MONTREAL – Parents of toddlers who refuse food or are picky eaters should not worry about this behavior affecting their child's health or weight, according to new research.
They should, however, be more concerned about the subconscious cues they give their children about body image and eating habits based on gender stereotypes, said Jill M. Denoma, principal investigator of the study, which was presented as a poster at an international conference sponsored by the Academy for Eating Disorders.
“Parents said their daughters ate enough, should stop eating so quickly, and should eat low-fat foods. But they said their sons didn't eat quite enough and were a little underweight, even though the boys and girls had essentially identical” body mass indexes (BMIs), she said in an interview.
“Parents probably have these ideas deeply ingrained, but they need to be aware of them and do what they can to avoid expressing them to their children,” said Ms. Denoma, a clinical psychologist and Ph.D. candidate at Florida State University in Tallahassee. “Doctors can educate parents and help them become aware of these stereotyped attitudes.”
The study included 93 mothers and their 3-year-olds (55 girls and 38 boys), plus 54 of the fathers. Eight-three percent of the children were white, 8% were Hispanic, 3% were Native American, 2% were African American, and 2% were Asian.
Parents answered questions about their children's appetite, BMI, and dietary habits and completed a battery of psychological assessment tests that included the Children's Eating Behavior Inventory and the Bayley Scales of Infant Development.
A subset of 26 children was retested at age 4 years.
The study identified four main areas of parental concern about children's eating habits: pickiness, food refusal, struggle for control, and concerns about praising the child about food intake.
“Parents come to their [physicians] worried about these things, but we actually didn't find any links between these behaviors and being underweight or not thriving nutritionally, so they can relax,” she said, adding that mothers' and fathers' opinions often differed about which eating habits were problematic. She suggested that both parents be included in such discussions.
In fact, about 20% of the girls and 18% of the boys were overweight based on their BMI, yet none of the parents described their children as fat. Ten percent of the children were described as plump, 76% as average, and 13% as underweight, Ms. Denoma reported.
“Doctors should be candid with parents of overweight children to help them keep their children at healthy weights and decrease the risk of medical problems associated with being overweight, such as diabetes,” she said.
The investigators found that one problematic eating habit–that of struggling for control over food–was linked to more generalized behavioral problems measured on the Child Behavior Checklist.
“Children who struggle for control with their parents during mealtimes are likely to exhibit troublesome behaviors in many areas of their life, such as acting out, aggression, and withdrawal,” Ms. Denoma said, suggesting that children with this eating behavior could be targets for assessment and intervention. Otherwise, she said, parents should be advised to just be patient with pickiness.