Basal Metabolism during Recovery from Severe Undernutrition

The studies reported below were made on two groups of individuals who had suffered severe restriction of food intake over periods of not less than 6 months and extending in some over I year.Group I comprised severely emaciated adults of both sexes, a high proportion of them elderly, admitted to hospital in The Hague, Holland, during the months of May and June 1945.Weight losses in this group ranged from 12 to 31-5 kg.Detailed diet histories were not obtained, but it is probable that, during the first 3 months of 'famine' conditions, the daily calorie intake did not exceed 1600 Cd., and during the subsequent and last 3 months it' may not have exceeded 1000.Of the seventeen patients studied in this group six have been discarded, either because no reliable estimate of their normal body-weights was available, or because it was not possible to obtain satisfactory and reproducible oxygen-consumption records.Group I1 contained, with one exception, young adult males who had been detained in a German civil prison for over 12 months.During this period the daily ration provided an average intake of not more than 1750 Cal./day.When they came under observation they were from 11.7 to 24'1 kg.under their normal weights.With the exception of some intermittent diarrhoea in Group I, all the subjects were found to be free from organic disease. EXPERIMENTAL MethodsDeterminations of oxygen consumption were made 13-15 hr. after the last meal, which contained less than one-fifth of the total daily intake.Subjects were under 'basal' conditions.Determinations in Group I were made with a Knipping apparatus and in Group I1 with the standard Benedict spirometer.Two or more om in.recordings of oxygen consumption were made.Values were accepted when two successive determinations agreed within & 5 %.The lower value was taken as the basal value.The heat productions were calculated from the oxygen-consumption values by assuming an R.Q. of 0.82 which gives a calorific value of 4.825 Cal./l. of oxygen.As Beattie & Herbert (1947) have pointed out that heat production/sq.m.