February 23, 2016
2 min read

Parental anxiety associated with 'fussy' eating among children

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Maternal and paternal anxiety and depression predicted fussy eating among their children at 4 years of age, and physicians should be aware that such consistent rejection of particular foods can be a nonclinical symptom of the parents internalizing their problems, according to data published in Archives of Disease in Childhood.

“Child fussy eating has been associated with functional constipation, weight problems and behavioral problems,” Lisanne M. de Barse, MSc, of the department of epidemiology at Erasmus MC-University Medical Center, in Rotterdam, the Netherlands, and colleagues wrote. “Previous research suggested parental controlling feeding and parental physical and mental health problems as potential risk factors for fussy eating (also called ‘picky’ or ‘selective’ eating). However, the etiology of fussy eating is not well understood.”

To analyze the association between parental anxiety and depression and fussy eating among their children, the researchers conducted a study embedded within Generation R, a population-based prospective cohort from fetal life onward, involving pregnant women living in Rotterdam, the Netherlands, with a delivery date between April 2002 and January 2006. The study included 4,746 4-year-old children and their parents.

The researchers assessed anxiety and depression among mothers and fathers using the Brief Symptom Inventory (BSI), once during midpregnancy and again 3 years later. The researchers used a scale of 0 to 4 to assess both anxiety and depression in parents. When the child reached 4 years of age, the researchers determined fussy eating with the Children’s Eating Behavior Questionnaire (CEBQ), using a scale of 1 to 5. In addition, used the Child Behavior Checklist for toddlers, measuring fussiness on a scale of 1 to 3.

According to the researchers, children had on average a 1.02 higher sum-score (95% CI, 0.59-1.46) on the food fussiness scale, per point on the anxiety scale in pregnancy, after adjusting for cofounders. In addition, mothers’ depressive symptoms during mid-pregnancy and 3 years later were associated with fussy eating in their children. For example, in the antenatal period, children had a 0.91 point higher sum-score on the food fussiness scale, per point on the depression scale (95% CI, 0.49-1.33). Although the researchers observed similar associations between paternal anxiety and depression with fussy eating, such issues during the antenatal period were not related to picky eating.

“We observed that maternal and paternal internalizing problems were prospectively associated with fussy eating in preschoolers,” de Barse and colleagues wrote. “For effective prevention and management of children’s fussy eating, the role of parents’ internalizing problems should be considered. Clinicians should be aware that not only severe anxiety and depression, but also milder forms of internalizing problems can affect child eating behavior.” – by Jason Laday

Disclosure: de Barse reports work in Erasmus AGE, a center for aging research funded by Nestle Nutrition, Metagenics Inc. and AXA. See the full study for further author disclosures.