To the question of optimizing the energy and protein supply of patients with anorexia nervosa

Aim. To develop a strategy of restorative nutritional and metabolic therapy for patients with anorexia nervosa (NA) considering the risk of refeeding syndrome. Materials and methods. We studied energy expenditure (indirect calorimetry on Cosmed Quark RMR apparatus) and daily nitrogen loss in 69 female patients aged from 18 to 55 years in the somatopsychiatric department of the Dzhanelidze Saint Petersburg Research Institute of Emergency Medicine. Results. During realimentation of patients with NA, the desirable amount of protein supply is 1.8-2.3 g/kg per day of actual body weight or 1.2-1.4 g/kg per day of ideal body weight. The desirable amount of energy supply is 56-76 kcal/kg per day of actual body weight or 37-50 kcal/kg per day of ideal body weight of patients. Using this strategy we achieve a positive result by gradually gaining body weight (500-1000 g per week). Conclusions. Nutritional and metabolic support of patients with NA should be carried out in the mode of patient-specific graded hyperalimentation, considering the initial somatometric indicators of trophological status and tolerance to a gradually increasing substrate load. Key words: anorexia nervosa, metabolism, nutrition. For citation: Luft V.M., Sergeeva A.M., Tyavokina E.Yu., Lapitsky A.V. To the question of optimizing the energy and protein supply of patients with anorexia nervosa. Consilium Medicum. 2020; 22 (6): 28-31. DOI: 10.26442/20751753.2020.6.200139

anorexia nervosa, metabolism, nutrition