A Clinical Approach to Body Composition in Wasting

  • Mark Wahlqvist
  • Sharon Marks
Part of the Basic Life Sciences book series (BLSC, volume 55)

Abstract

The term wasting is used by physicians as a clinical statement about loss of muscle mass and not even lean body mass in its entirety. Whatever the clinician nay think, it is not possible to make, for example, an assessment about reduced liver nitrogen or protein in conjunction with protein energy malnutrition (P.E.M.) in the face of associated changes of fatty liver. Where there is sufficient evidence of wasting by inspection or by scrutiny of a weight chart, the diagnosis is often made without further confirmatory investigations. In patients with oedema or obesity the wasting is less overt and the need for further assessment arises.

Keywords

Cholesterol Zinc Obesity Phosphorus Magnesium 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Alleyne, G. A. O., Hay, R. W., Picou, D. I., Starfield, J. P., and Whitehead, R G., 1977, in: “Protein-Energy Malnutrition”, Edward Arnold Ltd.Google Scholar
  2. American Psychiatric Association, 1980, Diagnostic and Statistical Manual of Mental Disorders, ed. 3, Washington D.C., APAGoogle Scholar
  3. Andrews, C. R., Esterman, A. J., Braunack-Mayer, A. J., and Rungie, C.M., 1986, “Aging in the Western Pacific.” World Health Organization, Manila.Google Scholar
  4. Burkinshaw, L., 1985, Measurements of human body composition in vivo, Prog Med Rad Phys, 2: 113.Google Scholar
  5. Chance, B., and Veech, R. L., 1988, Phosphorus magnetic resonance spectroscopy as a probe of nutritional state, in: “Nutrition and Metabolism in Patient care.” J. M. Kinney, K. N. Jeejeebhoy. G. L., Hill, and O. E. Owen, eds., W. B, Saunders Company.Google Scholar
  6. Coward, W. A., Parkinson. S. A., and Murgatroyd, P., 1988, Body composition measurements for nutrition research, Nutr Res Rev. 1: 115.PubMedCrossRefGoogle Scholar
  7. DSM-111-R, 1987, in “Diagnostic and Statistical Manual of Mental Disorders”, ed. 3 Revised, American Psychiatric Association, Washington.Google Scholar
  8. Forbes, G. B., “Human Body Composition”, Springer Verlag, New York 1987.CrossRefGoogle Scholar
  9. Garrow, J. S., Hastings, E. J., Cox, A. G., North, W. R. S., Gibson. M., Thomas, T. M., and Meade, T. W., 1988, Obesity and post- operative complications of abdominal operation. BMJ, 297 (6642): 181.PubMedCrossRefGoogle Scholar
  10. Gilman, A., Goodman, L. S., Rail, J. W., and Murad, F., 1985, “The Pharmacological basis of therapeutics”, 7th ed. MacMillan Publishing Company. New York.Google Scholar
  11. Harrison, J. E., McNeill, K. G., and Strauss, A. L., 1984, Nitrogen Index - total body protein normalized for body size. Nutr Res, 4: 209.CrossRefGoogle Scholar
  12. Hill, G. L., and Beddoe, A. H., 1988, Dimension of the human body and its compartments. in: “Nutrition and Metabolism in Patient Care,” J. H. Kinney, K. N. Jeejeebhoy. G. L. Hill, and O. E. Owen, eds., W. B., Saunders Company.Google Scholar
  13. Lukaski, H. C., 1987, Methods for the assessment of human body composition: traditional and new. Am J Clin Nutr, 46: 537.PubMedGoogle Scholar
  14. McClain, C. J., and Cohen, D. A., 1989, Increased tumor necrosis factor production by monocytes in alcoholic hepatitis. Hepatology, 9 (3): 349.PubMedCrossRefGoogle Scholar
  15. Moonen, C. T. W., Dimand, R. J., and Cox, K. L., 1988, The non-invasive determination of linoleic acid content of human adipose tissue by natural abundance carbon-13 nuclear magnetic resonance, Magn Reson Med 6: 140 (1988).PubMedCrossRefGoogle Scholar
  16. Otte, K. E., Ahlberg, P., D’Amore, F., and Stellfeld. M., 1989, Nutrition repletion in malnourished patients with emphysema, JPEN 13: 2, 152.CrossRefGoogle Scholar
  17. Quetelet, L. A., 1969. Physique Sociale, Brussels C., Musquardt, 2: 92.Google Scholar
  18. Rigg, B. L., 1988, Bone densitometry and clinical decision making in osteoporosis, Ann Intern Med, 108: 293.Google Scholar
  19. Steen, B., 1988, Body composition and ageing, Nutr Rev,46 (2): 45.PubMedCrossRefGoogle Scholar
  20. Stroud, D. B., Borovnicar, D. J., Lambert, J. R., McNeill. K. G., Marks, S. J., Rainer. H. C., Rassool, R. P., Strauss. B. J. G., Tai. E. H., Thompson. M. N., Wahlqvist. M. L., Watson, B. A., and Wright, C. M., Clinical studies of total body nitrogen in an Australian hospital, this volume.Google Scholar
  21. Wellcome Trust Working Party, 1970, Classification of Infantile Malnutrition. Lancet. ii:302.Google Scholar
  22. WHO: Infant and Young Child Nutrition. Report by the Director General to the World Health Assembly. May 1983 (Document URA 36/1983/7).Google Scholar
  23. Windsor, J. A., and Hill, G. L., 1988. Weight loss with physiologic impairment: a basic indicator of surgical risk, Ann Surg., 20: 290.CrossRefGoogle Scholar
  24. Wood, P. D., Stefanick, M. L., Dreon, D. M., Frey-Hewitt. B. Garay. S.C., Albers, J. J., Vranizan, K. M., Ellsworth, N. M., Terry. R. B., and Haskell, W. L., 1988, Changes in plasma lipids and lipoproteins in overweight men during weight loss through dieting as compared with exercise, NEJM 319 (18): 1173.PubMedCrossRefGoogle Scholar

Copyright information

© Plenum Press, New York 1990

Authors and Affiliations

  • Mark Wahlqvist
    • 1
  • Sharon Marks
    • 1
  1. 1.Department of MedicineMonash University Prince Henry’s HospitalMelbourneAustralia

Personalised recommendations