A nurse is reinforcing dietary teaching with a client who has a burn injury and adheres to a strict vegan diet. Which of the following food choices should the nurse recommend?

Choice A reason: Young adults (20s-30s) typically have balanced protein metabolism, with synthesis matching or exceeding catabolism (0.8 grams/kg body weight daily). Unless under stress or intense training, their protein breakdown is not significantly elevated, as their bodies prioritize muscle maintenance and growth, making this an incorrect choice.

Choice B reason: In old age (>65), protein catabolism may increase due to sarcopenia, where muscle breakdown outpaces synthesis, requiring 0.8-1.0 grams/kg protein daily. However, this is less pronounced than in acute illness, where catabolic stress dramatically accelerates protein loss, making age a less primary factor.

Choice C reason: Illness, especially acute conditions like infections or trauma, significantly increases protein catabolism due to elevated metabolic stress, inflammation, and cytokine release, which break down muscle for amino acids (up to 1.5 grams/kg daily). This catabolic state prioritizes energy and immune function, making it the primary condition for increased protein breakdown.

Choice D reason: Middle age (40s-50s) individuals typically maintain stable protein metabolism (0.8 grams/kg daily) unless affected by illness or inactivity. Catabolism is not inherently elevated compared to illness, where acute stress drives significant muscle protein breakdown, making this age group an incorrect choice.

Choice A reason: Brussels sprouts cooked in butter provide minimal protein (about 3 grams per cup) and are primarily a vegetable source of fiber and vitamins. Butter adds fat but no protein, making this inadequate for post-surgery healing, which requires high-quality protein for tissue repair.

Choice B reason: Soybean-based hamburger with cheese offers complete proteins, with soy providing all essential amino acids (about 20 grams per patty) and cheese adding high-quality dairy protein (about 7 grams per ounce). This supports tissue repair and immune function critical for post-surgery recovery.

Choice C reason: Pasta with red sauce is primarily a carbohydrate source, with pasta offering about 5 grams of protein per cup. Red sauce contributes negligible protein. This combination is insufficient for meeting the elevated protein needs required for surgical wound healing and tissue regeneration.

Choice D reason: Baked potato with sour cream and broccoli provides limited protein (potato: ~4 grams, broccoli: ~3 grams per cup, sour cream: ~1 gram per tablespoon). This meal is primarily carbohydrate-based, lacking the high-quality protein needed for optimal post-surgery tissue repair and recovery.