Nutrition lean body mass

O Parenteral nutrition (PN), also called total parenteral nutrition (TPN), is the intravenous administration of fluids, macronutrients, electrolytes, vitamins, and trace elements for the purpose of weight maintenance or gain, to preserve or replete lean body mass and visceral proteins, and to support anabolism and nitrogen balance when the oral/enteral route is not feasible or adequate. 

Trivalent chromium compounds (chromium chloride, chromium nicotinate, and chromium picohnate) are used by patients to enhance weight loss, to increase lean body mass, or to improve glycemic control. Drug histories should include attention to the use of over-the-counter nutritional supplements often regarded as harmless by the pubhc and lay media. The recommended daily allowance of chromium picolinate is 50-200 micrograms, but information about its toxicity is limited. 

The nutrition-focused physical examination consists of an assessment of lean body mass (LBM) and the physical findings of vitamin deficiency, trace element deficiency, and essential fatty acid deficiency. The assessment should characterize the presence and degree of muscle wasting, edema, loss of subcutaneous fat, dermatitis, glossitis, cheilosis, and/or jaundice (Table 135-2). 

Leptin, which is produced and secreted by fat cells, appears to function as a lipostat mechanism via regulation of satiety (see Chap. 140). Leptin concentrations often are elevated in ESKD patients, particularly those undergoing CAPD. Hyperleptinemia in ESKD patients may correlate positively with body fat mass and negatively with lean body mass. Further study is required to define the relationship between leptin concentrations and nutrition status in patients with CKD. ... 

The parameters of interest in body composition analysis (bioelectric impedance analysis, BIA) are total body water (TBW), extracellular/intracellular fluid balance, fat-free mass (lean body mass or muscle mass), and fat mass. Application areas are as diversified as sports medicine, nutritional assessment, and fluid balance in renal dialysis and transplantation. 

Steck, S.E., Chalecki, A.M., Miller, P., Conway, J., Austin, G.L., Hardin, J.W., Albright, C.D., and Thuillier, P. 2007. Conjugated linoleic acid supplementation for twelve weeks increases lean body mass in obese humans. Journal of Nutrition 137, 1188-1193. 

Body composition is a more sensitive indicator of infant nutritional status than measures of size. Depending on the method used, measurements can provide the mass of lean tissue, fat tissue, total body water, and bone. Methods vary greatly in terms of invasiveness, feasibility, cost, technology, need for trained personnel, accuracy, reliability, and precision. The most feasible methods for assessing infant body composition include anthropometry (e.g., skinfold measurements), dual X-ray absorptiometry (DEXA), and isotope dilution. A recent review concluded that for intergroup comparisons, skinfold thicknesses were useful, but for individual infant assessments, DEXA was recommended (Koo, 2000). In the absence of reference data based on a large sample of infants, the interpretation of body... 

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