Excessive caloric expenditure as a cause of malnutrition in patients with cancer.

The resting metabolic expenditure of 65 patients with advanced cancer was measured by indirect calorimetry. Resting metabolic expenditure was found to be abnormally high in about 60 per cent of the patients, and there was a strong correlation between resting metabolic expenditure and weight loss and between resting metabolic expenditure and variation in serum transferrin. No relation was observed between resting metabolic expenditure and serum albumin or between resting metabolic expenditure and creatinine-height index. We suggest that these high values of resting metabolic rate, despite the weight loss and starvation, could play a role in the genesis of malnutrition in patients with cancer. The importance of these findings for an adequate planning of nutritional rehabilitation of patients with cancer is emphasized.