Picky eating - A risk factor for underweight in Finnish preadolescents

Association Between Picky Eating, Weight Status, Vegetable, and Fruit Intake in Children and Adolescents: Systematic Review and Meta-Analysis

Aim: Picky eating is a common appetitive trait reported among children and adolescents and may have detrimental effects on their weight, vegetable, and fruit intake, impacting health status. However, an updated systematic review of the literature and summary of effect estimates is required. This study aims to explore the association between picky eating with weight, vegetable and fruit intake, vegetable-only intake, and fruit-only intake. Methods: A systematic literature search of six electronic scientific databases and data extraction was performed between November 2022 and June 2023. Original articles that examined picky eating in association with weight, vegetable and/or fruit intake were included. PRISMA guidelines were followed and meta-analytical and meta-regression analyses were conducted to compute summary effect estimates and explore potential moderators. PROSPERO registration: CRD42022333043. Results: The systematic review included 59 studies of which 45 studies were included in the meta-analysis. Overall, the summarized effect estimates indicated that picky eating was inversely associated with weight [Cohen's dz: -0.27, 95% confidence interval (CI): -0.41 to -0.14, p < 0.0001]; vegetable and fruit intakes (Cohen's dz: -0.35, 95% CI: -0.45, -0.25, p < 0.0001); vegetable-only intake (Cohen's dz: -0.41, 95% CI: -0.56, -0.26, p < 0.0001), and fruit-only intake (Cohen's dz: -0.32, 95% CI: -0.45, -0.20, p < 0.0001). Picky eating was positively associated with underweight (Cohen's dz: 0.46, 95% CI: 0.20, 0.71 p = 0.0008). Conclusion: Although effect sizes were small, picky eating was inversely associated with weight, vegetable, and fruit intakes, and positively associated with underweight in children and adolescents aged birth to 17 years.

Higher meal disengagement and meal presentation are uniquely related to psychological distress and lower quality of life in undergraduate students

Objective: Picky eating, which occurs in emerging adulthood and is associated with psychological distress and quality of life, has historically been conceptualized as unidimensional despite research suggesting it is a multifaceted construct. Participants: An undergraduate sample (N = 509; Mage = 19.96). Methods: A cross-sectional survey assessed picky eating facets (food variety, meal disengagement, meal presentation, and taste aversion), disordered eating, anxiety, depression, stress, obsessive compulsive disorder (OCD), and social phobia symptoms, and quality of life. Results: Meal disengagement was uniquely related to higher anxiety, depression, stress, and social phobia symptoms and lower quality of life, whereas meal presentation was uniquely related to higher anxiety, stress, and OCD symptoms, beyond covariates and disordered eating. Food variety and taste aversion were not uniquely related to outcomes. Conclusions: Considering picky eating multidimensionally may yield important insights beyond the broader construct in terms of its relationship with psychological well-being in undergraduates.

Patterns of Eating Behavior among 13-Year-Old Adolescents and Associated Factors: Findings from the Generation XXI Birth Cohort

Eating behavior adopted during adolescence may persist into adulthood. The aims of this study were to identify eating behavior patterns among Portuguese adolescents and to explore whether groups differ in terms of early life and family characteristics, severity of depressive symptoms, and body mass index (BMI) z-score. Participants were 3601 13-year-olds enrolled in the birth cohort Generation XXI. Eating behavior was assessed using the self-reported Adult Eating Behavior Questionnaire (AEBQ), validated in this sample. The severity of depressive symptoms was measured through the Beck Depression Inventory (BDI-II), and data on sociodemographic and anthropometrics were collected at birth and 13-years-old. Latent class analysis was conducted, and associations were estimated using multinomial logistic regression models. Five patterns of individuals were identified: "Picky eating", "Disinterest towards food", "Food neophilia", "Emotional eating", and "Food attractiveness". The adolescents' sex, maternal education, BMI z-score, and severity of depressive symptoms were significantly associated with the identified patterns. In particular, adolescents with a higher BMI z-score were more likely in "Food neophilia" while individuals with more severe depressive symptoms were in the "Picky eating", "Emotional eating", and "Food attractiveness" patterns. These findings suggest a starting point for the development and planning of targeted public health interventions.

Clinical Evolution of Preschool Picky Eater Children Receiving Oral Nutritional Supplementation during Six Months: A Prospective Controlled Clinical Trial

Objective: To determine if oral nutritional supplementation of picky eater children has a beneficial effect in addition to nutritional guidance on anthropometric parameters, nutrient intake, appetite, physical activity, and health complications. Methods: This is a randomized, single-blind, controlled clinical trial that included Brazilian picky eater children aged 24 to 60 months. The individuals were randomized into a control group (CG) (n = 17) and an intervention group (IG) (n = 18), and were followed up in seven meetings for 180 days (baseline plus one meeting every 30 days). The CG received nutritional guidance for food selectivity, while the IG received the same guidance plus oral nutritional supplementation. Anthropometric and nutrient intake assessments were carried out, and appetite, physical activity and health complications were investigated. Results: In the IG, the z-score of weight and height increased significantly over time (p < 0.05), while the body fat percentage (BFP) and BMI z-score remained unchanged. The percentage of inadequate intake of vitamins D, C and folate reduced in the IG over time compared to the CG (p < 0.05). In the IG, the score assigned by parents to the appetite scale increased over time (p < 0.05). There was no difference between the groups in the scores on the physical activity and global health scales, and in the number of health complications. Conclusions: Picky eater children that were supplemented increased their weight not by gaining fat, but due to an increase in stature, as shown by BMI z-score and BFP, that remained unchanged. Furthermore, they showed a decrease in inadequate micronutrient intake during the intervention. An improvement in appetite was also observed over time, attesting to the benefit of supplementation.

Relationship between Regular Leisure-Time Physical Activity and Underweight and Overweight Status in Taiwanese Young Adults: A Cross-Sectional Study

The aim of this study was to determine the association between regular leisure-time physical activity (LTPA) and various body mass index (BMI) categories in Taiwanese young adults. A total of 10,802 young adults (18−44 years) were enrolled in a national telephone survey. The questionnaire data from this survey included socio-demographic characteristics, zip code of residence, LTPA behaviors, self-reported health status, and self-evaluated anthropometric measurements, which included height, body weight, and BMI. Regular and non-regular LTPA behaviors were defined as follows: (1) Regular LTPA: participants who reported breathing quickly and sweating when participating in 150−300 min per week of moderate-intensity LTPA or 75−150 min per week of vigorous-intensity LTPA. (2) Non-regular LTPA: the rest of the participants. The various BMI categories were defined as (1) underweight (BMI < 18.5 kg/m2), (2) normal weight (18.5 ≤ BMI < 24 kg/m2), (3) overweight (24 ≤ BMI < 27 kg/m2), and (4) obese (BMI ≥ 27 kg/m2). When compared with participants with non-regular LTPA, participants with regular LTPA exhibited lower risks of being overweight (odds ratio [OR], 0.837; 95% confidence interval [CI] 0.738−0.948) and underweight (OR, 0.732; 95% CI 0.611−0.876). However, there was no significant relationship between regular LTPA and obesity risk when using non-regular LTPA as the baseline after adjusting for potential confounders. The study results revealed that regular LTPA effectively reduced the risks of being underweight and overweight. However, for people with obesity, regular LTPA was unable to significantly decrease their obesity risk.

Controlling feeding practices moderate the relationship between emotionality and food fussiness in young children

Emotional child temperament has consistently been found to be related to food fussiness. One factor that may exacerbate or reduce the risk conferred by children's emotionality is parent feeding practices during mealtimes. Specifically, the use of controlling feeding practices aimed at increasing food consumption may particularly affect children with an emotional temperament. The primary aim of this study was to investigate whether the association between child food fussiness and higher emotionality found in previous studies is moderated by maternal use of controlling feeding practices, namely verbal pressure, physical prompts and food rewards. Sixty-seven mother-child dyads were video-recorded during a meal in their home and mothers' use of controlling feeding practices during this meal were coded. Mothers completed a questionnaire assessing child temperament. Moderation analyses revealed that maternal use of verbal pressure and physical prompts moderated the relationship between higher emotionality and food fussiness, but maternal use of food rewards did not. These results indicate that the use of verbal pressure and physical prompts may have a particularly negative influence on fussy eating for children higher in emotionality.

Children's School-Day Nutrient Intake in Ontario: A Cross-Sectional Observational Study Comparing Students' Packed Lunches from Two School Schedules

This study compared the caloric and nutrient values of packed lunch contents and consumption in the Balanced School Day (BSD) (two 20 min eating periods) versus the Traditional Schedule (TS) (one 20 min lunch). Foods consumed during school were assessed by direct food observation in 321 grade 3 and 4 students, aged 7−10 years, at 9 BSD and 10 TS elementary schools in Ontario. Packed lunch contents in the BSD were significantly higher than the TS in energy (3128.14 ± 1100.36 vs. 2658.98 ± 951.34 kJ, p < 0.001, respectively). Similarly, carbohydrates, total sugar, protein, fat, saturated fatty acids (SFA), calcium, iron, and sodium were significantly higher in the BSD versus TS packed lunches. Correspondingly, students in the BSD consumed significantly more energy, carbohydrates, total sugar, and SFA compared to the TS. Overall, lunches brought by students in the BSD schedule provided more energy across all macronutrients, with only a few micronutrients showing increased amounts, suggesting two 20 min eating opportunities could contribute to excess caloric intake during school, potentially contributing to the prevalence of childhood overweight and obesity in Canada. Furthermore, packed lunches in both schedules had excess amounts of nutrients of concern and much work is needed to ensure that children in Canada receive nutritious lunches at school.

Association of Picky Eating with Weight and Height—The European Longitudinal Study of Pregnancy and Childhood (ELSPAC–CZ)

Objective: This study aimed to evaluate whether preschool children identified as picky eaters showed differences in anthropometric characteristics (weight and height) from their non-picky peers at 15 years of age. Design: This study was performed among the cohort members of the EL- SPAC–CZ study, a longitudinal study of pregnancy and childhood. The analysis included 2068 children (997 girls and 1071 boys) followed between births and 15 years of age. Picky eaters were identified at 1.5, 3, and 5 years of age. Anthropometric characteristics were measured at 15 years of age (15 years). Results: Picky eaters (n = 346; 16.7%) had a lower weight and height than non-picky eaters (n = 1722; 83.3%) at 15 years. This difference in weight and height was maintained after controlling for sex of the child, birth weight, birth length, maternal education, family structure at 15 years, and maternal age at childbirth. The picky children were on average 2.3 kg lighter and 0.8 cm shorter than non- picky children at 15 years. Conclusions: Persistent picky eating in preschool children is related to lower weight and height at 15 years of age in ELSPAC–CZ study.

Vpliv izbirčnosti v prehrani na prehranjenost otrok

Uvod: Vse pogosteje zaznavamo različne težave z načinom prehranjevanja pri otrocih. Otroci med 10. in 14. letom intenzivno rastejo in se razvijajo. Namen raziskave je bil ugotoviti vpliv izbirčnosti v prehrani otrok na njihovo prehranjenost v omenjeni starosti.Metode: Uporabljena je bila presečna opisna raziskava. Zajet je bil priložnostni vzorec osnovnošolcev zadnjega triletja. V raziskavi je sodelovalo 62 (49,2 %) učencev moškega in 64 (50,8 %) učencev ženskega spola zadnjega triletja ene izmed osnovnih šol v Sloveniji. Za zbiranje podatkov smo uporabili anketni vprašalnik, pridobili pa smo tudi podatke o telesni masi in višini. Uporabili smo opisno in sklepno statistiko (dvostranski test ANOVA).Rezultati: 37 (53,6 %) deklet in 28 (44,4 %) fantov je trdilo, da so izbirčni. Z dvostranskim testom ANOVA smo ugotovili, da obstaja povezava med izbirčnostjo in prehranjenostjo (p = 0,014). Pri dekletih je vidno večje odstopanje od prehranjenosti kot pri fantih.Diskusija in zaključek: Izbirčno prehranjevanje je v današnjem času zelo pogost problem, saj se je v njem prepoznala skoraj polovica vključenih učencev. Izbirčnost ima lahko negativne posledice v odrasli dobi. V starosti 10–14 let se ustvarjajo prehranjevalne navade, ki so lahko prisotne celotno življenje, zato je bistveno, da delujemo preventivno in s tem preprečimo negativne posledice. V prihodnosti bi bilo treba raziskovanje usmeriti v preventivne dejavnosti in promocijo zdravega prehranjevanja.

Measuring short-term eating behaviour and desire to eat: Validation of the child eating behaviour questionnaire and a computerized 'desire to eat' computerized questionnaire

The Child Eating Behaviour Questionnaire (CEBQ) is designed to measure 'usual' eating behaviour, with no time period attached, thus may not be suitable for assessing the effectiveness of short-term experimental studies. The aim of this study was to validate i) the CEBQ adapted to measure 'past week' rather than 'usual' eating behaviour, and ii) a computerized questionnaire assessing desire to eat core and non-core foods, against an objective measure of eating behaviour and food intake (eating in the absence of hunger (EAH) experiment). Children (n = 103) aged 8-12 years completed the desire to eat questionnaire followed by the EAH experiment while primary caregivers completed the adapted CEBQ. Results from the CEBQ showed that children with greater 'satiety responsiveness' (1-point higher) consumed less energy (-342 kJ; 95% CI -574, -110) whereas those with greater 'enjoyment of food' scale consumed more energy (380 kJ; 95% CI 124, 636) during the ad-libitum phase of the EAH experiment. Higher scores for slowness in eating (-705 kJ; 95% CI -1157, -254), emotional undereating (-590 kJ; 95% CI -1074, -106) and food fussiness (-629 kJ; 95% CI -1103, -155) were associated with lower total energy intake. Children who expressed greater desire to eat non-core foods consumed more energy in total (275 kJ; 95% CI 87, 463). Overall, this adapted CEBQ appears valid for measuring several short-term eating behaviours in children. The desire to eat questionnaire may be useful for identifying short-term susceptibility to overeating, however further investigation into how ratings of desire relate to the intake of highly palatable, energy dense foods is warranted.

Does Responsiveness to Basic Tastes Influence Preadolescents' Food Liking? Investigating Taste Responsiveness Segment on Bitter-Sour-Sweet and Salty-Umami Model Food Samples

The objective of this study was to investigate the relationships between taste responsiveness and food liking in preadolescents. Model food samples of grapefruit juice (GF) and vegetable broth (VB) modified with four additions of sucrose and sodium chloride, respectively, were employed. Intensity perception for sweetness, sourness, and bitterness were measured in GF while saltiness and umami were measured in VB. The children (N = 148) also completed food choice, familiarity, stated liking and neophobia questionnaires. The test was conducted at school, with instructions provided remotely via video call. Four segments were defined differing in basic taste responsiveness. Segments and sucrose concentrations significantly affected liking for GF, while no significant effect of segments and sodium chloride concentrations occurred on liking for VB. An increasing sucrose concentration was positively associated with liking for GF only in the segment with low responsiveness to bitter and sour tastes. No significant differences across segments were found for food choice, familiarity, stated liking, and neophobia. Conclusively, relationships between taste responsiveness and liking are product and basic taste-dependent in addition to being subject-dependent. Strategies to improve acceptance by using sucrose as a suppressor for warning sensations of bitterness and sourness can be more or less effective depending on individual responsiveness to the basic tastes.

Picky Eating Is Associated with Lower Nutrient Intakes from Children's Home-Packed School Lunches

The objective was to assess the relationship between children’s picky eating (PE) status and nutrient intake from home-packed school lunches. The lunches of 321 students, aged 7–10 years, were quantified via cross-sectional direct observation. Children were classified as having PE (n = 155) or not (non-PE; n = 166) based on food neophobia scores and parental perceptions of PE. The PE group consumed significantly less protein, folate, magnesium, potassium, zinc, and vitamins B1, B2, B3, B6, D, and E than the non-PE group; however, both groups consumed amounts exceeding Dietary Reference Intakes (DRIs) for protein, carbohydrates, sugar, sodium, iron, and vitamins B1, B2, B3, B6, B12, and C. Conversely, both groups consumed amounts significantly lower than DRIs for calcium, fibre, folate, magnesium, potassium, zinc, and vitamins A, D, E, and K. The PE group ate significantly less meat and alternatives, vegetables and fruit, and fruit than the non-PE group, and did not meet any of Canada’s Food Guide (2007) recommendations. The non-PE group met recommendations for meat and alternatives only. PE impacts the dietary intake of children’s home-packed lunches; however, many packed lunches were of low nutritional quality. Focus should be placed on provision of nutritionally complete school lunches for all children.

Food Neophobia among Adults: Differences in Dietary Patterns, Food Choice Motives, and Food Labels Reading in Poles

Food neophobia (FN) is associated with reduced quality of diet in adults; thus, the understanding of the relationship between FN and food consumption in more depth appears to be a key issue. The aim of the study was to assess the relationship between food neophobia, dietary patterns, food choice motives, and food label reading in the group of adults. Data were collected using the computer-assisted personal interviewing technique (CAPI). A cross-sectional quantitative survey was carried out in November-December 2017 in a sample of 1017 Polish adults. The questionnaire used in the study included the Food Neophobia Scale (FNS), the Beliefs and Eating Habits Questionnaire (KomPAN), and questions regarding food choice motives, reading food labels, and sociodemographic characteristics. The food neophobics were older, had a lower level of education, and had higher BMI compared to others. Compared to others, among the food neophobics, there were more people who often consumed vegetables, fruit, meat, and meat products and who rarely consumed functional and convenience food, sweets, and sweetened beverages. When choosing food, more food neophobics chose healthy and tasteless food products, while more food neophilics chose unhealthy and tasty products. More food neophobics declared not reading price and shelf-life information on food labels compared to the other two groups. Although food neophobia may make adaptation to dietary recommendations difficult, health-promoting features of the diet were observed within the food neophobics. Actions focusing on food choice motives may help even more to limit the effects of food neophobia in adults. Further research is recommended to confirm the observed relationships under different sociocultural conditions.

Transient Hyperphosphatasemia Due to Pomegranate Juice

In most cases, feeding problems in young children are mild and of no consequence. However, it is one of the situations that generate more anxiety in parents and can lead them to incorrect feeding patterns. We present the case of a 20-month-old male child who came to the emergency room with a pathological elevation of alkaline phosphatase secondary to an error in his dietary pattern.

The Combination of Food Approach and Food Avoidant Behaviors in Children with Autism Spectrum Disorder: "Selective Overeating"

Based on parent questionnaires, we demonstrate the presence of an eating pattern among children with autism spectrum disorder (ASD) that is characterized by both food selectivity and eating in the absence of hunger. Children with ASD were categorized as engaging in eating patterns of selective overeating, selective eating only, overeating only, or typical eating. Group differences were found in the areas of diet composition, body mass index, and behavioral flexibility. Both the selective overeating group and selective eating only group were prone to favor calorie-dense, nutrient-deficient diets as compared to other groups. Eating groups also presented with differing profiles of everyday behavioral flexibility. These results suggest that selective overeating in ASD may present unique challenges and require tailored interventions.

Fatores associados aos tipos de dificuldades alimentares em crianças entre 0 e 10 anos de idade: um estudo retrospectivo em um centro de referência brasileiro

Objetivo: identificar fatores associados à prevalência dos diferentes tipos de dificuldades alimentares em crianças com idade entre 0 e 10 anos.Métodos: trata-se de um estudo observacional retrospectivo com dados de crianças de 0 a 10 anos diagnosticadas com alguma dificuldade alimentar, atendidas em um centro de referência localizado no município de São Paulo, SP, Brasil. A presença da dificuldade alimentar foi analisada de acordo com o diagnóstico multidisciplinar, o aparecimento da queixa, os dados sobre a gestação e a amamentação, o estilo parental, a presença de causas orgânicas e as complicações associadas. Os dados foram tabulados no programa Microsoft Excel e as análises estatísticas foram realizadas no programa IBM SPSS Statistics 21 através de frequências absolutas e relativas, média, desvio padrão, teste do qui-quadrado e Kruskall-Wallis com o teste de post-hoc de Dunn.Resultados: foram avaliados 166 pacientes com um predomínio do sexo masculino, em idade pré-escolar e nascidos a termo. O diagnóstico mais prevalente foi de seletividade alimentar, sem doenças orgânicas ou reações associadas. Os diagnósticos de dificuldade alimentar apresentaram associação estatisticamente significativa com idade, idade gestacional de nascimento, idade e fase da alimentação de aparecimento da queixa.Conclusões: os fatores que apresentaram associação com os diferentes tipos de dificuldade alimentar foram a idade, a idade gestacional de nascimento e a idade e fase da alimentação de aparecimento da queixa. O presente estudo permite iniciar um direcionamento mais específico de ações de orientação e de prevenção de dificuldade alimentar. Dessa forma, destaca-se a importância da realização de estudos desse cunho.

Association between Food Preferences, Eating Behaviors and Socio-Demographic Factors, Physical Activity among Children and Adolescents: A Cross-Sectional Study

The prevalence of overweight and obesity is a serious health issue among children and adolescents worldwide. This study aimed to investigate factors influencing weight status-associated food preferences and eating behaviors. A cross-sectional study was conducted to collect data from 2578 pairs of Chinese children and parents in five cities from December 2018 to March 2019. There was an increase in consumptions of processed seafood, nuts and dried fruit/vegetables, and fruit/vegetable juice, but a reduction of consuming puffed and processed meat products, sugar/artificially sweetened beverages and milk tea, and picky eating. These food preferences differentiate between sexes. Picky eating behavior was greatly presented in children of lower educated mothers or heavy-smoking fathers. Children of the lower educated fathers consumed less processed seafood and dairy products, and those of the heavy-smoking fathers consumed more puffed products, but less fruit/vegetable juice, and had greater snack preference. The father’s body mass index(BMI)status was also positively associated with unhealthy behaviors. Those who exercised daily longer showed better eating behaviors, and picky eating and fast-food lovers likely occurred in higher-income families. Our study provides an insight into that fathers being educated for health-conscious advice and physical activity may be the potential strategies to foster their children’s healthy eating patterns. Their efficacy needs to be further investigated.

Correlation of Picky Eating in Children’s Growth: A Systematic Review

Introduction: picky eating is a problem that is now common in children, characterized by not trying or limiting variations in food, especially vegetables and fruit. Picky eating has an important role in the development of children, both physically and emotionally, so that it becomes a concern for the parents.Method: this systematic review aims to explain the correlation of picky eating on a child's growth using PRISMA approach from two database: Scopus and Proquest limited to the last 5 years; from 2015-2019 and obtained 15 articles that selected. Identification of articles using keywords ('picky eating' AND 'children' AND 'weight' or 'growth').Result: according to the findings, it was found nine articles that mentioned picky eating had an effect on growth and six articles mentioned no effect. Limitation of this study is that there are other factors that influence picky eating in selected articles.Conclusion: the most of the result from the studies show the behavior of picky eating in children can affect the growth of both body weight and height, and can also affect nutritional status, emotional status, physical activity and health status. Nurses can provide education about the effects of picky eating behavior on children in parents.

Young adult nutrition and weight correlates of picky eating during childhood

OBJECTIVE

To identify whether picky eating during childhood is associated with dietary intake, weight status and disordered eating behaviour during young adulthood.

DESIGN

A population-based study using data from young adults who responded online or by mail to the third wave of the Project EAT (Eating and Activity in Teens and Young Adults) study in 2008-2009. Participants retrospectively reported the extent to which they were a picky eater in childhood, sociodemographic characteristics, disordered eating behaviours, usual dietary intake, and weight and height.

SETTING

Participants were initially recruited in the Minneapolis/St. Paul metropolitan area of Minnesota, USA, in 1998-1999.

PARTICIPANTS

The analytic sample included 2275 young adults (55 % female, 48 % non-Hispanic White, mean age 25·3 (sd 1·6) years).

RESULTS

Young adults who reported picky eating in childhood were found to currently have lower intakes of fruit, vegetables and whole grains, and more frequent intakes of snack foods, sugar-sweetened beverages and foods from fast-food restaurants. No associations were observed between picky eating in childhood and young adults' weight status, use of weight-control strategies or report of binge eating.

CONCLUSIONS

While young adults who report picky eating during childhood are not at higher risk for disordered eating, those who were picky eaters tend to have less healthy dietary intake. Food preferences and dietary habits established by picky eaters during childhood may persist into adulthood.

Food neophobia and its association with food preferences and dietary intake of adults

AIM

To assess the association of food neophobia (FN) with food preferences, dietary intake and dietary quality.

METHODS

A cross-sectional study was conducted in a non-probabilistic sample of 229 Portuguese adults, aged 18 to 84 years. FN was measured with the FN Scale. Dietary intake over the previous 12 months was assessed by a validated semi-quantitative food frequency questionnaire. We defined a dietary pattern the Healthy Diet Indicator, to summarise the effects of overall dietary intake. Generalised linear models were performed to test associations in multivariate analyses (controlled for sex, age and education).

RESULTS

FN was negatively associated with a general liking for the act of eating ( β ^ = - 2.976 , 95 % CI : - 5.324 ; - 0.993 ) and with reduced preferences for specific foods (fruit and vegetables, some types of meat and fish and traditional Portuguese dishes with blood). Those with higher FN showed a lower consumption of fruits and vegetables, but a higher consumption of milk and codfish, a popular Portuguese ingredient. However, FN did not affect the macronutrients and energy intake, as well as sodium, added sugars and fibre intake. Adherence to a healthy dietary pattern was not significantly associated with FN.

CONCLUSIONS

FN was associated with a decreased consumption and preference for specific foods, but it had no impact on a healthy dietary pattern.