Apart from the frustration and stress that picky eating causes for parents of picky eaters, long term picky eating can lead to malnutrition which can manifest as either underweight or overweight. A third, less obvious sign of malnutrition is stunted growth in height which is difficult to undo.

Addressing Picky Eating is important and the first step should be to rule out any medical conditions that may result in feeding difficulties such as swallowing disorders or allergies. If no medical reasons exist, Picky Eating should be tackled to reduce meal time stress and the risk of Picky Eating following children in adulthood. The more prolonged Picky Eating is, the greater the risk on long term health.

While the diet of a picky eater might not be low enough in energy to restrict growth, it is likely to be low in essential nutrients for development, immunity and digestive health. The lack of dietary diversity together with the avoidance of ‘unacceptable’ meals results in a restricted opportunity to meet nutrient goals.

Picky Eaters are typically very selective eaters with potential sensitivities to texture, entire food groups such as meat or bitter flavours in some vegetables. Avoidance of entire food groups or foods with a certain textures results in a diet of poor diversity and a heavy reliance on a handful of foods that are unlikely to fulfill all the nutrient requirements of growing child.

Furthermore, if the handful of accepted foods fall into the treat food category due to the presence of saturated fats, added sugars or large amounts of salt, while lacking in fibre, protein vitamins and minerals, the nutrient composition of the Picky Eater’s diet comes into question. Examples of such foods include crisps, pastries, muffins, white bread or bread rolls, cereal bars, sweetened breakfast cereals, crumbed proteins, fried chips, biscuits and sweetened dairy products or dairy-like products. A heavy reliance on these foods to keep a Picky Eater fed may lead to obesity and hidden nutrient deficiencies such as iron deficiency.

The overall nutrient quality of a child’s diet can easily be assessed with reference to any typical healthy plate model that demonstrates the proportion of starch (¼) to protein (¼) to vegetables and fruit (½) to fat (small circle in the middle of the plate). If all the food consumed by a child on any given day were placed on a large plate, these recommended proportions should be achieved. In other words colour should dominate and the presence of lean protein must be evident. A daily provision of fruits, vegetables and lean protein is important for achieving nutrient goals.

If a child’s diet is overwhelmingly beige, this is a clear sign that the diet is carbohydrate, specifically starch, heavy but lacking in fibre. While children need carbohydrate, carbohydrate should come with nutrient benefits, namely fibre, vitamins and minerals. Carbohydrate is found in all plant based foods and the goal should be to meet carbohydrate needs with predominantly whole plant foods, limiting refined flours, bread crumbs and added sugars. Carbohydrate containing foods (starch, wholegrains, fruits, vegetables, legumes and dairy) should be paired with lean protein and healthy fats for optimal nutrient intake, blood glucose stabilization and satiety.

Tips for keeping Picky Eaters well nourished

• Stick to an eating routine and limit distractions at meal times
• Feed small meals often but limit grazing to ensure hunger at meal times
• Eat together as a family as often as possible
• Maintain a positive environment and a neutral attitude at meal times
• Do not avoid cooking vegetables because a child does not like them
• Always prepare one accepted vegetable. It should be eaten everyday if need be until other vegetables become accepted
• Try preparing disliked vegetables differently eg. roasting or steaming rather than boiling
• Set a good example
• Limit the purchasing of convenience snack foods (bars, crisps, biscuits, muffins)
• Reduce the use of crumbed protein products unless made from scratch
• Include children in the menu planning and food preparation
• Do not offer meal alternatives, make a family meal and stick with it
• Do not force a child to finish a meal
• Do not bribe a child with dessert

If a Picky Eater is failing to thrive, seek help from a dietitian who can assist in supporting the restrictive diet