Picky eaters in childhood tend to eat less healthy foods as adults, longitudinal study finds

A 14-year longitudinal study in the Netherlands found that children who were picky eaters at ages 4-5 consumed fruit, raw and cooked vegetables, fish, and dairy products less frequently 14 years later, around the age of 18. The study found no associations with the consumption of sweet drinks, snacks, meat, or eggs. The study was published in Appetite.

Healthy nutrition is crucial for children’s healthy development. Those who maintain well-balanced diets are less likely to develop chronic diseases later in life and are more apt to maintain a healthy weight. Despite this, many children globally don’t adhere to healthy, balanced diets.

Picky or fussy eating is a prevalent adverse eating behavior in children. Picky eaters often refuse specific foods, leading to limited dietary variety. They might be less adventurous in trying new foods (a trait referred to as food neophobia). Such children often derive less pleasure from eating, eat at a slower pace, and feel full more quickly. It’s estimated that picky eaters comprise between 6% and 50% of all children.

Study author Josine Pereboom and her colleagues wanted to explore how picky eating in early childhood is associated with dietary choices and habits in adulthood. They were particularly interested in the association between picky eating in childhood and the tendency to eat healthy and unhealthy food, as well as with weight status of young adults.

The study drew upon data from the KOALA Birth Cohort Study — KOALA being a Dutch acronym for Child, Parents, and Health; Attention to Lifestyle; and Genetic Predisposition. The cohort included 2,768 women from South-East Netherlands, pregnant between 2000 and 2002, and their offspring. These participants underwent periodic assessments post-enrollment.

Data used in the current study comes from 2007, when their children were 4 to 5 years old. In total, 2,046 mothers completed the assessment at that time. Later, in 2021, 926 mothers and 880 of their children, now around 18 years old, completed study assessments.

To assess picky eating, researchers asked mothers (back in 2007) to answer three questions about this issue from the Child Feeding Questionnaire (’My child’s diet consists of only a few foods’, ’My child is not willing to eat much of the food I serve’, and ’My child is picky about what he/she eats’). In 2021, these children, now young adults, completed a food frequency questionnaire in which they specified how often they eat different types of food. Additionally, they reported on their height and weight.

The results showed that, in 2021, participants reported that they eat fried snacks the least often, while eating cooked and stir-fried vegetables the most often. They reported eating more than one snack per day on average.

Children who were more prone to picky eating as children consumed fruit, raw and cooked vegetables, fish and dairy products less often as adults compared to participants who were not so picky with food as children. Young adults with a normal body mass index had the lowest picky eating scores as children (on average). However, childhood picky eating scores of participants with other body mass categories were not really that different.

There were no associations between picky eating in childhood and consumption of meat, eggs, fried snacks, chips, nuts and pretzels, cakes and biscuits, sweets, fruit juices, and soft drinks in adulthood.

“Picky eating in childhood is associated with lower intake frequencies of various healthy foods among young adults. It is therefore recommended to pay sufficient attention to picky eating in young children,” the study authors concluded.

The study sheds light on the links between dietary habits in childhood and later in life. However, it also has limitations that need to be taken into account. Notably, researchers did not reassess picky eating when participant became young adults. Also, the food frequency questionnaire they used asked only about how often participants consume certain type of food in terms of times per week, but did not ask about portion size. Results might not be the same if portion size was taken into account.

The paper, “Association of picky eating around age 4 with dietary intake and weight status in early adulthood: A 14-year follow-up based on the KOALA birth cohort study”, was authored by Josine Pereboom, Carel Thijs, Simone Eussen, Monique Mommers, and Jessica S. Gubbels.

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