Nutritional assessment of patients with anorexia and bulimia; clinical and laboratory findings
Hooker, C.; Hall, R.C.
Psychiatric Medicine 7(3): 27-36
1989
ISSN/ISBN: 0732-0868 PMID: 2813829 Document Number: 4391
Though their use is controversial, anthropometric measurements were found to correlate well with biochemical testing. Serial measurements are recommended for use through the course of the patients stay as an inexpensive means of documenting change. Twenty-four hour urinary creatinine appears to be a sensitive measure of protein stores. However, the use of 24 hour urine testing for nitrogen balance was of little value in accurately assessing the patients' true nutritional status. Therefore, we recommend that such testing be eliminated from routine baseline studies as it incurs added expense for the patient but provides no added information for the clinician. Overall, assessment of nutritional status is a multi-faceted process with no one test or type of test providing all the information needed. In addition, while clinical evaluation is sensitive to most deficits, in at least one case, the extent of impairment was not initially apparent on history and physical. Once a comprehensive nutritional assessment has been completed. individual patient needs can be determined. Then the focus can be switched to treatment planning which places food intake in its proper perspective and establishes parameters for returning laboratory values to acceptable levels.
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