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Human Nutrition and Metabolism

Improvement of Nutritional Status as Assessed by Multifrequency BIA During 15 Weeks of Refeeding in Adolescent Girls with Anorexia Nervosa¹

Claudia Mika^*,,2, Beate Herpertz-Dahlmann^*, Martina Heer^** and Kristian Holtkamp^*

^* Department of Child and Adolescent Psychiatry and Psychotherapy, and Institute of Aerospace Medicine, Technical University of Aachen, Aachen, Germany and ^** DLR-Institute of Aerospace Medicine, Space Physiology, Cologne, Germany

²To whom correspondence should be addressed. E-mail: cmika{at}ukaachen.de.

In patients with anorexia nervosa (AN), an assessment of changes in body composition and nutritional status is crucial for adequate nutritional management during refeeding therapies. Phase-sensitive multifrequency bioelectrical impedance analysis (BIA) is an inexpensive and noninvasive technique with which to determine nutritional status and body composition. We investigated 21 female adolescents with AN (initial BMI 15.5 ± 1.1 kg/m²) 4 times between wk 3 and 15 of inpatient refeeding and 19 normal-weight, age-matched female controls. From wk 3 to 15, BMI, fat mass, body cell mass (BCM), total body water (TBW), intracellular water (ICW) but not extracellular mass (ECM), and extracellular water (ECW) increased significantly. Reactance (Xc), phase angle (PhA), and the ECM/BCM index as parameters of nutritional status improved significantly in patients and no longer differed from controls in wk 15, although the BMI of patients was significantly lower than those of controls. Changes in the ECM/BCM index were due to accretion of BCM, which was associated with an increase of ICW. Multifrequency phase-sensitive BIA seems to be a promising tool for the assessment of changes in nutritional status and body composition in patients with AN. An individually determined and controlled hyperenergetic diet as part of a multidimensional, interdisciplinary treatment program for eating disorders seems to quickly improve the nutritional status of AN patients.

KEY WORDS: • anorexia nervosa • eating disorders • body composition • refeeding • nutritional status