Consequences of an extreme diet in the professional sport: Refeeding syndrome to a bodybuilder

Refeeding syndrome, as a life-threatening condition, is well known among severely malnourished or deeply metabolically stressed patients. This case presents an atypical manifestation of the syndrome to a young bodybuilder, whose extreme diet, including 5 months of insufficient nourishment before the sport competition and 6 days of carbohydrates overload afterwards, has led him to a bilateral lower - limb paralysis and drastic homeostatic disturbances. Severe hypokalemia, hypophosphatemia, hypomagnesemia and hyperglycemia with mildly elevated liver enzymes have occurred. The patient could barely move his legs and arms, and his state has been followed by a hypertensive crisis, which required an immediate intravenous treatment. Although his weight was 112,5 kg with a body mass index of 32,2 kg per square meter, and his blood serum albumin concentration resulted inside the normal range, the overall condition was corresponding to the state of extenuated and malnourished patients. This case reflects to high prevalence of eating disorders or non-adequate nutrition among weight-sensitive sport athletes. The importance of prevention and opportune diagnostics of refeeding syndrome among special vulnerable groups should be considered. (c) 2017 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.