PICKY EATING…OR SOMETHING MORE SERIOUS?
All You Need To Know About Avoidant Restrictive Food Intake Disorder
ARE YOUR KIDS PICKY EATERS?
Kids can be picky eaters and it’s natural for you, as a parent, to wonder if yours are getting all their nutritional needs met. How many times have you seen your toddler subsist on little more than crackers and milk?
Many kids go through periods of pickiness - it’s a part of trying to find some control in their new, exciting, and sometimes overwhelming world. For some children and adolescents (or even adults!), however, pickiness persists and evolves into something more serious.
Avoidant/Restrictive Food Intake Disorder (ARFID) is a feeding disturbance characterized by a continual failure to achieve the appropriate nutritional or energy needs for development. ARFID usually presents in children, but can affect some adults, especially after experiencing trauma or stroke. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) states that a person with ARFID may experience:
● Significant weight loss or failure to achieve the expected weight gain pattern in childhood (failure to thrive)
● Nutritional deficiencies
● Complete or partial dependence on enteral feeding (delivery of nutrition via tube directly into the duodenum or stomach) or oral nutritional supplementation for both macro and micronutrients
● Interference with development (developmental delay), especially psychosocial functioning
WHAT IS ARFID?
The true prevalence of ARFID is unknown, though several studies have attempted to surveille children and adolescents across ages to pinpoint how common it can be. One school-based evaluation of 1,144 children aged 8 to 13 in Switzerland indicated that as much as 3.2% of the sample population could be diagnosed with ARFID!
ARFID often affects younger children, affects a higher proportion of males, and tends to accompany other disorders. It is important to understand that ARFID is more than just “picky eating” but is a true dysfunction in eating behavior that can affect an individual’s ability to thrive and function normally. An individual with ARFID does not avoid food to achieve thinness nor do they have issues with body image; ARFID can only be diagnosed if the symptoms cannot be better explained by another eating disorder.
THE DANGERS OF ARFID
The inherent and practical danger of ARFID is lack of proper nutrition that can lead to deficiencies. A body requires many different vitamins, minerals, and macronutrients (carbohydrates, protein, and fats) to develop and prevent the onset of disease. Nutrient deficiencies can lead to a variety of health problems, such as stunted bone growth, skin problems, digestion issues, and even neurological problems. Some possible micronutrient deficiencies associated with ARFID include:
● Vitamin A deficiency. This can affect the appropriate development of eyesight and weaken the immune system. Vitamin A can be found in a variety of sources, especially orange and green vegetables.
● Folate deficiency. Folate plays a crucial role in brain and spinal cord development, which is why it is so essential for pregnant women to take. to insure proper fetal development. Natural sources of folate can be found in leafy green vegetables, citrus fruits, and beans.
● Vitamin D deficiency. Vitamin D is a nutrient critical to the development of a healthy immune system and in particular can help protect people from respiratory tract infections. It also promotes the absorption of calcium and phosphorous necessary for proper bone development and growth. Typically vitamin D is made by your body naturally with exposure to the sun, but dietary sources can also be meaningful contributors of this important nutrient. Vitamin D is found in mushrooms (one of the only vegetable sources of the vitamin) and fresh fish.
ENOF CAN HELP!
The good news, though, is that products such as ENOF (learn more about ENOF in this short video) can help overcome these deficiencies. A single serving of ENOF, just 1/12th of a teaspoon, packs in the nutritional equivalent of 2.5 servings of vegetables, all from organic spinach, broccoli, carrots, beets, tomatoes and shiitake mushrooms. Whether you or your child avoids vegetables as a function of ARFID or simply from picky eating, ENOF can become an important part of addressing nutrition gaps in your diet.