Association of Picky Eating and Food Neophobia with Weight: A Systematic Review

Background: Picky eating and food neophobia are common during childhood. Childhood eating behaviors are often predictive of adult eating behaviors. Objectives: Determine if childhood picky eating or food neophobia is associated with childhood weight status, or with becoming underweight, overweight, or obese later in childhood. Data Sources: We identified relevant studies from searches of PubMed, PsycINFO, and NEOHAL, as well as citations from identified studies. Study Eligibility Criteria and Participants: Inclusion criteria were original research articles examining a relationship between picky eating and/or food neophobia with childhood weight status. We summarized definitions and prevalence of picky eating or food neophobia and association with weight status. Study Appraisal: Two independent investigators assessed bias and confounding using the Agency for Healthcare Research and Quality's RTI Item Bank. Results: Forty-one studies met inclusion criteria. Picky eating was defined inconsistently, and a large variation in prevalence was found (5.8%-59%). Food neophobia was consistently defined as an unwillingness to try new foods, with a prevalence between 40% and 60%. No association existed between childhood weight status and food neophobia, and results were unclear for picky eating. Limitations: Risk of bias and confounding were moderate. Parental report was commonly used to assess picky eating, height, and weight and parental weight, feeding styles, and community characteristics were infrequently considered. Conclusions and Implications: Heterogeneous definitions used for picky eating led to a wide range of reported prevalence and an unclear relationship with weight. Consistent definitions and an improved understanding of such a relationship could help clinicians provide appropriate anticipatory guidance.