title: Nutritional aspects of eating episodes followed by vomiting in Brazilian patients with bulimia nervosa.
abstract: BACKGROUND
  The clinical aspects of bulimia nervosa (BN) are similar in countries with different sociocultural backgrounds, but less is known about dietary composition in patients from developing countries. Little is also known about the role that nutritional aspects may play in behaviours aimed at counteracting the effects of binge eating.
  
  
  OBJECTIVE
  To describe the daily energy intake and eating behaviour of BN patients in Brazil and compare the dietary patterns of the patients who terminated eating episodes by vomiting and those patients who did not.
  
  
  METHODS
  Thirty patients from an eating disorders programme in a university-affiliated hospital completed a 14-day dietetic diary; the data were analysed using nutritional software.
  
  
  RESULTS
  Mean age and BMI of the patients were respectively 27.2 +/- 9.6 years and 25.5 +/- 6.7 Kg/m2. The patients in the vomiting subgroup ate more irregularly and consumed a more variable number of meals per day than those in the non-vomiting subgroup. The daily energy intake of the patients as a whole was 2,202 kcal, with a macronutrient composition of 53% carbohydrates, 31% fats and 17% proteins. The mean energy intake of the eating episodes followed by vomiting was 1,331 kcal with a macronutrient profile of 51% carbohydrates, 36% fat and 14% protein. Intake and eating patterns were characterised by between- and within- individual variability, and so no significant differences were found in the subgroup comparisons. Foods with a high energy density were preferred during the eating episodes followed by vomiting.
  
  
  CONCLUSIONS
  The results indicate that patients who vomit have a more irregular and variable eating pattern than those who do not vomit, but their daily nutrient content is comparable.
authors.affiliation: Eating Disorders Program, Psychiatric Institute and Department, University of São Paulo, Brazil. marlealv@uol.com.br
authors.forename: M S
authors.initials: MS
authors.lastname: Alvarenga
authors.forename: A B
authors.initials: AB
authors.lastname: Negrão
authors.forename: S T
authors.initials: ST
authors.lastname: Philippi
mesh_terms: D000328:Adult; D015992:Body Mass Index; D001938:Brazil; D002032:Bulimia / Q000523:psychology*; D004435:Eating; D002149:Energy Intake; D005247:Feeding Behavior / Q000523:psychology*; D005260:Female; D006801:Humans; D018977:Micronutrients; D015596:Nutrition Assessment; D014839:Vomiting / Q000209:etiology*
chemical_list: D018977:Micronutrients