The persistence of picky eating: Opportunities to improve our strategies and messaging

Authors: ZUCKER, NANCY - Duke University; HUGHES, SHERYL - Children'S Nutrition Research Center (CNRC)

Submitted to: Pediatrics
Publication Type: Other
Publication Acceptance Date: 3/23/2020
Publication Date: 6/1/2020
Citation: Zucker, N.L., Hughes, S.O. 2020. The Persistence of picky eating: Opportunities to improve our strategies and messaging. Pediatrics. 145(6):e20200893. https://doi.org/10.1542/peds.2020-0893.
DOI: https://doi.org/10.1542/peds.2020-0893

Interpretive Summary:

Technical Abstract: There is a lack of a precise and accepted definition of picky eating in children. Additionally, there are variations of how picky eating presents in children. These issues make it difficult for pediatricians, health providers, researchers, and parents to manage it. This commentary article discusses the main points and findings of a recently published article by Fernandez and colleagues. Results from this study confirmed that differences in the definition and prevalence of picky eating indeed occur when thresholds in its measurement and definition are altered. It has been found that most children are selective in the foods they choose, but what characterizes this behavior is that it occurs sometimes and that these children are able to adapt this behavior. However, there is a group of children (about 14%) who are often or always selective and this behavior persists across time and situations. Future studies are needed to test this definition of consistency. Another major finding from the Fernandez and colleagues study showed that interventions for picky eating need to start at a younger age so as to hinder the development of picky eating at the appropriate developmental period, when children are more receptive to food exploration. Finally, the Fernandez and colleagues study provided some strategies to use for picky eating during this developmental period. The strategies need to be tested for effectiveness; however, until then, they provide concrete tactics parents may use to address picky eating in their children. These strategies include: 1) using an authoritative feeding style in which parents provide structure and guidance while being sensitive to the child’s needs and without being punitive; 2) working to create positive memories and experiences around food, such as cooking and gardening, to help picky eaters expand their preferences; and 3) minimizing the focus on outcomes (that is letting go of the need for a child to taste something) and instead focus on accumulating pleasant experiences.