title: Macro- and micronutrient intakes in picky eaters: a cause for concern?
abstract: Picky eating (PE) is characterized by an unwillingness to eat certain foods and by strong food preferences. PE may result in lower intakes of energy and nutrients, which may compromise health.
  
  
  
  We quantified nutrient and food group intakes in children identified as picky eaters or nonpicky eaters and compared intakes between groups and with United Kingdom reference nutrient intakes.
  
  
  
  PE was identified in an observational cohort (Avon Longitudinal Study of Parents and Children) from questionnaires administered when children were aged 2, 3, 4.5, and 5.5 y. Dietary intake was assessed at 3.5 and 7.5 y with a 3-d food record. The dietary assessment at 3.5 y compared picky eaters with nonpicky eaters identified at age 3 y, and the assessment at 7.5 y compared longitudinally defined PE groups.
  
  
  
  Picky eaters aged 3 y had lower mean carotene, iron, and zinc intakes than nonpicky eaters. There were similar differences between the longitudinally defined PE groups. Iron and zinc intakes were most likely to be below recommended amounts, with free sugar intake much higher than recommended. There were no significant differences in energy intakes between the groups, and intakes were adequate relative to estimated average requirements. Nutrient differences were explained by lower intakes of meat, fish, vegetables, and fruits in picky eaters than in nonpicky eaters. There were higher intakes of sugary foods and drinks in older picky eaters.
  
  
  
  PE did not result in compromised macronutrient intakes, although intakes of zinc and iron were more likely to be below recommendations for picky eaters than for nonpicky eaters. Emphasis should be placed on allaying parental concerns about picky eaters being prone to inadequate nutrient intakes and on encouraging all parents to extend their child's diet to include more nutrient-rich items, especially fruits and vegetables, and less nutrient-poor sugary foods.
authors.affiliation: Centre for Child and Adolescent Health, School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom; caroline.m.taylor@bristol.ac.uk.
authors.forename: Caroline M
authors.identifier: 0000-0001-8347-5092
authors.initials: CM
authors.lastname: Taylor
authors.affiliation: National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care West, Bristol, United Kingdom; and.
authors.forename: Kate
authors.identifier: 0000-0002-0602-1983
authors.initials: K
authors.lastname: Northstone
authors.affiliation: Nestlé Nutrition, King of Prussia, PA.
authors.forename: Susan M
authors.identifier: 0000-0001-7203-1349
authors.initials: SM
authors.lastname: Wernimont
authors.affiliation: Centre for Child and Adolescent Health, School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom.
authors.forename: Pauline M
authors.identifier: 0000-0003-1076-4779
authors.initials: PM
authors.lastname: Emmett
mesh_terms: D000818:Animals; D002648:Child; D002675:Child, Preschool; D002755:Choice Behavior; D003430:Cross-Sectional Studies; D004032:Diet; D002149:Energy Intake; D005260:Female; D005518:Food Preferences / Q000523:psychology*; D006801:Humans; D019266:Iron, Dietary / Q000008:administration & dosage / Q000032:analysis; D008137:Longitudinal Studies; D008297:Male; D018977:Micronutrients / Q000008:administration & dosage*; D015596:Nutrition Assessment; D064167:Recommended Dietary Allowances; D011795:Surveys and Questionnaires; D006113:United Kingdom; D015032:Zinc / Q000008:administration & dosage / Q000032:analysis
chemical_list: D019266:Iron, Dietary; D018977:Micronutrients; D015032:Zinc
keywords: ALSPAC; antioxidants; fruits; macronutrients; meat; micronutrients; picky eating; vegetables