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.

Keywords: children; diet; growth; picky eating; weight.

FIGURE 1

BMI percentiles from ages 5 to 15 y in girls classified as picky eaters (n = 29) compared with those classified as nonpicky eaters (n = 134) plotted on the CDC growth-reference chart (14). This CDC, Department of Health and Human Services, growth chart is made available under the Open Database License (http://opendatacommons.org/licenses/odbl/1.0/). Any rights in individual contents of the database are licensed under the Database Contents License (http://opendatacommons.org/licenses/dbcl/1.0/).

FIGURE 2

Mean ± SE intakes of fruit and veg (cup equivalents per day) from ages 5 to 15 y in girls classified as picky eaters (n = 29) compared with those classified as nonpicky eaters (n = 134). For veg, there was a significant main effect of the group on cup equivalents per day [P = 0.02; repeated-measures analysis (PROC MIXED; SAS Institute Inc.)]; neither the main effect of time nor the group × time interaction was significant. For fruit, there was a significant main effect of time on cup equivalents per day (P < 0.01); both the main effect of the group and the group × time interaction were NS. The 2015 Dietary Guidelines for Americans recommends 2-cup equivalents fruit/d and 3-cup equivalents veg/d for adolescents (0.5-cup equivalents is ∼85–125 g) (11). Veg, vegetables.