Question

JF is a 73-year-old male patient who is 6 feet 1 inch tall and weighs 155 lb. He is ambulatory (activity factor = 1.3) and has a sever infection (stress factor = 1.6).

Calculate:

(a) TDE

(b) grams of protein (1.25 g/kg/day)

(c) grams of lipid (30% TDE)

(d) grams of carbohydrate

(e) milliliters of fluid (32 mL/kg) required for enteral nutrition

Answer 1

Answer:

Data available: Age – 73 yrs

Sex – Male

                         Height – 6 feet 1 inch = 185.42 cms

                         Weight – 155lb = 70.30 kg

                         Activity factor – 1.3

                         Stress factor – 1.6

a) Calculate TDE

TDEE stands for Total Daily Energy Expenditure.

To calculate TDEE, multiply the BMR with the activity factor.

To calculate BMR (Basal Metabolic Rate) use the Mifflin-St Jeor formula

BMR = 5 + (10 x weight in kg) + (6.25 x height in cm) – (5 x age in years)

Substituting the values we get,

BMR = 5 + (10 x 70.30) + (6.25 x 185.42) – (5 x 73)

         = 5 + 703 + 1158.87 – 365

BMR = 1501.87

To calculate TDEE, multiply the BMR with the activity factor

TDEE = 1501.87 x 1.3 = 1952.43

Therefore TDEE = 1952.43 Calories

b) grams of protein (1.25 g/kg/day)

Body weight = 70.30kg

Protein = 1.25g x 70.30kg = 87.87g

Convert the protein intake from grams to calories, to do so, multiply the protein intake in grams by 4 since 1 gm of protein provides 4 Calories.

Therefore Protein (in Calories) = 87.87g x 4 Calories per gram = 351.48 Calories

c) grams of lipid (30% TDE)

Lipid = 30% x 1501.87 Calories = 450.561 Calories

You can convert this value from Calories to grams by dividing it by 9 since1gm of lipid provides 9 Calories.

Therefore lipid intake (in grams) = 450.56 ÷ 9 = 50.06gms

d) grams of carbohydrate

Subtract the Fat and Protein intake (in Calories) from the TDEE to calculate the amount of Carbohydrate

Carbohydrate (in Calories) = TDEE – (Fat intake (in calories) + Protein Intake (in Calories))

= 1501.87 – (450.56 + 351.48)

Carbohydrate (in Calories) = 699.83 Calories

You can convert this value from Calories to grams by dividing it by 4 since 1gm of carbohydrate provides 4 Calories)

Carbohydrate (in grams) = 699.83 ÷ 4 = 174.95 gm.

e) Milliliters of fluid (32 mL/kg) required for enteral nutrition

Milliliters of fluid = 32 ml x 70.30 kg = 2249.6ml

Therefore 2249.6 ml of fluid is required for enteral nutrition.