Association between picky eating behaviors and growth in preschool children

Jae Eun Shim; Ji Hyun Yoon; Kijoon Kim; Hee Young Paik

doi:10.4163/jnh.2013.46.5.418

Journal List > J Nutr Health > v.46(5) > 1081308

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Shim, Yoon, Kim, and Paik: Association between picky eating behaviors and growth in preschool children

Research Article

Journal of Nutrition and Health 2013; 46(5): 418-426.

Published online: 31 October 2013

DOI: https://doi.org/10.4163/jnh.2013.46.5.418

Association between picky eating behaviors and growth in preschool children

Jae Eun Shim¹, Ji Hyun Yoon^2,³, Kijoon Kim^2,⁴, Hee Young Paik^2,³

¹Department of Food and Nutrition, Daejeon University, Daejeon 300-716, Korea.

²Department of Food and Nutrition, Seoul National University, Seoul 151-742, Korea.

³Research Institute of Human Ecology, Seoul National University, Seoul 151-742, Korea.

⁴BOM Research Institute, Seoul National University, Seoul 151-742, Korea.

To whom correspondence should be addressed. (hypaik@snu.ac.kr)

Received 20 August 2013 Revised 9 September 2013 Accepted 8 October 2013

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

This study was conducted in order to investigate the association between picky eating behaviors of preschool children and growth outcomes. In this study, picky eating behaviors were defined as containing four constructs of 'eating a small amount (ES),' 'neophoic behavior (NB),' 'refusal of specific food groups (RF),' and 'preference for specific food-preparation methods (PP).' A 7-point scale was used for the multi-item questionnaire, which consisted of 21 items (three items for ES, two items for NB, nine items for RF, and seven items for PP), in order to evaluate picky eating behaviors of children. Subjects were recruited among visitors at a medical clinic in Seoul. A total of 150 self-administered survey responses from parents of preschool children were analyzed in order to investigate the association between picky eating behaviors of preschool children and growth outcomes. Height for age (HFA) and weight for height (WFH) z-scores were used for assessment of preschool children's growth. The prevalence of ES, NB, RF, and PP was 44%, 57%, 73%, and 53%, respectively. Children with ES had lower HFA (p < 0.05) and WFH (p < 0.0001) than those without ES, while children with NB, RF, or PP had HFA and WFH were similar to their counterparts. The mean HFA z-score of children with ES was less than 0 (p < 0.05) and the mean WFH z-scores of children with ES, NB, RF, or PP were less than 0 (p < 0.05). According to the study results, related growth outcome differed depending on constructs of picky eating behaviors. In particular, picky eating of ES showed a risk of faltering height growth in preschool children. Further comprehensive studies on the reason for ES and intervention approach is warranted.

Keywords: picky eating, preschool children, growth faltering

Figures and Tables

Table 1

Concept and constructs of picky eating behavior and questions used to measure each construct

1) Cronbach's coefficient α is 0.88 2) Cronbach's coefficient α is 0.79 3) Negatively worded questions were reverse scored

Table 2

Selected characteristics of subjects (n = 150)

1) n is different from other characteristics due to missing responses

Table 3

Mean scores of picky eating constructs and prevalence of picky eaters (n = 150)

1) No. of subjects whose scores were more than 4 in any one food group

Table 4

Comparison of growth status between picky eaters and non-picky eaters (n = 150)

^*: Mean values were different from those of non-picky eaters by t-test (^*: p < 0.05, ^**: p < 0.0001)

^†: Mean values were different from those of non-picky eaters by Wilcoxon rank sum test (p < 0.01)

Notes

This research was supported by a grant of Daejeon University in 2012.

References

1. WHO Multicentre Growth Reference Study Group. Assessment of differences in linear growth among populations in the WHO Multicentre Growth Reference Study. Acta Paediatr Suppl. 2006; 450:56–65.

2. Nicklas TA, Farris RP, Smoak CG, Frank GC, Srinivasan SR, Webber LS, Berenson GS. Dietary factors relate to cardiovascular risk factors in early life. Bogalusa Heart Study. Arteriosclerosis. 1988; 8(2):193–199.

3. Randall E, Marshall JR, Brasure J, Graham S. Dietary patterns and colon cancer in western New York. Nutr Cancer. 1992; 18(3):265–276.

4. Kelder SH, Perry CL, Klepp KI, Lytle LL. Longitudinal tracking of adolescent smoking, physical activity, and food choice behaviors. Am J Public Health. 1994; 84(7):1121–1126.

5. Berenson GS, Srinivasan SR, Bao W, Newman WP 3rd, Tracy RE, Wattigney WA. Association between multiple cardiovascular risk factors and atherosclerosis in children and young adults. The Bogalusa Heart Study. N Engl J Med. 1998; 338(23):1650–1656.

6. Lichtenstein AH, Kennedy E, Barrier P, Danford D, Ernst ND, Grundy SM, Leveille GA, Van Horn L, Williams CL, Booth SL. Dietary fat consumption and health. Nutr Rev. 1998; 56(5 Pt 2):S3–S19.

7. Lien N, Lytle LA, Klepp KI. Stability in consumption of fruit, vegetables, and sugary foods in a cohort from age 14 to age 21. Prev Med. 2001; 33(3):217–226.

8. Skinner JD, Carruth BR, Bounds W, Ziegler PJ. Children's food preferences: a longitudinal analysis. J Am Diet Assoc. 2002; 102(11):1638–1647.

9. Anzman SL, Rollins BY, Birch LL. Parental influence on children's early eating environments and obesity risk: implications for prevention. Int J Obes (Lond). 2010; 34(7):1116–1124.

10. Carruth BR, Ziegler PJ, Gordon A, Barr SI. Prevalence of picky eaters among infants and toddlers and their caregivers' decisions about offering a new food. J Am Diet Assoc. 2004; 104:1 Suppl 1. s57–s64.

11. Jacobi C, Schmitz G, Agras WS. Is picky eating an eating disorder? Int J Eat Disord. 2008; 41(7):626–634.

12. Carruth BR, Skinner J, Houck K, Moran J 3rd, Coletta F, Ott D. The phenomenon of "picky eater": a behavioral marker in eating patterns of toddlers. J Am Coll Nutr. 1998; 17(2):180–186.

13. Carruth BR, Skinner JD. Revisiting the picky eater phenomenon: neophobic behaviors of young children. J Am Coll Nutr. 2000; 19(6):771–780.

14. Lewinsohn PM, Holm-Denoma JM, Gau JM, Joiner TE Jr, Striegel-Moore R, Bear P, Lamoureux B. Problematic eating and feeding behaviors of 36-month-old children. Int J Eat Disord. 2005; 38(3):208–219.

15. Wardle J, Guthrie CA, Sanderson S, Rapoport L. Development of the children's eating behaviour questionnaire. J Child Psychol Psychiatry. 2001; 42(7):963–970.

16. Cooke L, Wardle J, Gibson EL. Relationship between parental report of food neophobia and everyday food consumption in 2-6-year-old children. Appetite. 2003; 41(2):205–206.

17. Steyn NP, Nel JH, Nantel G, Kennedy G, Labadarios D. Food variety and dietary diversity scores in children: are they good indicators of dietary adequacy? Public Health Nutr. 2006; 9(5):644–650.

18. Wright CM, Parkinson KN, Shipton D, Drewett RF. How do toddler eating problems relate to their eating behavior, food preferences, and growth? Pediatrics. 2007; 120(4):e1069–e1075.

19. Davies WH, Ackerman LK, Davies CM, Vannatta K, Noll RB. About your child's eating: factor structure and psychometric properties of a feeding relationship measure. Eat Behav. 2007; 8(4):457–463.

20. Shim JE, Kim J, Mathai RA. STRONG Kids Research Team. Associations of infant feeding practices and picky eating behaviors of preschool children. J Am Diet Assoc. 2011; 111(9):1363–1368.

21. Goulet O. Growth faltering: setting the scene. Eur J Clin Nutr. 2010; 64:Suppl 1. S2–S4.

22. Corvalán C, Kain J, Weisstaub G, Uauy R. Impact of growth patterns and early diet on obesity and cardiovascular risk factors in young children from developing countries. Proc Nutr Soc. 2009; 68(3):327–337.

23. Dubois L, Farmer AP, Girard M, Peterson K. Preschool children's eating behaviours are related to dietary adequacy and body weight. Eur J Clin Nutr. 2007; 61(7):846–855.

24. Galloway AT, Fiorito L, Lee Y, Birch LL. Parental pressure, dietary patterns, and weight status among girls who are "picky eaters". J Am Diet Assoc. 2005; 105(4):541–548.

25. Oh YJ, Chang YK. Children's unbalanced diet and parents' attitudes. Korean J Nutr. 2006; 39(2):184–191.

26. Kim Y, Han YS, Chung SJ, Lee Y, Lee SI, Choi H. Characteristics of infants' temperaments and eating behaviors, mothers' eating behaviors and feeding practices in poor eating infants. Korean J Community Nutr. 2006; 11(4):449–458.

27. Galloway AT, Fiorito LM, Francis LA, Birch LL. 'Finish your soup': counterproductive effects of pressuring children to eat on intake and affect. Appetite. 2006; 46(3):318–323.

28. Ogden J, Reynolds R, Smith A. Expanding the concept of parental control: a role for overt and covert control in children's snacking behaviour? Appetite. 2006; 47(1):100–106.

29. Newman J, Taylor A. Effect of a means-end contingency on young children's food preferences. J Exp Child Psychol. 1992; 53(2):200–216.

30. Birch LL, Marlin DW, Rotter J. Eating as the "means" activity in a contingency: effects on young children's food preference. Child Dev. 1984; 55(2):431–439.

31. Birch LL, Marlin DW. I don't like it; I never tried it: effects of exposure on two-year-old children's food preferences. Appetite. 1982; 3(4):353–360.

32. Bante H, Elliott M, Harrod A, Haire-Joshu D. The use of inappropriate feeding practices by rural parents and their effect on preschoolers' fruit and vegetable preferences and intake. J Nutr Educ Behav. 2008; 40(1):28–33.

33. Dovey TM, Staples PA, Gibson EL, Halford JC. Food neophobia and 'picky/fussy' eating in children: a review. Appetite. 2008; 50(2-3):181–193.

TOOLS

Similar articles