Determination of the Nutritional State

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Nutrition therapy should be based on the accurate determination of the patient's nutritional state (72, 73). The simplest parameter is weight control under standardized conditions (weighing in the morning, with an empty stomach and after having been to the bathroom). It should be taken into account that about 50% of people are overweight at the beginning of their disease. Even with these pa

Table 8.9 Diagnostic parameters of malnutrition (68, 106)

Parameter

Normal values

Body mass index (BMI) Triceps crease * Circumference of upper arm *

Creatinine height index (g creatinine x kg body weight**/height in cm)

Lymphocytes

Serum albumin

Men: 13.7-11.3 mm; women: 18.1-14.9 mm Men: 27.8-22.8 cm; women: 25.5-20.9 cm Men: 0.5-0.8; women: 0.2-0.4

> 200 mg/100 mL

* In the middle of the upper arm; ** ideal body weight.

tients, an unintended weight loss of more than 5 % of the starting weight within three months suggests an inadequate supply with nutrients. Fluid retention may obscure a loss of weight. Table 8.9 provides an overview of further easy-to-record diagnostic parameters of malnutrition.

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