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May 28, 2020
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Picky eating starts early, may protect against higher BMI scores

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Picky eating begins early in a child’s life and is associated with parental tactics to counteract pickiness, according to a recently published study in Pediatrics.

Megan H. Pesch, MD, MS, assistant professor of pediatrics at the University of Michigan, and colleagues also found a potential benefit: Picky eating was associated with lower BMI scores, and less picky eating with higher BMI scores.

“Some children may not grow out of picky eating, but it might be protective against later being overweight or obese and wasn't associated with being underweight — which, overall, may be somewhat reassuring for parents, as well as health care providers,” Pesch told Healio.

Megan H. Pesch

Pesch and colleagues obtained data on picky eating and maternal feeding behaviors among low-income U.S. children aged between 4 and 9 years via questionnaires from 317 mother-child dyads.

They measured responses according to the “Food Fussiness” subscale on the Children’s Eating Behavior Questionnaire, using a range of 1 to 5, with higher scores indicating pickier eating.

According to the study, three trajectories of picky eating were identified: persistently low picky eating in 29% (n = 92) of children; persistently medium picky eating in 57% (n = 181); and persistently high picky eating in 14% (n = 44).

Low picky eating was associated with being female, higher emotional regulation and lower emotional lability, compared with the medium and higher trajectories, Pesch and colleagues reported. Low picky eating was associated with low restriction and high picky eating was associated with high demandingness, they wrote.

“The one thing I want to emphasize is that we looked at trends of picky eating, trends of children's BMI, their growth, and then also trends of maternal eating behaviors. We saw what ran with what, and what was associated longitudinally, but we weren't able to really find what caused what,” Pesch said.

“For instance, we don't know if it's mothers being more demanding that cause your children to be picky. Or is it that the children are picky, and so parents, in response, started restricting more of those junk foods or really prepping the vegetables to try to get them to open up their diet. Likely it's a little bit of both.”

Pesch said she was expecting to find that more kids grew out of picky eating.

“I was expecting to find a group of kids who were picky at 4, but maybe it resolved by 7, or even 5; and I was expecting to find characteristics that were predictive of that group, so we could tell physicians or parents with better certainty who would grow out of picky eating, but that was not the case at all,” Pesch said.

“Even when we looked at our models in different ways, there were only five kids in this entire sample who had any sort of decrease in their picky eating over time, and that was just not statistically significant. So that very much shocked me.” – by Ken Downey Jr.

Disclosures: The authors report no relevant financial disclosures.