Should we worry about picky eating?
In the next #CO90sDiscoveries episode, Dr. Caroline Taylor explains whether or not we should worry about picky eaters.
Encouraging children to eat a balanced diet is a significant cause for concern for many parents and carers. Children of the 90s data now provides compelling evidence to reassure them that while a child’s fussy eating is distressing, it’s unlikely to have any long-term impact on their children’s health.
Measuring health and development
Toddlers are commonly known to go through a phase of picky eating. Their reluctance to try new foods or insist on eating only certain foods creates anxiety for parents and carers, who often fear their children will suffer ill health later in life.
Dr Caroline Taylor from the University of Bristol’s Centre for Academic Child Health has led a number of studies using Children of the 90s data to explore the long-term effects of picky or fussy eating, measuring health indicators such as height, weight and body composition.
“Much of the existing work concentrates on psychological and behavioural aspects rather than diet and health effects,” says Dr Taylor, who highlights the value of these studies in understanding long-term growth and development patterns. “What we’ve been able to do that other studies haven’t is to gain a detailed understanding of dietary habits and the effects they have.”
In one seminal study, 7,000 participants were assessed at the ages of two, three, four-and-a-half, five-and-a-half, and seven years old. Dr Taylor and fellow researchers found that children who were described by their parents as ‘picky eaters’ were getting enough to eat overall but tended to eat less meat, fruit and vegetables. This resulted in lower carotene, iron and zinc intakes, but only very rarely at worryingly low levels. Picky eaters also consumed more sugary foods and drinks than non-picky eaters.
Another study characterised the diets of 300 children aged between seven and 17 years old who had been identified as picky eaters when they were toddlers. The results were compared with 900 children in the same study who were not picky eaters. When the diets of children from both groups were compared when they were all 10 years old, those who had been picky eaters at the age of three still ate less fruit, vegetables and meat than the others.
By the time the fussy eaters turned 13, there were still differences but they were less pronounced. The average height, weight and body mass index (BMI) of the children who were picky eaters when they were toddlers were also found to be normal for their age – measured as above the 50th centiles, which indicates the average measurement for all children in the population.
“Early choosiness is a normal part of growing up; parents can relax in the knowledge that this phase shouldn’t limit their children’s growth,” says Dr Taylor.
In a separate study, they looked at 6,000 responses to a questionnaire asking participants for the reasons behind picky eating. 50% of three-year-olds whose mothers were worried about their child’s diet at 18 months old turned out to be picky eaters. Where mothers were more relaxed about their children’s eating habits at 18 months, the children were less likely to be picky eaters at 3 years old (17% of participants). The timing of being introduced to solid foods was also significant - where children weren’t given solids until they were 9 months old, they were more likely to be fussy about their food by the time they turned 3 years old.
Practical advice and support
Speaking with parents, carers and healthcare professionals was an instrumental part of sharing these findings in a way that would help them manage picky eating and access further advice in rare more serious cases.
Dr Taylor’s team held live Q&As on Facebook, made a podcast and delivered talks to groups of parents and schoolchildren, and health visitors, offering practical suggestions such as regular family mealtimes with home-cooked foods, persisting with unfamiliar foods, encouraging parents to lead by example with their own dietary habits, and introducing a variety of foods early on and into adolescence.
“Picky eating in children is very common, but for those few children at risk of not ‘growing out of it’ we are working on ways to identify them early on, so they can have the help and support they need,” adds Dr Taylor.
“We would like to see strategies developed for use in pre-school years to support parents, caregivers and healthcare providers, as well as the development of tools to help identify the few children who are likely to become fixed in their picky eating behaviour so that extra support can be given.”
- Picky eating in children: causes and consequences
- Picky/fussy eating in children: review of definitions, assessment, prevalence and dietary intakes
- Macro- and micronutrient intakes in picky eaters: a cause for concern?
- Picky eaters eating enough but falling short on their five a day
- Children who are picky eaters still grow up healthy
- Diet at age 10 and 13 years in children identified as picky eaters at age 3 years and in children who are persistent picky eaters in a longitudinal birth cohort study
- Growth and body composition in children who are picky eaters: a longitudinal view
- Picky eating in preschool children: associations with dietary fibre intakes and stool hardness
- Antecedents of picky eating behaviour in young children
- Factors associated with maternal worry about her young child exhibiting choosy feeding behaviour
What we discovered
- Children who had picky eating habits at three years old turned out to have a normal height, weight and body mass index (BMI) during adolescence.
- Children identified as picky eaters between the ages of two and seven years ate less meat, fruit and vegetables than those who were not picky eaters, resulting in lower intakes of carotene, iron and zinc, but without being at worryingly low levels. They also consumed more sugary foods and drinks than non-picky eaters.
- Children whose mothers who were very anxious about their child’s eating habits at 18 months old were more likely to be picky eaters at three years old than if the mother was not anxious.
- Children who weren’t given solid foods until they were nine months old were more likely to be fussy about their food by the time they turned three years old.