Nutritional assessment and skeletal muscle function.

The validity of skeletal muscle function as a functional measure of nutritional state was determined by stimulating the ulnar nerve at the wrist and measuring the force of isometric contractions of the adductor pollicis muscle. Nutritional state was evaluated by measuring body composition, by multiple-isotope dilution, in 21 malnourished and 44 normally nourished patients. No significant correlation between body composition and muscle function was found. In eight normally nourished volunteers, muscle function was determined before, after 24 and 48 h of complete starvation, and 6, 24, and 48 h following resumption of normal diet. Muscle function became abnormal after 24 h of starvation and deteriorated further after 48 h. Six hours following a single normal meal, muscle function returned to normal. Experimental data indicate that the response of the adductor pollicis muscle to ulnar nerve stimulation is not an accurate measure of nutritional state.