Refeeding efficacy on body composition in hospitalized patients with anorexia nervosa.
1994
Nunez C. | Carbajal A. | Moreiras O.
The changes in body composition of 10 patients with anorexia nervosa during a hospital refeeding period were studied and related with their energy and macronutrient intake. The nutritional status was evaluated by means of dietary [energy and nutrient intake using a 3-day precise weighing method], anthropometric [weight, height and skinfolds (biceps, triceps, suprailiac, subscapular)] and biochemical [haemoglobin, haematocrit, red blood cell count, total proteins, glucose, urea, uric acid, sodium and potassium ions] parameters. The energy intake, together with the supplement (500 kcal), ranged from 2490 to 3435 kcal. The protein intake was 96 +/- 17 g. Vitamin intake was adequate, except for vitamin D (1.3 ++/- 1.4 micrograms). However, the mineral intake, especially for iron (12.3 +/- 4.2 mg) and zinc (10.6 +/- 3.5 mg), was inadequate. Upon admission, the mean body weight was very low (35.1 +/- 5.7 kg), being 65 +/- 10.6% of the ideal body weight. Although most patients had biochemical values within the normal range, the weight and anthropometric measurements revealed a status of severe malnutrition with a great depletion of body fat content, ranging from 6.5 to 22.6%. After refeeding, positive differences in body weight were observed, although a wide range was found in weight gain between 16 and 196 g/day. These measurements can therefore be used as indicators for the response to clinical therapy. The final percentage of body fat (17.5 +/- 6.1 %) did not differ statistically from the initial one. These results indicate that even in the presence of normal blood levels, marked changes in body composition and energy metabolism could be detected. Regression analysis suggests that age, illness duration, the number of times that patients have been hospitalized and protein intake are the most important factors that account for weight gain.
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