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Are Food Allergies Linked to ARFID in Kids?

Published May 31, 2024

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Avoidant/Restrictive Food Intake Disorder (ARFID) is a relatively new diagnosis in the field of eating disorders, characterized by a persistent failure to meet nutritional needs due to an apparent lack of interest in eating, avoidance based on sensory characteristics of food, or concern about aversive consequences of eating. In this blog, we’ll explore what the current scientific literature tells us about whether if food allergies are linked to ARFID in kids. 

What is ARFID in Kids?

ARFID goes beyond typical picky eating and can lead to significant nutritional deficiencies, weight loss, or growth issues. Unlike other eating disorders, ARFID is not driven by body image concerns but rather by fear of adverse reactions or an aversion to certain food textures, smells, or tastes.

The Role of Food Allergies

Food allergies are adverse immune responses to specific foods, which can cause symptoms ranging from mild hives to severe anaphylaxis. These allergic reactions can understandably lead to food aversion and avoidance, potentially contributing to the development of ARFID.

  1. Prevalence of Food Allergies: According to a study published inPediatrics, food allergies affect approximately 8% of kids in the United States, with the most common allergens being peanuts, milk, shellfish, and tree nuts. These allergies can significantly impact dietary choices and behaviors.

  2. Impact on Eating Behavior: A study in theJournal of Allergy and Clinical Immunology found that kids with food allergies often exhibit heightened anxiety about eating and a tendency to avoid new or potentially allergenic foods. This avoidance can mirror the restrictive eating patterns seen in ARFID.

  3. Psychological Effects: The psychological impact of managing food allergies can contribute to disordered eating. Research from theJournal of Pediatric Psychology indicates that the constant vigilance required to avoid allergens can lead to heightened anxiety and fear around food, increasing the risk of developing ARFID.

  4. Sensory Sensitivities: Kids with food allergies may also have heightened sensory sensitivities, which can exacerbate food aversion. A study inAppetite found that sensory processing issues are more common in kids with ARFID, suggesting a potential overlap with the sensory aversions experienced by those with food allergies.

  5. Nutritional Deficiencies: Due to the restrictive nature of both food allergies and ARFID, affected kids are at a higher risk of nutritional deficiencies. Research in theEuropean Journal of Clinical Nutrition highlights that kids with food allergies who also exhibit restrictive eating behaviors may not receive adequate nutrients, exacerbating health issues and growth concerns.

Linking Food Allergies to ARFID

The link between food allergies and ARFID is becoming increasingly evident through various studies. While not all kids with food allergies develop ARFID, the anxiety and restrictive eating patterns associated with managing food allergies can contribute to the development of ARFID.

  • Case Studies and Clinical Observations: Clinical observations and case studies reported inEating Disorders: The Journal of Treatment & Prevention suggest that kids with severe food allergies are more likely to develop ARFID due to their heightened fear and anxiety around food intake.
  • Prevalence in Clinical Populations: In clinical settings, studies have shown a higher prevalence of food allergies among kids diagnosed with ARFID compared to the general population. This correlation indicates that food allergies can be a significant factor in the development and maintenance of ARFID.

Managing ARFID and Food Allergies

Addressing ARFID in kids with food allergies requires a multidisciplinary approach, involving pediatricians, allergists, dietitians, and mental health professionals. Strategies may include:

  • Nutritional Counseling: Ensuring balanced nutrition despite dietary restrictions.
  • Behavioral Therapy: Addressing anxiety and sensory sensitivities related to food.
  • Allergy Management: Educating families on safe food practices to reduce anxiety around eating.

Summary

Food allergies are significantly linked to ARFID in kids, with the anxiety and restrictive eating patterns associated with managing food allergies contributing to the development of ARFID. 

References:

  1. Pediatrics: "Prevalence of Food Allergies in US Children" (2011)
  2. Journal of Allergy and Clinical Immunology: "Eating Behaviors in Children with Food Allergies" (2015)
  3. Journal of Pediatric Psychology: "Psychological Impact of Food Allergies on Children" (2016)
  4. Appetite: "Sensory Sensitivities and ARFID" (2018)
  5. European Journal of Clinical Nutrition: "Nutritional Deficiencies in Children with Food Allergies" (2017)
  6. Eating Disorders: The Journal of Treatment & Prevention: "Case Studies of ARFID in Children with Food Allergies" (2019)
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