Stored Energy Increases Body Weight and Skeletal Muscle Mass in Older, Underweight Patients after Stroke.

Yoshihiro Yoshimura,Hidetaka Wakabayashi,Ai Shiraishi,Fumihiko Nagano,Takahiro Bise,Sayuri Shimazu,Ryo Momosaki

doi:10.3390/nu13093274

Yoshihiro Yoshimura, Hidetaka Wakabayashi + Show 5 more

Open Access

https://doi.org/10.3390/nu13093274

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Abstract

We conducted a retrospective observational study in 170 older, underweight patients after stroke to elucidate whether stored energy was associated with gains in body weight (BW) and skeletal muscle mass (SMM). Energy intake was recorded on admission. The energy requirement was estimated as actual BW (kg) × 30 (kcal/day), and the stored energy was defined as the energy intake minus the energy requirement. Body composition was measured by bioelectrical impedance analysis. The study participants gained an average of 1.0 ± 2.6 kg of BW over a mean hospital stay of 100 ± 42 days with a mean stored energy of 96.2 ± 91.4 kcal per day. They also gained an average of 0.2 ± 1.6 kg of SMM and 0.5 ± 2.3 kg of fat mass (FM). This means about 9600 kcal were needed to gain 1 kg of BW. In addition, a 1 kg increase in body weight resulted in a 23.7% increase in SMM and a 45.8% increase in FM. Multivariate regression analyses showed that the stored energy was significantly associated with gains in BW and SMM. Aggressive nutrition therapy is important for improving nutritional status and function in patients with malnutrition and sarcopenia.

Highlights

Malnutrition is commonly observed in the geriatric population and is associated with adverse outcomes in geriatric rehabilitation patients
The sample size for statistical power was calculated by using data from our previous study [34], and the results showed that the body weight (BW) of patients at hospital admission was normally distributed with a standard deviation (SD) of 8.0
We determined whether stored energy intake was associated with gains in BW and skeletal muscle mass (SMM) during hospitalization in older, underweight, post-stroke rehabilitation patients, and highlight two important findings: (1) Stored energy intake was associated with gain in BW and SMM, and (2) it took about 9600 kcal to gain 1 kg of body weight in these patients

Summary

Introduction

Malnutrition is commonly observed in the geriatric population and is associated with adverse outcomes in geriatric rehabilitation patients. Malnutrition, weight loss, body mass index (BMI) lower than 20 kg/m2 , sarcopenia, and reduced nutritional intake are established independent factors that negatively influence functional recovery in older inpatients [5,6,7]. The goal of geriatric rehabilitation is to promote functional recovery and thereby allow hospitalized patients to return to their homes. It is important to improve the nutritional status and sarcopenia in older rehabilitation patients to maximize favorable outcomes. Aggressive nutrition therapy improves the outcomes of older hospitalized patients [8,9,10]

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Conclusion