Food and Behaviour Research

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Growth and body composition in children who are picky eaters: a longitudinal view

Taylor CM, Steer CD, Hays NP, Emmett PM (2018) Eur J Clin Nutr.  2018 Jul 11.  doi: 10.1038/s41430-018-0250-7. [Epub ahead of print] 

Web URL: Read this and related abstracts on PubMed here

Abstract:

BACKGROUND/OBJECTIVES:

Picky eating may be associated with higher risk of being underweight and poor growth over time or conversely, being overweight. Our aim was to investigate if children identified as picky eaters showed differences in height, weight and body composition from their non-picky peers.

SUBJECTS/METHODS:

Picky eaters were identified in the Avon Longitudinal Study of Parents and Children cohort at 3 years of age. Height and weight were measured on seven occasions (age 7-17 years). Body composition was measured on five occasions by dual-energy x-ray absorptiometry (age 9-17 years). Participants were classified as thin/normal/overweight or obese at each age point using body mass index (BMI) classifications. Data were analysed with adjusted multiple regression analysis and mixed-design repeated measures ANOVA.

RESULTS:

There was a main effect of being a picky child on height and weight (and on BMI and lean mass index (LMI) in boys) (lower in the picky children, all p ≤ 0.044), but not on percentage body fat or fat mass index (and not on BMI and LMI in girls) (all p > 0.2). The mean heights, weights and BMIs of picky eaters were consistently above the 50th centiles of reference growth charts. More than two-thirds of picky eaters were not thin at any age point. However, being a picky eater was predictive of being thin at a few age points.

CONCLUSIONS:

The growth trajectories of children who were picky eaters were reassuring. The prevalence of thinness amongst some picky eaters is notable, suggesting that some children may need specific early identification, intervention and growth surveillance.

FAB RESEARCH COMMENT:

The data reported here are from a large birth cohort study (known as ALSPAC, or the 'Children of the '90s' study), and concern the physical growth (height and weight) at 7 and 17 years of age of children who were identified as 'picky' eaters in their pre-school years - at 3 years of age.

As a group, their average height and BMI were both above the midpoint expected from standardised 'growth charts', and two-thirds were 'not thin'.   And yet even these 'averaged-out' findings showed that for boys as a whole, picky eating predicted significantly lower height, weight and lean body mass. 

These results are described in the concusion as 'reassuring' - although this does seem rather complacent, given that:
  • physical growth is not an accurate indicator of overall health and wellbeing, as body growth does NOT necessarily mean that the brain's nutritional needs are being met - nor even the needs of all other vital organs.
Malnutrition in terms of essential nutrient deficiencies can (and does) often occur without a lack of calories or protein. 

And even though the abstract does refer to a notable 'prevalence of thinness amongst some picky eaters', again, the authors refer only to the need for 'growth surveillance' in such children - when in fact, the specific early identification and intervention that such children really need concerns their actual nutrition.

The associated news article and headline simply echo and expand on the word 'reassuring' (which quite frankly, these findings are NOT):


For a wider selection of information on selective or 'picky' eating, and its potential consequences if not well managed, please see the following lists, which are regularly updated.