Association of Picky Eating With Weight Status and Dietary Quality Among Low-Income Preschoolers

Brown, Callie L.; Perrin, Eliana M.; Peterson, Karen E.; Herb, Holly E. Brophy; Horodynski, Mildred A.; Contreras, Dawn; Miller, Alison L.; Appugliese, Danielle P.; Ball, Sarah; Lumeng, Julie C.

doi:10.1016/j.acap.2017.08.014

Cited by 46 publications

(43 citation statements)

References 35 publications

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“…While these findings may indicate that the Selective presentation without co‐occurring appetite disturbance is the least common of the three putative ARFID presentations, it appears likely that these two studies have disproportionately sampled patients with more severe symptoms, particularly at our intensive PHP (Norris and colleagues' ARFID sample was drawn from all levels of care, including outpatient, partial hospitalization, and inpatient treatment). None of the five selective eaters in our sample presented with clinically significant weight loss or a history of growth faltering, which is consistent with research in nonclinical samples suggesting that selective eating is not consistently related to weight (Brown et al, ). Highly selective eaters with normal weight would meet ARFID criteria if there was significant psychosocial disturbance, dependence on supplements, or if nutritional deficiencies (e.g., anemia, low serum Vitamin D) were detected upon medical evaluation.…”

Section: Discussionsupporting

confidence: 89%

Further support for diagnostically meaningful ARFID symptom presentations in an adolescent medicine partial hospitalization program

Zickgraf

Lane‐Loney

Essayli

et al. 2019

Intl J Eating Disorders

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Objective To identify potential presentations of avoidant/restrictive food intake disorder (ARFID) in a pediatric eating disorder partial hospitalization program (PHP) based on the nature of the eating restriction leading to core symptoms of ARFID. Method A retrospective chart review of 83 patients ages 8–17 admitted to a PHP and diagnosed with ARFID. Charts were independently reviewed by two coders, with high inter‐rater agreement (κ = 0.77). Distinct categories were identified and groups were compared on demographics, anthropometrics, comorbid psychopathology, and core ARFID symptoms. Results We identified cases characterized by predominantly selective eating based on aversions to the sensory properties of foods, lack of interest in eating/low appetite, and fear of aversive consequences from eating. We also distinguished a subset of patients with eating restrictions consistent with both selectivity and limited interest/appetite. The four primary ARFID presentation groups differed on core ARFID criteria, symptom trajectory and illness duration, mood and medical comorbidities, age, gender, and parent‐reported symptoms of psychopathology. Discussion The present findings suggest that there are diagnostically meaningful ARFID subtypes that can be differentiated based on the nature of their eating restrictions, as well as other demographic, illness history features, and psychiatric comorbidity. As treatments for youth with ARFID are developed and refined, it will be important to take into consideration not only demographic differences, but also the variability in symptoms, as this might require distinct interventions and levels of care. Additionally, differing mechanisms that maintain different types of eating restrictions might necessitate unique psychological and psychiatric interventions.

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Section: Discussionsupporting

confidence: 89%

Further support for diagnostically meaningful ARFID symptom presentations in an adolescent medicine partial hospitalization program

Zickgraf

Lane‐Loney

Essayli

et al. 2019

Intl J Eating Disorders

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“…The children described as picky eaters in this study were very similar to non-picky eaters demographically. Unlike the results of Brown et al (2018), there was no elevation of males among the picky eaters, nor was socio-economic status associated with picky eating. However, we found a substantial association with birth order; there was a significant elevation of first-born children among the picky eaters.…”

Section: Discussioncontrasting

confidence: 95%

Child and Maternal Correlates of Picky Eating in Young Children

Zohar¹,

Lev‐Ari²,

Bachner‐Melman³

2019

PSYCH

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Background: Picky eating (PE) is common in childhood but if it persists may pose a serious risk factor for restricting eating disorders. Methods: A community sample of 1055 mothers of children (mean age 3.4 + 1) was reported online on gestational history, early feeding [breastfeeding vs. formula], behavioral problems [CBCL], temperament [EAS], fears [FIYC], executive function [P-BRIEF], and self-reported on maternal perfectionism, anxiety, and on maternal attachment patterns. Results: 17.5% of the children were PE with an over-representation of first-borns (Chi-square = 28.1, p < 0.001). In temperament, PEs were shyer, more emotional and fearful than non-PEs, and higher on the CBCL-PDD, Affective, Anxiety, ADHD, and Oppositional, and lower in executive function. PEs' mothers were more perfectionistic and anxious and scored higher on avoidant and anxious attachment. Logistic regression identified 26.7% of the PEs with the CBCL Affective providing most of the explained variance. Conclusions: At the age of three, PE is associated with a wide range of behavioral problems and with poorly developed executive function. Maternal anxiety and perfectionism may contribute to PE at this developmental stage. Reassuring anxious and perfectionistic mothers may contribute to dealing effectively with PE.

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“…Children were from predominantly White families and middle class or higher socioeconomic status. Food insecurity was rare in this sample; while food security is not related to child food pickiness, 19 food insecurity is related with being at risk for overweight status in children 3 to 17 years of age, 60 which could further be associated with increased food consumption. In terms of the actors in the videos, actors were gender‐matched but not race‐matched to participants.…”

Section: Discussionmentioning

confidence: 62%

“…These findings highlight an opportunity to improve and refine preschool obesity‐prevention interventions and better understand the factors that influence children's food intake. Although picky eating in childhood is not directly a risk factor for obesity (some studies find a negative association between picky eating and BMI 15,16 and others find no association 17‐19 ), it is an ongoing challenge for parents and caregivers during this period (40%‐60% of preschool‐aged children are classified as picky eaters) 20,21 and the food preferences and picky eating trajectories established early in development tend to persist 22,23 …”

mentioning

confidence: 99%

Show or tell: Children's learning about food from action vs verbal testimony

DeJesus

Venkatesh

2020

Pediatric Obesity

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Summary Background Childhood obesity continues to be a critical health concern in the United States. Nonetheless, interventions that focus on delivering verbal lessons about food and health to children in preschool classrooms have had only modest effects. Objectives The present study examines the relative effectiveness of showing vs telling children about food to promote healthy eating, with a focus on unfamiliar foods and vegetables. Methods Three‐ to six‐year‐old children (n = 71) were tested in a laboratory study in which they watched videos of two people eating apple‐broccoli puree. One person took five bites of the food; the other said they liked the food. Results Children did not differentiate between the food they saw someone eat and the food they heard someone talk about. Children's food intake was negatively associated with parent reports of children's eating behavior on the Food Fussiness subscale of the Child Eating Behavior Questionnaire. We found similar patterns in an analogous toy task. In an unfamiliar object task, children selected the action demonstration as the right way to use the object. Conclusions We find no evidence that action vs verbal testimony is more persuasive in guiding children's food choices, but action testimony may be persuasive in other domains. The associations between children's food intake and pickiness provide growing evidence of alignment between parent assessments of their children's typical eating behavior and children's food choices in laboratory studies.

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Association of Picky Eating With Weight Status and Dietary Quality Among Low-Income Preschoolers

Abstract: Pediatric providers should support parents in expanding the number of healthy foods the child eats to improve dietary quality, but reassure parents that picky eating is not associated with children's weight status or micronutrient deficiencies.

Cited by 46 publications

References 35 publications

Further support for diagnostically meaningful ARFID symptom presentations in an adolescent medicine partial hospitalization program

Further support for diagnostically meaningful ARFID symptom presentations in an adolescent medicine partial hospitalization program

Child and Maternal Correlates of Picky Eating in Young Children

Show or tell: Children's learning about food from action vs verbal testimony

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