Assessment of macronutrient and micronutrient intake in women with anorexia nervosa

Hadigan, Colleen; Anderson, Ellen J.; Miller, Karen K.; Hubbard, Jane; Herzog, David B.; Klibanski, Anne; Grinspoon, Steven

doi:10.1002/1098-108x(200011)28:3<284::aid-eat5>3.0.co;2-g

Cited by 171 publications

(128 citation statements)

References 24 publications

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“…Only the percentage of calories consumed as protein was significantly correlated with GGT. Interestingly, the reported dietary intake of the subjects in this sample revealed less severe nutritional deficiencies than those noted in previous studies of adolescents and adults with AN [12][13]. Of the micronutrients analyzed, only vitamin E intake for both age groups was significantly less than the age-specific DRI.…”

Section: Discussioncontrasting

confidence: 58%

“…We were not able to compare formally the frequency of elevated ALT in the subgroups that did and did not use alcohol or antidepressants given the small cell sizes in these subgroups. Finally, nutritional data were obtained by self-report, and patients with AN have a tendency to overreport their nutritional intake [12]. It is possible that this phenomenon led to an over-estimation of the nutrient intake of our sample.…”

mentioning

confidence: 99%

“…Similarly, specific alterations in the dietary composition of adolescents with AN may lead to NAFLD. Higher carbohydrate and lower fat intake, commonly consumed by adolescents with AN [12][13], are associated with an increased risk for hepatic inflammation in obesity [14], but have not been studied in AN.…”

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confidence: 99%

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Prevalence and Predictors of Abnormal Liver Enzymes in Young Women with Anorexia Nervosa

Fong

DiVasta²,

DiFabio³

et al. 2008

The Journal of Pediatrics

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Objective-To determine the prevalence and predictors of abnormal liver enzyme levels in ambulatory young women with anorexia nervosa (AN).Study design-In this cross-sectional study of 53 females with AN, serum concentrations of liver enzymes and hormones were measured. Anthropometric, dietary, and body composition information was collected. Correlational analyses were performed between liver enzyme concentrations and these variables.Results-Elevated alanine aminotransferase (ALT) and gamma-glutamyltranspeptidase (GGT) levels were found in 14 subjects (26%) and 5 subjects (9%), respectively. ALT and GGT were inversely correlated with body mass index (r = −0.27 to −0.30, p ≤ 0.049) and percentage body fat (r = −0.36 to −0.47, p ≤ 0.007), but showed no relationship with lean body mass. Subjects with percentage body fat < 18% had higher ALT levels than those above this threshold (median 26.5 vs. 18.0 U/L, p = 0.01). Liver enzyme concentrations did not correlate with dietary variables, except for GGT and percentage of calories from protein (r = 0.28, p = 0.04).Conclusions-Serum ALT and GGT concentrations are inversely related to adiposity in young women with AN. Future studies are needed to determine if these liver enzyme elevation signify unrecognized, clinically relevant liver disease.Keywords eating disorders; adolescents; liver; malnutrition; alanine aminotransferase; gammaglutamyltranspeptidase Corresponding author: Catherine M. Gordon, MD, MSc, Divisions of Adolescent Medicine and Endocrinology, Children's Hospital Boston, 300 Longwood Ave, Boston, MA 02215, Tel: 617-355-8492, Fax: 617-730-0195, Email: catherine.gordon@childrens.harvard.edu For reprints, please contact the corresponding author, Catherine M. Gordon, MD, MSc. Edited by WFB Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. In this study, we sought to determine the prevalence and predictors of abnormal liver enzyme levels in ambulatory young women with AN. We hypothesized that individuals with more severe disease, as reflected by lower body mass index (BMI) and body fat, would be more likely to exhibit elevated ALT and gamma-glutamyltranspeptidase (GGT) levels. We also hypothesized that insulin resistance would be a predictor of abnormal ALT and GGT concentrations. We predicted that there would be a significant association between macronutrient caloric distribution and liver enzyme concentrations. Methods DesignThis study was a cross-sectional evaluation of data obtained from the baseline visit of a clinical bone density trial. SubjectsAdolescents and young women with AN were recruited from the Chil...

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Section: Discussioncontrasting

confidence: 58%

mentioning

confidence: 99%

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Prevalence and Predictors of Abnormal Liver Enzymes in Young Women with Anorexia Nervosa

Fong

DiVasta²,

DiFabio³

et al. 2008

The Journal of Pediatrics

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“…Na verdade, 58% das mulheres amenorréicas ou oligomenorréicas que vão a clínicas de infertilidade apresentam transtorno alimentar. As mulheres com amenorréia hipotalâmica funcional apresentam altos índices de características psicológicas associadas aos transtornos alimentares, tais como: sensação de inadequação, insegurança, perda de controle em relação à vida e confusão em identificar e responder a diferentes estados emocionais e a sensações do corpo relacionadas à alimentação (Hadigan et al, 2000). Mesmo que o peso corporal tenha se restabelecido parcial ou inteiramente, a presença de transtornos alimentares subclínicos pode contribuir para a persistência da amenorréia.…”

Section: Transtornos Alimentaresunclassified

Epidemiologia dos transtornos psiquiátricos na mulher

Andrade¹,

Viana²,

Silveira³

2006

Rev. psiquiatr. clín.

155

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ResumoA conscientização de que os transtornos mentais representam um sério problema de saúde pública é relativamente recente, ocorrendo a partir da publicação do estudo The Global Burden of Disease pela Organização Mundial da Saúde. Diferenças de gênero na incidência, prevalência e curso de transtornos mentais, assim como na apresentação clínica e na resposta terapêutica, têm sido extensivamente demonstradas por estudos epidemiológicos.Palavras-chave: Saúde mental da mulher, epidemiologia psiquiátrica, prevalência de transtornos mentais, diferenças de gênero, ciclo reprodutivo. AbstractThe awareness that mental disorders present a serious public health problem is relatively new, occurring after the publication of The Global Burden of Disease by the World Health Organization. Gender differences in the incidence, prevalence, and course of mental disorders, as well as in their clinical features and response to treatment; have been extensively demonstrated in epidemiological studies.

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“…In this regard, individuals with symptoms of binge eating disorders have been observed to consume greater amounts of carbohydrates and fats, even to the point of consuming an extra quantity of 1673·6 kJ/d (400 kcal/d) (48) . With respect to energy adequacy, some studies in clinical ED (46) and community populations with symptoms Values within a row with unlike superscript letters were significantly different (P < 0·05). *Energy: inadequate intake was when intake was lower than two-thirds of the Recommended Dietary Intake created for the Spanish population.…”

Section: Discussionmentioning

confidence: 99%

Dietary intake and nutritional risk in Mediterranean adolescents in relation to the severity of the eating disorder

Aparicio

Canals

Pérez

et al. 2014

Public Health Nutr.

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Objective: To assess the relationship between the degree of severity of eating disorders (ED) and energy and nutrient intakes and nutritional risk in a mixed-sex adolescent population without clinical symptoms. Design: Cross-sectional study. Setting: Data were collected in schools. Subjects: Adolescents (n 495) aged 14·2 (SD 1·0) years. The Eating Attitudes Test was used to detect adolescents at risk of ED (rED) and a structured interview based on the criteria of the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, was used to diagnose eating disorder not otherwise specified (EDNOS). Dietary intake was quantified using the 24 h recall method over three days and the probability of inadequate intake was determined. Results: Females presented lower intakes of energy, macronutrients and micronutrients (Ca, Fe, Mg, K, P, Na, thiamin, vitamins E, C, B 6 , B 12 , pantothenic acid, folic acid) because the severity of their ED was greater. These lower dietary intakes led to nutritional risk (for Ca, Fe, Mg, P, vitamins A, D, B 6 ) in more than 80 % and 60 % of females with EDNOS and rED, respectively. The multiple linear regression models showed that the rED and EDNOS groups presented a lower energy intake of 1597·4 kJ/d (381·8 kcal/d) and 3153·0 kJ/d (753·6 kcal/d), respectively. In contrast, little difference was observed in the nutritional intakes of males. Conclusions: The female adolescents showed lower energy and nutrient intakes as the ED became more severe, which led to energy, vitamin and mineral deficiencies in a high percentage of females with ED. These nutritional risks could hinder adequate physical and psychological development and lead to chronic ED. Keywords Eating disordersIntake Nutrition Adolescence Eating disorder not otherwise specifiedIn recent decades, eating disorders (ED) have become a significant public health problem principally impacting on adolescents, especially females, although a certain percentage of males have also been affected (1)(2)(3) . In parallel with this, there has been an exponential increase in overweight which may have contributed to the increase in ED (4) . Scientific research has indicated that cases of anorexia and bulimia represent only a small proportion of ED cases (0·3 % and 0·5 %, respectively) (5,6) , whereas cases of eating disorder not otherwise specified (EDNOS) are much more frequent (3-10 %) (2,5) , as are individuals at risk of ED (rED), who account for 13·5 %(1) in adolescents with no clinical symptoms.Among the risk factors identified in the multifactorial aetiology of ED are restrictive diets, high body weight, body dissatisfaction, and sociocultural and psychological factors (4,7,8) . However, although dietary restriction of nutritional intake is one of the principal predictors of ED, it has rarely been the object of real and quantitative study in schoolchildren at rED. As far we can ascertain, there are only four studies that have quantitatively evaluated dietary intake in adolescent females at rED, and none that have looked at bo...

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Assessment of macronutrient and micronutrient intake in women with anorexia nervosa

Cited by 171 publications

References 24 publications

Prevalence and Predictors of Abnormal Liver Enzymes in Young Women with Anorexia Nervosa

Prevalence and Predictors of Abnormal Liver Enzymes in Young Women with Anorexia Nervosa

Epidemiologia dos transtornos psiquiátricos na mulher

Dietary intake and nutritional risk in Mediterranean adolescents in relation to the severity of the eating disorder

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