Baskaran Charumathi, Carson Traci L, Campoverde Reyes Karen J, Becker Kendra R, Slattery Meghan J, Tulsiani Shreya, Eddy Kamryn T, Anderson Ellen J, Hubbard Jane L, Misra Madhusmita, Klibanski Anne
Pediatric Endocrine Unit, Massachusetts General Hospital, Boston, Massachusetts.
Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.
Int J Eat Disord. 2017 Sep;50(9):1050-1057. doi: 10.1002/eat.22732. Epub 2017 Jun 7.
Adolescents and women with anorexia nervosa (AN) are known to severely restrict total calorie and fat intake. However, data are limited regarding specific macronutrient intake associated with weight gain in AN.
To prospectively investigate dietary macronutrient composition associated with weight gain in adolescent girls with AN.
A prospective naturalistic study of 90 girls 12-18 years old; 45 with AN and 45 healthy normal-weight-controls over a 6-12-month period. Participants completed four-day food diaries and underwent body composition assessment using dual energy X-ray absorptiometry. Weight gain was defined as a ≥10% increase in body mass index (BMI) from baseline.
Baseline clinical characteristics did not differ between girls with AN who did not gain weight (AN-0) versus those who did (AN-1) over the following 6-12 month period except for percentage of calories from proteins (p = 0.046). At 6-12 month follow-up, AN-1 consumed a lower percentage of total calories from protein (p = .001), and a higher percentage of total calories from fat (p = .02) compared to AN-0. AN-1 had a significant increase in the percentage of total calories obtained from and poly-unsaturated-fatty acids (PUFA) (p = 0.006) compared to AN-0, between baseline and follow-up. Within the AN group, BMI at follow-up was associated positively with percentage of total calories obtained from fat, MUFA, and PUFA (p < .05) at 6/12 months, and inversely with the percentage of total calories obtained from carbohydrates and proteins (p = .03).
Consuming a greater proportion of total calories from fat is associated with weight gain in adolescent girls with AN.
已知患有神经性厌食症（AN）的青少年和女性会严格限制总热量和脂肪摄入。然而，关于与AN体重增加相关的特定宏量营养素摄入的数据有限。
前瞻性调查与患有AN的青春期女孩体重增加相关的膳食宏量营养素组成。
对90名12 - 18岁女孩进行前瞻性自然主义研究；45名患有AN，45名健康正常体重对照，为期6 - 12个月。参与者完成了为期四天的食物日记，并使用双能X线吸收法进行身体成分评估。体重增加定义为体重指数（BMI）较基线增加≥10%。
在接下来的6 - 12个月期间，未增重的AN女孩（AN - 0）与增重的女孩（AN - 1）之间的基线临床特征无差异，除了蛋白质热量百分比（p = 0.046）。在6 - 12个月的随访中，与AN - 0相比，AN - 1从蛋白质中摄入的总热量百分比更低（p = 0.001），从脂肪中摄入的总热量百分比更高（p = 0.02）。与AN - 0相比，AN - 1在基线和随访之间从多不饱和脂肪酸（PUFA）中获得的总热量百分比显著增加（p = 0.006）。在AN组内，随访时的BMI在6/12个月时与从脂肪、单不饱和脂肪酸和PUFA中获得的总热量百分比呈正相关（p < 0.05），与从碳水化合物和蛋白质中获得的总热量百分比呈负相关（p = 0.03）。
从脂肪中摄入更大比例的总热量与患有AN的青春期女孩体重增加有关。
