Abstract
BackgroundChildren’s fussy eating behavior has been related to both underweight and overweight in cross-sectional studies, but the direction of these associations and the relation with more detailed measures of body composition remains unclear. We aimed to examine whether fussy eating at age 4 years is longitudinally related to body mass index (BMI), fat mass index (FMI) and fat-free mass index (FFMI) at 6 years of age.MethodsThis study was embedded in Generation R, a population-based, prospective cohort. Data were available for 4191 children. The Children’s Eating Behaviour Questionnaire (CEBQ), administered at age 4 years, was used to derive a fussy eating profile. This profile is characterized by high scores on food avoidant scales and low scores on food approach scales. At age 6 years, height and weight were measured at our research center. Body fat and fat-free mass were measured using Dual-energy-X-ray absorptiometry. We used age- and sex-specific standard deviation scores (SDS) for all outcomes.ResultsAfter adjustment for confounders, the fussy eating profile was related to lower BMI-SDS (B = −0.37, 95 % CI: −0.47;−0.26), lower FMI-SDS (B = −0.22, 95 % CI: −0.33;−0.12) and lower FFMI-SDS (B = −0.41, 95 % CI: −0.54;−0.29). When adjusting for baseline BMI at 4 years, the fussy eating profile predicted a 0.11 lower BMI-SDS at age 6 (95 % CI: −0.19;−0.04). This change in BMI was mainly due to a decrease in FFMI (B = −0.19, 95 % CI: −0.29;−0.09). Fussy eaters also had a higher risk of becoming underweight than non-fussy eaters (OR = 2.28, 95 % CI: 1.34;3.87).ConclusionsOur findings suggest that young fussy eaters are at risk of having a lower fat free mass and of becoming underweight over a 2-year period. This implies that fussy eaters may benefit from careful monitoring to prevent an adverse growth development.Electronic supplementary materialThe online version of this article (doi:10.1186/s12966-015-0313-2) contains supplementary material, which is available to authorized users.
Highlights
Children’s fussy eating behavior has been related to both underweight and overweight in cross-sectional studies, but the direction of these associations and the relation with more detailed measures of body composition remains unclear
Fussy eating and body composition The associations between the fussy eating profile and body composition measures are presented in Table 2
Children classified as fussy eaters had a 0.37 lower body mass index (BMI) standard deviation (SD)-score at age 6 years than other children
Summary
Children’s fussy eating behavior has been related to both underweight and overweight in cross-sectional studies, but the direction of these associations and the relation with more detailed measures of body composition remains unclear. Fussy eaters often reject new food items (food neophobia), but they are characterized by their consistent rejection of specific familiar foods [4], especially vegetables [5, 6] This consistent refusal of specific food items may result in a restricted dietary variety [4], which could have consequences for a child’s health, growth, and development. In a study of 8- to 12year-old children, fussy eaters had a higher preference for fast food than did non-fussy eaters [7], suggesting that they may be at risk of overweight Both overweight and underweight in childhood have been related to several adverse health outcomes [8,9,10,11]. Child underweight is related to increased psychosocial problems, a poorer quality of life [10] and physical health problems like a relatively low bone mass [11] which may put these children at greater risk of fractures [12]
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