IZBIRLJIVA ISHRANA DECE
Apstrakt
Izbirljiva ishrana dece (bezobrazno i ljutito biranje hrane) se klasifikuje u grupu poremećaja ishrane i ponašanja, kada dete nevoljno jede već poznatu specifičnu hranu i/ili odbija novu hranu (neofobija hrane), kao i jaka sklonost ka određenoj hrani. Posledice mogu biti nutritivni deficiti koji utiču na zdravlje dece ali i nastanak gojaznosti. Roditelji navode da njihova deca unose jednoličnu hranu, da zahtevaju pripremanje hrane na specifičan način, nastupaju napadi besa kad im se uskrati hrana koju preferiraju.
Bolest izbegavanja hrane i restriktivni unos hrane (Avoidant restrictive food intake disorder - ARFID) je novo klasifikovan poremećaj u oblasti “Feeding and Eating Disorders” section of the Diagnostic and Statistical Manual of Mental disorders. ARFID je poremećaj ishrane koji uključuje različitu kliničku prezentaciju koja može rezultirati značajnim gubitkom telesne mase, nutritivnim deficitom, dovesti do potrebe za enteralnom ishranom ili dodacima ishrane i/ili znatnom psihosocijalnom disfunkcijom. Pojedina deca s ARFID-om se dijagnostikuje samo pri većem gubitku telesne mase ili kod velike zabrinutosti roditelja.
Ponašanje dece izbirljivih na hrani je povezano sa nekim psihološkim problemima dece kao što su izolacija, somatske smetnje, anksioznost i depresija, veći nivo agresivnosti pa se postavlja pitanje šta je uzrok a šta posledica.
Učestalo i dugotrajno ponašanje izbirljive ishrane može biti simptom kasnijeg poremećaja u ponašanju. Prevencija ponašanja izbirljive ishrane dece se vrši nuđenjem raznolike hrane rano u detinjstvu, potenciranjem društvene vrednosti i ugodnosti porodičnog obroka.
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