Assessment of macronutrient and micronutrient intake in women with anorexia nervosa

Objective: The purpose of this study is to evaluate the accuracy of diet hi story compared to observed food intake in the nutritional assessment of wom en with anorexia nervosa (AN) and healthy age-matched controls. Method: One -month diet history was compared to 1-day observed food intake in 30 women with AN and 28 control subjects. Results: Reported intake by diet history w as similar to observed intake for macronutrient composition and fat intake for patients with AN. Reported energy intake was higher than observed intak e (1,602 +/- 200 kcal vs. 1,289 +/- 750 kcal, p < .05), but was in agreemen t with predicted energy expenditure by the Harris-Benedict equation (1,594 +/- 78 kcal, p = .97) in patients with AN. Micronutrient intake by diet his tory was highly correlated with observed intake in patients with AN. More t han one half of the patients with AN failed to meet the recommended dietary allowance (RDA) for vitamin D, calcium, folate, vitamin B12, zinc, magnesi um, and copper when assessed by diet history. In contrast to patients with AN, diet history did not correlate with observed intake of energy, macronut rients, or most micronutrients among the controls. Discussion: Diet history is an accurate tool to assess fat intake and macronutrient composition in patients with AN and demonstrates significant micronutrient deficiencies in tl,is population. The agreement between total energy intake and predicted energy expenditure supports the overall utility of the diet history in the nutritional assessment of patients with AN. (C) 2000 by John Wiley & Sons, Inc.