The rate of adolescents presenting with anorexia nervosa (AN) is increasing. Medically unstable adolescents are admitted to the hospital for nutrition restoration. A lack of global consensus on appropriate refeeding practices of malnourished patients has resulted in inconsistent refeeding practices. Refeeding hypophosphatemia (RH) is the most common complication associated with refeeding the malnourished patient. This review sought to identify the range of refeeding rates adopted globally and the implication that total energy intake and malnutrition may have on RH while refeeding adolescents with anorexia nervosa. Studies were identified by a systematic electronic search of medical databases from 1980 to September 2012. Seventeen publications were identified, including 6 chart reviews, 1 observational study, and 10 case reports, with a total of 1039 subjects. The average refeeding energy intake was 1186 kcal/d, ranging from 125–1900 kcal/d, with a mean percentage median body mass index (% mBMI) of 78%. The average incidence rate of RH was 14%. A significant correlation between malnutrition (% mBMI) and post-refeeding phosphate was identified (R 2 = 0.6, P = .01). This review highlights the disparity in refeeding rates adopted internationally in treating malnourished adolescents with anorexia nervosa. Based on this review, the severity of malnutrition seems to be a marker for the development of RH more so than total energy intake.

Refeeding adolescents with AN with a higher energy intake was associated with greater weight gain but without an increase in complications associated with refeeding when compared with a more cautious refeeding protocol-thus challenging current refeeding recommendations.

Comprises of a literature review, highlighting this case as the youngest reported case of refeeding syndrome in anorexia nervosa. Discussion focuses on the possible deleterious affects that carbohydrates may have in exacerbating the refeeding syndrome.

Background Enteral tube feeding intolerances, such as diarrhea, are commonly reported in children. In the pediatric population, interest is growing in the use of blended diets for the management of enteral feeding intolerances. Fiber within a blended diet stimulates the growth of beneficial gut bacteria, which in turn produce short‐chain fatty acids, which are utilized as energy substrates for enterocytes. Enteral formula manufacturers have responded to this trend towards “real‐food” blended diets and developed an enteral formula with food‐derived ingredients. The aim of this study was to collect data relating to feed tolerance in children who had switched to an “enteral formula with food‐derived ingredients.” Methods A national multicenter retrospective study. Results Dietitians collected data from 43 medically unwell children between March 2021 and July 2021. Significant improvements were reported in children who had switched to an “enteral formula with food‐derived ingredients” in retching 17 of 18 children (95%), flatulence 6 of 8 children (85%), loose stools 10 of 11 children (90%), and constipation 10 of 11 children (90%). These improvements in gastrointestinal symptoms were reflected in weight change during the one month period measurements were collected (baseline, 19.5 kg [SD, 9]; 1 month, 20.1 kg [SD, 9]; P = 0.002). Conclusion We have observed beneficial outcomes in medically complex children who have switched to an “enteral formula with food‐derived ingredients.” Our data should motivate healthcare professionals to implement more research to better evaluate the clinical impact and mechanisms of action of blended diets and enteral formulas with food‐derived ingredients.

Higher levels of research activity within healthcare contexts are known to result in improvements to staff and patient satisfaction as well as treatment outcomes. In the United Kingdom (UK), clinical academic careers for Allied Health Professionals (AHPs) are a key priority development area. This article presents the results of a study that aimed to scope the research capacity of four AHP professions in a tertiary children’s hospital using the Research Capacity and Culture Tool. This tool captures individuals’ views of success or skill required for a number of research-related items within the three domains of individual, team and organisation. Response rate ranged between 45-71% across the four groups. Reported barriers to carrying out research included a lack of time, clinical work taking priority, and lack of suitable backfill (i.e., employing a therapist to cover the clinical post for the AHP to complete research activity). Motivators, on the other hand, included skill development, career advancement, and increased job satisfaction. As a first step to strengthen research skills, a systematic process was used to devise a suite of supportive strategies targeting the individuals’ perceived gaps in their research abilities across four pillars: (i) awareness, (ii) accessibility, (iii) opportunity and capacity, and (iv) knowledge and skills. This process drew on previously published accounts of successful research capacity and culture development, as well as the unique needs of staff at this tertiary children’s hospital. The outcome of this process was a structured framework to support research capacity, culture and engagement. The specific details of this framework are reported in this article together with further recommendations to promote research capacity, culture and engagement amongst AHPs.