Dietary energy density and diet variety as risk factors for relapse in anorexia nervosa: A replication

Objective: To replicate our previous findings of an association between energy density and diet variety in recently weight-restored patients with anorexia nervosa (AN) and clinical outcome in the year following treatment. Method: Nineteen hospitalized, weight-restored women with AN completed a food record, from which a diet energy density score (DEDS) and a diet variety score (DVS) were calculated. After hospital discharge, patients were contacted regularly; at the end of one year, clinical outcome was determined using modified Morgan-Russell criteria. As in our previous study, outcome was dichotomized into "full, good, or fair'' and "poor'' groups. Results: Data from 16 subjects were available. The DEDS was significantly lower (p < .05) in the poor outcome group (0.7 +/- 1) compared with the "full, good, or fair'' outcome group (0.9 +/- 1). Although the DVS was also lower in the poor outcome group (13.9 +/- 2) compared with the "full, good or fair'' outcome group (15.7 +/- 1.8), this difference was not statistically significant. Discussion: In recently weight-restored patients with AN, a lower DEDS, but not DVS, is associated with poor clinical outcome after inpatient treatment. This finding may be important in the assessment of risk for relapse in patients with AN. (C) 2011 by Wiley Periodicals, Inc.