Nutrition and Intake among Women with Anorexia Nervosa: Counseling should address total intake.

Reprinted from Eating Disorders Review
July/August Volume 26, Number 4
©2015 IAEDP

Prolonged dietary restriction is at the heart of AN, and nutritional counseling and treatment are essential. However, getting an accurate picture of the nutrient intake of an AN patient is far from easy and is often prone to error, according to Susan K. Raatz, of the USDA Human Research Center, Grand Forks, ND, and colleagues at the University of Minnesota, the University of North Dakota, the Neuropsychiatric Research Institute, Fargo, ND, and the University of California-San Francisco. Dr. Raatz notes that attention has been focused on reduced intake of energy and macronutrients, while few studies have described total micronutrient intake in patients with AN.

Dr. Raatz and colleagues assessed total reported energy and nutrient intake in a sample of women 19 to 30 years of age, with both restricting and binge-purge type AN (Nutrients. 2015. 7:3652). They then compared their results with the reported intake of a representative group of women who participated in the “What We Eat in America” portion of the National Health and Nutrition Examination Survey (NHANES) 2011-2012. Participants with either binge-purge or restricting-type AN were assessed with structured interviews, and their BMIs were determined.

To obtain detailed 24-hour dietary recall information, all participants were surveyed in telephone interviews on three separate occasions by trained interviewers using a structured nutritional interview, the NDS-R. To provide a comparison, the nutrient intake of non-pregnant women aged 19 to 30 years was derived from the 2011-2012 WWEIA/NHANES survey.

The mean age of participants was 22.5 years, and the average BMI was 17.2 kg/m2. Intake of most nutrients was insufficient but some participants reported high intake levels when compared to Dietary Reference Intake levels. Some participants may have inaccurately recorded their intake because reported intakes for some exceeded estimated energy needs, even though these participants maintained very low body weights. 

The authors suggest that counseling for AN patients be centered upon total food intake, to improve energy intake and to lessen individual gaps in nutrition.