Girls’ picky eating in childhood is associated with normal weight status from ages 5 to 15 y

Abstract

Background: Picky eating has been associated with lower weight status and limited food intake and variety in childhood. Little is known about how the persistence of picky eating in childhood is associated with changes in weight and food intake from childhood into adolescence. Objective: We determined whether picky eating identified in childhood was related to growth, nutrition, and parental use of pressure over a 10-y period. Design: Non-Hispanic white girls (n = 181) participated in a longitudinal study and were assessed biannually from ages 5 to 15 y. The Child Feeding Questionnaire was used to classify girls as persistent picky eaters or nonpicky eaters and to assess parental use of pressure to eat. Height and weight were measured to calculate body mass index (BMI) z scores at each occasion. Three 24-h dietary recalls obtained at each occasion were used to determine intakes of fruit and vegetables. With the use of repeated-measures analyses, differences between persistent picky eaters and nonpicky eaters in BMI z scores, dietary intake, and use of pressure were examined. Results: From ages 5 to 15 y, persistent picky eaters (n = 33; 18%) had lower BMI (tracking at the 50th percentile) than did nonpicky eaters (n = 148; tracking at the 65th percentile) (P = 0.02). Persistent picky eaters were less likely to be overweight into adolescence. Both groups consumed less than the recommended amounts of fruit and vegetables, although persistent picky eaters had lower intakes of vegetables than did nonpicky eaters at all time points (P = 0.02). Persistent picky eaters also received higher amounts of pressure (P = 0.01). Conclusions: Findings that persistent picky eaters were within the normal weight range, were less likely to be overweight, and had similar fruit intakes to those of nonpicky eaters suggest that higher parental concerns about persistent picky eaters are unwarranted. All parents and children could benefit from evidence-based anticipatory guidance on alternatives to coercive feeding practices to increase fruit and vegetable consumption.Am J Clin Nutr 2016;104:1577-82.

Picky eating in children: causes and consequences

“…It is also of note that the non-picky children in ALSPAC had a growth trajectory well above the 50 th centile of the growth charts so it is possible that in a population in which the children's growth was generally closer to the 50 th centile the trajectories of the picky eaters would be below the 50 th centile and therefore of greater concern. Similar results to those in the ALSPAC study in the UK were found in a group of US girls up to age 15 years, in whom picky eaters tracked about 15 centile points below the non-picky girls who tracked along the 65 th centile (38) . This difference in the location of the trajectories relative to the centiles could reflect a difference in the prevalence of overweight and obesity in the two cohorts and/or the use of different centile charts.…”

“…Although this does not capture all the proposed facets of picky eating behaviour, it does avoid the difficulty of forcing the caregiver to use their own definition of picky eating, and is similar to what might be asked of a parent by a healthcare provider. (2) This question, which is similar to that used in other recent studies (5; 14; 15) , was asked at four timepoints in ALSPAC (24,38,54 and 65 months old), which enables both identification of picky eaters at a single time point and identification of persistent picky eaters, who may be more at risk of adverse health and developmental outcomes than transient picky eaters. It also enables modelling of outcomes that occur after the exposure, enabling a greater degree of confidence in the causality of associations than in a strictly cross-sectional approach.…”

“…Others, however, have found an association of picky eating with being overweight (30) . As discussed by Berger et al (38) the interpretation of most of these studies are limited by their crosssectional design, meaning that it is not possible to establish causation. In a longitudinal study of weight, height, BMI and body composition in ALSPAC, the growth of children (boys and girls) up to age 17 years who were identified as picky eaters at age 3 years were assessed against reference growth charts for British children (52) .…”

Understanding Food Fussiness and Its Implications for Food Choice, Health, Weight and Interventions in Young Children: The Impact of Professor Jane Wardle

“…In Dutch children measured at age 9, picky eaters (n=403) where shorter, more likely to be underweight and less likely to be overweight than non-picky eaters (n=621) [106]. In a US sample of girls followed from age 5 to 15 years, persistent picky eaters (n=33) had lower BMI than non-fussy children (n=148) [112]. Nevertheless, an important observation was that the fussy eaters' BMI tracked the 50 th percentile, whereas the non-fussy eaters' BMI tracked the 65 th percentile.…”

Development of a tool to measure the number of foods and beverages consumed by children using National Health and Nutrition Examination Survey (NHANES) FFQ data

“…Certain studies have shown that children of pre-school age with obesity are more picky than normal-weight children (25) , and that picky eaters have a higher intake of savoury snacks and sweets (risk factors for obesity) at age 14 months (26) . However, other studies have shown a relationship between picky eating and underweight status (12,27) . A systematic review of forty-one studies examining the relationship between picky eating and weight found that the evidence is conflicting, and this may be partially due to the inconsistencies in the measurement of picky eating (28) .…”