Medical Comorbidities, Nutritional Markers, and Cardiovascular Risk Markers in Youth With ARFID

Author:

Burton‐Murray Helen123ORCID,Sella Aluma Chovel45,Gydus Julia E.56,Atkins Micaela12,Palmer Lilian P.6,Kuhnle Megan C.56,Becker Kendra R.136ORCID,Breithaupt Lauren E.1367ORCID,Brigham Kathryn S.138,Aulinas Anna91011ORCID,Staller Kyle12,Eddy Kamryn T.136ORCID,Misra Madhusmita1312ORCID,Micali Nadia131415,Thomas Jennifer J.136ORCID,Lawson Elizabeth A.135

Affiliation:

1. Harvard Medical School Boston Massachusetts USA

2. Center for Neurointestinal Health, Division of Gastroenterology Massachusetts General Hospital Boston Massachusetts USA

3. Mass General Brigham Eating Disorders Research Collaborative Boston Massachusetts USA

4. The Jesse Z. and Sara Lea Shafer Institute of Endocrinology and Diabetes, National Center for Childhood Diabetes Schneider Children's Medical Center of Israel Petah Tikva Israel

5. Neuroendocrine Unit, Division of Endocrinology, Department of Medicine Massachusetts General Hospital Boston Massachusetts USA

6. Eating Disorders Clinical and Research Program Massachusetts General Hospital Boston Massachusetts USA

7. Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology Massachusetts General Hospital Charlestown Massachusetts USA

8. Division of Adolescent and Young Adult Medicine Massachusetts General Hospital Boston Massachusetts USA

9. Department of Endocrinology and Nutrition, Hospital de la Santa Creu i Sant Pau IR‐SANTPAU Barcelona Spain

10. Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER Unidad 747), ISCIII Barcelona Spain

11. Department of Medicine University of Vic – Central University of Catalonia Barcelona Spain

12. Division of Pediatric Endocrinology Massachusetts General Hospital Boston Massachusetts USA

13. Great Ormond Street Institute of Child Health University College London London UK

14. Center for Eating and Feeding Disorders Research, Psychiatric Centre Ballerup Mental Health Services in the Capital Region of Denmark Copenhagen Denmark

15. Institute of Biological Psychiatry, Mental Health Center Sct. Hans Mental Health Services Copenhagen Roskilde Denmark

Abstract

ABSTRACTObjectiveAvoidant/restrictive food intake disorder (ARFID) is common among populations with nutrition‐related medical conditions. Less is known about the medical comorbidity/complication frequencies in youth with ARFID. We evaluated the medical comorbidities and metabolic/nutritional markers among female and male youth with full/subthreshold ARFID across the weight spectrum compared with healthy controls (HC).MethodIn youth with full/subthreshold ARFID (n = 100; 49% female) and HC (n = 58; 78% female), we assessed self‐reported medical comorbidities via clinician interview and explored abnormalities in metabolic (lipid panel and high‐sensitive C‐reactive protein [hs‐CRP]) and nutritional (25[OH] vitamin D, vitamin B12, and folate) markers.ResultsYouth with ARFID, compared with HC, were over 10 times as likely to have self‐reported gastrointestinal conditions (37% vs. 3%; OR = 21.2; 95% CI = 6.2–112.1) and over two times as likely to have self‐reported immune‐mediated conditions (42% vs. 24%; OR = 2.3; 95% CI = 1.1–4.9). ARFID, compared with HC, had a four to five times higher frequency of elevated triglycerides (28% vs. 12%; OR = 4.0; 95% CI = 1.7–10.5) and hs‐CRP (17% vs. 4%; OR = 5.0; 95% CI = 1.4–27.0) levels.DiscussionSelf‐reported gastrointestinal and certain immune comorbidities were common in ARFID, suggestive of possible bidirectional risk/maintenance factors. Elevated cardiovascular risk markers in ARFID may be a consequence of limited dietary variety marked by high carbohydrate and sugar intake.

Funder

National Institute of Mental Health

National Center for Advancing Translational Sciences

National Institute of Diabetes and Digestive and Kidney Diseases

Nutrition Obesity Research Center at Harvard

Publisher

Wiley

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