Comparison of metabolic parameters between oral and total parenteral nutrition in children with severe eating disorders

Fukushima J Med Sci. 2024 Apr 26;70(2):75-85. doi: 10.5387/fms.2023-02. Epub 2024 Apr 9.

Abstract

Background: This study investigated changes of lipid parameters in children with severe eating disorders during refeeding in order to explore the optimal timing for lipid preparation administration.

Methods: We prospectively assessed the physical conditions of patients with eating disorders after the start of nutrition therapy. The assessments were performed at admission and at 2 and 4 weeks. Lipid metabolism was assessed based on triglyceride (TG), total cholesterol (TC), and free carnitine (FC) levels, as well as acylcarnitine/free carnitine (AC/FC) ratio.

Results: A total of 18 patients were included. Of these, 12 and 6 received an oral diet (OD group) and total parenteral nutrition (TPN group), respectively. The mean body mass indexes at hospital admission were 12.8 kg/m2 in the OD group and 12.7 kg/m2 in the TPN group. At 2 weeks after the start of refeeding, TC, TG, and AC/FC levels were significantly lower in the TPN group than in the OD group. Other blood test results did not show any significant differences between the two groups.

Conclusions: Fat-free glucose-based nutrition promoted lipid metabolism over a 2-week period after the start of refeeding, suggesting that balanced energy and lipid intake are essential, even in TPN.

Keywords: lipid metabolism; nutrition therapy; refeeding; severe eating disorders; total parenteral nutrition.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Carnitine / administration & dosage
  • Carnitine / analogs & derivatives
  • Child
  • Child, Preschool
  • Feeding and Eating Disorders*
  • Female
  • Humans
  • Lipid Metabolism
  • Male
  • Parenteral Nutrition, Total*
  • Prospective Studies
  • Triglycerides / blood

Substances

  • Carnitine
  • Triglycerides