As a parent, you probably have never thought about this: Overly picky eating could be a sign of deeper trouble in kids

As a parent, you probably have never thought about this: Overly picky eating could be a sign of deeper trouble in kids

Last Updated on August 12, 2015 by Joseph Gut – thasso

Eating IIAugust 12, 2015 – This is a very interesting reading I just stumbled upon and, as a parent of four, effectively never have thought about.  I only just wondered, that was all. Here, based on a study published online on August 03, 2015 in Pediatrics, I might fundamentally rethink the eating behaviour of some of my kids. Of course, this being a blog about theragenomic medicine, genetics, and all this stuff of personalized medicine, an picky eating seems far away from all genetics and/or predisposition. But it might not be.

According to this study, clinicians should intervene when preschoolers are extremely picky eaters, as even moderate levels of selective eating (SE), which may actually be one form of the many  eating disorders, all of which seem to be associated with impaired psychological and psychosocial function. Clinicians should not view SE as a phase the child will “grow out of,” write Nancy Zucker, PhD, from the Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, the first author of this study, and  her colleagues. Rather, SE should be seen as a warning sign for current impairment and “a marker for later psychopathology.” Screening for SE in primary care practices would help identify vulnerable children. It is not uncommon for young children to turn up their noses at a variety of foods, with up to 20% of parents saying their 2- to 5-year-old children are “sometimes” or “often” selective about what they will eat, Dr Zucker and colleagues write. However, it remains murky as to when food aversion becomes severe enough for clinicians to take action.

 As part of a study of preschool anxiety, Dr Zucker and coauthors screened 3433 children aged 2 to 5 years treated at Duke Children’s Pediatric Primary Care clinics for risk of anxiety. They initially enrolled 944 children who screened high and a random sample of 189 of the remaining youths who had not screened high. After in-home assessments for 917 children, the researchers settled on a final sample of 180 participants for follow-up, many of whom had anxiety disorders. Parents completed an assessment of their child’s psychopathology, including questions that explored the degree of the children’s SE. Eschewing broccoli did not register as a red flag, as preschoolers typically dislike cruciferous vegetables. SE ranked as a “2” if the range of food the child ate was so limited that it made it difficult to have meals with others.

“Children with SE at either moderate or severe levels were more likely to have elevated symptoms of anxiety or depression, to experience hypersensitivity to taste and texture, to have mothers with elevated anxiety, and to have family conflicts around food,” Dr Zucker and colleagues write. “Compared with children with severe SE, children with moderate SE were more likely to endorse externalizing symptoms (specifically symptoms of [attention deficit/hyperactivity disorder]), to have a parent with a substance abuse history, and to have a mother who has sought mental health treatment.”

In addition, diagnosing the eating disorder as “avoidant/restrictive food intake disorder” would leverage a more sensitive diagnostic category that can be used beyond childhood. “There is much to learn about the management of SE,” Dr Zucker and colleagues conclude. “Findings may help health care providers better understand the complex challenges parents face when their child is a selective eater.”

Ph.D.; Professor in Pharmacology and Toxicology. Senior expert in theragenomic and personalized medicine and individualized drug safety. Senior expert in pharmaco- and toxicogenetics. Senior expert in human safety of drugs, chemicals, environmental pollutants, and dietary ingredients.