title: Picky eating in preschool children: Associations with dietary fibre intakes and stool hardness.
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.
authors.affiliation: Centre for Child and Adolescent Health, School of Social and Community Medicine, University of Bristol, Bristol, UK. Electronic address: Caroline.m.taylor@bristol.ac.uk.
authors.forename: Caroline M
authors.initials: CM
authors.lastname: Taylor
authors.affiliation: School of Social and Community Medicine, University of Bristol, Bristol, UK.
authors.forename: Kate
authors.initials: K
authors.lastname: Northstone
authors.affiliation: Nestlé Nutrition R&D, King of Prussia, PA, USA.
authors.forename: Susan M
authors.initials: SM
authors.lastname: Wernimont
authors.affiliation: Centre for Child and Adolescent Health, School of Social and Community Medicine, University of Bristol, Bristol, UK.
authors.forename: Pauline M
authors.initials: PM
authors.lastname: Emmett
mesh_terms: D002657:Child Development; D002664:Child Nutritional Physiological Phenomena; D002675:Child, Preschool; D015331:Cohort Studies; D003248:Constipation / Q000178:diet therapy / Q000453:epidemiology / Q000503:physiopathology / Q000517:prevention & control*; D000072001:Diet, Healthy; D004043:Dietary Fiber / Q000008:administration & dosage / Q000032:analysis / Q000627:therapeutic use*; D004739:England / Q000453:epidemiology; D005243:Feces / Q000737:chemistry; D005518:Food Preferences; D006244:Hardness; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D010349:Patient Compliance; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D055502:Secondary Prevention; D012720:Severity of Illness Index; D014675:Vegetables / Q000737:chemistry
keywords: ALSPAC; Constipation; Dietary fibre; Hard stools; Picky eating; Vegetables