Avoidant-restrictive food intake disorder (ARFID): A treatable complication of food allergy

Patrawala, Meera; Vickery, Brian P.; Proctor, Kaitlin B.; Scahill, Lawrence David; Stubbs, Kathryn H.; Sharp, William G.

doi:10.1016/j.jaip.2021.07.052

Cited by 20 publications

(9 citation statements)

References 9 publications

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“…One important risk factor for food exclusion can be the development of feeding issues/difficulties and mealtime behavioral concerns have been described in children with food allergy 32 . A recent study found a high incidence of avoidant‐restrictive food intake disorder (ARFID) in children with food allergy, with 37% meeting the criteria for diagnosis when assessed by a psychologist 33 . Conversely, a high incidence of food allergy has been reported in children referred to a multidisciplinary feeding clinic compared with the general population, suggesting an association between food allergy and feeding difficulties 34 .…”

Section: Resultsmentioning

confidence: 99%

“…32 A recent study found a high incidence of avoidantrestrictive food intake disorder (ARFID) in children with food allergy, with 37% meeting the criteria for diagnosis when assessed by a psychologist. 33 Conversely, a high incidence of food allergy has been reported in children referred to a multidisciplinary feeding clinic compared with the general population, suggesting an association between food allergy and feeding difficulties. 34 Adolescents with food allergy are more likely to have anorexia nervosa.…”

Section: Risk Factorsmentioning

confidence: 99%

See 1 more Smart Citation

Food allergy—A holistic approach to dietary management. A joint EAACI Research & Outreach Committee and INDANA review

Skypala,

Reese,

Durban

et al. 2023

Pediatric Allergy Immunology

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Following a diagnosis of IgE‐mediated food allergy, to secure the best outcome, the patient should receive individualized advice tailored to their specific needs, which considers the type and presentation of the food involved, level of exclusion required, risk of cross‐contamination and any variance required for age, ethnicity, financial issues, and lifestyle. Issues such as food labels “may contain” statements, and variation in the threshold of reaction and impact of cofactors should also be considered. Most important is the need to ensure that the diagnosis is robust, especially given the nutritional, psychological, and socioeconomic issues that can affect an individual with a diagnosis of food allergy. Unnecessary exclusion of one or more foods that have not triggered allergic reactions, especially in individuals with allergic comorbidities, can result in severe IgE‐mediated reactions on re‐exposure. Given that food allergies may change over time, the diagnosis should be reviewed, to determine whether resolution is likely, or new‐food triggers are reported. Regular assessment is vital, especially during childhood, to ensure reintroduction occurs at an appropriate time, thus enabling increased diversity of the diet and improvement in the quality of life. For some, an IgE‐mediated food allergy may necessitate the life‐long exclusion of foods, and for others, a food habitually eaten suddenly triggers an allergic reaction in adult life. People of all ages, ethnicities, and socioeconomic backgrounds deserve individual advice on the management of their food allergy to support a healthy diet and improve quality of life.

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Section: Resultsmentioning

confidence: 99%

Section: Risk Factorsmentioning

confidence: 99%

Food allergy—A holistic approach to dietary management. A joint EAACI Research & Outreach Committee and INDANA review

Skypala,

Reese,

Durban

et al. 2023

Pediatric Allergy Immunology

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“…To the Editor, Food allergy (FA) may affect mental health. 1 However, reviews analyzing this association present conflicting results, [2][3][4] the FA and control groups yielded significant results only for age and CCI (both p < .001; Table S1).…”

Section: Food Allergy Is Associated With Increased Risk Of Developing...mentioning

confidence: 99%

“…To our knowledge, this is the largest population-based study confirming the association between FA and PDs. Reviews have found that depression is associated with FA, although it was selfreported, possibly skewing the results, 1 and that health-related quality of life in FA is reduced, but that a definite association with PDs remains unclear. 2 This association may be bidirectional: chronic FAinduced stress by itself may trigger Th2 immunity, as demonstrated in asthma.…”

Section: Food Allergy Is Associated With Increased Risk Of Developing...mentioning

confidence: 99%

Food allergy is associated with increased risk of developing psychological disorders: A nationwide study of 603,257 Israelis

Nemet

Mahlab-Guri

Elbirt

et al. 2023

Allergy

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“…The type of quality of life impairments can vary, with one pediatric study showing that 100% of outpatients experienced family functioning impairment and 41% experienced social functioning impairment 20 . Another interview-based pediatric study showed that 63% of 54 children with food allergies met DSM-5 criteria for ARFID with dietary restrictions deemed beyond what would be medically necessary (ie, beyond allergen-containing foods) and with greater than expected psychosocial impairment reported by caregivers in the form of, for example, distressing and rigid eating behaviors 21 . More research characterizing the quality of life impairments in ARFID is needed, especially in adults.…”

Section: What Is Arfid?mentioning

confidence: 99%

The Intersection of Disorders of Gut-Brain Interaction With Avoidant/Restrictive Food Intake Disorder

Weeks¹,

Abber

Thomas

et al. 2023

Journal of Clinical Gastroenterology

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High rates of overlap exist between disorders of gut-brain interaction (DGBI) and eating disorders, for which common interventions conceptually conflict. There is particularly increasing recognition of eating disorders not centered on shape/weight concerns, specifically avoidant/restrictive food intake disorder (ARFID) in gastroenterology treatment settings. The significant comorbidity between DGBI and ARFID highlights its importance, with 13% to 40% of DGBI patients meeting full criteria for or having clinically significant symptoms of ARFID. Notably, exclusion diets may put some patients at risk for developing ARFID and continued food avoidance may perpetuate preexisting ARFID symptoms. In this review, we introduce the provider and researcher to ARFID and describe the possible risk and maintenance pathways between ARFID and DGBI. As DGBI treatment recommendations may put some patients at risk for developing ARFID, we offer recommendations for practical treatment management including evidence-based diet treatments, treatment risk counseling, and routine diet monitoring. When implemented thoughtfully, DGBI and ARFID treatments can be complementary rather than conflicting.

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Avoidant-restrictive food intake disorder (ARFID): A treatable complication of food allergy

Cited by 20 publications

References 9 publications

Food allergy—A holistic approach to dietary management. A joint EAACI Research & Outreach Committee and INDANA review

Food allergy—A holistic approach to dietary management. A joint EAACI Research & Outreach Committee and INDANA review

Food allergy is associated with increased risk of developing psychological disorders: A nationwide study of 603,257 Israelis

The Intersection of Disorders of Gut-Brain Interaction With Avoidant/Restrictive Food Intake Disorder

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