Service d'Endocrinologie et Nutrition, CHU Le Bocage, B.P. 77 908, 21079 Dijon, France.
Clin Nutr. 2010 Dec;29(6):749-55. doi: 10.1016/j.clnu.2010.05.007. Epub 2010 Jul 2.
BACKGROUND & AIMS: Body weight gain is an important goal in anorexia nervosa (AN) patients, but inflation in body fluids could artificially increase body weight during refeeding.
42 malnourished adult AN patients were refed using a normal-sodium diet, then 176 other malnourished adult AN patients received a refeeding low-sodium diet (BMI of the 218 patients: 13.4 ± 1.9 kg/m(2)). Sodium balance, body composition by a 2-electrode impedance method (BIA, for assessment of total and extracellular water, fat-free mass, FFM), resting energy expenditure and energy intake were calculated.
In the patients on normal-sodium diet, body weight, and total and extracellular water gains were higher than those of the low-sodium diet patients (P<0.01). Edema occurred more often in the former group (21% vs 6%; P<0.05). In almost all patients, BMI reached a plateau around 15-16 kg/m(2), then increased again. During this plateau, an increase in intracellular water and in "active FFM" was observed with BIA, together with a similar decrease in extracellular water.
In AN patients, who are always afraid of gaining too much weight, in regard to their food intake, it will be useful to give a low-sodium diet until a 15-16 kg/m(2) BMI. This should be integrated into the cognitive behavioral therapy.
体重增加是神经性厌食症（AN）患者的重要目标，但在重新进食期间，体液增加可能会人为地增加体重。
42 名营养不良的成年 AN 患者采用正常钠饮食进行喂养，然后 176 名其他营养不良的成年 AN 患者接受低钠喂养饮食（218 名患者的 BMI：13.4±1.9kg/m2）。计算钠平衡、双电极阻抗法（BIA，用于评估总水量和细胞外液、无脂肪质量、FFM）、静息能量消耗和能量摄入。
在接受正常钠饮食的患者中，体重和总水量及细胞外液增加均高于低钠饮食患者（P<0.01）。前者组水肿发生更常见（21%比 6%；P<0.05）。几乎所有患者的 BMI 均在 15-16kg/m2 左右达到平台期，然后再次增加。在此平台期，BIA 观察到细胞内水和“活性 FFM”增加，同时细胞外液也相似减少。
在 AN 患者中，他们总是担心体重增加过多，因此在他们的饮食摄入方面，给予低钠饮食直到 BMI 达到 15-16kg/m2 将是有用的。这应纳入认知行为疗法中。
