Potassium and Anorexia Christina Ferraiuolo - PowerPoint Presentation

Potassium and Anorexia Christina Ferraiuolo
Potassium and Anorexia Christina Ferraiuolo

Potassium and Anorexia Christina Ferraiuolo - Description

HLSC 415 Thesis Question What is the association between potassium levels in the body and Anorexia Nervosa Ice Breaker Take two What kind of micronutrient is potassium What relationship would it have with the heart ID: 658624 Download Presentation


anorexia potassium body levels potassium anorexia levels body nervosa statistics hypokalemia weight purging 001 adolescent anorexic mmol study question

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Potassium and Anorexia

Christina FerraiuoloHLSC 415Slide2

Thesis Question

What is the association between potassium levels in the body and Anorexia Nervosa?Slide3

Ice Breaker

Take two

What kind of micronutrient is potassium?What relationship would it have with the heart?Do you think there is a connection between anorexia and potassium?Slide4


Potassium is a micronutrient and an electrolyte

Infant RDI 0.4 g/dayChildren RDI 3-4 g/dayAdult RDI 4.7 g/dayBreastfeeding RDI 5.1 g/day


Potassium Sources

All meats and fishSoy productsFruits: cantaloupe, banana, kiwi, avocado

Vegetables: broccoli, sweet potato, and tomatoesMilk and yogurtNuts (Zieve,2010)Slide6


and Hyperkalemia

Too little potassium in the body is called HypokalemiaToo much potassium in the body is called




An eating disorder Body DimorphicObsession with weight and food

StarvationExercise excessively Abuse laxatives and diureticsSlide8

DSM IV TR Diagnostic Criteria for Anorexia

Intense fear of gaining weight

Distorted self imageAbsence of menstrual cycleRefusal to maintain body weight at healthy range

(Dryden-Edwards, 2010)Slide9

Anorexia complications

DeathAnemiaBone loss

Kidney ProblemsBrain damageHeart failure or abnormal heart rhythmElectrolyte abnormalities (Dryden-Edwards, 2010)Slide10

Anorexia and Hypokalemia

Potassium is an electrolyte

Found in food sourcesAnorexia patients lose potassium though weight regulationFatal electrical alterations of the heartSlide11

Thesis Question

What is the association between potassium levels in the body and Anorexia Nervosa?Slide12

Effect of Weight-Regulating Practices on Potassium Level in Patients with Anorexia or Bulimia Nervosa




, I.,


, K.,


, F.,


, R., & Ernst Jacoby, G. (2004). Effects of weight-regulating practices on potassium levels in patients with anorexia or bulimia nervosa.

European Eating Disorders Review,

12(5), 300-306.


: 10.1002/erv.591.Slide13


To define several diagnostic and symptomatic groups and test them separately for their potassium levels

Anorexia with vomitingAnorexia with vomiting and laxative abuseAnorexia without vomiting Slide14

Research Design

Descriptive EpidemiologicalCross sectional survey

Examining causal factors associated with different anorexia and bulimic groups with HypokalemiaRetrospective studySlide15


397 patients with preexisting eating disorder

Klinik am Korso in Bad Oeynhausen, Germany

Subgroups based on complete


Similarities in BMI, age, disease duration


: < 3.4


/l plasma potassiumSlide16

Identification of Statistics

DescriptiveInferentialCorrelation testsSlide18

Descriptive Statistics

Standard DeviationMeanRange


Inferential Statistics

Mann-Whitney U testKruskal-Wallis test

Analysis of Variance test (ANOVA)Post-hoc test (Scheffe’)Slide20

Correlation tests

Pearson’s two-tailed testing Spearman’s correlation testing

Multiple linear regressionStepwise Linear Regression (R2)Standardized regression coefficient Coefficient of determination Slide21

Interpretation of Results

Hypokalemia in purging anorexic (p = 0.001)

Hypokalemia in non-purging anorexic (p=0.82)Higher frequency (p = 0.001)Severity (p = 0.001)

Differences between anorexic subgroups (p = 0.001


Results continued

Potassium levels and BMI (r) 0.27 (p=0.001) Vomiting frequency, laxative abuse and potassium levels (r) -0.38 (p = 0.005)

Mean potassium 2.8 mmol/lSlide23

Table 2. Potassium levels and


proportion in the subgroups Slide24

Weaknesses of the Study

Number of participantsInternal Validity

Recall biasSelection biasConfounding variablesSlide25

Strengths of the Study

OrganizationExternal ValidityResults represent an entire populationSlide26


Hypokalemia more common in binging and purging anorexics

Potassium losses through stool, urine and vomitPossibly other factors associated with potassium loss not tested Slide27

Thesis Question

What is the association between potassium levels in the body and Anorexia Nervosa?Slide28

Effects of Anorexia Nervosa on Clinical, Hematological, Biochemical, and Bone Density Parameters in Community-Dwelling Adolescent Girls


, M.,


, A., Miller, K.,


, C., Worley, M.,


, L., et al. (2004). Effects of anorexia nervosa on clinical, hematological, biochemical, and bone density parameters in community-dwelling adolescent girls.

Pediatrics, 114(6), 1574-1583. doi:10.1542/peds.2004-0540.Slide29


To determine the medical effects of anorexia on a young population in terms of normal body functionSlide30

Research Design

Descriptive Epidemiological studyCross

sectionalProspective Community dwelling adolescent girlsAnorexia with outpatient care vs. healthy adolescents

118 adolescent girls

60 with DSM IV diagnosed anorexia

58 healthy- no past history of eating disorderSlide31


Referred by treatment programs in Boston, MA

Prospective data collection at baseline visitThree month or more community dwellingBiochemicalPotassium levelsAnthropometric


Identification of Statistics

Descriptive statisticsInferential statisticsSlide33

Descriptive Statistics

Mean Standard DeviationSlide34

Inferential Statistics

T-testUnivariate regression analysis

Correlation between variablesStepwise regression analysisSignificant predictorsSlide35

Interpretation of Results

Mean serum potassium levels higher in anorexicAN: 3.8 +/- 0.3

mmol/l Healthy: 3.6 +/- 0.2 mmol/l

no subject


Serum potassium< 3.0



Two subjects with history of purging behaviorSlide36

Weaknesses of the Study

Weakness in planningNo hypothesis statedLimited external validitySlide37

Strengths of the Study

Comparability to the control and observed groupDiverse referrals decrease selection bias

Limited external validityCaucasian Adolescent female specificSlide38


Normal serum potassium levelsHigher in anorexic

Due to dehydrationTotal potassium levels may still be lowNot at risk even with low BMIStill at risk for cardiac abnormalities

No purging behaviors observedSlide39

Thesis Question

What is the association between potassium levels in the body and Anorexia Nervosa?Slide40

Overall Conclusion

Potassium levels are influenced by AnorexiaBoth suggested potential cardiac risk

Differences in studiesSet potassium level as HypokalemicPopulation studiedSlide41

Did I answer my question?

Yes!Both saw changes in extracellular potassium in the Anorexic populationsSlide42

Future Direction

More research in diverse groups

Identify relationship of purging and potassium levels Identify other variables not accounted forMeasuring total potassium vs. only plasmaSlide43


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