Tratamento nutricional no transtorno alimentar restritivo evitativo: uma revisão integrativa

Autores

  • Deise Kelly Oliveira Cardoso Grupo de Obesidade e Transtornos Alimentares, GOTA, Instituto de Psiquiatria, IPUB, Universidade Federal do Rio de Janeiro, UFRJ, Rio de Janeiro, RJ, Brasil https://orcid.org/0000-0003-1052-4409
  • Carla Loureiro Mourilhe Silva Grupo de Obesidade e Transtornos Alimentares, GOTA, Instituto de Psiquiatria, IPUB, Universidade Federal do Rio de Janeiro, UFRJ, Rio de Janeiro, RJ, Brasil https://orcid.org/0000-0003-3636-1329
  • Carlos Eduardo Ferreira Moraes Grupo de Obesidade e Transtornos Alimentares, GOTA, Instituto de Psiquiatria, IPUB, Universidade Federal do Rio de Janeiro, UFRJ, Rio de Janeiro, RJ, Brasil https://orcid.org/0000-0002-8724-8652
  • Jose Carlos Borges Appolinário Grupo de Obesidade e Transtornos Alimentares, GOTA, Instituto de Psiquiatria, IPUB, Universidade Federal do Rio de Janeiro, UFRJ, Rio de Janeiro, RJ, Brasil https://orcid.org/0000-0002-6089-4400

DOI:

https://doi.org/10.25118/2763-9037.2023.v13.453

Palavras-chave:

transtorno da evitação ou restrição da ingestão de alimentos, neofobia alimentar, transtorno alimentar restritivo evitativo, TARE, transtorno alimentar

Resumo

O Transtorno Alimentar Restritivo Evitativo (TARE) consiste em uma perturbação na alimentação ou forma de comer, como uma aparente falta de interesse pela comida, evitação dos alimentos de acordo com determinadas características sensoriais e preocupação com consequências aversivas do comer, levando a uma incapacidade persistente em atender às necessidades nutricionais do organismo. O objetivo deste trabalho foi identificar e analisar os estudos, que abordam sobre o tratamento nutricional do TARE, com o intuito de auxiliar o profissional de nutrição na condução do tratamento adequado. Foi realizada uma revisão integrativa nas bases de dados Pubmed e Scielo utilizando como critérios de inclusão: tratamento, manejo e/ou gestão, cujo foco principal fosse tratamento nutricional da doença. Foram encontrados 163 artigos, desses somente 21 estudos foram incluídos na síntese interpretativa. O ano com o maior número de publicações foi 2019. Dentre os principais resultados, destacamos a necessidade de tratamento por uma equipe multidisciplinar treinada em transtornos alimentares, incluindo o profissional de nutrição, garantindo que o paciente tenha acesso à combinação médica, dietética e psicológica com maiores chances de sucesso e recuperação da saúde. Várias lacunas para trabalhos futuros foram encontradas, incluindo validação de instrumentos para avaliação do TARE; caracterização e diferenciação da doença em relação a anorexia nervosa; sistematização do tratamento nutricional de acordo com cada subgrupo característico do transtorno e a obtenção de dados epidemiológicos mais robustos.   

 

Downloads

Não há dados estatísticos.

Métricas

Carregando Métricas ...

Biografia do Autor

Deise Kelly Oliveira Cardoso, Grupo de Obesidade e Transtornos Alimentares, GOTA, Instituto de Psiquiatria, IPUB, Universidade Federal do Rio de Janeiro, UFRJ, Rio de Janeiro, RJ, Brasil

Carla Loureiro Mourilhe Silva, Grupo de Obesidade e Transtornos Alimentares, GOTA, Instituto de Psiquiatria, IPUB, Universidade Federal do Rio de Janeiro, UFRJ, Rio de Janeiro, RJ, Brasil

Carlos Eduardo Ferreira Moraes, Grupo de Obesidade e Transtornos Alimentares, GOTA, Instituto de Psiquiatria, IPUB, Universidade Federal do Rio de Janeiro, UFRJ, Rio de Janeiro, RJ, Brasil

Jose Carlos Borges Appolinário, Grupo de Obesidade e Transtornos Alimentares, GOTA, Instituto de Psiquiatria, IPUB, Universidade Federal do Rio de Janeiro, UFRJ, Rio de Janeiro, RJ, Brasil

Referências

American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-5. 5th ed. Washington: American Psychiatric Association; 2013. https://doi.org/10.1176/appi.books.9780890425596

Bourne L, Bryant-Waugh R, Cook J, Mandy W. Avoidant/restrictive food intake disorder: a systematic scoping review of the current literature. Psychiatry Res. 2020;288:112961. https://doi.org/10.1016/j.psychres.2020.112961 PMID:32283448

Feillet F, Bocquet A, Briend A, Chouraqui JP, Darmaun D, Frelut ML, Girardet JP, Guimber D, Hankard R, Lapillonne A, Peretti N, Rozé JC, Simeoni U, Turck D, Dupont C; Comité de nutrition de la Société française de pédiatrie. Nutritional risks of ARFID (avoidant restrictive food intake disorders) and related behavior. Arch Pediatr. 2019;26(7):437-41. https://doi.org/10.1016/j.arcped.2019.08.005 PMID:31500920

Thomas JJ, Lawson EA, Micali N, Misra M, Deckersbach T, Eddy KT. Avoidant/restrictive food intake disorder: a three-dimensional model of neurobiology with implications for etiology and treatment. Curr Psychiatry Rep. 2017;19:54. https://doi.org/10.1007/s11920-017-0795-5 PMID:28714048 - PMCID:PMC6281436

Zimmerman J, Fisher M. Avoidant/restrictive food intake disorder (ARFID). Curr Probl Pediatr Adolesc Health Care. 2017;47(4):95-103. https://doi.org/10.1016/j.cppeds.2017.02.005 PMID:28532967

Taylor CM, Wernimont SM, Northstone K, Emmett PM. Picky/fussy eating in children: review of definitions, assessment, prevalence and dietary intakes. Appetite. 2015;95:349-59. https://doi.org/10.1016/j.appet.2015.07.026 PMID:26232139

Dovey TM, Kumari V, Blissett J; Mealtime Hostage Parent Science Gang. Eating behaviour, behavioural problems and sensory profiles of children with avoidant/restrictive food intake disorder (ARFID), autistic spectrum disorders or picky eating: same or different? Eur Psychiatry. 2019;61:56-62. https://doi.org/10.1016/j.eurpsy.2019.06.008 PMID:31310945

Lowe KD, Barnes TL, Martell C, Keery H, Eckhardt S, Peterson CB, Lesser J, Le Grange D. Youth with avoidant/restrictive food intake disorder: examining differences by age, weight status, and symptom duration. Nutrients. 2019;11(8):1955. https://doi.org/10.3390/nu11081955 PMID:31434268 - PMCID:PMC6723819

Fisher MM, Rosen DS, Ornstein RM, Mammel KA, Katzman DK, Rome ES, Callahan ST, Malizio J, Kearney S, Walsh BT. Characteristics of avoidant/restrictive food intake disorder in children and adolescents: a "new disorder" in DSM-5. J Adolesc Health. 2014;55(1):49-52. https://doi.org/10.1016/j.jadohealth.2013.11.013 PMID:24506978

Badham J. Ensuring optimal breastfeeding and improvements in complementary feeding to improve infant and young child nutrition in developing countries. Matern Child Nutr. 2013;9(Suppl 1):1-5. https://doi.org/10.1111/mcn.12003 PMID:23167580 - PMCID:PMC6860879

Giugliani ERJ, Victora CG. Alimentação complementar. J Pediatr. Rio de Janeiro. 2000;76(Supl 3):S253-62. https://www.jped.com.br/pt-pdf-X2255553600029160

Brasil, Ministério da Saúde. Guia alimentar para crianças brasileiras menores de dois anos. Brasília: Ministério da Saúde; 2019. http://189.28.128.100/dab/docs/portaldab/publicacoes/guia_da_crianca_2019.pdf

Bialek-Dratwa A, Szymanska D, Grajek M, Krupa-Kotara K, Szczepanska E, Kowalski O. ARFID-strategies for dietary management in children. Nutrients. 2022;14(9):1739. https://doi.org/10.3390/nu14091739 PMID:35565707 PMCID:PMC9100178

Sociedade Brasileira de Pediatria. Manual de orientação para a alimentação do lactente, do pré-escolar, do escolar, do adolescente e na escola. 3. ed. rev. e ampliada. Rio de Janeiro: Sociedade Brasileira de Pediatria; 2012. https://www.sbp.com.br/fileadmin/user_upload/pdfs/14617a-PDManualNutrologia-Alimentacao.pdf

Victora CG, Adair L, Fall C, Hallal PC, Martorell R, Richter L, Sachdev HS; Maternal and Child Undernutrition Study Group. Maternal and child undernutrition: consequences for adult health and human capital. Lancet. 2008;371(9609):340-57. https://doi.org/10.1016/S0140-6736(07)61692-4 PMID:18206223 - PMCID:PMC2258311

González, C. Meu filho não come! Conselhos para prevenir e resolver esse problema. São Paulo: Editora Timo; 2016.

Dovey TM, Staples PA, Gibson EL, Halford JCG. Food neophobia and 'picky/fussy' eating in children: a review. Appetite. 2008;50(2-3):181-93. https://doi.org/10.1016/j.appet.2007.09.009 PMID:17997196

Lafraire J, Rioux C, Giboreau A, Picard D. Food rejections in children: cognitive and social/environmental factors involved in food neophobia and picky/fussy eating behavior. Appetite. 2016;96:347-57. https://doi.org/10.1016/j.appet.2015.09.008 PMID:26391004

Cooper M, Collison AO, Collica SC, Pan I, Tamashiro KL, Redgrave GW, Schreyer CC, Guarda AS. Gastrointestinal symptomatology, diagnosis, and treatment history in patients with underweight avoidant/restrictive food intake disorder and anorexia nervosa: impact on weight restoration in a meal-based behavioral treatment program. Int J Eat Disord. 2021;54(6):1055-62. https://doi.org/10.1002/eat.23535 PMID:33973254

Burton C, Allan E, Eckhardt S, Le Grange D, Ehrenreich-May J, Singh M, Dimitropoulos G. Case presentations combining family-based treatment with the unifield protocols for transdiagnostic treatment of emotional disorders in children and adolescents for comorbid avoidant restrictive food intake disorder and autism spectrum disorder. J Can Acad Child Adolesc Psychiatry. 2021;30(4):280-91. PMID:34777512 - PMCID:PMC8561848

Kerzner B, Milano K, MacLean WC Jr, Berall G, Stuart S, Chatoor I. A practical approach to classifying and managing feeding difficulties. Pediatrics. 2015;135(2):344-53. https://doi.org/10.1542/peds.2014-1630 - PMID:25560449

Ozier AD, Henry BW; American Dietetic Association. Position of the American Dietetic Association: nutrition intervention in the treatment of eating disorders. J Am Diet Assoc. 2011;111(8):1236-41. https://doi.org/10.1016/j.jada.2011.06.016 - PMID:21802573

Norris ML, Obeid N, Santos A, Valois DD, Isserlin L, Feder S, Spettigue W. Treatment needs and rates of mental health comorbidity in adolescent patients with ARFID. Front. Psychiatry. Sec. Psychological Therapy and Psychosomatics. 2021;12:680298.

https://doi.org/10.3389/fpsyt.2021.680298 - PMID:34349680 PMCID:PMC8327955

Murray HB, Calabrese S. Identification and management of eating disorders (including ARFID) in GI patients. Gastroenterol Clin North Am. 2022;51(4):765-83. https://doi.org/10.1016/j.gtc.2022.07.004 - PMID:36375995

Nascimento AG, Mattar LBF, Neri LCL, Yonamine GH, Silva APA. Educação nutricional em pediatria. Santana de Parnaíba: Editora Manole; 2018.

Petty MLB, Figueiredo M, Koritar P, Deram S, Pascoal C. Nutrição comportamental no atendimento de crianças. In: Alvarenga M, Figueiredo M, Timerman F, Antonaccio C, editores. Nutrição comportamental. 2. ed. Santana de Parnaíba: Editora Manole; 2019. p. 433-63.

Rowell K, McGlothlin J. Helping your child with extreme picky eating: a step-by-step guide for overcoming selective eating, food aversion, and feeding disorder. Oakland: New Harbinger Publications; 2015.

Trofholz AC, Schulte AK, Berge JM. How parents describe picky eating and its impact in family meals: a qualitative analysis. Appetite. 2017;110:36-43. https://doi.org/10.1016/j.appet.2016.11.027 - PMID:27889496 - PMCID:PMC5243124

Satter EM. The feeding relationship. J Am Diet Assoc. 1986;86(3):352-6. https://doi.org/10.1016/S0002-8223(21)03940-7 - PMID:3950279

Guss CE, Richmond TK, Forman S. A survey of physician practices on the inpatient medical stabilization of patients with avoidant/restrictive food intake disorder. J Eat Disord. 2018;6:22. https://doi.org/10.1186/s40337-018-0212-4 - PMID:30263118 - PMCID:PMC6157044

Brewerton TD, D'Agostino M. Adjunctive use of olanzapine in the treatment of avoidant restrictive food intake disorder in children and adolescents in an eating disorders program. J Child Adolesc Psychopharmacol. 2017;27(10):920-2. https://doi.org/10.1089/cap.2017.0133 PMID:29068721

Couturier J, Isserlin L, Norris M, Spettigue W, Brouwers M, Kimber M, McVey G, Webb C, Findlay S, Bhatnagar N, Snelgrove N, Ritsma A, Preskow W, Miller C, Coelho J, Boachie A, Steinegger C, Loewen R, Loewen T, Waite E, Ford C, Bourret K, Gusella J, Geller J, LaFrance A, LeClerc A, Scarborough J, Grewal S, Jericho M, Dimitropoulos G, Pilon D. Canadian practice guidelines for the treatment of children and adolescents with eating disorders. J Eat Disord. 2020;8:4. https://doi.org/10.1186/s40337-020-0277-8 PMID:32021688 - PMCID:PMC6995106

Eddy KT, Thomas JJ. Introduction to a special issue on child and adolescent feeding and eating disorders and avoidant/restrictive food intake disorder. Int J Eat Disord. 2019;52(4):327-30. https://doi.org/10.1002/eat.23052 - PMID:30793776

Thomas JJ, Wons OB, Eddy KT. Cognitive-behavioral treatment of avoidant/restrictive food intake disorder. Curr Opin Psychiatry. 2018;31(6):425-30.

https://doi.org/10.1097/YCO.0000000000000454 - PMID:30102641 - PMCID:PMC6235623

Mammel KA, Ornstein RM. Avoidant/restrictive food intake disorder: a new eating disorder diagnosis in the diagnostic and statistical manual 5. Curr Opin Pediatr. 2017;29(4):407-13. https://doi.org/10.1097/MOP.0000000000000507 -PMID:28537947

Pisciolaro F, Figueiredo M, Paulino E, Alvarenga M. Nutrição comportamental no atendimento de crianças. In: Alvarenga M, Figueiredo M, Timerman F, Antonaccio C, editores. Nutrição comportamental. 2. ed. Santana de Parnaíba: Editora Manole; 2019. p. 300-28.

Breiner CE, Miller ML, Hormes JM. ARFID parent training protocol: a randomized pilot trial evaluating a brief, parent-training program for avoidant/restrictive food intake disorder. Int J Eat Disord. 2021;54(12):2229-35. https://doi.org/10.1002/eat.23643 - PMID:34779528

Toomey KA. Picky eaters versus problem feeders. [place unknown]: [publisher unknown]; 2010, c2000. https://sosapproachtofeeding.com/wp-content/uploads/2019/01/Picky-Eaters-VS-Problem-Feeders.pdf

Kennedy GA, Wick MR, Keel PK. Eating disorders in children: is avoidant-restrictive food intake disorder a feeding disorder or an eating disorder and what are the implications for treatment? F1000Res. 2018;7:88. https://doi.org/10.12688/f1000research.13110.1 - PMID:29399331 PMCID:PMC5773930

Petty ML. Dificuldades alimentares na infância e transtorno alimentar restritivo evitativo. In: Alvarenga MS, Dunker KLL, Philippi ST, editores. Transtornos alimentares e nutrição da prevenção ao tratamento. Santana de Parnaíba: Editora Manole; 2020. p. 41-66.

Dolman L, Thornley S, Doxtdator K, Leclerc A, Findlay S, Grant C, Breakey VR, Couturier J. Multimodal therapy for rigid, persistent avoidant/restrictive food intake disorder (ARFID) since infancy: a case report. Clin Child Psychol Psychiatry. 2021;26(2):451-63. https://doi.org/10.1177/1359104520981401 - PMID:33334145

Hay P, Chinn D, Forbes D, Madden S, Newton R, Sugenor L, Touyz S, Ward W; Royal Australian and New Zealand College of Psychiatrists. Royal Australian and New Zealand college of psychiatrists clinical practice guidelines for the treatment of eating disorders. Aust N Z J Psychiatry. 2014;48(11):977-1008. https://doi.org/10.1177/0004867414555814 - PMID:25351912

Lock J, Sadeh-Sharvit S, L'Insalata A. Feasibility of conducting a randomized clinical trial using family-based treatment for avoidant/restrictive food intake disorder. Int J Eat Disord. 2019;52(6):746-51. https://doi.org/10.1002/eat.23077 PMID:30924958

Mahr F, Billman M, Essayli JH, Loney SEL. Selective serotonin reuptake inhibitors and hydroxyzine in the treatment of avoidant/restrictive food intake disorder in children and adolescents: rationale and evidence. J Child Adolesc Psychopharmacol. 2022;32(2):117-21. https://doi.org/10.1089/cap.2021.0038 PMID:34619050

Kambanis PE, Thomas JJ. Assessment and treatment of avoidant/restrictive food intake disorder. Curr Psychiatry Rep. 2023;25:53-64. https://doi.org/10.1007/s11920-022-01404-6 PMID:36640211

Peck SK, Towne T, Wierenga CE, Hill L, Eisler I, Brown T, Han E, Miller M, Perry T, Kaye W. Temperament-based treatment for young adults with eating disorders: acceptability and initial efficacy of an intensive, multi-family, parent-involved treatment. J Eat Disord. 2021;9:110. https://doi.org/10.1186/s40337-021-00465-x PMID:34496951 - PMCID:PMC8424819

Shimshoni Y, Silverman WK, Lebowitz ER. SPACE-ARFID: a pilot trial of a novel parent-based treatment for avoidant/restrictive food intake disorder. Int J Eat Disord. 2020;53(10):1623-35. https://doi.org/10.1002/eat.23341 - PMID:33464594

Thomas JJ, Becker KR, Kuhnle MC, Jo JH, Harshman SG, Wons OB, Keshishian AC, Hauser K, Breithaupt L, Liebman RE, Mirsa M, Wilhelm S, Lawson EA, Eddy KT. Cognitive-behavioral therapy for avoidant/restrictive food intake disorder: feasibility, acceptability, and proof-of-concept for children and adolescents. Int J Eat Disord. 2020;53(10):1636-46. https://doi.org/10.1002/eat.23355 PMID:32776570 - PMCID:PMC7719612

Wong L, Goh LG, Ramachandran R. Evolution of paediatric eating disorders in Singapore: a historical cohort study. Arch Dis Child. 2022;107(11):1046-8. https://doi.org/10.1136/archdischild-2022-323925 - PMID:35851292

Van Wye E, Matheson B, Citron K, Yang HJ, Datta N, Bohon C, Lock JD. Protocol for a randomized clinical trial for avoidant restrictive food intake disorder (ARFID) in low-weight youth. Contemp Clin Trials. 2023;124:107036. https://doi.org/10.1016/j.cct.2022.107036 - PMID:36460266

De Toro V, Aedo K, Urrejola P. Trastorno de evitación y restricción de la ingesta de alimentos (ARFID): lo que el pediatra debe saber. Andes Pediatr. 2021;92(2):298-307. https://doi.org/10.32641/andespediatr.v92i2.2794 PMID:34106171

Herpertz-Dahlmann B. Treatment of eating disorders in child and adolescent psychiatry. Curr Opin Psychiatry. 2017;30(6):438-45. https://doi.org/10.1097/YCO.0000000000000357 PMID:28777106

Katzman DK, Norris ML, Zucker N. Avoidant restrictive food intake disorder. Psychiatr Clin North Am. 2019;42(1):45-57. https://doi.org/10.1016/j.psc.2018.10.003 - PMID:30704639

Lesser AD, Mathis ES, Melicosta ME. Avoidant and restrictive food intake disorder: outcomes for 16 inpatient cases to target oral consumption using a medical and behavioral treatment model. Clin Pediatr (Phila). 2022;61(4):362-9. https://doi.org/10.1177/00099228221078419 PMID:35168390

Makhzoumi SH, Schreyer CC, Hansen JL, Laddaran LA, Redgrave GW, Guarda AS. Hospital course of underweight youth with ARFID treated with a meal-based behavioral protocol in an inpatient-partial hospitalization program for eating disorders. Int J Eat Disord. 2019;52(4):428-34. https://doi.org/10.1002/eat.23049 - PMID:30779365

Milano K, Chatoor I, Kerzner B. A functional approach to feeding difficulties in children. Curr Gastroenterol Rep. 2019;21:51. https://doi.org/10.1007/s11894-019-0719-0 - PMID:31444689

Ornstein RM, Essayli JH, Nicely TA, Masciulli E, Lane-Loney S. Treatment of avoidant/restrictive food intake disorder in a cohort of young patients in a partial hospitalization program for eating disorders. Int J Eat Disord. 2017;50(9):1067-74. https://doi.org/10.1002/eat.22737 - PMID:28644568

Sharp WG, Volkert VM, Scahill L, McCracken CE, McElhanon B. A systematic review and meta-analysis of intensive multidisciplinary intervention for pediatric feeding disorders: how standard is the standard of care? J Pediatr. 2017;181:116-124.e4. https://doi.org/10.1016/j.jpeds.2016.10.002 - PMID:27843007

Sharp WG, Burrell TL, Berry RC, Stubbs KH, McCracken CE, Gillespie SE, Scahill L. The autism managing eating aversions and limited variety plan vs parent education: a randomized clinical trial. J Pediatr. 2019;2011:185-192.e1. https://doi.org/10.1016/j.jpeds.2019.03.046 PMID:31056202 PMCID:PMC6661002

Waddle C, Gillespie SE. Examination of pediatric tube feeding schedules and oral intake: a retrospective cross-sectional study. Nutr Clin Pract. 2023;38(2):458-64. https://doi.org/10.1002/ncp.10912 - PMID:36172890

Downloads

Publicado

2023-05-06

Como Citar

1.
Cardoso DKO, Silva CLM, Moraes CEF, Appolinário JCB. Tratamento nutricional no transtorno alimentar restritivo evitativo: uma revisão integrativa. Debates em Psiquiatria [Internet]. 6º de maio de 2023 [citado 24º de junho de 2024];13:1-34. Disponível em: https://revistardp.org.br/revista/article/view/453

Edição

Seção

Artigos de Revisão

Plaudit

Artigos mais lidos do(s) mesmo(s) autor(es)