Trajectories of Picky Eating in Low-Income US Children

Pediatrics. 2020 Jun;145(6):e20192018. doi: 10.1542/peds.2019-2018.


Background and objectives: Picky eating is common, yet little is known about trajectories of picky eating in childhood. Our objectives were to examine trajectories of child picky eating in low-income US children from ages 4 to 9 years and associations of those trajectories with participant characteristics, including child BMI z score (BMIz) and maternal feeding-behavior trajectories.

Methods: Mother-child dyads (N = 317) provided anthropometry and reported on picky eating and maternal feeding behaviors via questionnaires at child ages 4, 5, 6, 8, and 9 years. At baseline, mothers reported on demographics and child emotional regulation. Trajectories of picky eating and maternal feeding behaviors were identified by using latent class analysis. Bivariate analyses examined associations of picky-eating trajectory membership with baseline characteristics and maternal feeding-behavior trajectory memberships. A linear mixed model was used to examine the association of BMIz with picky-eating trajectories.

Results: Three trajectories of picky eating emerged: persistently low (n = 92; 29%), persistently medium (n = 181; 57%), and persistently high (n = 44; 14%). Membership in the high picky-eating trajectory was associated with higher child emotional lability and lower child emotional regulation. Picky eating was associated with restriction (P = .01) and demandingness (P < .001) trajectory memberships, such that low picky eating was associated with low restriction and high picky eating was associated with high demandingness. Medium and high picky-eating trajectories were associated with lower BMIz.

Conclusions: Picky eating appears to be traitlike in childhood and may be protective against higher BMIz.