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Young children are famous for being picky eaters--so much that nearly every parent has struggled with their toddler during a meal at one time or another. Once children reach the age of one or two, their willingness to try new and different foods drops remarkably. Some term this food aversion "neophobia," or the fear of trying anything new that usually arises during early childhood (Caring Online). Very young children will often restrict the types of foods they will eat, show strong flavor and texture preferences, and eat smaller amounts of food than is expected of them (Kedesdy & Budd 1998). Picky eaters show a strong fondness for sweet and salty foods and often refuse to eat anything that tastes sour or bitter (Caring Online). Parents of picky eaters frequently worry that their children are not getting the proper nutrition that they need, but this is not generally the case. Picky eating is an extremely common phase of development that does not usually cause significant health, developmental, or social problems as the individual ages. However, it is possible for extreme picky eating to have negative consequences later in life. Picky eating may result in growth failure, susceptibility to chronic illness, and even death if not properly treated (Manikam & Perman 2000). Picky eating habits may also be precursors or warning signs of the development of an eating disorder later in life. They may have harmful nutritional effects as well. These ideas, as well as the surrounding literature, are discussed below.
Picky Eating and Eating Disorders
There have been very few studies conducted about the effects of childhood picky eating behaviors on the development of eating disorders later in life. One study that does address this issue was performed by Margaret Marchi, Ph.D and Patricia Cohen, Ph.D. In this study, problematic eating behaviors were traced in a large sample of children over a period of ten years. Children and their parents were questioned about the occurrence of unpleasant meals, struggles over eating, and picky eating during their daily routines, as well as about the amount of food eaten, speed of eating, and interest in food eaten. Picky eating was found to be very common among young children, regardless of sex differences. The study found that children who had troublesome patterns of eating when young were more likely to have problems with food later in life. Picky eaters showed an increase in the frequency and severity of bulimic and anorexic symptoms upon adolescence and adulthood (Marchi & Cohen 1990).
Kotler et al. (2001) showed many of these same results. This study examined the extent to which symptoms of eating disorders remained stable over time, as well as the effect early childhood eating problems have on the development of eating disorders. This study showed a dramatic increase in the risk of developing an eating disorder when an individual had experienced eating problems earlier in life (Kotler et al. 2001).
Another study, dated 1986, does not show a strong relationship between disturbed childhood eating patterns and bulimia later in life. In this study, twenty bulimic women and their parents were questioned retrospectively about childhood eating problems. Only two of the families reported fussy eating during childhood. Data from this study does not suggest a relationship between childhood feeding problems as a causal factor in the development of bulimia later in life (Mitchell et al. 1986).
Picky Eating and Nutrition
In addition to the possibility of developing an eating disorder as a result of picky eating in childhood, there may also be severe nutritional consequences. Several studies have looked at the effects of picky eating on adequate nutrition. These studies have shown mixed results. One study proposed to measure to what extent neophobic children met daily nutritional requirements. In this study children were divided into three groups based on their willingness to try new foods: neophobic, average, and neophilic. The diets of these children were monitored in order to track the nutritional content of the foods they ate. It was found that the neophobic children showed a lower diet quality, less food variety, and a higher intake of saturated fats than the other two groups. While it was originally believed that neophobic children would not get enough essential nutrients, for the most part neophobic children met the daily RDA/DRI recommendations (Falciglia et al. 2000). Other studies that have examined nutrition in relation to picky eating have found similar results. Carruth et al. (1998) showed that picky eaters had "significantly lower dietary variety and diversity scores" than their peers, but a follow-up to this study provided conflicting results. The second study showed no substantial difference in nutrient intake, height, or weight between the original groups of picky and normal eaters. This study also indicated that in some children, neophobic behaviors did not improve as the child grew older (Carruth & Skinner 2000). These studies do not give much support to a link between picky eating and poor nutrition.
Treatment for Picky Eating
For the most part, neophobic behaviors will disappear as children grow older. As children are exposed to more and more new things they become less afraid of what they do not know. In cases where picky eating becomes extreme, though, intervention may be necessary. Structured behavioral interventions, systematic desensitization, and cognitive behavioral therapies all prove useful in these situations (Kedesdy & Budd 1998). Many more general methods of dealing with a picky eater exist as well. These methods stress the importance of allowing the child to become familiar with new foods, even if this involves touching or playing with the food. Some other helpful strategies involve pairing new foods with old favorites and putting sauce, salt, or sugar on the new food. It is emphasized that children should not be forced to eat anything they are uncomfortable with. Parents should be patient and let their children discover new foods for themselves (Caring Online).
As seen in the above discussion surrounding the negative effects of picky eating, there is a great deal of controversy surrounding the issue. Studies concerning the role of picky eating in poor nutrition and the development of eating disorders have given contrasting results. Many of these studies suggest that further research in this area needs to be performed in order to gauge the true extent of the relationship between picky eating, eating disorders, and other nutritional problems. It makes sense to think that problematic eating patterns that evolve in childhood would cause problems for an individual as he or she ages. There simply needs to be more empirical evidence to show that such relationships exist.
Carruth, B. R., Skinner, J., Houch, K., Moran, J. III, Coletta, F. Ott, D. (1998). The phenomenon of "picky eater": a behavioral marker in eating patterns of toddlers. Journal of the American College of Nutrition, 17,2:180-6.
Carruth, B. R., & Skinner, J. D. (2000). Revisiting the picky eater phenomenon: neophobic behaviors of young children. Journal of the American College of Nutrition, 19,6:771-80.
Falciglia, G. A., Couch, S. C., Gribble, L. S., Pabst, S. M. Frank, R. (2000). Food neophobia in childhood affects dietary variety. Journal of the American Dietetic Association, 100, 12: 1474-81.
Kotler, L. A., Cohen, P., Davies, M., Pine, D. S., Walsh, B. T. (2001). Longitudinal relationships between childhood, adolescent, and adult eating disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 40,12:1434-40.
Kedesdy, Jurgen H., & Budd, Karen S. (1998). Childhood Feeding Disorders: Biobehavioral Assessment and Intervention, Baltimore: Paul H. Brookes Publishing Co., Inc.
Marchi M, & Cohen, P. (1990). Early childhood eating behaviors and adolescent eating disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 29,1:112-7.
Manikam, R., & Pesrman, J. A. (2000). Pediatric feeding disorders. Journal of Clinical Gastroenterology, 30,1:34-46.
Mitchell, J. E., Boutacoff, L. & Wilson, D. (1986). Absence of early feeding problems among bulimic women. American Journal of Orthopsychiatry, 56:313-6.
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