ/day. His BMR was determined by measuring oxygen consumption with a respirometer; regardless of the fuel being oxidized, 1 L of oxygen is equivalent to 20 kJ. His oxygen consumption was 11.2 L/h. What is his BMR (in MJ/day)?

Assuming the mean BMR for his age and weight = 4.8 MJ/day, what is his daily energy deficit now?

How much intravenous glucose would be required daily to restore energy balance and prevent further weight loss? (energy yield of glucose = 16 kJ/g).

What volume of 5% glucose would be required?

CHAPTER

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