"It's always on the safe list": Investigating experiential accounts of picky eating adults

A tradeoff between safety and freedom: Adults' lived experiences of ARFID

BACKGROUND

Avoidant restrictive food intake disorder (ARFID) is characterized as a pattern of restrictive eating leading to significant medical and/or psychosocial impairment (American Psychiatric Association in Diagnostic and statistical manual of mental disorders, American Psychiatric Association, Washington, D.C., 2013). Most existing research on ARFID utilizes quantitative methodologies to study children and adolescents. As a result, the experiences of adults with ARFID have been underrepresented in research. To fill this gap, the current study examines the lived experiences of adults with a DSM-5 diagnosis of ARFID.

METHOD

Participants (n = 9) included adult women aged 20-42 (M = 27, SD = 6.2) recruited from social media advertising. Open-ended, semi-structured interviews were conducted. Data were analyzed using interpretative phenomenological analysis (IPA).

RESULTS

One of three overarching themes identified by IPA will be discussed in this study: "A tradeoff between safety and freedom," which consists of two subthemes: (a) Ensuring safety from food unknowns and (c) Longing for Freedom. This overarching theme explores the influence of ARFID on an individual's sense of safety and freedom.

DISCUSSION

This study is one of few to qualitatively examine ARFID, and the only to do so using IPA. Findings offer novel insights relevant to researchers and clinicians who treat adults with ARFID and who wish to increase consideration and understanding of patient lived experience in their work.

Heritability of adult picky eating in the Netherlands

Adult picky eating (APE), the rejection of familiar and unfamiliar foods leading to a diet with limited variety, is an understudied phenomenon which can have both physical and psychological negative consequences. The aetiology of individual differences in APE is understudied, although there is reason to believe that it is partly heritable. Therefore, we aimed to estimate the heritability of APE with data from the Netherlands Twin Register (n = 8016) with classical genetic structural equation modelling. In order to use these data, we firstly investigated whether a Food Preference Questionnaire (FPQ) could measure APE with a pre-registered prestudy. Adult participants (n = 414) filled in online questionnaires, including a FPQ and measures related to APE. Spearman's rho correlation quantified the relationship between different elements of the Dutch FPQ and different scores on measures of APE. Results of the prestudy showed that the mean liking score on the FPQ could be used to measure APE (ρ > .50). This measure was then used in the main study to estimate the heritability of APE. Results showed that broad-sense heritability for APE is 49 % (additive genetic effects 14 % (95 % CI [00, 38]) + dominance genetic effects 35 % (95 % CI [11, 52]), while the remaining variance is explained by unique environmental factors. Future studies may focus on uncovering the specific genetic and unique environmental factors that play a role in APE.

High arousal as the source of food rejection in food neophobia

Food neophobia (FN) at moderate to high levels is very common among adult populations in all cultures and is usually defined in terms of rejection of unfamiliar foods. However, food rejection in FN is only partly related to food familiarity. Experimental and survey studies have suggested that unpleasantly high arousal may be induced by food novelty, but also be produced by foods with intense or complex flavours, that are perceived as dangerous or foreign, or that have unusual ingredients. Liking for foods with these characteristics have recently been shown to be strongly negatively associated with FN. Thus, induced high arousal may underlie food rejection in FN. Here, we collected familiarity, liking and arousal ratings, and scores on the standard Food Neophobia Scale from more than 7000 consumers in four countries - Australia, United Kingdom, Singapore, Malaysia - for a series of food names that were manipulated to produce standard and 'high arousal' (variant) versions of the same foods. Consistent across all four countries, arousal ratings increased, and liking decreased, with decreases in food familiarity. Variant food names were always associated with ratings of higher arousal than the standard names. The variant foods were generally less familiar than the standard foods, although this was not a necessary condition for their higher arousal ratings, suggesting that the other arousal-inducing factors (e.g., flavour intensity) also played a role. Across all foods, arousal ratings increased, and liking ratings decreased, as FN increased, but these effects were accentuated for the variant foods. The consistency of these effects across multiple countries supports a view that arousal is universally a strong determinant of liking for foods and that this underlies the rejection of foods, familiar and novel, in FN.

Understanding consumer liking of beef patties with different firmness among younger and older adults using FaceReader™ and biometrics

Sensorial perceptions change as people age and biometrics analysis can be used to explore the unconscious consumer responses. Investigation was conducted of effects of consumer age (younger, 22-52 years; older, 60-76 years) on facial expression response (FER) during consumption of beef patties with varying firmness (soft, medium, hard) and taste (±plum sauce). Video images were collected and FERs analysed using FaceReader™. Younger people exhibited higher intensity for happy/sad/scared and lower intensity for neutral/disgusted, relative to older people. Interactions between age and texture/sauce showed little FER variation in older people, whereas younger people showed considerable FER variation. Younger people, but not older people, had lowest intensity of happy FER and highest intensity of angry FER for the hard patty. Sauce addition resulted in higher intensity of happy/contempt in younger consumers, but not older consumers. FER collected using FaceReader™ was successfully used to differentiate between the unconscious responses of younger and older consumers.

How multiple threats to safety affects quality of life for picky eating adults: A new explanatory model

Picky eating describes a pattern of eating characterised by a narrow dietary range with rejection of both novel and familiar foods. Research has suggested that picky eating in adulthood is associated with several negative psychosocial outcomes including impaired quality of life. This research aimed to build and test a model explaining the relationship between picky eating and quality of life. 230 participants were recruited via online support forums for picky eating, and an undergraduate research participation scheme. Participants completed self-report measures of picky eating, sensory sensitivity, disgust, anxiety, fear of negative evaluation and eating related quality of life. Regression analysis indicated that picky eating, disgust sensitivity, anxiety, and fear of negative evaluation were all associated with impaired eating-related quality of life. A theoretical model was then devised which aimed to explain the interactions between these factors, and Path Analysis indicated that this model was a good fit for the data. This Safety in Picky Eating and Quality of life (SPEQ) model suggests that threat perception and the drive for safety underlies the relationship between picky eating and impaired quality of life. The SPEQ model provides a preliminary basis for understanding how picky eating impacts quality of life in adulthood.

Food neophobia and the evaluation of novel foods in adults; the sensory, emotional, association (SEA) model of the decision to taste a novel food

Reluctance to eat new foods, known as food neophobia, is well researched in children but not adults. Two studies were carried out to understand the emotional, sensory, and cognitive factors associated with food neophobia in an adult sample, and to propose a preliminary explanation of the decision to taste a novel food named the SEA model (Sensory, Emotional, cognitive Association model). Participants were recruited through opportunity sampling of a university population in the Leicester region of the UK. Study one (n = 534) was a cross sectional study examining associations between self-report measures of food neophobia, emotional variables and sensory variables. In study two (n = 160), participants completed an online cognitive evaluation of 7 images of novel fruits and vegetables, rating perceived familiarity, categorisation as fruit or vegetable, cognitive associations based on appearance (what does the food look like), liking of any associated foods, and expected liking of the novel food. In study 1 it was found that tactile sensitivity and disgust sensitivity were the main sensory and emotional variables associated with food neophobia. In study 2, it was found that food neophobia and lower expected liking of novel foods were associated with disgust sensitivity, associating the novel foods with disliked foods, and lower perceived familiarity. The SEA model further proposes that underlying tendencies and automatic reactions to foods, combine with cognitive associations based on negative memories and negative beliefs about tasting new foods, to create expected disliking of a food and a decreased likelihood that it will be tried. Further work is needed to fully test the SEA model of the decision to taste a novel food, in particular to further examine how associations are formed.