Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, 446 E Ontario St, Chicago, Illinois, 60611.
Department of Pediatrics, Division of Pulmonary Medicine, Northwestern University Feinberg School of Medicine, 420 E. Superior Street, Chicago, Illinois, 60611.
Int J Eat Disord. 2018 Mar;51(3):187-213. doi: 10.1002/eat.22831. Epub 2018 Feb 22.
Pediatric chronic illnesses (CI) can affect a child's mental health. Chronic illnesses with treatment regimens that specify a therapeutic diet may place the child at increased risk for disordered eating and specific eating disorders (ED). The aim of this review is to examine the relation between diet-treated CI and disordered eating and to determine the order of onset to infer directionality. Diet-treated CI is hypothesized to precede and to be associated with disordered eating.
A comprehensive search of empirical articles that examine the relation between diet-treated CI (diabetes, cystic fibrosis, celiac disease, gastrointestinal disorders, and inflammatory bowel diseases) and disordered eating was conducted in Medline and PsycINFO using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A table of the sample's characteristics, ED measures, major pertinent findings, and the onset of CI in relation to ED were provided.
Diet-treated CI was associated with disordered eating and ED. Diet-treated CI had onset prior to disordered eating in most studies, except for inflammatory bowel diseases. Disordered eating and unhealthy weight management practices put children at risk for poor medical outcomes.
Interventions for diet-treated CI require a focus on diet and weight, but may increase the risk for disordered eating. Future research is needed to elucidate the mechanisms that transform standard treatment practices into pathological eating, including characteristics and behaviors of the child, parents/care providers, family, and treatment providers.
儿科慢性病（CI）会影响儿童的心理健康。有治疗方案规定特殊饮食疗法的慢性病可能会使儿童面临饮食失调和特定饮食障碍（ED）的风险增加。本综述的目的是检查饮食治疗的 CI 与饮食失调之间的关系，并确定发病顺序以推断方向性。假设饮食治疗的 CI 先于饮食失调，并与之相关。
根据系统评价和荟萃分析的首选报告项目指南，在 Medline 和 PsycINFO 中进行了全面的文献检索，以查找检查饮食治疗的 CI（糖尿病、囊性纤维化、乳糜泻、胃肠道疾病和炎症性肠病）与饮食失调之间关系的实证文章。提供了样本特征、ED 测量、主要相关发现以及 CI 与 ED 发病顺序的表格。
饮食治疗的 CI 与饮食失调和 ED 有关。在大多数研究中，饮食治疗的 CI 先于饮食失调发病，除了炎症性肠病。饮食失调和不健康的体重管理措施使儿童面临不良医疗结局的风险。
饮食治疗的 CI 干预措施需要关注饮食和体重，但可能会增加饮食失调的风险。需要进一步研究阐明将标准治疗实践转化为病理性进食的机制，包括儿童、父母/护理提供者、家庭和治疗提供者的特征和行为。
