In burn patients, caloric support above energy expenditure has what effect on lean body mass preservation?

• A. Increases lean body mass preservation
• B. Decreases lean body mass preservation
• C. Has no effect on lean body mass preservation
• D. Improves lean body mass preservation with high protein

Answer: (C)

Lean body mass preservation in burn patients is driven mainly by providing enough protein to maintain a positive nitrogen balance. The body’s hypermetabolic, catabolic response uses amino acids from lean tissue to support repair and immune function. Simply giving calories beyond what is needed for energy does not supply the necessary amino acids for muscle protein synthesis, so lean mass is not reliably preserved by caloric excess alone. In practice, adequate protein intake is the key factor in protecting lean tissue, with energy provision managed to avoid negative energy balance.