Genetic Correlates of Wasting: a Pilot Study With Children Attending a Tertiary Feeding Clinic

Study Overview
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Brief Summary
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This is a pilot study of children attending the Glasgow feeding clinic (GFC) which looks after a range of children with severe feeding problems who commonly have low appetite and extreme thinness. The investigators want to find out if these children are more likely to carry genetic markers of thinness.

Detailed Description
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Thinness occurs as a result of undereating, but it is not always clear why an individual child has not eaten enough, or how to get them to eat more. There is a need to understand the child characteristics that predispose to undereating and the how these operate, in order to design more effective treatment and prevention programmes. The Glasgow feeding clinic (GFC) looks after a range of children with severe feeding problems who commonly have low appetite and extreme thinness. The investigators want to find out if these children are more likely to carry genetic markers of thinness. The investigators will invite up to 60 families to complete a standardised online questionnaire (ICFET) about their child's eating behaviour and collect a saliva sample from their child, sent by post. The investigators will identify how many genetic markers for thinness each carries and relate this to their ICFET appetite scores and existing growth measurements as well as their feeding history.

Official Title
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What Makes Children Thin? Genetic and Behavioural Correlates of Wasting: a Pilot Study With Children Attending a Tertiary Feeding Clinic

Conditions
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Undernutrition, Eating Disorders, Underweight

Intervention / Treatment
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* Behavioral: Feeding clinic


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: All participants currently attending Glasgow Feeding Clinic or assessed there within the last 2 years. NB current ethical application is restricted to children aged 1-7 years, but the investigators plan to apply to extend that to age 16 years. Exclusion Criteria: Sample not to be collected with 2 weeks of any symptoms or recent contact with Covid 19

Ages Eligible for Study
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Minimum Age: 1 Year
Maximum Age: 16 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Behavioral: Feeding clinic|These children have all attended a multidisciplinary feeding clinic with severe food refusal and were commonly receiving tube feeding or supplement drinks. The clinic helps children progress onto a normal oral diet|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Genotype risk score | This the number of risk polymorphisms present for each child ranges from 0-20. a high score suggests more thinness | Within 1-2 months of recruitment | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Eating behaviour score | Measure of appetite and food refusal assessed using standard questionnaire (International Complementary Feeding Evaluation Tool (ICFET) Score from 1-5, hihger score suggests greater avidity | At recruitment or up to 2 months before | 
| Body mass index | weight (kg)/Height (m) squared | Up to two years before genetic test | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Child, Genetics, Eating behaviour, Tube feeding, Avoidant Restrictive food intake disorder