Early neurodevelopmental problems and risk for avoidant/restrictive food intake disorder (ARFID) in 4‐7‐year‐old children: A Japanese birth cohort study

Abstract

Background: An overrepresentation of neurodevelopmental problems (NDPs) has been observed in individuals with avoidant/restrictive food intake disorder (ARFID).Previous studies on the association between ARFID and NDPs have been limited by cross-sectional data from clinical samples of small size. This study aimed to extend previous research by using prospectively collected data in a non-clinical child cohort.We examined the occurrence of early NDPs in 4-7-year-old children with suspected ARFID and how predictive early NDPs are of ARFID. Methods: Data were collected via parent-report a sub-sample of the Japan Environment and Children's Study (JECS) including 3728 children born 2011-2014 in Kochi prefecture. NDPs were assessed biannually between 0.5 and 3 years of age with the Ages and Stages Questionnaire-3, at age 2.5 years with the ESSENCE-Q, and at age 1 and 3 years via parent-reported clinical diagnoses. ARFID was identified cross-sectionally (at age 4-7 years) using a newly developed screening tool. Logistic regressions were used to test association of (1) a composite early NDP risk score, (2) specific early NDPs, and (3) neurodevelopmental trajectories over time with ARFID. Results: Children in the highest risk percentiles of the NDP risk score had roughly three times higher odds of having suspected ARFID; the absolute risk of later ARFID for children above the 90th percentile was 3.1%. Early NDPs (excluding early This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

What do we know about the epidemiology of avoidant/restrictive food intake disorder in children and adolescents? A systematic review of the literature

“…The majority were conducted in Western countries ( n = 23) (Bertrand et al., 2021; Cooney et al., 2018; Eddy et al., 2015; Farag et al., 2022; Fisher et al., 2014, 2015; Forman et al., 2014; Goldberg et al., 2020; Gonçalves et al., 2019; Katzman et al., 2021; Koomar et al., 2021; Krom et al., 2019; Kurz et al., 2015; Murray et al., 2022; Nicely et al., 2014; Norris et al., 2014; Nygren et al., 2021; Ornstein et al., 2013; Pinhas et al., 2017; Schmidt et al., 2018; Schöffel et al., 2021; Venema et al., 2022; Williams et al., 2015), predominantly the USA ( n = 9) (Eddy et al., 2015; Fisher et al., 2014, 2015; Forman et al., 2014; Koomar et al., 2021; Murray et al., 2022; Nicely et al., 2014; Ornstein et al., 2013; Williams et al., 2015), with two carried out in multiple countries (Fisher et al., 2014; Pinhas et al., 2017). One study took place in the Middle East (Iron‐Segev et al., 2022) and six in East Asian countries: four in Japan (Dinkler et al., 2022a, 2022b; Seike et al., 2016a, 2016b), one in Taiwan (Chen et al., 2020) and one in Singapore (Wong et al., 2022). The majority ( n = 21) of studies focussed on clinical populations (Bertrand et al., 2021; Cooney et al., 2018; Eddy et al., 2015; Farag et al., 2022; Fisher et al., 2014, 2015; Forman et al., 2014; Goldberg et al., 2020; Katzman et al., 2021; Koomar et al., 2021; Krom et al., 2019; Murray et al., 2022; Nicely et al., …”

“…By contrast, the Canadian national surveillance study of ARFID with patients aged 5–18 years found the highest incidence in the 10–14 years old group (3.43 per 100,000 patients) (Katzman et al., 2021 ). The average age of patients with ARFID in the included studies ranged from 1.85 to 16.3 years (Cooney et al., 2018 ; Dinkler et al., 2022a , 2022b ; Eddy et al., 2015 ; Farag et al., 2022 ; Fisher et al., 2014 , 2015 ; Forman et al., 2014 ; Goldberg et al., 2020 ; Katzman et al., 2021 ; Krom et al., 2019 ; Murray et al., 2022 ; Nicely et al., 2014 ; Norris et al., 2014 ; Nygren et al., 2021 ; Pinhas et al., 2017 ; Schöffel et al., 2021 ; Venema et al., 2022 ; Wong et al., 2022 ).…”

“…The PRISMA flowchart is shown in Figure 1 and summarises the stages of the review. Thirty studies met inclusion criteria and were included in the review (Bertrand et al., 2021 ; Chen et al., 2020 ; Cooney et al., 2018 ; Dinkler et al., 2022a , 2022b ; Eddy et al., 2015 ; Farag et al., 2022 ; Fisher et al., 2014 , 2015 ; Forman et al., 2014 ; Goldberg et al., 2020 ; Gonçalves et al., 2019 ; Iron‐Segev et al., 2022 ; Katzman et al., 2021 ; Koomar et al., 2021 ; Krom et al., 2019 ; Kurz et al., 2015 ; Murray et al., 2022 ; Nicely et al., 2014 ; Norris et al., 2014 ; Nygren et al., 2021 ; Ornstein et al., 2013 ; Pinhas et al., 2017 ; Schmidt et al., 2018 ; Schöffel et al., 2021 ; Seike et al., 2016a , 2016b ; Venema et al., 2022 ; Williams et al., 2015 ; Wong et al., 2022 ). Key aspects of the included studies using clinical samples are presented in Table 1 and those using community and school samples in Table 2 .…”

“…One of the studies included in this review used surveillance methodology and found the incidence of ARFID in children and adolescents aged 5–18 in Canada was 2.02 (95%CI, 1.76–2.31) per 100,000 patients (Katzman et al., 2021 ). Finally, studies from non‐clinical samples used self‐report or parent‐report instruments (6 of 29 studies) with ARFID estimates ranging from 0.3% to 15.5% (Chen et al., 2020 ; Dinkler et al., 2022a ; Gonçalves et al., 2019 ; Iron‐Segev et al., 2022 ; Kurz et al., 2015 ; Schmidt et al., 2018 ) and one used a risk score to identify ARFID in children with neurodevelopmental problems (those on the 90 th percentile for neurodevelopmental problems presented with a risk of 3.1% of having ARFID) (Dinkler et al., 2022b ). In addition, two other studies reported that the encounter rate of students with ARFID by Yogo teachers (a particular type of teachers in Japan responsible for monitoring students' height and weight and leading on health education) ranged from 10.7% to 13% (Seike et al., 2016a , 2016b ).…”

“…Neurodevelopmental disorders are also common, especially ASD. Results from this review showed that the prevalence of ARFID in individuals with ASD can be as high as 28% (Koomar et al., 2021 ; Nygren et al., 2021 ) and children with several neurodevelopmental problems had three times higher odds of having ARFID (Dinkler et al., 2022b ). This is consistent with a meta‐analysis which found that feeding difficulties were five times more frequent in children with ASD than in typically developing children, with higher levels of nutritional deficiency in the ASD population (Sharp et al., 2013 ).…”