REFEEDING EFFICACY ON BODY-COMPOSITION IN HOSPITALIZED-PATIENTS WITH ANOREXIA-NERVOSA

The changes in body composition of 10 patients with anorexia nervosa d uring 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, hae matocrit, red blood cell count, total proteins, glucose, urea, uric ac id, sodium and potassium ions] parameters. The energy intake, together with the supplement (500 kcal), ranged from 2490 to 3435 kcal. The pr otein intake was 96+/-17 g. Vitamin intake was adequate, except for vi tamin D (1.3+/-1.4 mu g). However, the mineral intake, especially for iron (12.3+/-4.2 mg) and zinc (10.6+/-3.5 mg), was inadequate. Upon ad mission, 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 biochemic al values within the normal range, the weight and anthropometric measu rements revealed a status of severe malnutrition with a great depletio n of body fat content, ranging from 6.5 to 22.6%. After refeeding, pos itive 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 ther apy. The final percentage of body fat (17.5+/-6.1%) did not differ sta tistically from the initial one. These results indicate that even in t ile presence of normal blood levels, marked changes in body compositio n and energy metabolism could be detected. Regression analysis suggest s that age, illness duration, the number of times that patients have b een hospitalized and protein intake are the most important factors tha t account for weight gain.