Available at www.sciencedirect.com http://intl.elsevierhealth.com/journals/clnu ORIGINAL ARTICLE Bone mineral density in adolescent girls with early onset of anorexia nervosa Antonella Diamanti a,Ã , Carla Bizzarri b , Manuela Gambarara a , Angelica Calce a , Francesco Montecchi c , Marco Cappa b , Giuseppe Bianco c , Massimo Castro a a Gastroenterology and Nutrition Unit, Pediatric Hospital ‘‘Bambino Gesu `’’, Piazza S. Onofrio, 4-00165 Rome, Italy b Endocrinology Unit, Pediatric Hospital ‘‘Bambino Gesu `’’, Piazza S. Onofrio, 4-00165 Rome, Italy c Neuropsychiatry Unit, Pediatric Hospital ‘‘Bambino Gesu `’’, Piazza S. Onofrio, 4-00165 Rome, Italy Received 24 July 2006; accepted 25 December 2006 KEYWORDS Anorexia nervosa; Bone mineral density; Protein intake; Physical activity Summary Background & Aims: To assess prevalence of bone mineral density (BMD) reduction and relationship between bone mineral status and anthropometric assessment, nutritional intake and physical activity in adolescents with early anorexia nervosa (AN). Methods: Fifty-seven consecutive AN patients and 57 healthy controls underwent anthropometric status, bone density, body composition and physical activity evaluations. In AN patients clinical features and nutritional intake were also assessed. Results: Thirty-five patients with AN (62%) and 44 healthy subjects (77%) (pNS) showed normal BMD. Mean value of BMD Z-score was 0.670.9 in AN patients and 0.271.4 in controls (pNS). Weight at diagnosis and lean mass resulted the main predictor of bone loss but also height, best weight before diagnosis and BMI resulted correlated with bone mineral status in AN patients. Additionally, AN patients maintained good levels of protein intake and sport activity Conclusions: Early diagnosis may prevent bone loss in AN patients. Protein intake and moderate physical activity seem to be useful to maintain an adequate bone mineral status. & 2007 Published by Elsevier Ltd. Introduction Anorexia nervosa (AN) is a common chronic disorder with prevalence of 0.2–1% in female adolescents and young women. 1–5 Bone loss occurs early in the progress of AN, representing the most frequent organic complication of AN ARTICLE IN PRESS 0261-5614/$ - see front matter & 2007 Published by Elsevier Ltd. doi:10.1016/j.clnu.2006.12.008 Ã Corresponding author. Tel.: +39668592329; fax: +39668592876. E-mail address: diamanti@opbg.net (A. Diamanti). Clinical Nutrition (2007) 26, 329–334