Picky eating is relatively common in young children, but that doesn't make it harmless, conclude the authors of a study published online today in Pediatrics.

"Eating problems among preschool-aged children are so pervasive that clinicians and researchers often treat them as developmentally normal" lament the authors of the study, who then present results suggesting they are anything but.

The children in their research identified as having either moderate or severe picky eating were also more likely to show elevated symptoms of anxiety and depression, as well as sensory sensitivities to the taste and texture of foods. Moreover, the problems continued: when they received a follow-up about two years later, these children were 1.7 times as likely to show increased symptoms of anxiety, even when their original levels of anxiety were taken into account.

In the study, over 900 children were recruited from pediatricians' offices and their parents were interviewed about their eating habits and a wide variety of other problems. Over seventeen percent of the children were identified as displaying moderate picky eating, meaning they ate only within a range of certain preferred foods. An additional three percent had severe picky eating, where eating outside of the home was very challenging due to the extremely limited range of foods those children would accept. Children with severe picky eating were also found to have oral-motor problems that made swallowing more difficult.

Parents of picky eaters often feel blamed by healthcare professionals for failing to present a wide enough variety of foods or giving in too easily when their child refuses a new food. But, the authors note, their finding that both moderate and severe picky eating were associated with a three- to fivefold increase in family conflicts around food suggests these parents were hardly just accommodating to their child's demands.

The results suggest that children with even moderate levels of picky eating are at risk for other problems in childhood and that the "just relax" or "wait and see" approach is not enough. Rather, a new approach to treatment is indicated. "We need to develop interventions that don't just focus on the anxiety piece, but that incorporate the sensory sensitivity and the disgust aspects of the condition," states Nancy Zucker, PhD, Director of the Duke Center for Eating Disorders and lead author of the study.

Of course, proper recognition of the problem by healthcare professionals is a crucial first step. But here, there is yet more bad news. For instance, problematic picky eating is a diagnosable eating disorder and that disorder has a name: Avoidant/Restrictive Food Intake Disorder or ARFID. A recent study involving about 2,500 Canadian pediatricians found, however, that 63 percent – nearly two-thirds! – were not familiar with the diagnosis.

The good news is that ARFID has been receiving so much press lately that better recognition of the problem and the effective treatments for it will naturally result. Stay tuned.

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