Department of Food Studies, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden.
Unit of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
Int J Behav Nutr Phys Act. 2018 Aug 9;15(1):74. doi: 10.1186/s12966-018-0706-0.
Characteristics of picky eaters of different weight status have not been sufficiently investigated. We used two newly developed screening cut-offs for picky eating in the Food fussiness (FF) subscale of the Child Eating Behavior Questionnaire (CEBQ) to investigate the prevalence and characteristics of picky eaters in preschool-aged children with thinness, normal weight, overweight or obesity.
Data for 1272 preschoolers (mean age 4.9 years) were analyzed. The parent-reported FF subscale ranges from 1 to 5, and two screening cut-offs were applied to classify children as picky eaters (3.0 and 3.33). Structural Equation Modeling was used to study associations with other factors in the CEBQ, the Child Feeding Questionnaire (CFQ) and the Lifestyle Behavior Checklist (LBC). Scores were compared separately for each weight status group.
Nearly half of the children were classified as moderate or severe picky eaters (cut-off 3.0) and 30% as severe (cut-off 3.33). For both cut-offs, prevalence was significantly lower in the obesity group. Still, one-third of children with obesity met the cut-off of 3.0 and 17% met the cut-off of 3.33. While picky eaters displayed similar patterns across weight status groups, some differences emerged. Food responsiveness was lower for picky eaters, but the difference was significant only among children with obesity. Slowness in eating was not as pronounced among picky eaters in the obesity group. In the overweight and obesity groups, parents of picky eaters did not report as high pressure to eat, as compared to the thinness or normal weight groups; in the obesity group, parents of picky eaters also perceived their children's weight as lower. In all weight status groups, parents of picky eaters were more likely to report their children had too much screen time, complained about physical activity, and expressed negative affect toward food.
Picky eating was less common but still prevalent among children with obesity. Future studies should investigate the potential influence of picky eating on childhood overweight and obesity. Moreover, as children with picky eating display higher emotional sensitivity, further research is needed to understand how to create positive eating environments particularly for children with picky eating and obesity.
不同体重状态下的挑食者的特征尚未得到充分研究。我们使用儿童饮食行为问卷（CEBQ）中食物挑剔（FF）分量表中两个新开发的挑食筛查切点，来调查瘦弱、正常体重、超重或肥胖的学龄前儿童中挑食者的患病率和特征。
对 1272 名学龄前儿童（平均年龄 4.9 岁）的数据进行了分析。父母报告的 FF 分量表范围为 1 到 5，使用两个筛查切点将儿童分类为挑食者（3.0 和 3.33）。结构方程模型用于研究与 CEBQ、儿童喂养问卷（CFQ）和生活方式行为检查表（LBC）中其他因素的关联。分别比较每个体重组的得分。
近一半的儿童被归类为中度或重度挑食者（切点 3.0），30%为重度挑食者（切点 3.33）。对于两个切点，肥胖组的患病率都显著较低。尽管如此，三分之一的肥胖儿童符合 3.0 的切点，17%符合 3.33 的切点。虽然挑食者在不同体重组中表现出相似的模式，但也出现了一些差异。食物反应性较低，但仅在肥胖儿童中差异显著。在肥胖组中，挑食者的进食速度并不那么明显。在超重和肥胖组中，与瘦弱或正常体重组相比，挑食者的父母报告的进食压力没有那么大；在肥胖组中，挑食者的父母也认为他们孩子的体重较低。在所有体重组中，挑食者的父母更有可能报告孩子看太多屏幕，抱怨身体活动量，对食物表示负面情绪。
挑食在肥胖儿童中虽然少见但仍很普遍。未来的研究应该调查挑食对儿童超重和肥胖的潜在影响。此外，由于挑食的儿童表现出更高的情绪敏感性，因此需要进一步研究如何为挑食和肥胖的儿童创造积极的饮食环境。
