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Terapia nutricional em politraumatizados sob ventilação mecânica: estudo comparativo entre prescrição e oferta calóricaCouto, Cecília Flávia Lopes January 2011 (has links)
Introdução: No período de hipermetabolismo em que se encontra o paciente politraumatizado, é necessário que a administração calórica seja adequada e suficiente para suprir o intenso gasto energético do organismo. Com suporte nutricional inadequado, as reservas de aminoácidos dos músculos esqueléticos e respiratórios são exigidas, expondo o paciente crítico ao risco nutricional e suas consequências. Objetivos: Quantificar o aporte calórico administrado a pacientes em ventilação mecânica (VM), analisar a adequação da prescrição e correlacionar as calorias ofertadas com o tempo em VM. Métodos: Estudo de coorte prospectivo observacional conduzido na Unidade de Terapia Intensiva de um hospital público de Porto Alegre (RS) no período de abril de 2008 a julho de 2009. Foram estudados 60 pacientes politraumatizados em Nutrição Enteral e VM e internados por mais de 5 dias na UTI. Foram verificados o tempo de permanência em VM e a oferta calórica durante o período que permaneceram em terapia nutricional enteral. Resultados: A média do percentual de calorias administradas foi de 68,6% (±12,3) do prescrito. Nove pacientes (15,0%) receberam menos da metade do que deveriam, apenas 16 (26,7%) receberam no mínimo 80,0%. Apenas 25,0% dos pacientes receberam prescrição calórica adequadamente (entre 90% e 110%). Não houve associação significativa entre o Valor Energético Total administrado e o tempo de VM (rs=0,130; p=0,321), tempo de UTI (rs=-0,117; p=0,372) e tempo de internação hospitalar (rs=-0,152; p=0,246). Conclusão: Neste estudo foi verificado que maioria dos pacientes politraumatizados em ventilação mecânica não recebeu um aporte energético adequado, ficando assim expostos aos riscos da desnutrição e seus desfavoráveis desfechos clínicos. / Introduction: During the period of hypermetabolism faced by multiple trauma patients, their calorie intake has to be appropriate and sufficient to meet their high energy expenditure. When there is not appropriate nutritional care, the amino acids from the skeletal and respiratory muscles are used; thus critical patients are exposed to nutritional risk and its consequences. Objectives: To quantify the calories provided to patients on mechanical ventilation (MV); to analyze the appropriateness of the prescription; and to correlate the calories offered with the period of time on MV. Methods: Prospective observational cohort study conducted at the intensive care unit (ICU) of a public hospital in Porto Alegre (RS), Brazil, from April 2008 to July 2009. We studied 60 multiple trauma patients on MV receiving enteral nutrition who remained longer than 5 days at the ICU. We investigated the length of time patients were on MV and their calorie intake while receiving enteral nutrition. Results: The mean percentage of calories was 68.6% (±12.3) of the amount prescribed. Nine patients (15.0%) received less than half of the prescription. Only 16 (26.7%) patients received at least 80.0%. Only 25.0% of patients received the amount of calories according to the prescription (between 90% and 110%). There was no significant association between total energy value and the period of time on MV (rs = 0.130, p = 0.321), length of ICU stay (rs = -0.117, p = 0.372), and length of hospital stay (rs = -0.152, p = 0.246). Conclusion: We found that most multiple trauma patients on MV did not receive an adequate energy intake; therefore, they were exposed to the risks of malnutrition and its adverse clinical outcomes.
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Terapia nutricional em politraumatizados sob ventilação mecânica: estudo comparativo entre prescrição e oferta calóricaCouto, Cecília Flávia Lopes January 2011 (has links)
Introdução: No período de hipermetabolismo em que se encontra o paciente politraumatizado, é necessário que a administração calórica seja adequada e suficiente para suprir o intenso gasto energético do organismo. Com suporte nutricional inadequado, as reservas de aminoácidos dos músculos esqueléticos e respiratórios são exigidas, expondo o paciente crítico ao risco nutricional e suas consequências. Objetivos: Quantificar o aporte calórico administrado a pacientes em ventilação mecânica (VM), analisar a adequação da prescrição e correlacionar as calorias ofertadas com o tempo em VM. Métodos: Estudo de coorte prospectivo observacional conduzido na Unidade de Terapia Intensiva de um hospital público de Porto Alegre (RS) no período de abril de 2008 a julho de 2009. Foram estudados 60 pacientes politraumatizados em Nutrição Enteral e VM e internados por mais de 5 dias na UTI. Foram verificados o tempo de permanência em VM e a oferta calórica durante o período que permaneceram em terapia nutricional enteral. Resultados: A média do percentual de calorias administradas foi de 68,6% (±12,3) do prescrito. Nove pacientes (15,0%) receberam menos da metade do que deveriam, apenas 16 (26,7%) receberam no mínimo 80,0%. Apenas 25,0% dos pacientes receberam prescrição calórica adequadamente (entre 90% e 110%). Não houve associação significativa entre o Valor Energético Total administrado e o tempo de VM (rs=0,130; p=0,321), tempo de UTI (rs=-0,117; p=0,372) e tempo de internação hospitalar (rs=-0,152; p=0,246). Conclusão: Neste estudo foi verificado que maioria dos pacientes politraumatizados em ventilação mecânica não recebeu um aporte energético adequado, ficando assim expostos aos riscos da desnutrição e seus desfavoráveis desfechos clínicos. / Introduction: During the period of hypermetabolism faced by multiple trauma patients, their calorie intake has to be appropriate and sufficient to meet their high energy expenditure. When there is not appropriate nutritional care, the amino acids from the skeletal and respiratory muscles are used; thus critical patients are exposed to nutritional risk and its consequences. Objectives: To quantify the calories provided to patients on mechanical ventilation (MV); to analyze the appropriateness of the prescription; and to correlate the calories offered with the period of time on MV. Methods: Prospective observational cohort study conducted at the intensive care unit (ICU) of a public hospital in Porto Alegre (RS), Brazil, from April 2008 to July 2009. We studied 60 multiple trauma patients on MV receiving enteral nutrition who remained longer than 5 days at the ICU. We investigated the length of time patients were on MV and their calorie intake while receiving enteral nutrition. Results: The mean percentage of calories was 68.6% (±12.3) of the amount prescribed. Nine patients (15.0%) received less than half of the prescription. Only 16 (26.7%) patients received at least 80.0%. Only 25.0% of patients received the amount of calories according to the prescription (between 90% and 110%). There was no significant association between total energy value and the period of time on MV (rs = 0.130, p = 0.321), length of ICU stay (rs = -0.117, p = 0.372), and length of hospital stay (rs = -0.152, p = 0.246). Conclusion: We found that most multiple trauma patients on MV did not receive an adequate energy intake; therefore, they were exposed to the risks of malnutrition and its adverse clinical outcomes.
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Balanço energético em idosos residentes no município de Niterói, Rio de JaneiroSilva, Bruna de Andrade Messias da January 2016 (has links)
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Previous issue date: 2016 / Universidade Federal Fluminense. Centro de Ciências Médicas. Hospital Universitário Antônio Pedro / O objetivo deste estudo foi avaliar diferentes métodos para se obter o balanço energético (BE) e seus componentes em uma amostra de idosos (idade ≥ 60 anos) residentes no município de Niterói, Rio de Janeiro. O BE foi calculado através da diferença entre a ingestão energética (IE), obtida por recordatório alimentar de 24 horas, e o gasto energético total diário (GETD), avaliado através de métodos subjetivos (n=97) (requerimento energético e recordatório de atividade física de 24 horas - RAF24h) e método objetivo (n=88) (acelerometria). Os dois últimos também foram utilizados na avaliação do perfil de atividade física (AF), através dos quais verificou-se os idosos que alcançaram as recomendações de 30 minutos diários e 150 minutos semanais de AF moderada. Também avaliou-se aqueles que atingiram a recomendação de 10000 passos por dia. Independentemente do método utilizado, em menos da metade dos dias analisados (31,8% por RAF24h e 27,5% por acelerometria) os idosos conseguiram atingir a recomendação de 30 minutos de AF moderada e apenas 32 indivíduos realizaram a recomendação semanal de 150 minutos de AF moderada. Em média, o número de passos diários realizado pela amostra foi abaixo da recomendação. Dentre os métodos de avaliação do GETD, tanto a acelerometria quanto o requerimento energético, apresentaram resultados mais próximos ao esperado, principalmente quando equações específicas para a população de Niterói foram utilizadas, 1352,1 e 1581,7 kcal.dia-1 respectivamente, apresentando também melhores resultados na avaliação do BE. Os achados do presente estudo indicam que ainda são necessários mais esforços para o estímulo à prática de atividade física em idosos. Equações oriundas de amostras da população de interesse pareceram melhor estimar o GETD e o BE em idosos de Niterói / The objective of this study was to assess different methods of estimatating energy balance (EB) and its components in a sample of elderly (age ≥ 60 years) living in the city of Niterói, Rio de Janeiro. EB was calculated as the difference between energy intake (EI) obtained by 24-hour dietary recall, and total daily energy expenditure (TDEE) measured by subjective methods (n = 97) (energy requirement and 24-hour physical activity recall, 24hPAR) and an objective method (n = 88) (accelerometry). The latter two were also used to evaluate the physical activity pattern and the number of the elderlies seniors who achieved the recommendations of 30 minutes per day and 150 minutes per week of moderate to vigorous physical activity (MVPA). Also assessed are those that reached the recommended 10,000 steps a day. Independently of the method used, in less than half of the analyzed days (31.8% by 24hPAR and 27.5% by accelerometry) the elderlies reached 30 minutes of MVPA and only 32 individuals reached weekly recommendation of 150 minutes of MVPA. On average, the daily number of steps performed by the sample was below the recommendation. Among the methods of estimating TDEE, both accelerometry and the energy requirement presented expected results, especially when specific equations for the population of Niterói were used, 1352,1 e 1581,7 kcal.dia-1 respectively. The findings of this study indicate that more efforts are still needed to stimulate the practice of physical activity in this population. Equations derived from samples of the population of interest improve the final estimates of TDEE and EB in the Niteroi elderlies
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Balanço energético em idosos residentes no município de Niterói, Rio de JaneiroSilva, Bruna de Andrade Messias da January 2016 (has links)
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Previous issue date: 2016 / Universidade Federal Fluminense. Centro de Ciências Médicas. Hospital Universitário Antônio Pedro / O objetivo deste estudo foi avaliar diferentes métodos para se obter o balanço energético (BE) e seus componentes em uma amostra de idosos (idade ≥ 60 anos) residentes no município de Niterói, Rio de Janeiro. O BE foi calculado através da diferença entre a ingestão energética (IE), obtida por recordatório alimentar de 24 horas, e o gasto energético total diário (GETD), avaliado através de métodos subjetivos (n=97) (requerimento energético e recordatório de atividade física de 24 horas - RAF24h) e método objetivo (n=88) (acelerometria). Os dois últimos também foram utilizados na avaliação do perfil de atividade física (AF), através dos quais verificou-se os idosos que alcançaram as recomendações de 30 minutos diários e 150 minutos semanais de AF moderada. Também avaliou-se aqueles que atingiram a recomendação de 10000 passos por dia. Independentemente do método utilizado, em menos da metade dos dias analisados (31,8% por RAF24h e 27,5% por acelerometria) os idosos conseguiram atingir a recomendação de 30 minutos de AF moderada e apenas 32 indivíduos realizaram a recomendação semanal de 150 minutos de AF moderada. Em média, o número de passos diários realizado pela amostra foi abaixo da recomendação. Dentre os métodos de avaliação do GETD, tanto a acelerometria quanto o requerimento energético, apresentaram resultados mais próximos ao esperado, principalmente quando equações específicas para a população de Niterói foram utilizadas, 1352,1 e 1581,7 kcal.dia-1 respectivamente, apresentando também melhores resultados na avaliação do BE. Os achados do presente estudo indicam que ainda são necessários mais esforços para o estímulo à prática de atividade física em idosos. Equações oriundas de amostras da população de interesse pareceram melhor estimar o GETD e o BE em idosos de Niterói / The objective of this study was to assess different methods of estimatating energy balance (EB) and its components in a sample of elderly (age ≥ 60 years) living in the city of Niterói, Rio de Janeiro. EB was calculated as the difference between energy intake (EI) obtained by 24-hour dietary recall, and total daily energy expenditure (TDEE) measured by subjective methods (n = 97) (energy requirement and 24-hour physical activity recall, 24hPAR) and an objective method (n = 88) (accelerometry). The latter two were also used to evaluate the physical activity pattern and the number of the elderlies seniors who achieved the recommendations of 30 minutes per day and 150 minutes per week of moderate to vigorous physical activity (MVPA). Also assessed are those that reached the recommended 10,000 steps a day. Independently of the method used, in less than half of the analyzed days (31.8% by 24hPAR and 27.5% by accelerometry) the elderlies reached 30 minutes of MVPA and only 32 individuals reached weekly recommendation of 150 minutes of MVPA. On average, the daily number of steps performed by the sample was below the recommendation. Among the methods of estimating TDEE, both accelerometry and the energy requirement presented expected results, especially when specific equations for the population of Niterói were used, 1352,1 e 1581,7 kcal.dia-1 respectively. The findings of this study indicate that more efforts are still needed to stimulate the practice of physical activity in this population. Equations derived from samples of the population of interest improve the final estimates of TDEE and EB in the Niteroi elderlies
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Diet during pregnancy:dietary patterns and weight gain rate among Finnish pregnant womenArkkola, T. (Tuula) 29 December 2009 (has links)
Abstract
Proper nutrition and optimal weight status in pregnancy are important for both the mother and her child. The present study was aimed at assessment of maternal food and nutrient intake, dietary supplement use, dietary patterns, and weight during pregnancy. Additionally, associations between maternal weight, socio-demographic and perinatal factors and advanced beta cell autoimmunity in the offspring were examined.
The results from a one-year cohort of mothers entering the ongoing Type 1 Diabetes Prediction and Prevention (DIPP) study in 1998–99 (n = 797) suggested that healthy food choices were positively correlated with maternal age and education. Dietary supplements were used by 85% of the women. However, the intake of vitamin D did not meet the recommendation and folic acid intake was inadequate in 44% of the pregnant women when both food and supplementation intakes were taken into account.
Seven dietary patterns were identified in 3730 pregnant women who entered the DIPP study between 1997 and 2002. The ‘healthy’, the ‘low-fat foods’ and the ‘alcohol and butter’ dietary patterns were positively associated with maternal age and education. The ‘fast food’ dietary pattern was positively associated and the ‘alcohol and butter’ pattern was inversely associated with the rate of maternal weight gain during pregnancy.
Altogether, 4093 children and their mothers comprised the study population in which the relationships between maternal initial body mass index, weight gain rate, and the development of beta cell autoimmunity in the offspring were examined. Maternal weight status during pregnancy was not related to the risk of advanced beta cell autoimmunity. A higher level of maternal education was significantly associated with a decreased risk of advanced beta cell autoimmunity in children.
More attention should be paid to nutritional guidance among Finnish pregnant women, especially as regards young and less well educated women. Dietary patterns may be useful for risk group identification and they may offer a framework for further research concerning diet and health outcomes among mothers and their children.
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Etude de la variabilité interindividuelle de l'efficience alimentaire de la vache laitière / Study of the between-cows variability of feed efficiency in dairy cowsFischer, Amélie 12 April 2017 (has links)
L’amélioration de l’efficience alimentaire des animaux peut contribuer à un élevage plus durable par la réduction des ressources utilisées et des rejets associés. Les caractères qui déterminent l’efficience alimentaire des vaches laitières restent mal identifiés. Le projet se propose donc d’identifier les facteurs biologiques associés à la variabilité interindividuelle de l’efficience alimentaire des vaches laitières. La variation d’efficience alimentaire a été estimée avec l’ingéré résiduel, classiquement défini comme la variabilité résiduelle de l’énergie nette ingérée corrigée pour l’énergie nette du lait, l’entretien et les variations de réserves corporelles. Cet ingéré résiduel inclut par définition toutes les erreurs de mesure. Pour réduire ces erreurs, la note d’état corporel, qui classiquement se fait par notation visuelle, a été automatisée et de nombreux autres caractères candidats ont été mesurés fréquemment dans un environnement stable sur quasiment toute la lactation.La variabilité de l’ingéré résiduel ne représentait que 8% de la variabilité de l’ingéré mesuré, dont 58,9% étaient associés à de l’efficience et non de l’erreur. L’étude de la répétabilité de cet ingéré résiduel au cours de la lactation suggère d’éviter les 7 premières quinzaines au profit du milieu de lactation. Parmi tous les caractères mesurés, le comportement alimentaire, la température ruminale, la variation des réserves corporelles et l’activité expliquaient 58,9% de la variabilité de l’ingéré résiduel. Les effets de plusieurs de ces caractères semblent confondus. Leur lien de causalité av / Achieving higher feed efficiency of animals is expected to improve animal production sustainability through reduction of the used resources and of the associated emissions. The traits determining feed efficiency remain poorly understood. The present project aimed therefore at identifying the biological factors associated with feed efficiency differences in lactating dairy cows. Feed efficiency variation was estimated with the traditional residual intake, which was defined as the residual variability of net energy intake which is not explained by net energy required for lactation, maintenance and body reserves change. This residual intake includes by definition all measurement errors. To reduce these errors, body condition score, which is commonly measured visually, has been automated and several other candidate traits were measured frequently in a steady environment for almost whole lactation.Residual intake variability represented only 8% of intake variability in our study, among which only 58.9% were found to be associated with feed efficiency variability and not to errors. The repeatability analysis of the residual intake throughout the lactation suggested to avoid the 7 first lactation fortnights, and rather to focus on lactation middle. Among all measured traits, feeding behaviour, rumen temperature, body reserves change and activity explained 58.9% of residual intake variability. Many of these traits seemed confounded with others, which claimed for the need for further work to properly define their causal relationship with feed efficiency, especially focussing on di
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The Effects of Menstrual Cycle Phases and Adiposity on Energy Balance in WomenMcNeil, Jessica N. January 2011 (has links)
Energy intake (EI) and energy expenditure (EE) across the menstrual cycle (MC), while considering body adiposity, have not been previously evaluated in the same individuals. This study mainly examined the variations in energy balance (EB) across MC. Seventeen women (Body fat-DXA:28.5%) participated in three identical sessions during distinct phases of the MC: Early-follicular, Late-follicular/ovulation and Mid-luteal (confirmed by basal temperature and sex-steroid hormones). EI, resting metabolic rate (RMR), physical-activity EE (PAEE), severity of PMS, leptin and relative-reinforcing value (RRV) of preferred foods were measured during each phase. No differences in body fat, EI, RMR, PAEE, leptin and RRV of food were noted across MC. Trends were noted in preferred snack (p=0.06) and combined snack/fruit (p=0.06) intakes, while differences were noted in severity of PMS (p<0.05) across phases. Changes in EB across the MC were not noted. PMS was more severe, and preferred snack and combined snack/fruit intakes were slightly higher during mid-luteal phase.
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Využití nepřímé kalorimetrie v praxi nutričního terapeuta / Use of indirect calorimetry in nutritional therapyPokorná, Veronika January 2020 (has links)
Introduction: Indirect calorimetry (IC) is a very accurate and non-invasive method which is used in clinical practice to measure the resting metabolic rate. This method is based on the assumption that oxygen consumption, carbon dioxide production and nitrogen metabolite waste are in definite relation to energy consumption. Based on the measurement of resting metabolic rate, a nutritional therapist can individually determine daily energy intake of a respective individual, the optimal amount of specific nutrients and thus prevents excessive or inadequate intake of energy and nutrients. Objective: The main aim of this thesis is to compare for group of overweight patients the results of the measurement of the resting metabolic rate (RMR), values of the resting metabolic rate calculated according to the Harris-Benedict (HB) equation and the actual energy intake calculated from the diet report obtained from the patients. In addition, the body composition of the examined group with a focus on the amount of muscle tissue is also marginally evaluated. Methods: The research sample includes in total 50 persons-36 women and 14 men. These persons are patients of the General Faculty Hospital in Prague. The average age is 46 years for women and 51 years for men. The average BMI for women is 38,2 kg/m2 and for men...
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The relationship between single nucleotide polymorphism in taste receptor genes and body composition, energy intake, and macronutrient consumption in young adultsSunbul, Manal Abbas 11 May 2022 (has links) (PDF)
Genetic variations in taste receptor genes play a notable role in human taste perception and food preferences and intake, which may affect nutritional and health status. Understanding how genetic variations in taste receptor genes influence food perception, preferences, and intake can play an important role in designing effective interventions to improve the quality of peoples' nutrition and minimize the risk of diet-related diseases such as obesity. The objective of this study was to investigate single nucleotide polymorphisms (SNPs) of umami taste receptor gene TAS1R1 and GRM4 and sweet taste receptor gene TAS1R3 and percentage of body fat mass (BF%) among young adults. 833 young adults aged 18-31 years old were enrolled in a cross-sectional study. Umami and sweet taste receptor genotypes were determined and analyzed. A strong association was observed between the allele frequencies of sweet taste receptor gene TAS1R3 for SNPs rs307355 and rs35744813 and BMI, and between the same SNPs rs307355 and rs35744813 and BF%. In addition, the allele frequencies of SNP rs2499729 were significantly related to the likelihood of having obesity based on BMI classification. However, there was no association between the allele frequencies of the SNPs of the umami taste receptor genes; TAS1R1 for rs34160967 and BMI or BF%. The results of this study also indicated association in total energy intake and the percentage of energy from carbohydrates, protein, and fat intake between the alleles of the sweet receptor gene TAS1R3 for rs307355 and 35744813. Furthermore, a notable association was also detected in the percentage of energy from fat intake among the alleles of the umami receptors gene TAS1R1 rs34160967, and a significant relation in the percentage of energy from carbohydrates and protein intake between the different genotype polymorphisms of the umami receptor GRM4 gene for rs2499729.
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Macro- and Micronutrient Intake in Children with Avoidant/Restrictive Food Intake DisorderSchmidt, Ricarda, Hiemisch, Andreas, Kiess, Wieland, von Klitzing, Kai, Schlensog-Schuster, Franziska, Hilbert, Anja 05 May 2023 (has links)
Although case studies in avoidant/restrictive food intake disorder (ARFID) indicate severe nutritional deficiencies in those with a highly limited amount or variety of food intake, systematic analyses on food intake in treatment-seeking children and adolescents with ARFID are lacking. Within this study, n = 20 patients with an interview-based diagnosis of ARFID (0–17 years) were included and compared to n = 20 healthy controls individually matched for age and sex. Children or parents completed three-day food diaries and a food list. Macronutrient, vitamin, and mineral supply was determined based on the percentage of their recommended intake. The results showed a significantly lower total energy and protein intake in ARFID versus controls, with trends for lower fat and carbohydrate intake. ARFID subtypes of limited amount versus variety of food intake significantly differed in macro-, but not micronutrient intake. Those with ARFID met only 20–30% of the recommended intake for most vitamins and minerals, with significantly lower intake relative to controls for vitamin B1, B2, C, K, zinc, iron, and potassium. Variety of food intake was significantly reduced in ARFID versus controls in all food groups except carbohydrates. This study demonstrated that ARFID goes along with reduced everyday life macro- and micronutrient intake, which may increase the risk for developmental and health problems. Future studies additionally assessing serum nutrient levels in a larger sample may further explore differences in food intake across diverse ARFID presentations.
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