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Nutrition therapy during initiation of refeeding in underweight children and adolescent inpatients with anorexia nervosa: a systematic review of the evidence.

Abstract

Restoration of weight and nutritional rehabilitation are recognized as fundamental steps in the therapeutic treatment of children and adolescent inpatients with anorexia nervosa (AN). However, current recommendations on initial energy requirements for this population are inconsistent, with a clear lack of empirical evidence. Thus, the aim of our study was to systematically review, assess, and summarize the available evidence on the effect of differing nutrition therapies prescribed during refeeding on weight restoration in hospitalized children and adolescents (aged 19 years and younger) with diagnosed AN. Searches were conducted in Scopus, Web of Science, Global Health (CABI), PubMed, and the Cochrane database for articles published in English up to May 2012, and complemented by a search of the reference lists of key publications. Seven observational studies investigating a total of 403 inpatients satisfied the inclusion criteria. The range of prescribed energy intakes varied from 1,000 kcal to >1,900 kcal/day with a progressive increase during the course of hospitalization. It appeared that additional tube feeding increased the maximum energy intake and led to greater interim or discharge weight; however, this was also associated with a higher incidence of adverse effects. Overall, the level of available evidence was poor, and therefore consensus on the most effective and safe treatment for weight restoration in inpatient children and adolescents with AN is not currently feasible. Further research on refeeding methods is crucial to establish the best practice approach to treatment of this population.

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  • Authors

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    MeSH

    Adolescent
    Anorexia Nervosa
    Child
    Energy Intake
    Enteral Nutrition
    Evidence-Based Medicine
    Humans
    Intubation, Gastrointestinal
    Observational Studies as Topic
    Refeeding Syndrome
    Thinness
    Weight Gain

    Pub Type(s)

    Comparative Study
    Journal Article
    Review
    Systematic Review

    Language

    eng

    PubMed ID

    24512952

    Citation

    Rocks, Tetyana, et al. "Nutrition Therapy During Initiation of Refeeding in Underweight Children and Adolescent Inpatients With Anorexia Nervosa: a Systematic Review of the Evidence." Journal of the Academy of Nutrition and Dietetics, vol. 114, no. 6, 2014, pp. 897-907.
    Rocks T, Pelly F, Wilkinson P. Nutrition therapy during initiation of refeeding in underweight children and adolescent inpatients with anorexia nervosa: a systematic review of the evidence. J Acad Nutr Diet. 2014;114(6):897-907.
    Rocks, T., Pelly, F., & Wilkinson, P. (2014). Nutrition therapy during initiation of refeeding in underweight children and adolescent inpatients with anorexia nervosa: a systematic review of the evidence. Journal of the Academy of Nutrition and Dietetics, 114(6), pp. 897-907. doi:10.1016/j.jand.2013.11.022.
    Rocks T, Pelly F, Wilkinson P. Nutrition Therapy During Initiation of Refeeding in Underweight Children and Adolescent Inpatients With Anorexia Nervosa: a Systematic Review of the Evidence. J Acad Nutr Diet. 2014;114(6):897-907. PubMed PMID: 24512952.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Nutrition therapy during initiation of refeeding in underweight children and adolescent inpatients with anorexia nervosa: a systematic review of the evidence. AU - Rocks,Tetyana, AU - Pelly,Fiona, AU - Wilkinson,Paul, Y1 - 2014/02/07/ PY - 2013/03/06/received PY - 2013/11/20/accepted PY - 2014/2/12/entrez PY - 2014/2/12/pubmed PY - 2014/7/24/medline KW - Anorexia nervosa KW - Children and adolescents KW - Inpatients KW - Nutrition therapy KW - Refeeding SP - 897 EP - 907 JF - Journal of the Academy of Nutrition and Dietetics JO - J Acad Nutr Diet VL - 114 IS - 6 N2 - Restoration of weight and nutritional rehabilitation are recognized as fundamental steps in the therapeutic treatment of children and adolescent inpatients with anorexia nervosa (AN). However, current recommendations on initial energy requirements for this population are inconsistent, with a clear lack of empirical evidence. Thus, the aim of our study was to systematically review, assess, and summarize the available evidence on the effect of differing nutrition therapies prescribed during refeeding on weight restoration in hospitalized children and adolescents (aged 19 years and younger) with diagnosed AN. Searches were conducted in Scopus, Web of Science, Global Health (CABI), PubMed, and the Cochrane database for articles published in English up to May 2012, and complemented by a search of the reference lists of key publications. Seven observational studies investigating a total of 403 inpatients satisfied the inclusion criteria. The range of prescribed energy intakes varied from 1,000 kcal to >1,900 kcal/day with a progressive increase during the course of hospitalization. It appeared that additional tube feeding increased the maximum energy intake and led to greater interim or discharge weight; however, this was also associated with a higher incidence of adverse effects. Overall, the level of available evidence was poor, and therefore consensus on the most effective and safe treatment for weight restoration in inpatient children and adolescents with AN is not currently feasible. Further research on refeeding methods is crucial to establish the best practice approach to treatment of this population. SN - 2212-2672 UR - https://www.unboundmedicine.com/medline/citation/24512952/Nutrition_therapy_during_initiation_of_refeeding_in_underweight_children_and_adolescent_inpatients_with_anorexia_nervosa:_a_systematic_review_of_the_evidence_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S2212-2672(13)01782-6 DB - PRIME DP - Unbound Medicine ER -