Excessive physical activity in young girls with restrictive-type anorexia nervosa: its role on cardiac structure and performance.

PURPOSE: The aim of this study was to investigate the influence of hyperactivity on left ventricular mass (LVM) in Anorexia Nervosa restricting-type (AN-R) and the correlation between LVM and auxologic parameters/circulating hormones. METHODS: Echocardiography was performed in 44 AN-R girls, subgrouped in 24 hyperactive (ANH+) and 20 non-hyperactive (ANH-), and in 20 controls (HC). LVM indexed to Body Surface Area (LVMi) and LVM indexed to height (LVMh) were calculated. RESULTS: LVMi and LVMh were significantly lower in the AN-R subjects compared to HC. Moreover, both LVMi and LVMh were higher in the ANH+ than in the ANH-. In the HC, LVMi was higher when compared to the ANH- subjects than to the ANH+. Stepwise analysis revealed that in the ANH+ group, fT4 was the only independent predictor of LVMh, while in the ANH- group, height was the only independent predictors of LVMi. CONCLUSIONS: Despite its negative influence on disease severity and outcome, hyperactivity from the standpoint of cardiac function makes the LVM of AN-R young girls more similar to HC. LEVEL OF EVIDENCE: Level III, case-control study.

Parent-child Interaction Treatment for Preschoolers with Feeding Disorders.

BACKGROUND: This study examined the immediate outcome of Feeding Disorders (FD) in preschoolers referred to the family treatment program Cerco Asilo. METHOD: 21 children (mean age [SD=1]: 39 months [1]; range 9-65 months) with a diagnosis of FD were included in the treatment for 24 weeks. Specifically, seven subjects were diagnosed with Infantile Anorexia (IA), nine subjects with Sensory Food Aversion (SFA), and five subjects with Feeding Disorder of Caregiver-Infant Reciprocity (FDCIR). RESULTS: The great majority of patients with SFA and with FDCIR resolved the FD, whereas children with IA did not respond well to the treatment. LIMITATIONS: The study's main limitations are the relatively small sample size, and the lack of a control group. CONCLUSIONS: Findings suggest that changes in the parentchild relationship could generally promote FD resolution, other than IA. These data may have implications for clinical practice suggesting the need to develop ad hoc intervention protocols tailored to children with IA and their families.

The role of wearable sensors and wireless technologies for the assessment of heart rate variability in anorexia nervosa.

PURPOSE: Bradycardia and abnormal cardiac autonomic function are related to increased mortality in anorexia nervosa (AN). The aim of this study was to assess heart rate (HR) and HR variability of young adolescents with AN as compared to controls by means of wearable sensors and wireless technologies. METHOD: The ECG signal was recorded in 27 AN girls and 15 healthy girls at rest using a wearable chest strap. The tachogram, the mean intervals between R peaks (meanRR), the root mean square of successive differences (RMSSD), the power of low-frequency (LF) and high-frequency (HF) bands and the LF/HF ratio were assessed. RESULTS: All AN girls showed a reduced HR and an increased meanRR and RMSSD. An HF increase, a LF decrease, and a LF/HF reduction indicated a prevalence of the parasympathetic on sympathetic activity. CONCLUSIONS: The instruments used in this pilot study were feasible, unobtrusive and extremely suitable in AN subjects who are burdened by high incidence of cardiovascular mortality; their application could open to new approaches of vital signs monitoring in hospitals as well as in home settings.