ABSTRACT
While numerous studies have highlighted the need to approach anorexia nervosa from a multidisciplinary perspective, the dietary and nutritional aspects of the disorder are rarely considered in depth. Basic guidelines to monitor food intake of patients, are available. A literature review was performed in Medline, searching for articles related to the dietary and nutritional management of anorexia nervosa and published over the last five years. Thefinal analysis focused on 102 articles. This review summarizes the different therapeutic contexts and objectives, nutritional support, the use of dietary supplements, the role of artificial nutrition, refeeding syndrome, involuntary treatment and nutritional education.
Subject(s)
Humans , Anorexia Nervosa/diet therapy , Nutritional Support/methods , Anorexia Nervosa/psychology , Dietary SupplementsABSTRACT
Se ha descrito una importante actividad física en pacientes con trastornos alimentarios y la hiperactividad llega a estar presente en más del 80 por ciento en las fases graves. El inicio de la restricción alimentaria se produce a edades más tempranas cuando existe ejercicio físico intenso, la insatisfacción corporal es mayor entre pacientes practicantes de ejercicio y la presencia de actividad intensa en la anorexia precede a la dieta restrictiva. El objetivo de nuestro estudio fue evaluar la presencia de ejercicio al inicio del trastorno, y las posibles diferencias en la modalidad, según edad, sexo y subgrupos diagnósticos. La evaluación del ejercicio de los pacientes (N = 745), se hizo a través de la entrevista Eating Disorders Examination (EDE). Se recogió la presencia o no de actividad física conducente al consumo calórico, la pérdida de peso o la modificación de la figura, tipo de actividad e intensidad. Se consideró sólo la presencia de intensidad moderada o alta, y con clara relación con los objetivos mencionados. 407 pacientes (54,63 por ciento) realizaban ejercicio:68,96 por ciento en anorexia, 68,96 por ciento en bulimia y 34,73 por ciento en los trastornos no especificados, sin diferencias significativas entre hombres y mujeres. La hiperactividad fue lo más frecuente, (47,42 por ciento), seguida de la actividad en gimnasio (25,79 por ciento). Considerando los diferentes diagnósticos observamos diferencias significativas. La correcta evaluación del ejercicio excesivo es fundamental en los trastornos alimentarios a fin de incluir dicho aspecto en los programas de tratamiento.
Intense physical activity has been reported in patients with eating disorders, and hyperactivity can be found in more than 80 percent in severe stages. The beginning of food restriction occurs at earlier ages if there is an intense physical activity; body dissatisfaction is more intense among patients who practice exercise; and the presence of intense activity in anorexia nervosa usually precedes to the restrictive diet. The aim of this study was to evaluate the presence of exercise at the beginning of the eating disorder, and to analyze possible differences in the kind of exercise, according to age, sex and diagnostic subgroups. In order to evaluate the exercise 745 patients were assessed by the Eating Disorders Examination (EDE). The presence of physical activity (driving to caloric consumption, weight loss or modification of body shape), kind of activity, and its intensity were considered. Only the presence of moderate or high intensity clearly related with the mentioned objectives was considered. 407 patients (54,63 percent) engaged in exercise: 68,96 percent with anorexia, 68,96 percent with bulimia, and 34,73 percent with other non-specified eating disorders. There were not significant differences between men and women. Hyperactivity was the most frequent (47,42 percent), followed by gym activity (25,79 percent). Taking into account the different clinic subgroups, we could observe significant differences. To assess eating disorders, a correct evaluation of the physical activity should be necessary in order to include this aspect in treatment programs.