Daily caloric needs

Patients who remain unconscious after a serious surgical operation are given 100 to 150 g of glucose daily through the intravenous administration of a 5% solution. This amount of glucose falls far short of the daily caloric needs of the patient. What is the benefit of the administration of glucose ... 

To estimate your basal metabolic rate, multiply your weight in pounds by 10 kcal/lb. Then, to get a rough estimate of your daily caloric needs, choose your general level of activity according to Table 16.3 and multiply your basal metabolic rate by the appropriate factor given in the table. 

Julie weighs 110 lb and is a college freshman—she plays tennis or skates several times a week and keeps in shape by running every day. Using Table 16.3, estimate her daily caloric needs. 

From what we know about Julie, her activity level is moderate. Therefore, using the factor of 1.6 from Table 16.3, her estimated daily caloric needs are... 

Jack weighs 160 lb. As a graduate student he spends most of his time reading in the library or working at the computer. Estimate his daily caloric needs. 

Our daily caloric needs are determined mainly by our weight and level of physical activity, (a) True (b) False... 

Nutrient and food coloring j- Affects daily caloric need... 

Calories (estimated daily caloric need = 1760 Calories)... 

Most CF patients have an increased caloric need due to increased energy expenditure through increased work of breathing and increased basal metabolism. Prevention of malnutrition requires early nutritional intervention. In patients with mild lung disease and well-controlled absorption, required caloric intake is approximately 100% to 120% of the recommended daily allowance (RDA) for age.15 As lung disease progresses, caloric requirements increase. 

In a differentiated organism, each tissue must be provided with fuels that it can use, in amounts sufficient to meet its own energy needs and to perform its specialized roles. Energy production must meet needs that vary widely, depending on level of exertion, composition of fuel molecules in the diet, time since last feeding, and so forth. In humans, for example, the daily caloric intake may vary by 4-fold, depending in part on the level of exertion-from 1500 to 6000 kcal/day in an average-sized human or, in the thermodynamic units used in the text, from 6000 to 25,000 kJ/day. 

ESTIMATION OF DAILY CALORIC (EHERGYI NEEDS OF ADULTS ... 

Fats and carbohydrates are the principal sources of energy in foods. Pure fat has a caloric value (heat of combustion) of 4080 kcal per pound, and pure carbohydrate (sugar) a caloric value of about 1860 kcal per pound. The caloric values of foods are obtained by use of a bomb calorimeter, just as was described above for fuels. The third main constituent of food, protein, is needed primarily for growth and for the repair of tissues. About 50 g of protein is the daily requirement for an adult of average size. Usually about twice this amount of protein is ingested. Tliis amount, 100 g, has a caloric value of only about 400 kcal, the heat of combustion of protein being about 2000 kcal per pound. Accordingly fat and carbohydrate must provide about 2600 kcal of the 3000 kcal required daily. 

The early phase of SBS is associated with large day-to-day variations in fluid and electrolyte losses. Strict output records should be assessed, as well as all intake including intravenous medications. Initially, it is recommended to start a standard PN solution that meets the patient s maintenance metabolic, fluid, and electrolyte needs, and a separate intravenous replacement solution is typically necessary to keep the patient euvolemic based on actual fluid losses. Insensible losses should be estimated between 300 and 800 mL/day above measured output, and daily urine output should be kept at least 1 L. As fluid and electrolyte losses stabilize over time it becomes possible to incorporate these replacement requirements into the PN solution. The PN solution typically is composed of standard crystalline amino acids, glucose, and intravenous lipids. A generic caloric breakdown for SBS patients based on a need of 30 to 40 kcaV kg per day may be 1.5 g/kg of protein per day, approximately 20% to 30% of calories from intravenous lipids, and the remainder of calories from carbohydrates. An example of a PN formula for the patient with SBS is given in Table 139-2. 

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