Characteristics of childhood picky eaters in low-income families

1. During this longitudinal study, 3 consistent trajectories of picky eating were noted: persistently low, persistently medium, and persistently high.

2. Reduced picky eating habits were associated with female gender, greater child emotional stability and control, higher BMI, lower restriction behavior, and less demanding behavior.

Evidence Rating Level: 2 (Good)

Study Rundown: While picky eating is common in childhood, there is limited research examining the trajectory of this behavior. In addition, no previous study has taken a longitudinal approach to understand the characteristics of children who are picky eaters in low-income families. To further characterize picky eating in this population, mother-child pairs were recruited from Head Start Programs in Michigan and followed from the time the children were 3-4 years old until 9 years of age. Over this time period, multiple questionnaires assessing child and maternal eating patterns and childhood behavior were completed. Children’s body mass indices (BMIs) we also assessed. The recognized trajectories of picky eating were persistently low, persistently medium, and persistently high. Overall, lower picky eating habits were associated with female gender, greater emotional stability and control, higher BMI, lower restriction behavior (a measure of limiting highly desired foods), and lower demandingness behavior (a measure of encouraging or discouraging children’s eating). Of note, this study relied heavily on maternally-reported data and the examination of solely low-income families may limit the findings’ generalizability. However, the use of questionnaires that are reliable and valid to conduct this longitudinal study allows strong conclusions to be made about the population of interest. This may help pediatricians better understanding their patients’ eating habits and aid in providing relevant anticipatory guidance.

Click to read the study published today in Pediatrics

Click to read the accompanying commentary in Pediatrics

Relevant Reading: Association of Picky Eating and Food Neophobia with Weight: A Systematic Review

In-Depth [prospective cohort study]: Mother-child pairs from low-income families were recruited from Head Start Programs in Michigan and followed longitudinally from 3-4 years of age until 9 years of age. Children’s BMIs and various questionnaires assessing feeding behaviors were collected at established time points. A total of 397 mother-child pairs made up the final data set. The 3 trajectories of picky eating were persistently low (n = 92; 29%), persistently medium (n = 181; 57%), and persistently high (n = 44; 14%). More children were identified as female in the persistently low picky eating trajectory than in the persistently medium picky eating trajectory (p = .003). Child emotional regulation was higher in the persistently low picky eating trajectory than in the persistently medium and high trajectories (p < .001). Consistent with the prior finding, emotional lability was noted to be lower in the persistently low trajectory than in the persistently medium and high trajectories (p = .007 and .005, respectively). The persistently medium (p = .046) and persistently high (p = .03) picky eating trajectories correlated with lower BMIs. The trajectories of restriction behavior were persistently low (n = 17; 6%), medium decreasing (n = 126; 46%), and persistently high (n = 132; 48%). The trajectories of pressure to eat were persistently low (n = 96; 35%), decreasing (n = 131; 47%), and persistently high (n = 49; 18%). Finally, the trajectories for demandingness were low decreasing (n = 41; 15%), medium decreasing (n = 160; 58%), and high decreasing (n = 75; 27%).

Image: PD

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