Brennan Cliona, Felemban Lara, McAdams Ellen, Walsh Kevin, Baudinet Julian
Maudsley Centre for Child and Adolescent Eating Disorders, South London and Maudsley NHS Foundation Trust, De Crespigny Park, Denmark Hill, London SE5 8AZ, UK.
Department of Human Nutrition and Dietetics, School of Health Sciences, London Metropolitan University, 166-220 Holloway Road, London N7 8DB, UK.
Nutrients. 2024 Nov 28;16(23):4117. doi: 10.3390/nu16234117.
Although dietitians possess expert knowledge on the interplay between nutrition and health, their specific role in family therapy for anorexia nervosa (FT-AN) remains a topic of debate. Some of the literature indicates insufficient evidence to affirm the impact of dietetic interventions, emphasising variability in outcomes and a need for standardised research. This study aimed to identify the clinical characteristics of adolescents requiring dietetic intervention during FT-AN and to assess differences in clinical outcomes between those receiving dietetic support and those who did not. A retrospective cohort study was conducted at the Maudsley Centre for Child and Adolescent Eating Disorders in London. Patients were selected from electronic records. Inclusion criteria were ICD-10 diagnosis of AN and completion of FT-AN treatment between January 2020 and December 2022. Collected data included weight (kg and %mBMI), eating disorder symptom severity, pre-assessment anxiety (patient and parent), and details of FT-AN sessions (i.e., frequency and amount). The sample was divided into two groups: those who received dietetic input and those who did not. Statistical analyses included Mann-Whitney U tests, χ tests, independent -tests, and a logistic regression to examine differences at baseline, 4-6 weeks post-assessment, and discharge. The study included 92 participants (dietetic group = 33 participants; non-dietetic group = 59 participants). Baseline characteristics were comparable between groups. The logistic regression showed no significant predictors for dietetic input. At 4-6 weeks, those requiring dietetic input exhibited lower %mBMI (83.3% vs. 87.3%, = 0.027) and poorer weight gain (+2.3 kg vs. +3.1 kg, = 0.04). By discharge, weight restoration was similar (92% vs. 93% mBMI, = 0.64), although the dietetic group had more therapeutic treatment sessions (24 vs. 19, = 0.04). This study found no specific predictors for prioritising dietetic input in young people during FT-AN treatment. While those receiving dietetic support struggled with weight gain early and attended more sessions, both groups achieved similar weight outcomes by the end of treatment. Future research should focus on the timing and content of dietetic interventions, as well as perspectives from patients and caregivers, to better understand their role and impact on cognitive and emotional recovery aspects.
尽管营养师拥有营养与健康相互作用方面的专业知识，但他们在神经性厌食症家庭治疗（FT-AN）中的具体作用仍是一个有争议的话题。一些文献表明，没有足够的证据来肯定饮食干预的影响，强调结果的变异性以及对标准化研究的需求。本研究旨在确定FT-AN期间需要饮食干预的青少年的临床特征，并评估接受饮食支持的青少年与未接受饮食支持的青少年在临床结果上的差异。在伦敦的莫兹利儿童与青少年饮食失调中心进行了一项回顾性队列研究。患者从电子记录中选取。纳入标准为ICD-10诊断为神经性厌食症且在2020年1月至2022年12月期间完成FT-AN治疗。收集的数据包括体重（千克和%mBMI）、饮食失调症状严重程度、评估前的焦虑（患者和家长）以及FT-AN治疗课程的详细信息（即频率和数量）。样本分为两组：接受饮食指导的和未接受饮食指导的。统计分析包括曼-惠特尼U检验、χ检验、独立t检验以及逻辑回归，以检查基线、评估后4 - 6周和出院时的差异。该研究包括92名参与者（饮食组 = 33名参与者；非饮食组 = 59名参与者）。两组之间的基线特征具有可比性。逻辑回归显示没有饮食指导的显著预测因素。在4 - 6周时，需要饮食指导的青少年的%mBMI较低（83.3%对87.3%，P = 0.027），体重增加较差（+2.3千克对+3.1千克，P = 0.04）。到出院时，体重恢复情况相似（92%对93% mBMI，P = 0.64），尽管饮食组接受的治疗课程更多（24节对19节，P = 0.04）。本研究未发现FT-AN治疗期间确定年轻人优先接受饮食指导的具体预测因素。虽然接受饮食支持的人在早期体重增加方面存在困难且参加的课程更多，但两组在治疗结束时体重结果相似。未来的研究应关注饮食干预的时间和内容，以及患者和照顾者的观点，以更好地理解它们在认知和情感恢复方面的作用和影响。
