A one-year follow-up study in anorexia nervosa. Dietary pattern and anthropometrical evolution

Objective: To find out the modifications and the interrelationships between the energy and macronutrient intakes and anthropometric measurements of a group of anorexia nervosa patients (ANP), with homogenous diagnosis, age an d treatment, during a 1 y follow-up. Design: Longitudinal study design. Subjects: Fourteen restricting-type ANP in the adolescent age (11-21 y) wer e recruited for the study and evaluated at four time intervals during 1 y o f multidisciplinary treatment: (a) on admission (AN0); (b) after 1 month (A N1); (c) after 6 months (AN6); (d) after 1 y (AN12). Measures: Energy and macronutrient composition of the diet (48 h recall) an d anthropometric measurements including skinfold thickness. Results: Mean weight and BMI were under the 3rd percentile in AN0. All anth ropometrical parameters increased significantly in AN1 compared to AN0 and did not change in AN6 and AN12. Energy and macronutrient intakes increased significantly in AN1. The dietary changes were not maintained in the subseq uent time intervals and there was an overall tendency to turn back to AN0 r esults. Energy intake adequacy to Spanish Recommended Intakes (RI) showed o nly an acceptable ratio in AN1 (94% RI); however, a preserved protein intak e was found throughout the study (mean intakes between 128.5% and 230.0% RI ). Negative correlations were found at AN12 between size of arm's subcutane ous fat stores and energy and macronutrient intakes. Conclusion: In this 1 y follow-up study the decrease in the intake of energ y and macronutrients after discharge seems to be related to anthropometric evolution, so that a return to restrictive eating behaviour had occurred in those subjects who had reached the highest values in their subcutaneous fa t stores, probably related to dissatisfaction with self-body image.