Picky eating in preschool children: Associations with dietary fibre intakes and stool hardness

Caroline M Taylor,Kate Northstone,Susan M Wernimont,Pauline M Emmett

doi:10.1016/j.appet.2016.02.021

Abstract

It has been suggested that constipation may be associated with picky eating. Constipation is a common condition in childhood and a low intake of dietary fibre may be a risk factor. Differences in fibre intake between picky and non-picky children and its relation to stool consistency is currently not well-understood. Children enrolled in the Avon Longitudinal Study of Parents and Children identified as picky eaters (PE) were compared with non-picky eaters (NPE): (1) to determine dietary fibre intake at 38 months; (2) to investigate whether any difference in dietary fibre intake was predictive of usual stool hardness at 42 months. PE was identified from questionnaires at 24 and 38 months. Usual stool hardness was identified from a questionnaire at 42 months. Dietary intake was assessed at 38 months with a food frequency questionnaire. Dietary fibre intake was lower in PE than NPE (mean difference −1.4 (95% CI –1.6, –1.2) g/day, p < 0.001). PE was strongly associated with dietary fibre intake (adjusted regression model; unstandardised B −1.44 (95% CI –1.62, –1.24) g/day, p < 0.001). PE had a lower percentage of fibre from vegetables compared with NPE (8.9% vs 15.7%, respectively, p < 0.001). There was an association between PE and usually having hard stools (adjusted multinomial model; OR 1.31, 95% CI 1.07, 1.61; p = 0.010). This was attenuated when dietary fibre was included in the model, suggesting that fibre intake mediated the association (OR 1.16, 95% CI 0.94, 1.43, p = 0.180). Picky eating in 3-year-old children was associated with an increased prevalence of usually having hard stools. This association was mediated by low dietary fibre intake, particularly from vegetables, in PE. For children with PE, dietary advice aimed at increasing fibre intake may help avoid hard stools.

Highlights

Picking eating is known to result in rejection of specific familiar and unfamiliar foods (Dovey, Staples, Gibson, & Halford, 2008; Taylor, Wernimont, Northstone, & Emmett, 2015), with a reduction in dietary variety and an unhealthy or possibly inadequate diet (Carruth et al, 1998; Jacobi, Agras, Bryson, & Hammer, 2003; Li et al, 2014; Northstone & Emmett, 2013)
The aim of this study was to determine dietary fibre intake, and the relative contribution from food sources, in preschool-age children enrolled in the Avon Longitudinal Study of Parents and Children (ALSPAC) who were identified as picky eaters compared with those who were not picky eaters
To assess differences in diet according to picky eating score, food frequency questionnaire (FFQ) data were available for 9544 children and food record (FR) data were available for 815 children

Summary

Introduction

Picking eating is known to result in rejection of specific familiar and unfamiliar foods (Dovey, Staples, Gibson, & Halford, 2008; Taylor, Wernimont, Northstone, & Emmett, 2015), with a reduction in dietary variety and an unhealthy or possibly inadequate diet (Carruth et al, 1998; Jacobi, Agras, Bryson, & Hammer, 2003; Li et al, 2014; Northstone & Emmett, 2013). Several studies have shown that children who are picky eaters frequently reject, or limit their intake of vegetables (Cardona Cano et al, 2015; Galloway, Fiorito, Lee, & Birch, 2005; Galloway, Lee, & Birch, 2003; Haszard, Skidmore, Williams, & Taylor, 2014; Jacobi et al, 2003; Jones, Steer, Rogers, & Emmett, 2010; Li et al, 2014; Tharner et al, 2014; Xue, Lee, et al, 2015; Xue, Zhao, et al, 2015), which is likely to result in a low intake of dietary fibre. Two further studies have documented low fibre intakes in preschool-age picky eaters but did not include a comparison group (Kwok, Ho, Chow, So, & Leung, 2013; Volger et al, 2013)

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