GUIDELINES FOR DIETARY REGIMES IN PATIENT S WITH ANOREXIA-NERVOSA BASED ON THE EVALUATION OF THEIR NUTRITIONAL-STATUS

The evaluation of the nutritional status of patients with anorexia ner vosa is of great utility when establishing guidelines for specific and appropriate dietary programs to face nutritional deficiencies and thu s favoring their recovery. The nutritional status of patients was eval uated by means of antropometrical, biochemical, and dietetical paramet ers in a group of 78 anoretics who followed a psychiatric and nutritio nal therapy, 57 in an ambulatory basis and 21 as in-patients. Antropom etrical parameters (weight and body mass index) showed a severe deplet ion of the nutritional status, particularly in in-patients. Only 25% o f patients had a body mass index higher than 18 and 5% had values with in normal ranges. While biochemical indexes (hemoglobin, hematocrit, r ed blood cells, mean corpuscular volume, total proteins and vitamins: thiamine, riboflavin, B-6, ascorbic acid, alpha-tocopherol, retinol an d beta-carotene) were within normal ranges in most cases, there were v ariable percentages of patients with marginal values and clearly defic ient for group B vitamins: thiamine (79+/-11 U/l; P-25=70 U/l), ribofl avin (884+/-160 U/l; P-5=640 U/l) and B-6 (309+131 U/l; P-25=227 U/l). The study of diet showed a marked lack of energy supply (only 25% of patients had their needs satisfied (P-75=101%) and minerals (iron, mag nesium, and zinc). intake of proteins and vitamins was, in general, sa tisfactory. Critical points to be considered in refeeding are energy a nd mineral deficiencies. Considering the peculiar food habits practice s in these patients and particularly their food aversions, different p ortions are offered of different foodstuffs with a high density of cal cium, iron and zinc, which can be combined to form easily accepted die ts.