Energy Requirements and Nutritional Status 

  1. ]]Explain the difference between basal metabolic rate (BMR) and resting metabolic rate (RMR).]]    * ==BMR== - metabolic activity necessary to sustain life (i.e. respiration, body temperature, heart beat, etc.)      * Also known as %%basal energy expenditure (BEE)%%      * Measured after a 12hr fast and restful sleep        * Before any physical activity; in a comfortable setting      * Expressed as kcal/kg body weight/hr    * ==RMR==      * Measured after a 5 hr fast      * Allowed some movement before testing (i.e. showering, dressing, walking) prior to testing      * Requires a rest period of 20 mins prior to testing - results are only 10% higher than BMR
  2. ]]Calculate the energy requirements of a person given a predictive equation.]]    * Determining Energy expenditure:      * Metabolic cart - measures RMR      * Predictive equations - BMR        * Provides estimates when RMR is not possible        * %%Harris-Benedict - Total Energy Expenditure (TEE)%%        * %%Rough Estimate: 25-35 kcal/kg%%    * Harris-Benedict Equation      * BEE(female)=655.1+[9.563xwt(kg)]+[1.850xht(cm)]−[4.676xage]BEE (female) = 655.1 + [9.563 x wt (kg)] + [1.850 x ht (cm)] - [4.676 x age]      * BEE(male)=66.5+[13.75xwt(kg)]+[5.003xht(cm)]−[6.775xage]BEE (male) = 66.5 + [13.75 x wt (kg)] + [5.003 x ht (cm)] - [6.775 x age]    * Total Energy Expenditure (TEE)      * AKA Estimated Energy Requirement (EER)      * Incorporates BEE      * TEE=BEEx(ActivityFactorORStressFactor)TEE = BEE x (Activity Factor OR Stress Factor)

            * Rough Estimate      * Most frequently used in hospital setting      * Uses rough estimate of 25−35kcal/kg25-35 kcal/kg      * Stress factors will help to select the low or high end of the range

  1. ]]Identify factors that may increase or decrease BMR.]]    * Increase:      * height      * growth      * greater lean tissue      * fever      * illnesses      * environment      * hormones (e.g. thyroid)      * nicotine      * caffeine    * Decrease:      * increased age      * fasting/starvation/dieting      * malnutrition      * sleep
  2. ]]Define nutrition assessment and its 4 components.]]    * A comprehensive analysis of a person’s nutrition status that uses the following information:      * Historical (health status, medication history, socioeconomic status and diet history)      * Anthropometric Measurements (e.g. height and weight)      * Physical exams      * Lab tests (urine and blood)    * Informs us about malnutrition      * Complications of malnutrition:        * Poor wound healing, compromised immune status and function, impaired organ function, increased mortality, increased health care spending/usage    * Screening - process to identify a person who is malnourished or at risk of becoming malnourished    * Assessment - comprehensive evaluation. To make a diagnosis of malnutrition syndrome associated with: starvation, chronic disease or organ failure, acute disease or injury      * done by a dietician

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