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Picky eating among kids can be a challenge for parents, but because it’s so common, it’s often seen as a normal part of development. Yet a new study linking picky or selective eating to symptoms of psychological disorders such as anxiety and depression suggests it may be worth a closer look.

To be clear, the “picky eating” explored in the study wasn’t an aversion to Brussels sprouts or a short-lived preference for a particular food. Rather, it referred to broader and more persistent food aversions — the sort that lead parents to prepare special meals for kids, and in severe cases, make it hard to eat anywhere outside of home.

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The study, published in the journal Pediatrics, included 917 kids ages 2-5. Researchers from Duke University and Duke University School of Medicine assessed the kids’ eating habits, psychiatric symptoms, functioning, and other variables through interviews with caregivers.

Around 20 percent of the kids studied were classified as selective eaters. Compared with non-picky eaters, these kids were significantly more likely to show symptoms of depression, social anxiety, and generalized anxiety. Those classified as severely selective — around 3 percent of the total sample — tended to have more severe symptoms. Kids in this group were seven times as likely to have a social anxiety diagnosis and more than twice as likely to have been diagnosed with depression compared to non-picky eaters.

Selective eating also predicted future anxiety. In a follow-up assessment of nearly 200 of the kids, picky eaters were 1.7 times as likely to show increased symptoms of generalized anxiety disorder compared to non-picky eaters when controlling for baseline symptom levels.

While not all picky eaters will struggle with anxiety or depression, eating habits may help alert parents and health providers to vulnerability for these disorders, which can be difficult to detect.

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“It’s so important to try to identify problems early, not only so we can treat problems for children and families now, but also so we can help prevent suffering and impairment later on,” said
coauthor Helen Egger, a child psychiatrist and epidemiologist
and chief of the division of Child and Family Mental Health and Developmental Neuroscience at Duke University Medical Center. “Kids who [are in treatment] at age 15 may have had problems since age 2.”

Selective eating was also associated with high levels of sensory sensitivity in the study — hypersensitivity to food texture, smells, and visual cues (for instance, detecting flaws in an object, or a piece of food). Understanding more about these sensitivities may lead to more effective psychological interventions for eating issues, said coauthor Nancy Zucker, associate professor of psychiatry and behavioral sciences at Duke University School of Medicine and director of the Duke Center for Eating Disorders. It also “exonerates” parents, she said, as many say they often feel blamed by health care providers for not presenting their kids a variety of novel foods.

“These kids are literally sensitive kids,” she said. “They are not just rejecting food. . . . The issue is more complex than we’d understood. But this opens up a lot of different doors for parents to embrace that sensitivity, to be curious to what kids notice about food.”

For parents looking for the most effective way to introduce new foods, Zucker advised trying outside of family mealtime.

“Family meals should be a peaceful time, a time for families to share their day,” she said. Encouraging new foods might make this time “something that kids dread, and you miss the whole point of being with family. Like you can practice with an instrument at home, you can practice with foods [outside of meal time].”

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Ami Albernaz can be reached at ami.albernaz@gmail.com.