Macro- and micronutrient intakes in picky eaters: a cause for concern?

Introduction  Picky eating is characterised by an unwillingness to eat some foods and strong food preferences. This may result in lower intakes of energy and nutrients, which may compromise health.

Objectives  Our aim was to quantify nutrient and food group intakes in children identified as picky eaters (PE) or non-PE, and to compare intakes between groups and with UK reference nutrient intakes.

Design  PE was identified in an observational cohort (Avon Longitudinal Study of Parents and Children) from questionnaires at 2, 3, 4.5 and 5.5 years of the child’s age. Dietary intake was assessed at 3.5 and 7.5 years with a 3-day food record. Comparisons were made for PE versus non-PE at 3 years with diet at 3.5 years and for longitudinally defined PE groups with diet at 7.5 years.

Results Children who were PE at 3 years had lower mean carotene, iron and zinc intakes than non-PE. There were similar differences between the longitudinally defined PE groups. Iron and zinc intakes were most likely to be below recommended amounts, with intake of free sugars much higher than recommendations. There were no significant differences in energy intakes between the groups and intakes were adequate in comparison with estimated average requirements. Nutrient differences were explained by lower intakes of meat, fish, vegetables and fruits in PE than non-PE; in the older PE children there were higher intakes of sugary foods/drinks.

Conclusion  Picky eating did not result in compromised macronutrient intakes, although intakes of zinc and iron were more likely to be below recommendations in PE than non-PE. Emphasis should be placed on allaying parental concerns about children with picky eating being prone to inadequate nutrient intakes and on encouraging all parents to extend their child’s diet to include more nutrient-rich items, especially fruit and vegetables, and less nutrient-poor sugary foods.