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Dedicated to up to date pediatric feeding and dysphagia information

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Hi, I'm Krisi Brackett, PhD, CCC-SLP,C/NDT. This blog is dedicated to current information on pediatric feeding and swallowing issues. Email me at feedingnewsletter@gmail.com with questions.

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Essay on Food Neophobia and Picky Eating

May 1, 2021 by Krisi Brackett 1 Comment

Here is another article from class looking at the comparison of food neophobia and picky eating- research was looking at typically developing children. There is a lot of work to be done looking at these issues in children with special needs or developmental delay. Read if interested…

Food neophobia and Picky eating

Food neophobia and picky eating are frequently reported to coexist in children (Kutbi, 2020) but are characterized differently in research and clinical practice.  Taylor & Emmett state that they are different constructs but are “inter-related and both contribute to the rejection or acceptance of foods, particularly of fruits and vegetables (2020). Food neophobia is defined as the reluctance to eat or avoidance of new foods while picky eating refers to an inadequate consumption of a variety of foods or reluctance to eat a substantial amount of foods  that are familiar or unfamiliar (Kutbi, 2020; Dovey et al., 2008). According to Dovey et al., picky eating is differentiated from food neophobia through the novelty value of food although food neophobia can be part of picky eating, picky eating is not part of food neophobia (2008).

At this time, there is no standard definition or measure of picky eating (Zucker & Hughes, 2020). Eating characteristics that are used to describe picky eating are unwilling to try new foods and consuming a limited type and amount of food (van der Horst et al., 2016). According to Taylor & Emmett, causes of picky eating include early feeding difficulty, late introduction of lumpy foods, and parental pressure to eat (2020). Personality, early introduction of complementary foods, and absence of exclusive breast feeding may also contribute to pickiness (Shriver, class slides, 2021). Picky eating may be most prevalent in children 2-6 years of age and is characterized by poor intake and rejection of foods. Foods may be rejected based on their sensory properties such as texture, smell, or feel (Dovey et al., 2008). Children with picky eating often have poor dietary variety and reduced nutrient intake which is related to lower acceptance of fruits, meats, vegetables and grains and may affect growth and development (Cole et al., 2017; Taylor & Emmet, 2020).

Food neophobia is characterized by the fear of new foods and is thought to have an evolutionary connection with avoidance of potential toxins in unfamiliar foods (Dovey et al., 2008). Food neophobia is associated with lower fruit, vegetable, and variety of intake. The exact timing of food neophobia has not been established and multiple researchers suggest it peaks between 2 and 6 years of age and decreases as children get older (Dovey et al., 2008). Association of anxiety, phobias, and emotions has been linked with neophobia with rejection of the food being primarily visual with a fear of “disgust” related to the food (Dovey et al., 2008). Pliner et al. (1992)  has developed a 10 question scale to measure neophobia. 

Strategies to improve food acceptance among children who are picky eaters stems from building comfort and familiarity with foods. Zucker & Hughes (2020) state that caregivers can work to create positive memories and experiences around food (eg, cooking, gardening) to help picky eaters expand their preferences. Many researchers have written about the benefits of repeated exposure to gain acceptance of a food (Cooke, 2007; Llewellyn & Syrad, 2019). van ver Horst (2012) suggests benefits of creating a food enjoyment to decrease pickiness and that parental controlling practices (pressuring or restricting) might create a negative environment. Parents can encourage healthy eating practices by repeatedly exposing infants and children to healthy food tastes, by using recipes or cooking techniques that their children enjoy, and by enabling children to attend enjoyable, sociable mealtimes (Haines et al, 2019). Although strategies for diet expansion are not fully studied, other considerations include structured meals and snacks, family mealtime, parental modeling of food acceptance, as well as serving children the same food as their parents (Skafida, 2013; Llewellyn & Syrad, 2019).

References

Cole, N. C., An, R., Lee, S. Y., & Donovan, S. M. (2017). Correlates of picky eating and food   neophobia in young children: a systematic review and meta-analysis. Nutrition reviews, 75(7), 516–532. https://doi.org/10.1093/nutrit/nux024

Cooke L. (2007). The importance of exposure for healthy eating in childhood: a review. Journal  of human nutrition and dietetics : the official journal of the British Dietetic Association,  20(4), 294–301. https://doi.org/10.1111/j.1365-277X.2007.00804.x

Daniels L. A. (2019). Feeding Practices and Parenting: A Pathway to Child Health and Family Happiness. Annals of nutrition & metabolism, 74 Suppl 2, 29–42.

https://doi.org/10.1159/000499145

Dovey, T. M., Staples, P. A., Gibson, E. L., & Halford, J. C. (2008). Food neophobia and ‘picky/ fussy’ eating in children: a review. Appetite, 50(2-3), 181–193.

https://doi.org/10.1016/j.appet.2007.09.00

Kutbi H. A. (2020). The Relationships between Maternal Feeding Practices and Food Neophobia  and Picky Eating. International journal of environmental research and public health,  17(11), 3894. https://doi.org/10.3390/ijerph17113894

Llewellyn, C. & Syrad, H. (2019). An Appetite for Life: How to Feed Your child From the Start. The Experiment, LLC. 

Picky Eating. 2021 in Ellyn Satter Institute, www.ellynsatterinstitute.org/how-to-feed/childhood-feeding-problems/. Retrieved March 26, 2021.

Pliner, P., & Hobden, K. (1992). Development of a scale to measure the trait of food neophobia  in humans. Appetite, 19(2), 105–120. https://doi.org/10.1016/0195-6663(92)90014-w

Shriver, L. (2021). Class Slides. Picky Eating & Food Neophobia. Child & Adolescent Nutrition,  NTR 750X, UNCG, Spring 2021.

Skafida V. (2013). The family meal panacea: exploring how different aspects of family meal      occurrence, meal habits and meal enjoyment relate to young children’s diets. Sociology  of health & illness, 35(6), 906–923. https://doi.org/10.1111/1467-9566.12007

Taylor, C. M., & Emmett, P. M. (2019). Picky eating in children: causes and consequences. The  Proceedings of the Nutrition Society, 78(2), 161–169. https://doi.org/10.1017/ S0029665118002586

van der Horst K. (2012). Overcoming picky eating. Eating enjoyment as a central aspect of children’s eating behaviors. Appetite, 58(2), 567–574. https://doi.org/10.1016/ j.appet.2011.12.019

van der Horst, K., Deming, D. M., Lesniauskas, R., Carr, B. T., & Reidy, K. C. (2016). Picky eating: Associations with child eating characteristics and food intake. Appetite, 103, 286–293. https://doi.org/10.1016/j.appet.2016.04.027

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

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  1. Kristin Warren says

    August 10, 2021 at 4:26 am

    Krisi, I’m a huge fan of your site and compilation of research. In your lit search did you come across best practice techniques for targeting/treating the food neophobia? Does best practice place treatment more in the hands of feeding therapists, or with psych, or both? Thanks for all you do!
    Krissy Warren, peds SLP

    Reply

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