ARFID—Strategies for Dietary Management in Children
Abstract
:1. Introduction
2. Epidemiology of ARFID
3. Diagnostic Criteria
4. Consequences of ARFID
5. Strategies with ARFID
6. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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A. An eating or feeding disorder (e.g., an apparent lack of interest in food or eating; avoidance of foods because of their sensory characteristics; concern about the consequence of eating), which manifests as an inability to get adequate nutrients and/or energy into the body with food and links to at least one of the following: 1. Significant weight loss (or lack of expected weight gain or growth in children); 2. Significant nutritional deficiencies; 3. Dependence on enteral feeding or oral food supplements; 4. Disturbances in psychosocial functioning. |
B. The disorder cannot be explained by lack of food availability or cultural and religious reasons/practices. |
C. This disorder does not occur exclusively in the course of anorexia nervosa or bulimia nervosa and is not the result of abnormalities in the experience of body weight and shape. |
D. This disorder cannot be explained by the current state of health or other co-occurring mental disorders. |
Type of Food Avoided | Nutrient Deficiency | Basic Parameter | Health Consequences of Deficiency |
---|---|---|---|
Cereal products | carbohydrates | body weight and height | hypotrophy |
fiber | e.g., screening for cancer, atherosclerosis, cholelithiasis | Atherosclerosis, gallstones, diverticulosis, and colorectal cancer, breast cancer in women. | |
Milk and milk products | calcium | PTH, alkaline phosphatases | rickets, hypocalciuria, reduced bone mineral density, osteopenia, bone weakness or fractures, and osteoporosis. |
Animal products and dairy products | Riboflavin/Vitamin B2 | the serum concentration of vit. B2 | Low energy levels, poor growth, dry skin/skin problems, hair loss, dry cracked lips or cracks at the corners of the mouth, magenta tongue swelling, itchy and/or red eyes, sore throat, loss of lean body mass, anemia, and cataracts |
total protein | Plasma protein, albumin, prealbumin | malnutrition, edema | |
vitamin B12 Cobalamin | plasma cobalamin | Hyperhomocysteinemia, megaloblastic or macrocytic anemia, low energy, weakness, numbness or tingling in hands or feet, difficulty walking or instability, constipation, anorexia, confusion, poor memory, mood changes, psychosis, and mouth/tongue discomfort | |
Iron | Plasma ferritin, the plasma iron | Microcytic anemia, pallor, weakness, fatigue or drowsiness, irritability, poor concentration, learning, cognitive difficulties, mood changes, reduced exercise endurance, headaches, temperature intolerance, weakened immune system, and reduced appetite due to mucosal changes (disappearance of tongue papillae with taste buds, reduced saliva production) | |
Selenium | Selenium in plasma | Oxidative stress | |
Zinc | Plasma zinc | Oxidative stress, poor growth, and development, anorexia, weakened immune system, impaired night vision, taste and smell changes, hair loss, diarrhea, and poor wound healing | |
Fish | omega-3 acids | omega-3 acids in plasma | central nervous system disorders and cardiovascular disorders |
vitamin D3 | plasma vitamin D3 | rickets, osteomalacia, and osteopenia | |
Vegetables and fruits | folates | plasma folate | Hyperhomocysteinemia, megaloblastic or macrocytic anemia, persistent fatigue, pallor, palpitations, dyspnoea, headache, mouth ulcers, increased risk of birth defects, poor concentration, increased irritability, and weight loss |
Vitamin C | Vitamin C in plasma | Microcytic anemia, scurvy, petechiae, easy bruising, bleeding, and swollen gums, anorexia, anemia, malaise, muscle, joint pains, corkscrew, perianal hemorrhage, wound healing disorders, hyperkeratosis, weakness, and mood disorders | |
Animal and vegetable fats | Vitamin E | Vitamin E/lipids | Oxidative stress |
Vitamin A | Plasma vitamin A | Hemeralopia, poor night vision/night blindness, weakened immune system, hyperkeratosis, and impaired wound healing | |
Vitamin K | Plasma vitamin K | Bruising and easy bleeding and prolonged prothrombin time | |
Fat | observation | Weight loss and absence of menstruation |
STRONGLY DISAGREE | DISAGREE | SLIGHTLY DISAGREE | SLIGHTLY AGREE | AGREE | STRONGLY AGREE | ||
---|---|---|---|---|---|---|---|
1 | I am a picky eater | □ | □ | □ | □ | □ | □ |
2 | I dislike most of the foods that other people eat | □ | □ | □ | □ | □ | □ |
3 | The lisf of foods that I like and will eat is shorter that the list of foods I won’t eat | □ | □ | □ | □ | □ | □ |
4 | I am not very interester in eatingl I seem to have a smaller appetite than other people | □ | □ | □ | □ | □ | □ |
5 | I have to push myself to eat regular meals throughout the day, or to eat a large enough amount of food at meals | □ | □ | □ | □ | □ | □ |
6 | Even when I am eating a food I really like, it is hard for me to eat a large enough volume at meals | □ | □ | □ | □ | □ | □ |
7 | I avoid of put off eating because I am afraid of GI discomfort, choking, or vomiting | □ | □ | □ | □ | □ | □ |
8 | I restrict myself to certain food because I am afraid that other foods will cause GI discomfort, choking, or vomiting | □ | □ | □ | □ | □ | □ |
9 | I eat small portion because I am afraid that other foods will cause GI discomfort, choking, or vomiting | □ | □ | □ | □ | □ | □ |
Please Read Through the Following Statements and Check the Box that Describes You Best. | |||||||
---|---|---|---|---|---|---|---|
Never True | Always True | ||||||
1 | If I was allowed to, I would not eat. | □ | □ | □ | □ | □ | □ |
2 | Food/eating does not interest me. | □ | □ | □ | □ | □ | □ |
3 | I do not eat when I’m sad, worried, or anxious. | □ | □ | □ | □ | □ | □ |
4 | Other people think that I weigh too little. | □ | □ | □ | □ | □ | □ |
5 | I would like to weigh more. | □ | □ | □ | □ | □ | □ |
6 | I feel fat, even if other people do not agree with me. | □ | □ | □ | □ | □ | □ |
7 | As long as I do not look too fat or weigh too much, everything else does not matter. | □ | □ | □ | □ | □ | □ |
8 | I am a picky eater. | □ | □ | □ | □ | □ | □ |
9 | I do not like to try new food. | □ | □ | □ | □ | □ | □ |
10 | I am afraid of choking or vomiting while eating. | □ | □ | □ | □ | □ | □ |
11 | I am afraid of swallowing food. | □ | □ | □ | □ | □ | □ |
12 | I do not like to try food with a specific smell, taste, appearance, or a certain consistency (e.g., crispy or soft). | □ | □ | □ | □ | □ | □ |
13 | I like to eat things that are not meant for eating (e.g., sand). | □ | □ | □ | □ | □ | □ |
14 | I regurgitate food that I have already swallowed. | □ | □ | □ | □ | □ | □ |
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Białek-Dratwa, A.; Szymańska, D.; Grajek, M.; Krupa-Kotara, K.; Szczepańska, E.; Kowalski, O. ARFID—Strategies for Dietary Management in Children. Nutrients 2022, 14, 1739. https://doi.org/10.3390/nu14091739
Białek-Dratwa A, Szymańska D, Grajek M, Krupa-Kotara K, Szczepańska E, Kowalski O. ARFID—Strategies for Dietary Management in Children. Nutrients. 2022; 14(9):1739. https://doi.org/10.3390/nu14091739
Chicago/Turabian StyleBiałek-Dratwa, Agnieszka, Dorota Szymańska, Mateusz Grajek, Karolina Krupa-Kotara, Elżbieta Szczepańska, and Oskar Kowalski. 2022. "ARFID—Strategies for Dietary Management in Children" Nutrients 14, no. 9: 1739. https://doi.org/10.3390/nu14091739