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Clinical nutrition, enteral and parenteral nutrition

Long-term effects of enteral feeding on growth and mental health in adolescents with anorexia nervosa—results of a retrospective German cohort study

European Journal of Clinical Nutrition volume 68, pages 171–177 (2014)Cite this article

Subjects

Abstract

Background/objective:

Anorexia nervosa (AN) is a severe eating disorder with a high mortality rate. Treatment regimes show regional and global variation and are sometimes supported by enteral feeding (EF) via nasogastric tube, although risks and benefits are still unclear. We aimed to find out whether EF improves growth and AN recovery and prevents psychiatric comorbidities.

Subjects/methods:

Data were retrospectively collected from medical records and follow-up data were collected via questionnaires. Two hundred and eight female AN patients who were hospitalized below the age of 18 years with a mean follow-up of 6 years were analyzed. We calculated relative risks for the association between EF and suboptimal growth, remission of AN and the occurrence of psychiatric comorbidities, adjusting for potential confounders.

Results:

A third of the analyzed girls received EF at any time. In the adjusted analyses, we found no significant associations between EF and suboptimal growth, the persistence of AN and the occurrence of psychiatric comorbidities, respectively.

Conclusion:

Our data suggest EF to be neither a risk factor nor beneficial for growth, recovery or persistence of AN and the occurrence of psychiatric comorbidities.

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Acknowledgements

We are grateful to the support of Dr med. Günther Hinrichs (ZIP Kiel), Dr med. Joachim Walter (Katholisches Kinderkrankenhaus Wilhelmstift, Hamburg), Dr med. Jan Gerrit Behrens (MediClin Seepark, Bad Bodenteich) and Dr phil. Dipl. Psych. Dorothé Verbeek (UKSH Lübeck) who gave clinical advice and made the data available. We thank all patients who took part in this study. We thank Kristiane Krüger for her help in recruiting the sample and collecting the data and to Sabine Brehm, the medical documentalist. We furthermore thank Lucia Albers and Dr Otmar Bayer for statistical support. Parts of the manuscript arose from the PhD Thesis of KK (at the University of Lübeck) and from the Master Thesis of IN (at the University of Munich).

Author Contributions

The author’s responsibilities were as follows: IN: analyses and principle authorship of the manuscript; KK: recruitment and data collection, descriptive analyses; RvK: interpretation of the data and contribution to final draft; UT: conception of research question, project management, contribution to final draft of the manuscript.

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Authors and Affiliations

  1. Division of Epidemiology, Institute for Social Paediatrics and Adolescent Medicine, Ludwig-Maximilians-Universität München, Munich, Germany

    I Nehring & R von Kries

  2. Department of Paediatric and Adolescent Medicine, University of Lübeck, Lübeck, Germany

    K Kewitz & U Thyen

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  1. I Nehring
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Correspondence to I Nehring.

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Nehring, I., Kewitz, K., von Kries, R. et al. Long-term effects of enteral feeding on growth and mental health in adolescents with anorexia nervosa—results of a retrospective German cohort study. Eur J Clin Nutr 68, 171–177 (2014). https://doi.org/10.1038/ejcn.2013.244

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