Guidelines for the dietetic treatment of patients with anorexia nervosa based on an assessment of their nutritional status
Núñez, C.; Moreiras, O.; Carbajal, A.
Revista Clinica Espanola 195(4): 226-232
1995
ISSN/ISBN: 0014-2565 PMID: 7784656 Document Number: 5369
The evaluation of the nutritional status of patients with anorexia nervosa is of great utility when establishing guidelines for specific and appropriate dietary programs to face nutritional deficiencies and thus favoring their recovery. The nutritional status of patients was evaluated by means of anthropometric, biochemical, and dietetic parameters in a group of 78 anorexics who followed a psychiatric and nutritional therapy, 57 in an ambulatory basis and 21 as in-patients. Anthropometric parameters (weight and body mass index) showed a severe depletion of the nutritional status, particularly in in-patients. Only 25% of patients had a body mass index higher than 18 and 5% had values within normal ranges. While biochemical indexes (hemoglobin, hematocrit, red blood cells, mean corpuscular volume, total proteins and vitamins: thiamine, riboflavin, B6, ascorbic acid, alpha-tocopherol, retinol and beta-carotene) were within normal ranges in most cases, there were variable percentages of patients with marginal values and clearly deficient for group B vitamins: thiamine (79 +/- 11 U/l; P25 = 70 U/l), riboflavin (884 +/- 160 U/l; P5 = 640 U/l) and B6 (309 +/- 131 U/l; P25 = 227 U/l). The study of the diet showed a marked lack of energy supply (only 25% of patients had their needs satisfied (P75 = 101%) and minerals (iron, magnesium, and zinc). Intake of proteins and vitamins was, in general, satisfactory. Critical points to be considered in refeeding are energy and mineral deficiencies.
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