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Jani R, Irwin C, Rigby R, Byrne R, Love P, Khan F, Larach C, Yang WY, Mandalika S, Knight-Agarwal CR, Naumovski N, Mallan K. Association Between Picky Eating, Weight Status, Vegetable, and Fruit Intake in Children and Adolescents: Systematic Review and Meta-Analysis. Child Obes 2024. [PMID: 38990706 DOI: 10.1089/chi.2023.0196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/13/2024]
Abstract
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.
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Affiliation(s)
- Rati Jani
- School of Health Sciences and Social Work, Griffith Health, Griffith University, Gold Coast, Queensland, Australia
| | - Chris Irwin
- School of Health Sciences and Social Work, Griffith Health, Griffith University, Gold Coast, Queensland, Australia
| | - Roshan Rigby
- School of Health Sciences and Social Work, Griffith Health, Griffith University, Gold Coast, Queensland, Australia
| | - Rebecca Byrne
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Kelvin Grove, Brisbane, Australia
| | - Penelope Love
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Melbourne, Australia
| | - Farheen Khan
- College of Home Science, Nirmala Niketan, Mumbai, India
| | - Catalina Larach
- School of Health Sciences and Social Work, Griffith Health, Griffith University, Gold Coast, Queensland, Australia
| | - Wai Yew Yang
- Department of Nutrition and Dietetics, School of Health Sciences, International Medical University, Kuala Lumpur, Malaysia
| | | | - Catherine R Knight-Agarwal
- Department of Nutrition and Dietetics, School of Health Sciences, University of Canberra, Canberra, New South Wales, Australia
| | - Nenad Naumovski
- Department of Nutrition and Dietetics, School of Health Sciences, University of Canberra, Canberra, New South Wales, Australia
| | - Kimberley Mallan
- School of Behavioural and Health Sciences, Australian Catholic University, Brisbane, Queensland, Australia
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Clinical Evolution of Preschool Picky Eater Children Receiving Oral Nutritional Supplementation during Six Months: A Prospective Controlled Clinical Trial. CHILDREN 2023; 10:children10030495. [PMID: 36980052 PMCID: PMC10047348 DOI: 10.3390/children10030495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 02/09/2023] [Accepted: 02/24/2023] [Indexed: 03/06/2023]
Abstract
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.
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Packed School Lunch Food Consumption: A Childhood Plate Waste Nutrient Analysis. Nutrients 2023; 15:nu15051116. [PMID: 36904116 PMCID: PMC10004809 DOI: 10.3390/nu15051116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 02/21/2023] [Accepted: 02/21/2023] [Indexed: 02/25/2023] Open
Abstract
Packed school lunch consumption remains a sparsely studied aspect of childhood nutrition. Most American research focuses on in-school meals provided through the National School Lunch Program (NSLP). The wide variety of available in-home packed lunches are usually nutritionally inferior compared to the highly regulated in-school meals. The purpose of this study was to examine the consumption of home-packed lunches in a sample of elementary-grade children. Through weighing packed school lunches in a 3rd grade class, mean caloric intake was recorded at 67.3% (32.7% plate waste) of solid foods, while sugar-sweetened beverage intake reported a 94.6% intake. This study reported no significant consumption change in the macronutrient ratio. Intake showed significantly reduced levels of calories, sodium, cholesterol, and fiber from the home-packed lunches (p < 0.05). The packed school lunch consumption rates for this class were similar to those reported for the regulated in-school (hot) lunches. Calories, sodium, and cholesterol intake are within childhood meal recommendations. What is encouraging is that the children were not "filling up" on more processed foods at the expense of nutrient dense foods. Of concern is that these meals still fall short on several parameters, especially low fruit/vegetable intake and high simple sugar consumption. Overall, intake moved in a healthier direction compared to the meals packed from home.
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Children's School-Day Nutrient Intake in Ontario: A Cross-Sectional Observational Study Comparing Students' Packed Lunches from Two School Schedules. Nutrients 2022; 14:nu14091966. [PMID: 35565933 PMCID: PMC9104756 DOI: 10.3390/nu14091966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 04/29/2022] [Accepted: 05/06/2022] [Indexed: 11/20/2022] Open
Abstract
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.
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Li P, Ren Z, Zhang J, Lan H, Szeto IMY, Wang P, Zhao A, Zhang Y. Consumption of Added Sugar among Chinese Toddlers and Its Association with Picky Eating and Daily Screen Time. Nutrients 2022; 14:nu14091840. [PMID: 35565808 PMCID: PMC9102033 DOI: 10.3390/nu14091840] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 04/25/2022] [Accepted: 04/26/2022] [Indexed: 02/05/2023] Open
Abstract
Objectives: This study aimed to examine the relationship between daily screen time, picky eating, and consumption frequency of sugared foods and sugar-sweetened beverages (SSBs). Methods: The research data came from the Young Investigation (YI) study conducted in 10 cities in China. This study used sociodemographic information, feeding behavior, picky eating reported by parents, and the consumption frequency of sugared foods and SSBs of 879 toddlers aged 1−3 years. The relationship between daily screen time and picky eating behavior was assessed using logistic regression. The zero-inflated negative binomial (ZINB) model was used to fit the consumption frequencies of sugared foods and SSBs. Results: In all, 13.1% (n = 115) of toddlers did not have sugared foods 1 month before the survey, while 73.3% (n = 644) of toddlers did not have SSBs 1 month before the survey. The consumption rate of sugared foods was relatively higher than SSBs (χ2 = 661.25, p < 0.001). After adjusting for social demographic information, no relationship was found between daily screen time and picky eating (OR = 1.437; 95% CI: 0.990,2.092). The ZINB model showed that, among children who ate sugared foods, children who were picky eaters ate them more often (IRR = 1.133; 95% CI: 1.095,1.172), but no association was found between picky eating and the chance of avoiding sugared foods (OR = 0.949; 95% CI: 0.613,1.471). Children who were picky eaters were less likely not to drink SSBs (OR = 0.664; 95% CI: 0.478,0.921). However, among children who consumed SSBs, picky eaters drank them less frequently (IRR = 0.599; 95% CI: 0.552,0.650). Children with a screen time of no less than 1 h/d ate sugared foods more frequently (IRR = 1.383; 95% CI: 1.164,1.644), and they were less likely to avoid sugared foods (OR = 0.223; 95% CI: 0.085,0.587). The longer the screen time per day was, the less likely children did not have SSBs (<1 h/d: OR = 0.272; 95% CI: 0.130, 0.569; ≥1 h/d: OR = 0.136; 95% CI: 0.057, 0.328). Conclusions: The consumption rate of sugared foods was higher than that of SSBs. Picky eating and daily screen time were related to the consumption frequency of added sugar among Chinese toddlers aged 1−3 years. Picky eaters consumed sugared foods more frequently and were more likely to drink SSBs. Children whose daily screen time reached 1 h/d were more likely to eat sugared foods and drink SSBs.
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Affiliation(s)
- Pin Li
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University Health Science Center, Beijing 100191, China; (P.L.); (Z.R.); (J.Z.)
| | - Zhongxia Ren
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University Health Science Center, Beijing 100191, China; (P.L.); (Z.R.); (J.Z.)
| | - Jian Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University Health Science Center, Beijing 100191, China; (P.L.); (Z.R.); (J.Z.)
| | - Hanglian Lan
- Yili Maternal and Infant Nutrition Institute, Inner Mongolia Yili Industrial Group Co., Ltd., Hohhot 010110, China; (H.L.); (I.M.-Y.S.)
- Inner Mongolia Dairy Technology Research Institute Co., Ltd., Hohhot 010110, China
| | - Ignatius Man-Yau Szeto
- Yili Maternal and Infant Nutrition Institute, Inner Mongolia Yili Industrial Group Co., Ltd., Hohhot 010110, China; (H.L.); (I.M.-Y.S.)
- Inner Mongolia Dairy Technology Research Institute Co., Ltd., Hohhot 010110, China
| | - Peiyu Wang
- Department of Social Science and Health Education, School of Public Health, Peking University Health Science Center, Beijing 100191, China;
| | - Ai Zhao
- Vanke School of Public Health, Tsinghua University, Beijing 100084, China
- Correspondence: (A.Z.); (Y.Z.)
| | - Yumei Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University Health Science Center, Beijing 100191, China; (P.L.); (Z.R.); (J.Z.)
- Beijing Key Laboratory of Toxicological Research and Risk Assessment for Food Safety, School of Public Health, Peking University, Beijing 100022, China
- Correspondence: (A.Z.); (Y.Z.)
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