Child and parent predictors of picky eating from preschool to school age

Abstract

BackgroundPicky eating is prevalent in childhood. Because pickiness concerns parents and is associated with nutrient deficiency and psychological problems, the antecedents of pickiness need to be identified. We propose an etiological model of picky eating involving child temperament, sensory sensitivity and parent-child interaction.MethodsTwo cohorts of 4-year olds (born 2003 or 2004) in Trondheim, Norway were invited to participate (97.2% attendance; 82.0% consent rate, n = 2475) and a screen-stratified subsample of 1250 children was recruited. We interviewed 997 parents about their child’s pickiness and sensory sensitivity using the Preschool Age Psychiatric Assessment (PAPA). Two years later, 795 of the parents completed the interview. The Children’s Behavior Questionnaire (CBQ) was used to assess children’s temperament. Parent- child interactions were videotaped and parental sensitivity (i.e., parental awareness and appropriate responsiveness to children’s verbal and nonverbal cues) and structuring were rated using the Emotional Availability Scales (EAS).ResultsAt both measurement times, 26% of the children were categorized as picky eaters. Pickiness was moderately stable from preschool to school age (OR = 5.92, CI = 3.95, 8.86), and about half of those who displayed pickiness at age 4 were also picky eaters two years later. While accounting for pickiness at age 4, sensory sensitivity at age 4 predicted pickiness at age 6 (OR = 1.25, CI = 1.08, 2.23), whereas temperamental surgency (OR = 0.88, CI = 0.64, 1.22) and negative affectivity (OR = 1.17, CI = 0.75, 1.84) did not. Parental structuring was found to reduce the risk of children’s picky eating two years later (OR = 0.90, CI = 0.82, 0.99), whereas parental sensitivity increased the odds for pickiness (OR = 1.10, CI = 1.00, 1.21).ConclusionsAlthough pickiness is stable from preschool to school age, children who are more sensory sensitive are at higher risk for pickiness two years later, as are children whose parents display relatively higher levels of sensitivity and lower levels of structuring. Our findings suggest that interventions targeting children’s sensory sensitivity, as well as parental sensitivity and structuring, might reduce the risk of childhood pickiness. Health care providers should support parents of picky eaters in repeatedly offering unfamiliar and rejected foods to their children without pressure and acknowledging child autonomy.Electronic supplementary materialThe online version of this article (doi:10.1186/s12966-017-0542-7) contains supplementary material, which is available to authorized users.

Emotional Over‐ and Undereating in Children: A Longitudinal Analysis of Child and Contextual Predictors

“…However, considering the significance of the interaction (p = .042), there is a distinct possibility of a chance finding. Although there is some support for the notion that very high sensitivity may have some costs in the case of food and feeding, stemming from an earlier report that found high sensitivity to predict increased pickiness in children (Steinsbekk, Bonneville-Roussy, et al, 2017), the present Soothability 9 Sensitivity Finding is in obvious need of replication before potential mechanisms are addressed.…”

“…Some past research (e.g., Steinsbekk, Belsky, & Wichstrøm, 2016;Steinsbekk, Bonneville-Roussy, Fildes, Llewellyn, & Wichstrøm, 2017) has examined how parental feeding and children's eating may influence each other, but there are virtually no longitudinal studies on emotional undereating. Research testing broader and more encompassing etiological models of the development of emotional over-and undereating is lacking.…”

Aspectos comportamentais e ambientais associados às dificuldades alimentares na infância: Estudo com grupo controle

“…Uma coorte realizada entre os 4 e 6 anos de crianças nascidas entre 2003 e 2004 na Noruega, propondo um modelo etiológico de seletividade alimentar, visou testar este modelo em uma amostra representativa de crianças norueguesas e concluiu que a estruturação adequada de parentalidade reduz o risco de seletividade alimentar. 20 O presente estudo apresenta limitações que não puderam ser controladas em sua concepção, a saber: 1) Não foi possível coletar dados socioeconômicos, impedindo a comparação segundo faixas sociais. Apesar disso, as crianças incluídas no grupo controle referem-se às diferentes faixas socioeconômicas atendidas pelo hospital, enquanto os pacientes atendidos no serviço ambulatorial (grupo caso) são tipicamente oriundos de grupos de alto poder aquisitivo, porém sem dados específicos a respeito de acesso a bens de consumo ou renda.…”

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“…Such practice may lead to increased carbohydrate consumption and distortion in the nutritional composition of the diet, with a low intake of vegetables, vegetables, and fruits (Ong et al 2014, Taylor et al 2015. The prevalence is higher in preschool children and seems to disappear up to seven years (Steinsbekk et al 2017). The development of PE can be caused by factors such as pressure to eat, practices and parental styles of feeding, short time or absent breastfeeding, the introduction of complementary foods before six months or late introduction of foods that require chewing (Taylor et al 2019).…”