Characterization, drivers, and outcomes of picky eating behavior in the STRONG Kids 2 longitudinal birth cohort study

Early childhood is a highly transitional phase of life in which rapid development of mealtime behaviors and taste preferences occurs. Picky eating is a common phenomenon observed in young children by caregivers, and often encompasses behaviors including avoiding the intake of certain foods, rejecting novel or familiar foods, eating a limited variety of foods, and eating an inadequate amount of food. Habits formed during this stage of life can predict long-term diet quality and health. Therefore, picky eating is often a source of concern for caregivers. As picky eating is a multifaceted interaction of factors related to both the caregiver and the child, its mitigation is complex. There has been little longitudinal research on the development and outcomes of picky eating behavior in young children. The Synergistic Theory Research Obesity and Nutrition Group (STRONG) Kids 2 (SK2) longitudinal birth cohort study is examining the various predictors of weight trajectory and dietary habits in young children, offering an opportunity to investigate the many factors involved in picky eating behavior from the ages of 12- to 48-months, holistically. The purpose of this thesis research was to understand the drivers and outcomes of picky eating, as it is perceived by caregivers over time, in young children in the SK2 longitudinal birth cohort. To achieve this goal, four specific aims were outlined: 1) categorize the longitudinal patterns of picky eating behavior, as it is perceived by parents and caregivers, of children in the SK2 cohort; 2) determine which observed child behaviors contribute to caregiver perception of picky eating in the SK2 cohort in terms of longitudinal patterns of mealtime behaviors and food refusals; 3) determine the relationship between longitudinal patterns of picky eating behavior, as it is perceived by caregivers, and their potential driving factors including age of introduction to solid foods (ISF), parental feeding practices, and home food availability; and 4) associate the longitudinal patterns of picky eating, as it is perceived by caregivers, to the outcomes of BMI trajectory and food intake. Participants were 164 parent-child dyads enrolled in the SK2 study. Data was collected from surveys administered at 12-, 18-, 24-, 36-, and 48-month timepoints in which parents were questioned about their child’s picky eating, mealtime behaviors, food refusals, and food intake. Parents also answered survey questions regarding their feeding practices, food availability in their home, and their perceptions of child weight. Three longitudinal patterns, or clusters, of parentally perceived picky eating were identified and determined to be related to the observation of difficult mealtime behaviors and food refusals. Parent-associated factors, including age of ISF, food availability, and feeding style, did not play a significant role in picky eating behavior over time in the cohort. No differences were found across clusters of picky eaters in parental classification of child weight, actual child weight, or food intake. The results of this research suggest that picky eating is a variable phenomenon associated with several food-related behaviors. Though it is unlikely to lead to serious health outcomes, the improvement of dietary quality in young children should be prioritized. This research can help guide mitigation strategies to lessen difficult mealtime behaviors and increase children’s intake of nutritious foods. Further longitudinal research is recommended to improve understanding of the driving factors and long-term outcomes of picky eating behavior.LimitedAuthor requested closed access (OA after 2yrs) in Vireo ETD syste