Abstract
Patients with AN reduce their metabolic rates to compensate for decreased caloric intake. Little is known, however, on substrate utilization during refeeding. 9 malnourished girls with AN (age range 14.4-16.9 years old), weight as ideal weight for height 73.2 ± 11.5% were studied for the changes in Resting Energy Expenditure (REE) and substrate utilization in hospital (4-8 weeks) and while maintaining their weight after discharge (20-50 weeks). REE was measured by open circuit indirect calorimetry after overnight fast (12-14 h). Substrate utilization was calculated from protein oxidation derived from urine nitrogen excretion and non-protein RQ (nPRQ.). The contribution of each macronutrient expressed as % of total REE.
On admission, body weight and REE were reduced. On refeeding, carbohyrobrate utilization increased and net fat synthesis was seen. Protein oxidation increased almost twice than normal. On normal weight and weight maintenance substrate utilization returned to normal. We concluded that refeeding changes substrate utilization after overnight fast, causes an excess use of protein and futile cycle, synthesizing fat from carbohydrate.
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Vaisman, N., Rossi, M., Goldberg, E. et al. “ABNORMAL” SUBSTRATE UTILIZATION ON REFEEDING PATIENTS WITH ANOREXIA NERVOSA (AN). Pediatr Res 21 (Suppl 4), 280 (1987). https://doi.org/10.1203/00006450-198704010-00680
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DOI: https://doi.org/10.1203/00006450-198704010-00680