Picking Apart Picky Eating, Part 1: Selective Eating in Children
“Try it–you’ll like it!” It’s something children and toddlers hear a lot. Most kids go through phases of picky eating, sometimes even fairly extreme. Mostly, this is part of normal development. From an evolutionary standpoint, where not all foods were safe to eat (especially combined with a young child’s desire to put everything they can possibly find into their mouths), it’s probably not always a bad thing for little kids to be cautious when it comes to eating. By the time they generally become more willing to try new foods, they have a little better sense of what’s safe and what’s not. This is combined with the general trait of being adventurous and open-minded.
In recent years, psychologists and researchers have begun paying attention to selective or picky eating. This increased awareness has been, in part, due to the recommendation that picky/selective eating be included in the Diagnostic and Statistical Manual when it persists for an unusually long period of time. Most of the time, children outgrow their picky eating phases. But for a small subset of this population, the selective eating or food neophobia persists, even into adulthood.
It’s not a disorder that’s discussed as much as anorexia and bulimia. But for those who have this disorder, it can put a tremendous damper on psychological, social, and occupational development. So I thought I would do two blog posts on selective eating: one in children, and one in adults. To start with, I’m going to discuss picky eating in children.
The young picky eater
To start with, I’m not going to be discussing the normal food fads of toddlerhood. For one, they’re not disorders (however frustrating they must be to parents). For another, that’s not really my area of expertise.
So what exactly is picky eating? And how do you distinguish “normal” picky eating from the more problematic type?
Researchers have developed three different sets of criteria, below. In terms of doing the best job of capturing problematic picky eating, I think the middle and right-hand criteria do the best job, although I’m not sure that there has been much in the way of validation, especially since selective eating isn’t well-defined.
Initial studies of picky eating in childhood found that patterns of inhibited or selective eating began shortly after birth, while the babies were still breast or bottle feeding. Female picky eaters generally ate fewer calories between ages 3.5 and 5.5 than their normal eating counterparts, and parents of picky eaters reported more overall negative moods in their children (Jacobi et al., 2003).
A 2008 follow-up study by some of the same researchers concluded, however, that picky eating wasn’t an eating disorder per se. Instead, it appeared to be associated with a broader range of problematic behaviors (Jacobi et al., 2008). A study of 426 children between ages 8 and 12, as well as their primary caregivers, found that approximately one in five children in this age group were considered picky eaters by their parents (rates were equal for boys and girls). Although measures of height and weight were similar between the different groups, other characteristics showed distinct differences. Mothers of picky eaters said that their children ate a more limited number of foods, required special preparation of foods more often, showed a lower acceptance of new foods, were more inhibited about food, had more parent-child struggles about food, and expressed special food preferences more often. Children who were classified as picky eaters also had higher levels of internalizing (turning anger inwards) and externalizing (turning anger outwards) behaviors. The authors concluded that picky eating seemed to be more of a symptom of a larger behavioral or psychological problem in these children rather than a problem in and of itself.
The genetics of childhood picky eating
Whether picky eating is one aspect of a larger problem or a stand-alone disorder
I got the idea for these blog posts by stumbling across a study on the genetic basis of food neophobia in children (aka selective eating). Besides sounding more highbrow, I think the name “food neophobia” is perhaps a little more descriptive of what is going on in children with these symptoms. These kids aren’t gourmands- they have a very limited range of foods that they will eat (usually highly processed, high fat, high carbohydrate foods) and a marked fear of expanding their range of foods.
Researchers recruited 66 families with same-sex twins to participate in a study about food neophobia in childhood (Faith et al., 2013). The parents completed a variety of questionnaires about their feeding style, food environment, their child’s eating habits, and other psychological factors. The parents and children also completed a lab study of a sample meal. By comparing how many twins both had picky eating, how many didn’t, and how many twin pairs had one picky eater and one regular eater, the researchers could determine the relative effects of genes and environment.
Basically, if picky eating were 100% genetic, then identical (monozygotic) twins would always be either both picky eaters or both not, since they share the same genes. Similarly, fraternal (dizygotic) twins would be both picky eaters or both not 50% of the time, since they only share half of their DNA like normal siblings. If picky eating were 100% environmental, then monozygotic and dizygotic twins would have the same proportion of both picky eater pairs and one picky eater and one normal eater pairs. Math helps the researchers figure out exactly how much genes and environment contribute to a particular condition.
For picky eating, the researchers found that, in this population, picky eating explained 72% of the variation in picky eating. What that means is that approximately 72% of the variability between normal and picky eating in these twins was due to genetics. Other factors were related to environmental factors, including the different ways parents tended to respond to each child.
Conclude the authors:
The present findings have implications for health professionals and parents. First, our results underscore the important role of ‘nature’ on young children’s tendency to avoid new foods. This information may be valuable to parents who believe that they alone ‘make’ their children food neophobic through ‘bad parenting.’ Pediatricians may be in a unique position to disabuse parents of such beliefs, which discussing strategies to encourage acceptance of new foods.
Julie O’Toole from the Kartini Clinic shares her thoughts on childhood selective eating here that are worth reading.
Without treatment, more severe forms of picky eating tend to persist into late childhood, adolescence, and beyond. Concludes one prospective study of children through age 11 (Mascola, Bryson, & Agras, 2010):
Parents of picky eaters were more likely to report that their children consumed a limited variety of foods, required food prepared in specific ways, expressed stronger likes and dislikes for food, and threw tantrums when denied foods. They were also more likely to report struggles over feeding, preparing special meals, and commenting on their child’s eating. Hence, picky eating is a prevalent concern of parents and may remain so through childhood. It appears to be a relatively stable trait reflecting an individual eating style.