ABSTRACT
The inflammatory response, recognized for decades as the major metabolic feature of injury and infection, is one of the main reasons why nutrition support in such patients can be a challenge. What is only recently becoming appreciated is the extent to which the inflammatory response underlies the nutritional issues of chronic diseases (1,19). An inflammatory component may be a significant cause of changes in body composition in such disparate diseases as congestive heart failure, cancer, chronic obstructive pulmonary disease, HIV, and rheumatological disorders (11,12,17,19,28). The recognition that inflammation may drive what until recently has been thought of as purely nutritional effects of disease opens a new avenue for the management of the body wasting of disease (cachexia). This chapter will address the mechanism of the inflammatory response that leads to cachexia, distinguish emaciation due to starvation from that due to inflammation, and explore potential ways of managing the problem.
