September 16, 2011 ISMA Annual Meeting The Picky Eater: Pediatric conditions with adult consequences...
-
Upload
noah-norton -
Category
Documents
-
view
217 -
download
0
Transcript of September 16, 2011 ISMA Annual Meeting The Picky Eater: Pediatric conditions with adult consequences...
![Page 1: September 16, 2011 ISMA Annual Meeting The Picky Eater: Pediatric conditions with adult consequences Theresa Rohr-Kirchgraber, MD, FACP.](https://reader036.fdocuments.net/reader036/viewer/2022062713/56649ced5503460f949baa5c/html5/thumbnails/1.jpg)
September 16, 2011 ISMA Annual Meeting
The Picky Eater: Pediatric conditions with adult
consequences
Theresa Rohr-Kirchgraber, MD, FACP
![Page 2: September 16, 2011 ISMA Annual Meeting The Picky Eater: Pediatric conditions with adult consequences Theresa Rohr-Kirchgraber, MD, FACP.](https://reader036.fdocuments.net/reader036/viewer/2022062713/56649ced5503460f949baa5c/html5/thumbnails/2.jpg)
Dietary Guidelines 2010http://www.choosemyplate.gov/foodgroups/downloads/MyPlate/selectedmessages.pdf
Balancing CaloriesEnjoy your food, but eat lessAvoid oversized protions
Foods to IncreaseMake ½ plate fruits and vegetablesMake ½ grains whole grainsSwitch to fat-free or low-fat milk
Foods to ReduceCompare sodium in foods like soup, bread, and frozen meals and choose the foods with lower numbersDrink water in stead of sugary drinks.
![Page 3: September 16, 2011 ISMA Annual Meeting The Picky Eater: Pediatric conditions with adult consequences Theresa Rohr-Kirchgraber, MD, FACP.](https://reader036.fdocuments.net/reader036/viewer/2022062713/56649ced5503460f949baa5c/html5/thumbnails/3.jpg)
April 18, 2023Customize footer: View menu/Header and Footer
Food Avoidance Emotional Disorder
Picky Eating
Selective Eating
Eating Disorder
Anorexia Nervosa
Bulimia Nervosa
Binge Eating Disorder
Eating Disorder Not otherwise specified
![Page 4: September 16, 2011 ISMA Annual Meeting The Picky Eater: Pediatric conditions with adult consequences Theresa Rohr-Kirchgraber, MD, FACP.](https://reader036.fdocuments.net/reader036/viewer/2022062713/56649ced5503460f949baa5c/html5/thumbnails/4.jpg)
Picky Eating
• Common during early childhood
• Food Neophobia (avoidance of novel foods)
• Rejection of Food• Transient• Severe
April 18, 2023Customize footer: View menu/Header and Footer
![Page 5: September 16, 2011 ISMA Annual Meeting The Picky Eater: Pediatric conditions with adult consequences Theresa Rohr-Kirchgraber, MD, FACP.](https://reader036.fdocuments.net/reader036/viewer/2022062713/56649ced5503460f949baa5c/html5/thumbnails/5.jpg)
Picky Eating/Selective Eating
8-12 yoa
• 13-22%• Not underweight• Not associated with
maternal or child symptoms of eating disorders
• 47% having enduring problems
<6 years of age
• 18-45%• Transient minor to life
threatening• Wt loss• Failure to Thrive/Poor
growth• Longer feeding time• Predict Anorexia• Boys > Girls
April 18, 2023Customize footer: View menu/Header and Footer
![Page 6: September 16, 2011 ISMA Annual Meeting The Picky Eater: Pediatric conditions with adult consequences Theresa Rohr-Kirchgraber, MD, FACP.](https://reader036.fdocuments.net/reader036/viewer/2022062713/56649ced5503460f949baa5c/html5/thumbnails/6.jpg)
Childhood
Normal eating
• Age 2 erratic eatingFrequent food shifts
• Express independence• Outgrow PE
Selective Eating
• More severe/persistent• Mealtime disruptive
behaviorsPlaying with food
Excessive slow eating
Gagging/resist self feeding
Spitting out food
• Preferences for carbohydrates
• Anxiety with meals/foodApril 18, 2023Customize footer: View menu/Header and Footer
![Page 7: September 16, 2011 ISMA Annual Meeting The Picky Eater: Pediatric conditions with adult consequences Theresa Rohr-Kirchgraber, MD, FACP.](https://reader036.fdocuments.net/reader036/viewer/2022062713/56649ced5503460f949baa5c/html5/thumbnails/7.jpg)
Selective Eating
• Physical Complications
Poor growth• Non-food-related symptoms
Anxious
Obsessional ruminations
Seperation anxiety
Stomach pain
HeadachesApril 18, 2023Customize footer: View menu/Header and Footer
![Page 8: September 16, 2011 ISMA Annual Meeting The Picky Eater: Pediatric conditions with adult consequences Theresa Rohr-Kirchgraber, MD, FACP.](https://reader036.fdocuments.net/reader036/viewer/2022062713/56649ced5503460f949baa5c/html5/thumbnails/8.jpg)
Avoidant/Restrictive Food Intake Disorder (ARFID)• Feeding Disorder of Infancy or Early
Childhood• Data in adults not well defined
April 18, 2023Customize footer: View menu/Header and Footer
![Page 9: September 16, 2011 ISMA Annual Meeting The Picky Eater: Pediatric conditions with adult consequences Theresa Rohr-Kirchgraber, MD, FACP.](https://reader036.fdocuments.net/reader036/viewer/2022062713/56649ced5503460f949baa5c/html5/thumbnails/9.jpg)
Picky Eaters in Adults
• Extremely limited range of foods• Avoidance of unfamiliar foods• Rejection of foods based on sensory
characteristics.• Stable trait• Anxiety in eating-related situations• Disordered Eating
April 18, 2023Customize footer: View menu/Header and Footer
![Page 10: September 16, 2011 ISMA Annual Meeting The Picky Eater: Pediatric conditions with adult consequences Theresa Rohr-Kirchgraber, MD, FACP.](https://reader036.fdocuments.net/reader036/viewer/2022062713/56649ced5503460f949baa5c/html5/thumbnails/10.jpg)
Characteristics
High Pathology
• OCD 25%• Eating Disorders• Social Anxiety related to
eating• Impairment in social
functioning
Low Pathology
• Picky Eating alone• Low comorbidities• OCD 8%
April 18, 2023Customize footer: View menu/Header and Footer
![Page 11: September 16, 2011 ISMA Annual Meeting The Picky Eater: Pediatric conditions with adult consequences Theresa Rohr-Kirchgraber, MD, FACP.](https://reader036.fdocuments.net/reader036/viewer/2022062713/56649ced5503460f949baa5c/html5/thumbnails/11.jpg)
Picky Eating Not Weight Related?
April 18, 2023Customize footer: View menu/Header and Footer
![Page 12: September 16, 2011 ISMA Annual Meeting The Picky Eater: Pediatric conditions with adult consequences Theresa Rohr-Kirchgraber, MD, FACP.](https://reader036.fdocuments.net/reader036/viewer/2022062713/56649ced5503460f949baa5c/html5/thumbnails/12.jpg)
Binge Eating
Adult picky eaters co-occurs with symptoms of Eating Disorders it appears to be characterized by binge eating problems and obesity rather than sustained strict dietary restrictions.
April 18, 2023Customize footer: View menu/Header and Footer
![Page 13: September 16, 2011 ISMA Annual Meeting The Picky Eater: Pediatric conditions with adult consequences Theresa Rohr-Kirchgraber, MD, FACP.](https://reader036.fdocuments.net/reader036/viewer/2022062713/56649ced5503460f949baa5c/html5/thumbnails/13.jpg)
2/3 lb. Monster Thickburger ®
Two 1/3 lb. charbroiled 100% Black Angus beef patties, 4 strips of bacon, 3 slices of American cheese and mayonnaise on a sesame seed bun.
April 18, 2023Customize footer: View menu/Header and Footer
![Page 14: September 16, 2011 ISMA Annual Meeting The Picky Eater: Pediatric conditions with adult consequences Theresa Rohr-Kirchgraber, MD, FACP.](https://reader036.fdocuments.net/reader036/viewer/2022062713/56649ced5503460f949baa5c/html5/thumbnails/14.jpg)
Picky Eating-balanced diet?
Preference for
carbohydrates
breads
sweets
Avoidance of
fruits
vegetablesApril 18, 2023Customize footer: View menu/Header and Footer
![Page 15: September 16, 2011 ISMA Annual Meeting The Picky Eater: Pediatric conditions with adult consequences Theresa Rohr-Kirchgraber, MD, FACP.](https://reader036.fdocuments.net/reader036/viewer/2022062713/56649ced5503460f949baa5c/html5/thumbnails/15.jpg)
Multiple Food Allergies
34 yo♂ allergies
Bluish nodules on both legs, sensitive to touch
Spontaneous ecchymosis
Asthenia, dyspnea and palpitations
April 18, 2023Customize footer: View menu/Header and Footer
![Page 16: September 16, 2011 ISMA Annual Meeting The Picky Eater: Pediatric conditions with adult consequences Theresa Rohr-Kirchgraber, MD, FACP.](https://reader036.fdocuments.net/reader036/viewer/2022062713/56649ced5503460f949baa5c/html5/thumbnails/16.jpg)
Petechia and gingivitis
Anemia
April 18, 2023Customize footer: View menu/Header and Footer
![Page 17: September 16, 2011 ISMA Annual Meeting The Picky Eater: Pediatric conditions with adult consequences Theresa Rohr-Kirchgraber, MD, FACP.](https://reader036.fdocuments.net/reader036/viewer/2022062713/56649ced5503460f949baa5c/html5/thumbnails/17.jpg)
April 18, 2023Customize footer: View menu/Header and Footer
![Page 18: September 16, 2011 ISMA Annual Meeting The Picky Eater: Pediatric conditions with adult consequences Theresa Rohr-Kirchgraber, MD, FACP.](https://reader036.fdocuments.net/reader036/viewer/2022062713/56649ced5503460f949baa5c/html5/thumbnails/18.jpg)
20 yo ♀, BMI 21, presents with fatigue. Anemic-hct 21, MCV 112 w/ bizarre appearing cells.
![Page 19: September 16, 2011 ISMA Annual Meeting The Picky Eater: Pediatric conditions with adult consequences Theresa Rohr-Kirchgraber, MD, FACP.](https://reader036.fdocuments.net/reader036/viewer/2022062713/56649ced5503460f949baa5c/html5/thumbnails/19.jpg)
B12 deficiency presenting as Leukemia
April 18, 2023Customize footer: View menu/Header and Footer
![Page 20: September 16, 2011 ISMA Annual Meeting The Picky Eater: Pediatric conditions with adult consequences Theresa Rohr-Kirchgraber, MD, FACP.](https://reader036.fdocuments.net/reader036/viewer/2022062713/56649ced5503460f949baa5c/html5/thumbnails/20.jpg)
Pathogenesis
• Autism Spectrum Disorder• Anxiety Disorder• Food preferences inheritable• Biological• Exacerbated by family and social
consequences of the problem• Family Conflict• Avoidance of situations associated with
eatingApril 18, 2023Customize footer: View menu/Header and Footer
![Page 21: September 16, 2011 ISMA Annual Meeting The Picky Eater: Pediatric conditions with adult consequences Theresa Rohr-Kirchgraber, MD, FACP.](https://reader036.fdocuments.net/reader036/viewer/2022062713/56649ced5503460f949baa5c/html5/thumbnails/21.jpg)
Parental Characteristics
• ↑Anxiety about child’s eating• Lost confidence in their parenting ability• Tried multiple tactics that failed
• Bribing, coaxing, threatening, withholding
• Unable to set limits• Depression• Selective Eating
April 18, 2023Customize footer: View menu/Header and Footer
![Page 22: September 16, 2011 ISMA Annual Meeting The Picky Eater: Pediatric conditions with adult consequences Theresa Rohr-Kirchgraber, MD, FACP.](https://reader036.fdocuments.net/reader036/viewer/2022062713/56649ced5503460f949baa5c/html5/thumbnails/22.jpg)
Provider
• Ask 24 hour diet history• Ask about soda, “juice”, all drinks• Give advice and education
April 18, 2023Customize footer: View menu/Header and Footer
![Page 23: September 16, 2011 ISMA Annual Meeting The Picky Eater: Pediatric conditions with adult consequences Theresa Rohr-Kirchgraber, MD, FACP.](https://reader036.fdocuments.net/reader036/viewer/2022062713/56649ced5503460f949baa5c/html5/thumbnails/23.jpg)
Diet History
1.) Are you comfortable with your body size?
2.)What have you done to change your body size in the last year?
3.) Tell me what you had to eat in the last 24 hours?
April 18, 2023Customize footer: View menu/Header and Footer
![Page 24: September 16, 2011 ISMA Annual Meeting The Picky Eater: Pediatric conditions with adult consequences Theresa Rohr-Kirchgraber, MD, FACP.](https://reader036.fdocuments.net/reader036/viewer/2022062713/56649ced5503460f949baa5c/html5/thumbnails/24.jpg)
24 hour diet history
Tell me what you had to eat yesterday.
How many servings of dairy?
How many sodas? Gatorade? PowerAde?
How much juice? “Energy Drinks”?What kind of “juice”?
![Page 25: September 16, 2011 ISMA Annual Meeting The Picky Eater: Pediatric conditions with adult consequences Theresa Rohr-Kirchgraber, MD, FACP.](https://reader036.fdocuments.net/reader036/viewer/2022062713/56649ced5503460f949baa5c/html5/thumbnails/25.jpg)
16 year old ♀volleyball player
April 18, 2023
Sports physical
Healthy
ROS unremarkable
![Page 26: September 16, 2011 ISMA Annual Meeting The Picky Eater: Pediatric conditions with adult consequences Theresa Rohr-Kirchgraber, MD, FACP.](https://reader036.fdocuments.net/reader036/viewer/2022062713/56649ced5503460f949baa5c/html5/thumbnails/26.jpg)
6 cans of soda/day
April 18, 2023Customize footer: View menu/Header and Footer
![Page 27: September 16, 2011 ISMA Annual Meeting The Picky Eater: Pediatric conditions with adult consequences Theresa Rohr-Kirchgraber, MD, FACP.](https://reader036.fdocuments.net/reader036/viewer/2022062713/56649ced5503460f949baa5c/html5/thumbnails/27.jpg)
Girls’ Early Sweetened Carbonated Beverage Intake Predicts Different Patterns of Beverage and Nutrient Intake across Childhood and Adolescence
• Soda consumption at age 5→→ ↑adolescence
• Soda→↑added sugars, ↓protein, ↓ fiber, ↓calcium,↓ vitamin D, ↓magnesium, ↓potassium
April 18, 2023Fiorito, l et al, J Amer Diet Assn, 2010;110:543-550
![Page 28: September 16, 2011 ISMA Annual Meeting The Picky Eater: Pediatric conditions with adult consequences Theresa Rohr-Kirchgraber, MD, FACP.](https://reader036.fdocuments.net/reader036/viewer/2022062713/56649ced5503460f949baa5c/html5/thumbnails/28.jpg)
17 yo Myalgias
Worsening over the last few months
Physically active.
Diet: 2-3 sodas per day, fast food 2-3 x per week, milk with cereal in the morning
FHx: lactose intolerance
Exam unremarkable
![Page 29: September 16, 2011 ISMA Annual Meeting The Picky Eater: Pediatric conditions with adult consequences Theresa Rohr-Kirchgraber, MD, FACP.](https://reader036.fdocuments.net/reader036/viewer/2022062713/56649ced5503460f949baa5c/html5/thumbnails/29.jpg)
Vitamin D level <12
![Page 30: September 16, 2011 ISMA Annual Meeting The Picky Eater: Pediatric conditions with adult consequences Theresa Rohr-Kirchgraber, MD, FACP.](https://reader036.fdocuments.net/reader036/viewer/2022062713/56649ced5503460f949baa5c/html5/thumbnails/30.jpg)
Vitamin D
![Page 31: September 16, 2011 ISMA Annual Meeting The Picky Eater: Pediatric conditions with adult consequences Theresa Rohr-Kirchgraber, MD, FACP.](https://reader036.fdocuments.net/reader036/viewer/2022062713/56649ced5503460f949baa5c/html5/thumbnails/31.jpg)
17 yo♀ Well Child Visit
• Obese• G1P1• Complicated with
spina bifida
April 18, 2023Customize footer: View menu/Header and Footer
![Page 32: September 16, 2011 ISMA Annual Meeting The Picky Eater: Pediatric conditions with adult consequences Theresa Rohr-Kirchgraber, MD, FACP.](https://reader036.fdocuments.net/reader036/viewer/2022062713/56649ced5503460f949baa5c/html5/thumbnails/32.jpg)
RDA Fruits and Vegetables5 per day
April 18, 2023Customize footer: View menu/Header and Footer
![Page 33: September 16, 2011 ISMA Annual Meeting The Picky Eater: Pediatric conditions with adult consequences Theresa Rohr-Kirchgraber, MD, FACP.](https://reader036.fdocuments.net/reader036/viewer/2022062713/56649ced5503460f949baa5c/html5/thumbnails/33.jpg)
April 18, 2023USDA
![Page 34: September 16, 2011 ISMA Annual Meeting The Picky Eater: Pediatric conditions with adult consequences Theresa Rohr-Kirchgraber, MD, FACP.](https://reader036.fdocuments.net/reader036/viewer/2022062713/56649ced5503460f949baa5c/html5/thumbnails/34.jpg)
Folate Deficiency
• 1/3 patients with severe depression• vitamin may enhance recovery of the
mental state
April 18, 2023
Bottiglieri B, Laundy M, Crellin R, Toone BK, Carney MW, Reynolds EH. Homocysteine, folate, methylation, and monoamine metabolism in depression. J Neurol Neurosurg Psychiatry. 2000;69(2):228-232.
![Page 35: September 16, 2011 ISMA Annual Meeting The Picky Eater: Pediatric conditions with adult consequences Theresa Rohr-Kirchgraber, MD, FACP.](https://reader036.fdocuments.net/reader036/viewer/2022062713/56649ced5503460f949baa5c/html5/thumbnails/35.jpg)
24 hour diet history:Breakfast40% of kids skip
Decreased reading scores
Increased iron deficiency anemia
Increased Obesity
50% of adults skip
Irritability
Restless
Tired
April 18, 2023Customize footer: View menu/Header and Footer
![Page 36: September 16, 2011 ISMA Annual Meeting The Picky Eater: Pediatric conditions with adult consequences Theresa Rohr-Kirchgraber, MD, FACP.](https://reader036.fdocuments.net/reader036/viewer/2022062713/56649ced5503460f949baa5c/html5/thumbnails/36.jpg)
![Page 37: September 16, 2011 ISMA Annual Meeting The Picky Eater: Pediatric conditions with adult consequences Theresa Rohr-Kirchgraber, MD, FACP.](https://reader036.fdocuments.net/reader036/viewer/2022062713/56649ced5503460f949baa5c/html5/thumbnails/37.jpg)
16 yo ♂Stomach Pain
• 3-4 months• Worsening• Nausea• Midepigastric
April 18, 2023
![Page 38: September 16, 2011 ISMA Annual Meeting The Picky Eater: Pediatric conditions with adult consequences Theresa Rohr-Kirchgraber, MD, FACP.](https://reader036.fdocuments.net/reader036/viewer/2022062713/56649ced5503460f949baa5c/html5/thumbnails/38.jpg)
April 18, 2023
![Page 39: September 16, 2011 ISMA Annual Meeting The Picky Eater: Pediatric conditions with adult consequences Theresa Rohr-Kirchgraber, MD, FACP.](https://reader036.fdocuments.net/reader036/viewer/2022062713/56649ced5503460f949baa5c/html5/thumbnails/39.jpg)
The Importance of Family Dinners
• 3x “excellent” relationship with their mothers and fathers.
• >2x as likely to say their parents are good listeners.
April 18, 2023News release, National Center on Addiction and Substance Abuse, Columbia University. Feinstein, E. The Importance of Family Dinners VI.WebMD Health News: “More Americans Using Illicit Drugs.” Customize footer: View menu/Header and Footer
![Page 40: September 16, 2011 ISMA Annual Meeting The Picky Eater: Pediatric conditions with adult consequences Theresa Rohr-Kirchgraber, MD, FACP.](https://reader036.fdocuments.net/reader036/viewer/2022062713/56649ced5503460f949baa5c/html5/thumbnails/40.jpg)
<3 Dinner/week vs >4 dinners/wk.
• 1.5 times likelier to have friends who drink regularly and use marijuana.
• 1.5 times likelier to have friends who abuse prescription drugs in order to get high.
• 1.25 times more likely to have friends who use illegal drugs such as LSD, ecstasy, cocaine, methamphetamine, and heroin
April 18, 2023Customize footer: View
![Page 41: September 16, 2011 ISMA Annual Meeting The Picky Eater: Pediatric conditions with adult consequences Theresa Rohr-Kirchgraber, MD, FACP.](https://reader036.fdocuments.net/reader036/viewer/2022062713/56649ced5503460f949baa5c/html5/thumbnails/41.jpg)
Parent
• Model good behavior• Make family meals a priority• Encourage different foods• Give choices• Limit junk food in the home• Read labels• Realistic portions• Don’t barter
April 18, 2023Customize footer: View menu/Header and Footer
![Page 42: September 16, 2011 ISMA Annual Meeting The Picky Eater: Pediatric conditions with adult consequences Theresa Rohr-Kirchgraber, MD, FACP.](https://reader036.fdocuments.net/reader036/viewer/2022062713/56649ced5503460f949baa5c/html5/thumbnails/42.jpg)
“Good girls who eat their carrots get ice cream.”
“I’m entitled to this whole bag of cookies because I won the new account.”
April 18, 2023Customize footer: View menu/Header and Footer
![Page 43: September 16, 2011 ISMA Annual Meeting The Picky Eater: Pediatric conditions with adult consequences Theresa Rohr-Kirchgraber, MD, FACP.](https://reader036.fdocuments.net/reader036/viewer/2022062713/56649ced5503460f949baa5c/html5/thumbnails/43.jpg)
“Let’s stop for ice cream to cheer you up.”
“I am entitled to this whole pint of ice cream, because I am sad.”
April 18, 2023Customize footer: View menu/Header and Footer
![Page 44: September 16, 2011 ISMA Annual Meeting The Picky Eater: Pediatric conditions with adult consequences Theresa Rohr-Kirchgraber, MD, FACP.](https://reader036.fdocuments.net/reader036/viewer/2022062713/56649ced5503460f949baa5c/html5/thumbnails/44.jpg)
April 18, 2023http://www.eatright.org/default.aspx
American Dietetic Association Foundation Survey Finds Children Skipping Meals, Snacking FrequentlyTuesday, November 09, 2010
![Page 45: September 16, 2011 ISMA Annual Meeting The Picky Eater: Pediatric conditions with adult consequences Theresa Rohr-Kirchgraber, MD, FACP.](https://reader036.fdocuments.net/reader036/viewer/2022062713/56649ced5503460f949baa5c/html5/thumbnails/45.jpg)
How do we get here?
April 18, 2023Customize footer: View menu/Header and Footer
![Page 46: September 16, 2011 ISMA Annual Meeting The Picky Eater: Pediatric conditions with adult consequences Theresa Rohr-Kirchgraber, MD, FACP.](https://reader036.fdocuments.net/reader036/viewer/2022062713/56649ced5503460f949baa5c/html5/thumbnails/46.jpg)
Sneak it in!
April 18, 2023Customize footer: View menu/Header and Footer
![Page 47: September 16, 2011 ISMA Annual Meeting The Picky Eater: Pediatric conditions with adult consequences Theresa Rohr-Kirchgraber, MD, FACP.](https://reader036.fdocuments.net/reader036/viewer/2022062713/56649ced5503460f949baa5c/html5/thumbnails/47.jpg)
Recommendations
Be patient
Make meal time regular, peacefull, varied
Include children in making meals
Include children in grocery shopping
Discuss with physician and refer when needed
GET TREATMENT!
April 18, 2023Customize footer: View menu/Header and Footer
![Page 48: September 16, 2011 ISMA Annual Meeting The Picky Eater: Pediatric conditions with adult consequences Theresa Rohr-Kirchgraber, MD, FACP.](https://reader036.fdocuments.net/reader036/viewer/2022062713/56649ced5503460f949baa5c/html5/thumbnails/48.jpg)
THANK YOU!
Questions?
![Page 49: September 16, 2011 ISMA Annual Meeting The Picky Eater: Pediatric conditions with adult consequences Theresa Rohr-Kirchgraber, MD, FACP.](https://reader036.fdocuments.net/reader036/viewer/2022062713/56649ced5503460f949baa5c/html5/thumbnails/49.jpg)
30 yo ♂physician
• Refuses all fruits/vegetables
• Wt gain when lived with a AN
• Anxiety around group meals
• Unable to talk about nutrition with patients and families
April 18, 2023This picture is a representation and not of the physicians discussed in this case
![Page 50: September 16, 2011 ISMA Annual Meeting The Picky Eater: Pediatric conditions with adult consequences Theresa Rohr-Kirchgraber, MD, FACP.](https://reader036.fdocuments.net/reader036/viewer/2022062713/56649ced5503460f949baa5c/html5/thumbnails/50.jpg)
BibliographyLéger D, Scurvy: Reemergence of nutritional deficiencies Can Fam Physician. 2008 October; 54(10): 1403–1406.
Frikke-Schmidt H, Lykkesfeldt J, Role of Marginal Vitamin C Deficiency in Atherogenesis:
In Vivo Models and Clinical Studies 2009 Basic & Clinical Pharmacology & Toxicology, 104, 419–433
Des Roches*, L. Paradis, J. Paradis, S. Singer Food allergy as a new risk factor for scurvy June 2006 Allergy 2006: 61:1487–1488
http://www.choosemyplate.gov/foodgroups/downloads/MyPlate/selectedmessages.pdf
Nicholls D, Christie D, Randall L, Lask B, Selective Eating: Symptom, Disorder or Normal Variant
Clin Child Psychol Psychiatry 2001 6: 257
Watikins B, Cooper PJ, Lask B, History of eating disorders in mothers with children with early onset eating disorder or disturbance. Eur Eat Dis Review 20 (2012) 121-125
April 18, 2023Customize footer: View menu/Header and Footer