Picky eaters are at risk

Many kids are picky eaters but new research suggests the trait is even more common in autistic children who tend to refuse more foods and are more likely to restrict their diets to a smaller variety of foods than other children.

Such habits in both autistic and non-autistic children may put them at nutritional risk.

"If children are not eating foods from each of the food groups in sufficient amounts they may be at risk for nutrient inadequacy," Dr. Linda Bandini, of the E. K. Shriver Center, University of Massachusetts Medical School and Boston University told Reuters Health in an email.

At the same time, Bandini is quick to remind parents who may be concerned about their own children's eating habits that picky eating is not a "core symptom of autism."

"Autism is diagnosed in children who have limitations or difficulties in several key developmental areas such as language, communication, social interaction, and rigid behavior. They may or may not be picky eaters, so this behavior alone is not at all indicative of having autism," Bandini said.

Bandini and colleagues wanted to know if children with autism spectrum disorder (ASD) had different eating habits than "typically developing" children (as anecdotal evidence suggested) and whether such differences, if they existed, had an effect on nutrition.

The resulting Children's Activity and Meal Patterns Study (CHAMPS) enrolled 111 children aged 3 to 11 - 53 with ASD and 58 typically developing children. The children were weighed and measured. Parents were asked about their child's dietary habits and kept a food diary for three days.

The act of selective eating was divided into three patterns - refusing certain foods, a limited variety or repertoire of foods consumed, and restricting consumption almost exclusively to one food item, which is eaten frequently throughout the day.

Picky eaters were found in both the ASD and typically developing children although the children with ASD "displayed more food refusal and exhibited a more limited food repertoire," the authors report in the Journal of Pediatrics.

Contrary to popular perception, picky eating habits did not appear to be tied to a child's age. Levels of food refusal and food repertoire in typical children were similar across age groups.

In addition, reports from only 4 of 53 parents of ASD children that their child ate a single food 4 or 5 times a day prompted the authors to conclude this most extreme example of selective eating "does not occur as commonly in children with ASDs as might be assumed based on anecdotal reports."

Although the number of children studied was small, the research suggested the greatest nutritional risk came not from refusing certain foods but rather from diets with a limited variety or repertoire of foods. Because autistic children in the study were more likely to limit the variety of foods they ate, a larger number of them came up short in requirements for vitamins A, C, D, as well as zinc, calcium and fiber compared to the typically developing kids, Bandini and colleagues note.

More research is now needed, they say, to study eating patterns over time to confirm whether food selectivity lasts into adulthood and in the same way in ASD and typically developing children, and what impact prolonged food selectivity has on nutritional status.

How do you get your picky child to eat your food?
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