Kanayama Shunsuke, Sakai Chieko, Aoto Haruka, Endo Yuri, Minamimae Keiko, Katayama Takeshi, Nagaishi Jun-Ichi, Hanaki Keiichi
School of Health Sciences, Tottori University, Yonago, Japan.
Division of Health Sciences, Graduate School of Medical Sciences, Tottori University, Yonago, Japan.
Pediatr Int. 2019 Jan;61(1):73-79. doi: 10.1111/ped.13730. Epub 2018 Dec 30.
The number of adolescent patients with anorexia nervosa is increasing. In addition, an increase in pre-adolescent patients with premenarchal onset has also been recognized. Detection of the disease in childhood and adolescence, however, is not always easy because the symptoms are not characteristic during this period. This study was performed to investigate detection of anorexia nervosa in children/adolescents by comparing energy and nutrient intake between patients with anorexia nervosa and healthy thin persons.
The subjects consisted of 13 girls aged 14.4 ± 3.5 years with anorexia nervosa and 320 healthy girls aged 12.4 ± 1.3 years. Dietary intake was evaluated using a validated diet history questionnaire designed for children/adolescents. Daily energy and nutrient intake were expressed as a percentage of the age- and sex-matched reference amount.
Healthy lean (body mass index [BMI], <50th percentile) girls with an above-average score for desiring thinness had higher fat and lower cereal intake, and a trend of lower carbohydrate intake. In contrast, patients with anorexia nervosa, compared with thin (BMI <5th percentile) girls, characteristically had significantly lower energy, fat, zinc, vitamin C, and confectionery intake.
Lean girls with an above-average desire for thinness appear to restrict their energy intake by reducing their intake of carbohydrates such as cereals while maintaining a relatively high fat intake. In contrast, girls with anorexia nervosa avoided fat and had a preference for vegetables. This characteristic eating pattern could be a useful clue for detection of anorexia nervosa in thin children and adolescents.
神经性厌食症的青少年患者数量正在增加。此外，青春期前发病的青春期前患者数量也有所增加。然而，在儿童和青少年时期发现这种疾病并不总是容易的，因为在此期间症状并不典型。本研究旨在通过比较神经性厌食症患者和健康瘦人之间的能量和营养摄入情况，调查儿童/青少年神经性厌食症的检测情况。
研究对象包括13名年龄为14.4±3.5岁的神经性厌食症女孩和320名年龄为12.4±1.3岁的健康女孩。使用经过验证的针对儿童/青少年的饮食史问卷评估饮食摄入量。每日能量和营养摄入量以年龄和性别匹配的参考量的百分比表示。
渴望瘦的得分高于平均水平的健康瘦女孩（体重指数[BMI]<第50百分位数）脂肪摄入量较高，谷类摄入量较低，碳水化合物摄入量有降低趋势。相比之下，神经性厌食症患者与瘦女孩（BMI<第5百分位数）相比，其能量、脂肪、锌、维生素C和糖果摄入量显著降低。
渴望瘦的得分高于平均水平的瘦女孩似乎通过减少谷类等碳水化合物的摄入量来限制能量摄入，同时保持相对较高的脂肪摄入量。相比之下，神经性厌食症女孩避免摄入脂肪，偏好蔬菜。这种独特的饮食模式可能是检测瘦儿童和青少年神经性厌食症的有用线索。
