Prevalence of Avoidant/Restrictive Food Intake Disorder in Portuguese children aged 2-10 years: a cross-sectional study.

BACKGROUND: Avoidant/Restrictive Food Intake Disorder (ARFID) is an eating disorder characterised by the avoidance or restriction of food intake, associated with high sensory sensitivity, disinterest in eating, or fear of adverse consequences. It can lead to nutritional deficiencies, impaired growth, or psychosocial difficulties. Although recognition of ARFID has increased internationally, prevalence data in Portugal remain scarce. METHODS: This cross-sectional, descriptive observational study assessed the prevalence of ARFID in children aged 2-10 years attending a private outpatient clinic. Paediatricians applied DSM-5-TR diagnostic criteria during routine consultations. Parents completed online questionnaires, including the Children's Eating Behaviour Questionnaire (CEBQ) and the Child Feeding Questionnaire (CFQ). RESULTS: Of the 163 children assessed, ARFID was diagnosed in 3.1% of cases. Four of the five identified children were male (80%), with a mean age of 5.8 years (SD = 2.17). On the CEBQ, children with ARFID showed the highest mean scores on the food fussiness and satiety responsiveness subscales, indicating greater selectivity and heightened sensitivity to fullness. The lowest mean scores were observed in emotional overeating and desire to drink. On the CFQ, perceived responsibility and monitoring were the subscales with the highest mean values. CONCLUSIONS: This study provides the first prevalence estimate of ARFID in Portuguese clinical practice. Although the small sample limits generalisability, the findings emphasise the need to raise awareness among both clinicians and parents to promote earlier recognition, thereby improving support for children and families and helping to reduce the long-term impact of ARFID.