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

Int J Eat Disord. 2024 Nov;57(11):2167-2175. doi: 10.1002/eat.24243. Epub 2024 Jun 28.

Abstract

Objective: Avoidant/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).

Method: In 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.

Results: Youth 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.

Discussion: Self-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.

Keywords: allergy and immunology; avoidant/restrictive food intake disorder; feeding and eating disorders; food allergies; gastrointestinal disease; high‐sensitive C‐reactive protein; lipid panel; metabolic diseases; nutritional insufficiency; triglycerides.

MeSH terms

  • Adolescent
  • Avoidant Restrictive Food Intake Disorder
  • Biomarkers* / blood
  • C-Reactive Protein / metabolism
  • Cardiovascular Diseases* / epidemiology
  • Child
  • Comorbidity*
  • Female
  • Heart Disease Risk Factors
  • Humans
  • Male

Substances

  • Biomarkers
  • C-Reactive Protein