Academic journal article Childhood Obesity

Association of Picky Eating and Food Neophobia with Weight: A Systematic Review

Academic journal article Childhood Obesity

Association of Picky Eating and Food Neophobia with Weight: A Systematic Review

Article excerpt

[Author Affiliation]

Callie L. Brown. 1 Department of General Pediatrics and Adolescent Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC.

Emily B. Vander Schaaf. 1 Department of General Pediatrics and Adolescent Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC.

Gail M. Cohen. 2 Department of Pediatrics, Wake Forest School of Medicine, Winston-Salem, NC. 3 Brenner FIT Program, Brenner Children's Hospital, Winston-Salem, NC.

Megan B. Irby. 2 Department of Pediatrics, Wake Forest School of Medicine, Winston-Salem, NC. 3 Brenner FIT Program, Brenner Children's Hospital, Winston-Salem, NC.

Joseph A. Skelton. 2 Department of Pediatrics, Wake Forest School of Medicine, Winston-Salem, NC. 3 Brenner FIT Program, Brenner Children's Hospital, Winston-Salem, NC. 4 Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC.

Address correspondence to: Callie L. Brown, MD, Department of General Pediatrics and Adolescent Medicine, University of North Carolina at Chapel Hill, 260 MacNider Building, CB# 7220, Chapel Hill, NC 27599-7220, E-mail: callie.brown@unc.edu

Introduction

Parents commonly express concern that their children are poor eaters. As a feature of normal development, most children experience a reduction in appetite1 and a decreased rate of growth2,3 between 2 and 6 years of age. Food preferences are typically established during toddlerhood, although toddlers' preferences for certain foods may vary significantly on a weekly or even a daily basis.4 Young children may need to try a novel food as many as 15 times before they will accept it as a component of their normal diet.5 Picky or fussy eating is often defined as eating a limited variety of foods. As the terms are often used interchangeably, we will use the term picky eating to also refer to fussy eating, food fussiness, and selective eating throughout this article.4,6 Food neophobia, the fear/hesitation of eating new or novel foods, is often considered to be one specific component of picky eating.4 Given that picky eating and food neophobia are conceptualized based on a spectrum of behaviors6 and nearly all children experience picky eating or food neophobia to some degree,7 it is not well understood to what extent these behaviors affect weight status later in life.

It is well established that childhood eating behaviors predict adult eating behaviors,8,9 and children who are overweight or obese are more likely to be overweight or obese in adulthood compared to their normal weight counterparts.10 Some evidence suggests that picky eaters who do not consume sufficient calories may become underweight.11,12 However, parents may also compensate for children's pickiness by pressuring their child to eat or by offering foods their children may find more acceptable, such as calorie-dense foods, which may inadvertently increase the risk for obesity.

While there are reports of picky eating and food neophobia in the obesity literature,13 it remains unknown whether picky eating during childhood plays a role in determining weight trajectory or future weight status. This systematic review seeks to determine if the presence of picky eating or food neophobia behaviors during childhood is associated with childhood weight status or with becoming underweight, overweight, or obese later in childhood or adolescence. We hypothesize that children reported to be picky eaters are at a higher risk for becoming overweight or obese as older children and adolescents, likely due to a preference for calorie-dense foods and decreased intake of fruits and vegetables. In addition, we describe the various definitions and reported prevalence of picky eating and food neophobia. …

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