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Brown CL, Perrin EM, Peterson KE, Brophy Herb HE, Horodynski MA, Contreras D, Miller AL, Appugliese DP, Ball SC, Lumeng JC. Association of Picky Eating With Weight Status and Dietary Quality Among Low-Income Preschoolers. Acad Pediatr 2018; 18:334-341. [PMID: 28887030 PMCID: PMC5837907 DOI: 10.1016/j.acap.2017.08.014] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Revised: 08/18/2017] [Accepted: 08/29/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Picky eating is common in children. Few studies have examined predictors of picky eating, and the association of picky eating with weight status and dietary quality is inconsistent in the literature. We aimed to identify predictors of picky eating and to test the association of picky eating with child body mass index z-score (BMIz), dietary quality, and micronutrient intake. METHODS This was a cross-sectional analysis of baseline data from a randomized controlled trial to prevent obesity among 506 preschoolers attending Head Start. Parents completed questionnaires to assess picky eating and child temperament. Three 24-hour dietary recalls were collected to assess dietary intake. Multivariate regression models assessed child, parent, and family predictors of picky eating; additional models tested adjusted associations of picky eating with child BMIz, dietary quality (measured using the Healthy Eating Index-2010), and micronutrient intake. RESULTS Picky eating was predicted by male sex, older child age, and more difficult temperament but not race/ethnicity, maternal body mass index, maternal depressive symptoms, household food insecurity, or single parent home. Picky eating was not associated with child BMIz or micronutrient deficiencies; it was inversely associated with total Healthy Eating Index-2010 score and servings of whole fruit, total vegetables, greens and beans, and total protein foods. CONCLUSIONS Pediatric providers should support parents in expanding the number of healthy foods the child eats to improve dietary quality, but reassure parents that picky eating is not associated with children's weight status or micronutrient deficiencies.
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Affiliation(s)
- Callie L Brown
- Department of Pediatrics, Wake Forest University School of Medicine, Winston-Salem, NC.
| | - Eliana M Perrin
- Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, The University of North Carolina at Chapel Hill School of Medicine
| | - Karen E Peterson
- Center for Human Growth and Development, University of Michigan; Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor; Department of Nutrition, Harvard W.T. Chan School of Public Health, Boston, Mass
| | - Holly E Brophy Herb
- Department of Human Development and Family Studies, Michigan State University, East Lansing
| | | | - Dawn Contreras
- Department of Human Development and Family Studies, Michigan State University, East Lansing; Health and Nutrition Institute, Michigan State University Extension, East Lansing
| | - Alison L Miller
- Center for Human Growth and Development, University of Michigan; Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor
| | | | - Sarah C Ball
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor
| | - Julie C Lumeng
- Center for Human Growth and Development, University of Michigan; Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor; Department of Pediatrics, University of Michigan Medical School, Ann Arbor
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52
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Zickgraf HF, Ellis JM. Initial validation of the Nine Item Avoidant/Restrictive Food Intake disorder screen (NIAS): A measure of three restrictive eating patterns. Appetite 2018; 123:32-42. [DOI: 10.1016/j.appet.2017.11.111] [Citation(s) in RCA: 77] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2017] [Revised: 11/28/2017] [Accepted: 11/28/2017] [Indexed: 12/31/2022]
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53
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Taste the feeling or feel the tasting: Tactile exposure to food texture promotes food acceptance. Appetite 2018; 120:297-301. [DOI: 10.1016/j.appet.2017.09.010] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Revised: 08/25/2017] [Accepted: 09/13/2017] [Indexed: 01/22/2023]
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Foster BA, Aquino CA, Mejia S, Turner BJ, Singhal A. Identification and Characterization of Families That Are Positively Deviant for Childhood Obesity in a Latino Population: A Case-Control Study. J Obes 2018; 2018:9285164. [PMID: 30018820 PMCID: PMC6029506 DOI: 10.1155/2018/9285164] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Revised: 04/16/2018] [Accepted: 05/06/2018] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Childhood obesity is a complex public health challenge that requires innovative, sustainable solutions. Positive deviance, inspired by the science of complexity, is an approach that examines what allows certain individuals to succeed despite being predicted to fail. This study is aimed at identifying and defining positive deviants for early childhood obesity. METHODS This case-control study used medical record data to identify Latino children aged 2-5 and classify them using their longitudinal weight change. Parents of children with trajectories toward a healthy weight from an obese weight (cases) and parents of children with stable obese weight trajectories over time (controls) were recruited. Mixed-methods analyses were used including a semistructured interview and quantitative surveys evaluating diet, physical activity, sleep, feeding practices, and self-efficacy. Qualitative description was applied to the qualitative data; quantitative data were analyzed using descriptive statistics and logistic regression modeling. RESULTS Of eligible Latino children identified from the overall data set (n=1,621), 257 (16%) had trajectories toward a healthy weight, and among these, 21 positively deviant cases completed the study with 23 matched controls. Positive deviant families were characterized by lower education, higher self-efficacy, and a more Mexican cultural orientation. Findings suggest that effective engagement of other caregivers and creating healthy food environments were important determinants of healthy weight outcomes. CONCLUSIONS Positive deviants (cases) were distinct from controls in several parenting strategies such as creating healthy food environments and engaging caregivers. They had higher self-efficacy despite lower education. There were fewer differences in diet and physical activity than expected.
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Affiliation(s)
- Byron A. Foster
- Departments of Dermatology and Pediatrics, Oregon Health & Science University, Portland, OR, USA
- Center for Research to Advance Community Health, University of Texas Health San Antonio, San Antonio, TX, USA
| | - Christian A. Aquino
- School of Medicine, University of Texas Health San Antonio, San Antonio, TX, USA
| | - Sharol Mejia
- School of Medicine, University of Texas Health San Antonio, San Antonio, TX, USA
| | - Barbara J. Turner
- Center for Research to Advance Community Health, University of Texas Health San Antonio, San Antonio, TX, USA
- School of Medicine, University of Texas Health San Antonio, San Antonio, TX, USA
| | - Arvind Singhal
- Department of Communication, The University of Texas at El Paso, El Paso, TX, USA
- Inland University of Applied Sciences, Elverum, Norway
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Walton K, Kuczynski L, Haycraft E, Breen A, Haines J. Time to re-think picky eating?: a relational approach to understanding picky eating. Int J Behav Nutr Phys Act 2017; 14:62. [PMID: 28476160 PMCID: PMC5420103 DOI: 10.1186/s12966-017-0520-0] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Accepted: 04/26/2017] [Indexed: 01/28/2023] Open
Abstract
Background Estimates of picky eating are quite high among young children, with 14-50% of parents identifying their preschoolers as picky eaters. Dietary intake and preferences during the preschool years are characterized by slowing growth rates and children developing a sense of autonomy over their feeding and food selection. We argue that the current conceptualization of picky eating defines acts of resistance or expressions of preference (acts of autonomy) by a child as deviant behaviour. This conceptualization has guided research that uses a unidirectional, parent to child approach to understanding parent-child feeding interactions. Objectives By reviewing the current feeding literature and drawing parallels from the rich body of child socialization literature, we argue that there is a need to both re-examine the concept and parent/clinician perspectives on picky eating. Thus, the objective of this paper is two-fold: 1) We argue for a reconceptualization of picky eating whereby child agency is considered in terms of eating preferences rather than categorized as compliant or non-compliant behaviour, and 2) We advocate the use of bi-directional relational models of causality and appropriate methodology to understanding the parent-child feeding relationship. Discussion Researchers are often interested in understanding how members in the parent-child dyad affect one another. Although many tend to focus on the parent to child direction of these associations, findings from child socialization research suggest that influence is bidirectional and non-linear such that parents influence the actions and cognitions of children and children influence the actions and cognitions of parents. Bi-directional models of causality are needed to correctly understand parent-child feeding interactions. Conclusions A reconceptualization of picky eating may elucidate the influence that parental feeding practices and child eating habits have on each other. This may allow health professionals to more effectively support parents in developing healthy eating habits among children, reducing both stress around mealtimes and concerns of picky eating.
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Affiliation(s)
- Kathryn Walton
- Department of Family Relations and Applied Nutrition, University of Guelph, 50 Stone Rd. E, Guelph, ON, N1G 2W1, Canada.
| | - Leon Kuczynski
- Department of Family Relations and Applied Nutrition, University of Guelph, 50 Stone Rd. E, Guelph, ON, N1G 2W1, Canada
| | - Emma Haycraft
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Andrea Breen
- Department of Family Relations and Applied Nutrition, University of Guelph, 50 Stone Rd. E, Guelph, ON, N1G 2W1, Canada
| | - Jess Haines
- Department of Family Relations and Applied Nutrition, University of Guelph, 50 Stone Rd. E, Guelph, ON, N1G 2W1, Canada
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Gibson EL, Cooke L. Understanding Food Fussiness and Its Implications for Food Choice, Health, Weight and Interventions in Young Children: The Impact of Professor Jane Wardle. Curr Obes Rep 2017; 6:46-56. [PMID: 28205158 DOI: 10.1007/s13679-017-0248-9] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
PURPOSE OF REVIEW This review examines the concepts of fussy eating and food neophobia in the context of key determinants of the development of children's food preferences. We discuss the evidence for genetic versus parental and other environmental influences on the ontogeny of these behavioural traits and the implications of current knowledge for interventions that attempt to lessen the impact of these traits on children's diets. Finally, we consider whether these traits increase the risk of a child becoming obese, or alternatively, underweight and malnourished. RECENT FINDINGS Fussy eating and neophobia are related concepts with both genetic and environmental aetiologies. Parent-child correlations and heritability estimates are moderate to high for both traits, but aspects of the family environment remain influential in young children, although no longer in young adults. Parental strategies based around repeat tasting opportunities can improve acceptance of disliked foods in even the fussiest children. Fussy eating and neophobia are not risk factors for obesity but could limit growth in severe cases. Fussy eating and food neophobia are common concerns for parents, though health risks are low. Dissemination of evidence-based strategies to parents that can encourage a more varied diet in young children would be helpful.
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Affiliation(s)
- E Leigh Gibson
- Department of Psychology, Whitelands College, University of Roehampton, Holybourne Avenue, London, SW15 4JD, UK.
| | - Lucy Cooke
- Health Behaviour Research Centre, Department of Epidemiology and Public Health, UCL, London, UK
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57
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Berger PK, Hohman EE, Marini ME, Savage JS, Birch LL. Girls' picky eating in childhood is associated with normal weight status from ages 5 to 15 y. Am J Clin Nutr 2016; 104:1577-1582. [PMID: 27797710 PMCID: PMC5118736 DOI: 10.3945/ajcn.116.142430] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Accepted: 09/20/2016] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Picky eating has been associated with lower weight status and limited food intake and variety in childhood. Little is known about how the persistence of picky eating in childhood is associated with changes in weight and food intake from childhood into adolescence. OBJECTIVE We determined whether picky eating identified in childhood was related to growth, nutrition, and parental use of pressure over a 10-y period. DESIGN Non-Hispanic white girls (n = 181) participated in a longitudinal study and were assessed biannually from ages 5 to 15 y. The Child Feeding Questionnaire was used to classify girls as persistent picky eaters or nonpicky eaters and to assess parental use of pressure to eat. Height and weight were measured to calculate body mass index (BMI) z scores at each occasion. Three 24-h dietary recalls obtained at each occasion were used to determine intakes of fruit and vegetables. With the use of repeated-measures analyses, differences between persistent picky eaters and nonpicky eaters in BMI z scores, dietary intake, and use of pressure were examined. RESULTS From ages 5 to 15 y, persistent picky eaters (n = 33; 18%) had lower BMI (tracking at the 50th percentile) than did nonpicky eaters (n = 148; tracking at the 65th percentile) (P = 0.02). Persistent picky eaters were less likely to be overweight into adolescence. Both groups consumed less than the recommended amounts of fruit and vegetables, although persistent picky eaters had lower intakes of vegetables than did nonpicky eaters at all time points (P = 0.02). Persistent picky eaters also received higher amounts of pressure (P = 0.01). CONCLUSIONS Findings that persistent picky eaters were within the normal weight range, were less likely to be overweight, and had similar fruit intakes to those of nonpicky eaters suggest that higher parental concerns about persistent picky eaters are unwarranted. All parents and children could benefit from evidence-based anticipatory guidance on alternatives to coercive feeding practices to increase fruit and vegetable consumption.
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Affiliation(s)
- Paige K Berger
- Department of Foods and Nutrition, University of Georgia, Athens, GA; and
| | - Emily E Hohman
- Center for Childhood Obesity Research, Pennsylvania State University, State College, PA
| | - Michele E Marini
- Center for Childhood Obesity Research, Pennsylvania State University, State College, PA
| | - Jennifer S Savage
- Center for Childhood Obesity Research, Pennsylvania State University, State College, PA
| | - Leann L Birch
- Department of Foods and Nutrition, University of Georgia, Athens, GA; and
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58
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Taylor CM, Northstone K, Wernimont SM, Emmett PM. Macro- and micronutrient intakes in picky eaters: a cause for concern? Am J Clin Nutr 2016; 104:1647-1656. [PMID: 27935522 PMCID: PMC5118732 DOI: 10.3945/ajcn.116.137356] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Accepted: 10/11/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Picky eating (PE) is characterized by an unwillingness to eat certain foods and by strong food preferences. PE may result in lower intakes of energy and nutrients, which may compromise health. OBJECTIVES We quantified nutrient and food group intakes in children identified as picky eaters or nonpicky eaters and compared intakes between groups and with United Kingdom reference nutrient intakes. DESIGN PE was identified in an observational cohort (Avon Longitudinal Study of Parents and Children) from questionnaires administered when children were aged 2, 3, 4.5, and 5.5 y. Dietary intake was assessed at 3.5 and 7.5 y with a 3-d food record. The dietary assessment at 3.5 y compared picky eaters with nonpicky eaters identified at age 3 y, and the assessment at 7.5 y compared longitudinally defined PE groups. RESULTS Picky eaters aged 3 y had lower mean carotene, iron, and zinc intakes than nonpicky eaters. There were similar differences between the longitudinally defined PE groups. Iron and zinc intakes were most likely to be below recommended amounts, with free sugar intake much higher than recommended. There were no significant differences in energy intakes between the groups, and intakes were adequate relative to estimated average requirements. Nutrient differences were explained by lower intakes of meat, fish, vegetables, and fruits in picky eaters than in nonpicky eaters. There were higher intakes of sugary foods and drinks in older picky eaters. CONCLUSIONS PE did not result in compromised macronutrient intakes, although intakes of zinc and iron were more likely to be below recommendations for picky eaters than for nonpicky eaters. Emphasis should be placed on allaying parental concerns about picky eaters being prone to inadequate nutrient intakes and on encouraging all parents to extend their child's diet to include more nutrient-rich items, especially fruits and vegetables, and less nutrient-poor sugary foods.
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Affiliation(s)
- Caroline M Taylor
- Centre for Child and Adolescent Health, School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom;
| | - Kate Northstone
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care West, Bristol, United Kingdom; and
| | | | - Pauline M Emmett
- Centre for Child and Adolescent Health, School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
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59
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Barbalho SM, Fontana LCS, Finalli EFR, Martuchi KA, Ferreira MC, Filho MEP, Cerri SVDC, Sasaki V, Spada APM, Oshiiwa M, Santos MCBD, Pescinini-Salzedas LM, Bragante LS. Eating habits and presence of cardiovascular risks in children. Int J Adolesc Med Health 2016; 30:/j/ijamh.ahead-of-print/ijamh-2016-0045/ijamh-2016-0045.xml. [PMID: 27508956 DOI: 10.1515/ijamh-2016-0045] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Accepted: 07/13/2016] [Indexed: 01/20/2023]
Abstract
INTRODUCTION The changes in the eating habits associated with physical inactivity are directly related to the increase in the prevalence of obesity and associated diseases such as diabetes mellitus (DM), metabolic syndrome and cardiovascular diseases. OBJECTIVE The aim of this study was to investigate the relationship between the frequency of consumption of some food groups (snacks, fruits, vegetables and candies), physical exercise, nutritional classification and biochemical profile in children. METHODS After the approval of the Ethics Committee, we studied 882 schoolchildren ranging between 6 and 10 years of age. Biochemical and anthropometric evaluations were performed and questionnaires were used in order to check the eating habits and physical activity. RESULTS Our results showed that we may relate the consumption of snacks, fruits, vegetables or candies with modifications in the glycemia, triglycerides, total cholesterol, HDL-c, and LDL-c but we did not observe association with the nutritional classification. It is noteworthy to say that almost 50% of the studied children were overweight or obese and many presented alterations in the lipid and glucose levels. CONCLUSION Our results also show that many children have abnormal levels of lipids and glycemia and a great number of them are classified as overweight or obese. In this context, we can say that urgent approaches are needed to be carried out by a multidisciplinary team in order to improve the diet and reduces the risk factors in this population of children and prevent secondary diseases in adolescence and adulthood.
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Affiliation(s)
- Sandra Maria Barbalho
- Department of Biochemistry and Pharmacology, School of Medicine, University of Marília (UNIMAR), Av. Higino Muzzi Filho 1001, Marília 15525-902, SP, Brazil.,Department of Biochemistry and Nutrition, Faculty of Food Technology of Marília (FATEC), Av. Castro Alves, 62, Marília 17506-000, SP, Brazil, Mobile: +(55 14) 99655-3190
| | | | | | | | | | | | | | | | | | - Marie Oshiiwa
- Department of Biochemistry, School of Medicine, University of Marília (UNIMAR), Marília, SP, Brazil.,Department of Biochemistry and Nutrition, Faculty of Food Technology of Marília (FATEC), Marília, SP, Brazil
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Brown CL, Vander Schaaf EB, Cohen GM, Irby MB, Skelton JA. Association of Picky Eating and Food Neophobia with Weight: A Systematic Review. Child Obes 2016; 12:247-62. [PMID: 27135525 PMCID: PMC4964761 DOI: 10.1089/chi.2015.0189] [Citation(s) in RCA: 93] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Picky eating and food neophobia are common during childhood. Childhood eating behaviors are often predictive of adult eating behaviors. OBJECTIVES Determine if childhood picky eating or food neophobia is associated with childhood weight status, or with becoming underweight, overweight, or obese later in childhood. DATA SOURCES We identified relevant studies from searches of PubMed, PsycINFO, and NEOHAL, as well as citations from identified studies. Study Eligibility Criteria and Participants: Inclusion criteria were original research articles examining a relationship between picky eating and/or food neophobia with childhood weight status. We summarized definitions and prevalence of picky eating or food neophobia and association with weight status. STUDY APPRAISAL Two independent investigators assessed bias and confounding using the Agency for Healthcare Research and Quality's RTI Item Bank. RESULTS Forty-one studies met inclusion criteria. Picky eating was defined inconsistently, and a large variation in prevalence was found (5.8%-59%). Food neophobia was consistently defined as an unwillingness to try new foods, with a prevalence between 40% and 60%. No association existed between childhood weight status and food neophobia, and results were unclear for picky eating. LIMITATIONS Risk of bias and confounding were moderate. Parental report was commonly used to assess picky eating, height, and weight and parental weight, feeding styles, and community characteristics were infrequently considered. CONCLUSIONS AND IMPLICATIONS Heterogeneous definitions used for picky eating led to a wide range of reported prevalence and an unclear relationship with weight. Consistent definitions and an improved understanding of such a relationship could help clinicians provide appropriate anticipatory guidance.
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Affiliation(s)
- Callie L. Brown
- Department of General Pediatrics and Adolescent Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Emily B. Vander Schaaf
- Department of General Pediatrics and Adolescent Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Gail M. Cohen
- Department of Pediatrics, Wake Forest School of Medicine, Winston-Salem, NC.,Brenner FIT Program, Brenner Children's Hospital, Winston-Salem, NC
| | - Megan B. Irby
- Department of Pediatrics, Wake Forest School of Medicine, Winston-Salem, NC.,Brenner FIT Program, Brenner Children's Hospital, Winston-Salem, NC
| | - Joseph A. Skelton
- Department of Pediatrics, Wake Forest School of Medicine, Winston-Salem, NC.,Brenner FIT Program, Brenner Children's Hospital, Winston-Salem, NC.,Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC
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61
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Harris HA, Fildes A, Mallan KM, Llewellyn CH. Maternal feeding practices and fussy eating in toddlerhood: a discordant twin analysis. Int J Behav Nutr Phys Act 2016; 13:81. [PMID: 27412445 PMCID: PMC4944306 DOI: 10.1186/s12966-016-0408-4] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Accepted: 06/30/2016] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Parental feeding practices are thought to play a causal role in shaping a child's fussiness; however, a child-responsive model suggests that feeding practices may develop in response to a child's emerging appetitive characteristics. We used a novel twin study design to test the hypothesis that mothers vary their feeding practices for twin children who differ in their 'food fussiness', in support of a child-responsive model. METHODS Participants were mothers and their 16 month old twin children (n = 2026) from Gemini, a British twin birth cohort of children born in 2007. Standardized psychometric measures of maternal 'pressure to eat', 'restriction' and 'instrumental feeding', as well as child 'food fussiness', were completed by mothers. Within-family analyses examined if twin-pair differences in 'food fussiness' were associated with differences in feeding practices using linear regression models. In a subset of twins (n = 247 pairs) who were the most discordant (highest quartile) on 'food fussiness' (difference score ≥ .50), Paired Samples T-test were used to explore the magnitude of differences in feeding practices between twins. Between-family analyses used Complex Samples General Linear Models to examine associations between feeding practices and 'food fussiness'. RESULTS Within-pair differences in 'food fussiness' were associated with differential 'pressure to eat' and 'instrumental feeding' (ps < .001), but not with 'restriction'. In the subset of twins most discordant on 'food fussiness', mothers used more pressure (p < .001) and food rewards (p < .05) with the fussier twin. Between-family analyses indicated that 'pressure to eat' and 'instrumental feeding' were positively associated with 'food fussiness', while 'restriction' was negatively associated with 'food fussiness' (ps < .001). CONCLUSIONS Mothers appear to subtly adjust their feeding practices according to their perceptions of their toddler's emerging fussy eating behavior. Specifically, the fussier toddler is pressured more than their less fussy co-twin, and is more likely to be offered food rewards. Guiding parents on how to respond to fussy eating may be an important aspect of promoting feeding practices that encourage food acceptance.
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Affiliation(s)
- Holly A Harris
- Centre for Children's Health Research, Queensland University of Technology, South Brisbane, 4101, Australia.,School of Exercise and Nutrition Sciences, Queensland University of Technology, Kelvin Grove, Brisbane, 4059, Australia.,Health Behaviour Research Centre, University College London, London, WC1E 6BT, UK
| | - Alison Fildes
- Health Behaviour Research Centre, University College London, London, WC1E 6BT, UK
| | - Kimberley M Mallan
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Kelvin Grove, Brisbane, 4059, Australia.,School of Psychology, Australian Catholic University, Brisbane, 4014, Australia
| | - Clare H Llewellyn
- Health Behaviour Research Centre, University College London, London, WC1E 6BT, UK. .,University College of London, Gower Street, London, WC1E 6BT, UK.
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Dubedout S, Cascales T, Mas E, Bion A, Vignes M, Raynaud JP, Olives JP. Troubles du comportement alimentaire restrictifs du nourrisson et du jeune enfant : situations à risque et facteurs favorisants. Arch Pediatr 2016; 23:570-6. [DOI: 10.1016/j.arcped.2016.03.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Revised: 02/22/2016] [Accepted: 03/19/2016] [Indexed: 01/31/2023]
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63
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Chodkowski BA, Cowan RL, Niswender KD. Imbalance in Resting State Functional Connectivity is Associated with Eating Behaviors and Adiposity in Children. Heliyon 2016; 2:e00058. [PMID: 26878067 PMCID: PMC4750053 DOI: 10.1016/j.heliyon.2015.e00058] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Revised: 12/17/2015] [Accepted: 12/22/2015] [Indexed: 12/05/2022] Open
Abstract
Background and Hypothesis Over the past 30 years, childhood obesity in the US has nearly doubled, while obesity has tripled among adolescents. Non-homeostatic eating, influenced by impulsivity and inhibition, may undermine successful long-term weight loss. We hypothesized that unhealthy eating habits and adiposity among children are associated with functional connectivity between brain regions associated with impulsivity, response inhibition, and reward. Methods We analyzed resting state functional magnetic resonance images from 38 children, ages 8–13. Using seed-based resting state functional connectivity, we quantified connectivity between brain regions associated with response inhibition (inferior parietal lobe [IPL]), impulsivity (frontal pole), and reward (nucleus accumbens [NAc]). We assessed the relationship of resting state functional connectivity with adiposity, quantified by BMI z-score, and eating behaviors, as measured by the Child Eating Behaviour Questionnaire (CEBQ). We computed an imbalance measure—the difference between [frontal pole:NAC] and [ipl:nac] functional connectivity—and investigated the relationship of this imbalance with eating behaviors and adiposity. Results As functional connectivity imbalance is increasingly biased toward impulsivity, adiposity increases. Similarly, as impulsivity-biased imbalance increases, food approach behaviors increase and food avoidance behaviors decrease. Increased adiposity is associated with increased food approach behaviors and decreased food avoidance behaviors. Conclusions In the absence of any explicit eating-related stimuli, the developing brain is primed toward food approach and away from food avoidance behavior with increasing adiposity. Imbalance in resting state functional connectivity that is associated with non-homeostatic eating develops during childhood, as early as 8–13 years of age. Our results indicate the importance of identifying children at risk for obesity for earlier intervention. In addition to changing eating habits and physical activity, strategies that normalize neural functional connectivity imbalance are needed to maintain healthy weight. Mindfulness may be one such approach as it is associated with increased response inhibition and decreased impulsivity.
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Affiliation(s)
- BettyAnn A. Chodkowski
- Chemical and Physical Biology Program, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Ronald L. Cowan
- Department of Psychiatry, Vanderbilt University School of Medicine, Nashville, TN, USA
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Psychology, Vanderbilt University, Nashville, TN, USA
| | - Kevin D. Niswender
- Department of Veterans Affairs, Tennessee Valley Healthcare System, Nashville, TN, USA
- Department of Molecular Physiology and Biophysics, Vanderbilt University School of Medicine, Nashville, TN, USA
- Division of Diabetes, Endocrinology and Metabolism, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN, USA
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Zickgraf HF, Franklin ME, Rozin P. Adult picky eaters with symptoms of avoidant/restrictive food intake disorder: comparable distress and comorbidity but different eating behaviors compared to those with disordered eating symptoms. J Eat Disord 2016; 4:26. [PMID: 27800160 PMCID: PMC5086050 DOI: 10.1186/s40337-016-0110-6] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Accepted: 07/11/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND One presentation of Avoidant/Restrictive Food Intake Disorder (ARFID) is characterized by picky eating, i.e., selective eating based on the sensory properties of food. The present study has two aims. The first is to describe distress and impairment in individuals with ARFID secondary to picky eating. The second is to determine whether eating behaviors hypothesized to be specific to picky eating can differentiate picky eaters with and without ARFID from typical eaters (e.g., individuals not reporting picky or disordered eating) and individuals who strongly endorse attitudes associated with anorexia and bulimia (eating disordered attitudes). METHODS Participants were recruited from Amazon's Mechanical Turk (N = 325) and an online support group for adult picky eaters (N = 81). Participants were grouped based on endorsement of picky eating, ARFID symptoms, and elevated eating disordered attitudes on the Eating Attitudes Test (EAT-26). The resulting four eating behavior groups were compared on measures of distress and impairment (e.g., anxiety/depression and, obsessive compulsive disorder symptoms, eating-related quality of life) and on measures of eating behaviors associated with picky eating (e.g., food neophobia, inflexibility about preparation and presentation of preferred foods, sensitivity to sensory stimuli, and eating from a very narrow range of foods). The groups were compared using one way ANOVA with post-hoc Tamhane's T2 tests. RESULTS On measures of distress and impairment, participants with ARFID reported higher scores than both typical eaters and picky eaters without ARFID, and comparable scores to those with disordered eating attitudes. Three of four measures of picky eating behavior, eating inflexibility, food neophobia, and eating from a range of 20 or fewer foods, distinguished picky eaters with and without ARFID form typical eaters and those with disordered eating attitudes. Picky eaters with ARFID reported greater food neophobia and eating inflexibility, and were more likely to eat from a narrow range of foods, compared to picky eaters without ARFID. CONCLUSIONS Adult picky eaters can be differentiated from those with symptoms of anorexia and bulimia by their stronger endorsement of food neophobia and inflexible eating behaviors, and by eating from a very narrow range of foods. Picky eaters with ARFID symptoms can be differentiated from picky eaters without these symptoms on the basis of these three eating behaviors, and by their higher endorsement of internalizing distress, OCD symptoms, and eating-related quality of life impairment. This study provides evidence that ARFID symptoms exist independently of symptoms of other eating disorders and are characterized by several distinct eating behaviors. In a clinical analogue sample of disordered eaters, ARFID symptoms were associated with distress and impairment at levels comparable to symptoms of anorexia and bulimia.
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Affiliation(s)
- Hana F Zickgraf
- Department of Psychology, University of Pennsylvania, 3720 Walnut Street, Philadelphia, PA 19104 USA
| | - Martin E Franklin
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3535 Market Street, Philadelphia, PA 19104 USA
| | - Paul Rozin
- Department of Psychology, University of Pennsylvania, 3720 Walnut Street, Philadelphia, PA 19104 USA
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