Total body potassium, intracellular potassium and body composition in patients with anorexia nervosa during refeeding

Pirke, Karl M.; Pahl, Jörg J.; Schweiger, Ulrich; Münzing, Wolfgang; Lang, Peter; Büll, Ü.

doi:10.1002/1098-108x(198602)5:2<347::aid-eat2260050213>3.0.co;2-l

Cited by 12 publications

(7 citation statements)

References 10 publications

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“…Similarly, during the treatment of malnourished children weight gain was more rapid in the early recovery, with a tendency to lay down more fat in following phases (Standard et al, 1959). As far as refed anorectic patients are concerned, cross-sectional and longitudinal studies have given fairly contradictory results, indicating that FM represents, on average, 21 -77% of the weight regained (Russel & Mezey, 1962;Forbes et al, 1984;Pirke et al, 1986;Mitchell & Truswell, 1987;Vaisman et al, 1988;Krahn et al, 1993;Waller et al, 1996;Orphanidou et al, 1997;Polito et al, 1998;Probst et al, 2001). This discrepancy could be explained by differences in baseline patients' general characteristics, measurement meth- Body composition changes in anorexia L Scalfi et al ods, refeeding programmes, etc.…”

Section: Discussionmentioning

confidence: 99%

“…With respect to refed patients, changes in FFM and FM (Orphanidou et al, 1997;Probst et al, 2001), body potassium (Pirke et al, 1986), total body water and its intracellular=extracellular distribution (Vaisman et al, 1988), as well as in bioimpedance analysis (Polito et al, 1998;Scalfi et al, 1999), have been observed after weight recovery. The studies available in the literature also indicate that FM represents 21 -77% of the weight gained (Russell & Mezey, 1962;Forbes et al, 1984;Pirke et al, 1986;Mitchell & Truswell, 1987;Vaisman et al, 1988;Krahn et al, 1993;Waller et al, 1996;Orphanidou et al, 1997;Polito et al, 1998;Probst et al, 2001;Grinspoon et al, 2001), while the number of calories needed to put down body mass seems to increase during refeeding (Salisbury et al, 1995). Nevertheless, despite the widespread use of anthropometric techniques for the assessment of nutritional status, only a few studies have so far examined the changes in skinfolds and circumferences which occur during weight recovery (Forbes et al, 1984;Nuñez et al, 1994;Orphanidou et al, 1997;Polito et al, 1998;Probst et al, 2001).…”

Section: Introductionmentioning

confidence: 99%

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Body composition changes in patients with anorexia nervosa after complete weight recovery

Scalfi¹,

Polito

Bianchi

et al. 2002

Eur J Clin Nutr

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Objective: To assess body composition changes occurring in female anorectic patients after complete weight recovery. Design: Longitudinal study. Subjects: Ten female patients with anorexia nervosa (age at baseline: 19.7 AE 5.8 y) were studied both when undernourished (body mass index, BMI 14.8 AE Interventions: Fat mass and fat-free mass were determined by dual-energy X-ray absorptiometry. Skinfold thicknesses and circumferences were also measured. Arm muscle area and arm fat area were calculated by standard formulas. Results: The undernourished patients had lower fat-free mass, fat mass, skinfold thicknesses and circumferences. After refeeding, fat mass represented 25 -71% (mean 56%) of the mass regained, this percentage being directly related to the extent of weight gain. The increases in skinfolds and circumferences depended upon the site considered and were correlated to a various extent with those in weight or BMI. Skinfolds at biceps and abdominal sites and the waist-to-hip ratio remained significantly higher, whereas arm muscle circumference was significantly lower, in the refed group than in the control one. Conclusion: The percentage of fat in the weight regained by refed female anorectic patients was directly related to the extent of body mass increase. Refed anorectic patients appear to preferentially regain fat in the abdominal and triceps regions. Abnormalities in skinfolds (at biceps and abdominal sites), arm muscle area and waist-to-hip ratio still persist in refed anorectic patients in comparison to control healthy controls.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Body composition changes in patients with anorexia nervosa after complete weight recovery

Scalfi¹,

Polito

Bianchi

et al. 2002

Eur J Clin Nutr

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“…The published studies on body composition in eating disorders are difficult to compare and mostly based on very small groups. We have found only a few studies (Pirke et al 1986;Charest-Lilly et al 1987;Mayo-Smith et al 1989;Hannan et al 1990Hannan et al , 1993aVaisman et al 1991;Russell et al 1994;Young et al 1994) in which more than fifteen patients have been investigated.…”

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confidence: 99%

Body composition in female anorexia nervosa patients

Probst¹,

Goris

Vandereycken³

et al. 1996

Br J Nutr

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For the first time, body composition has been studied in a very large sample of female anorexia nervosa patients (n 200) using two methods: anthropometry (skinfold thickness) and densitometry (underwater weighing). The concurrent validity of both methods appeared to be good (v 0.84). Although the mean percentage of body fat (13.5) in our sample corresponds with most of the previous reports, the range (4.3-24.8) is great. Our study shows that BMI is not a good measure of fatness. Age and duration of illness were not related to body fat. Percentage fat was found to be different (t 2.76, P < 0.01) according to the diagnostic subtype of anorexia newosa: restricters (12.9) v. bingers and/or purgers (14.7).Anorexia nervosa : Body composition: Antbropometry : Densitometry : Underwater weighingThe decrease in body fat in anorexia nervosa (AN) patients due to a prolonged restriction of oral nutrient intake and weight loss has important physiologial consequences with respect to morbidity and mortality (Russell et al. 1983). Knowledge of body composition in these patients is, therefore, clinically most relevant. Body-composition studies are generally based on the principle that one can estimate the relative proportion of two components: fat mass (FM) and fat-free mass (FFM; water, proteins and minerals). A wide variety of methods, from relatively simple and cheap to sophisticated and expensive ones, are available to measure body composition (for a recent review, see Heymsfield et al. 1995). The published studies on body composition in eating disorders are difficult to compare and mostly based on very small groups. We have found only a few studies (Pirke et al. 1986; Charest-Lilly et al. 1987; Mayo-Smith et al. 1989;Hannan et al. 1990 Hannan et al. , 1993aVaisman et al. 1991;Russell et al. 1994;Young et al. 1994) in which more than fifteen patients have been investigated.In the context of a large research and treatment project on psychological and physiological aspects of how AN patients feel and think about their own body (Probst et al. 1995) we applied two methods of body composition assessment: the densitometric technique of underwater weighing (UWW) and the anthropometric approach of measuring skinfold thickness (SFT). UWW is considered to be the method of reference for body composition with reliability coefficients (test-retest correlations) above r 0-95 and concurrent validity coefficients usually above r 0.80 (Heymsfield et al. 1995). SFT is a classic technique with a generally weaker reliability (but usually above r 0.90). The standard error for prediction of fat percentage from SFT is in general 2.6-3.4 % of body weight, which is not very different from the standard error obtained with UWW. Since SFT measures only subcutaneous adipose tissue, its validity is somewhat lower. The correlation between UWW and SFT ranges from 0.65 to 0.93 (Heymsfield et al. 1995).The aims of our study were: (1) to estimate body composition in a large group of AN patients who were all in a starvation state; (2) to test the concurrent v...

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“…Seven patients with anorexia nervosa, 10 patients with bulimia, and 14 healthy controls were studied by the potassium 40 method as described in detail by Pirke et al (1986) and by the electrical conductivity method. Clinical data are given in Table 1.…”

Section: Patients and Control Subjectsmentioning

confidence: 99%

“…However, the correlation between results obtained by the potassium 40 method and the conductivity method were not as high as reported by Lukaski et al (1985) for healthy men. A reason for this may be that the correction for intracellular potassium loss by measuring potassium content in erythrocytes is not sufficiently precise for use in patients with eating disorders (Pirke et al, 1986). Furthermore, water and electrolyte disturbances are frequently observed in anorexic patients (Gold et al, 1983) and may introduce minor changes in conductance and resistance, so that the formula applied to calculate fat-free mass may not be completely appropriate for emaciated subjects.…”

Section: Disc Usslo Nmentioning

confidence: 99%

Assessment of body composition by measurement of electrical conductivity in patients with anorexia nervosa and bulimia

Pirke

Muenzing

Moser

et al. 1989

Int. J. Eat. Disord.

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Total body potassium, intracellular potassium and body composition in patients with anorexia nervosa during refeeding

Cited by 12 publications

References 10 publications

Body composition changes in patients with anorexia nervosa after complete weight recovery

Body composition changes in patients with anorexia nervosa after complete weight recovery

Body composition in female anorexia nervosa patients

Assessment of body composition by measurement of electrical conductivity in patients with anorexia nervosa and bulimia

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