Correlates of picky eating and food neophobia in young children: a systematic review and meta-analysis

Context: Picky eating behavior is prevalent among toddlers and may negatively impact their growth and development. Objective: This article summarizes the correlates of picky eating and food neophobia in young children, which were identified using a socio-ecological framework. Data Sources: A literature search was conducted in 4 electronic databases. Study Selection: Inclusion criteria were English-language peer-reviewed publications that investigated correlate(s) of picky eating or food neophobia in children aged <= 30 months. Data Extraction: Correlates were categorized into 4 levels: cell, child, clan (family), and community/country. Thirty-two studies, which examined 89 correlates, were identified from the keyword searches of the databases and manual searches of the reference lists of included articles. Results: The most examined correlates were characteristics related to the child (sex, weight, and dietary intake) and parent (feeding beliefs and practices). A meta-analysis estimated the prevalence of picky eating to be 22%. Each additional month of a child's age was associated with a 0.06 U increase in the Children's Eating Behavior Questionnaire food fussiness score. Conclusion: This review highlights the importance of investigating child-parent dyads and bidirectional feeding interactions and draws attention to the lack of picky eating research at the level of the cell and the community/country.