Assessing the Body Composition of "Picky Eaters" Using Body Impedance Analysis: An Experience From a Tertiary Care Center

Overview

Journal Cureus

Specialty Biomedical Engineering

Date 2024 Jun 18

PMID 38887328

Authors

Rola Sleiman

Wessam Abdelkader

Dana AlTannir

Affiliations

Soon will be listed here.

Abstract

Background: Picky eating might be associated with a higher risk of being underweight and poor growth. This study aimed to investigate if picky eaters aged between three and 12 years showed differences in height, weight, and body composition compared to their non-picky peers using a body impedance analysis (BIA).

Methods: This cross-sectional study was conducted between March 1, 2022, and July 31, 2022, on children aged three to 12 years who presented to the outpatient pediatric clinics at Al Habib Ar Rayyan in Riyadh, Saudi Arabia. Body composition was measured using BIA after manually inserting the height, gender, and age into the machine, where body mass index (BMI), fat mass, and skeletal muscle mass were recorded. Participants were classified as under/normal/over for each body composition measurement.

Results: A total of 2234 children were entered into the final data analysis. Our analysis showed that 1917 (85.8%) were Saudis and 1117 (50%) were males. The mean age of participants was 6.08±2.01 years and 1151 (51.5%) were in the pre-school age. The reported prevalence of picky eaters was 1684 (75.4%), of whom, 606 (27.0%) were selective eaters, 365 (16.2%) were low appetite eaters, and 723 (32.2%) were both selective and low appetite eaters. Being underweight was significantly more common among the picky eaters 487 (28.9%) compared to those non-picky eaters 55 (10.0%) (p<0.001). Significantly, 1280 (76%) picky eaters had below-average skeletal muscle mass compared to 151 non-picky eaters (27.5%) (p<0.001). The low appetite picky eater group had more under skeletal muscle mass children 277 (75.9%) compared to the selective picky eater group 412 (68.0%) (p=0.009). Additionally, the low appetite group possessed lower muscle ratios (p=0.012) and were more underweight than the selective group (p<0.001). Furthermore, the low appetite group showed a higher percentage of children below the 3rd percentile in the height for age category (p=0.003) compared to the selective group.

Conclusion: This study is the first of its kind in Saudi and globally to evaluate body composition using BIA among children. The study showed that picky eating is more associated with underweight children and low muscular mass. Despite the normal BMI, height, and weight of a picky eater, their skeletal muscle mass might be less than average, which could be associated with an increased risk of morbidity.

References

Samuel T, Musa-Veloso K, Ho M, Venditti C, Shahkhalili-Dulloo Y . A Narrative Review of Childhood Picky Eating and Its Relationship to Food Intakes, Nutritional Status, and Growth. Nutrients. 2018; 10(12). PMC: 6316224. DOI: 10.3390/nu10121992. View

Grulichova M, Kuruczova D, Svancara J, Pikhart H, Bienertova-Vasku J . Association of Picky Eating with Weight and Height-The European Longitudinal Study of Pregnancy and Childhood (ELSPAC-CZ). Nutrients. 2022; 14(3). PMC: 8839058. DOI: 10.3390/nu14030444. View

Xue Y, Lee E, Ning K, Zheng Y, Ma D, Gao H . Prevalence of picky eating behaviour in Chinese school-age children and associations with anthropometric parameters and intelligence quotient. A cross-sectional study. Appetite. 2015; 91:248-55. DOI: 10.1016/j.appet.2015.04.065. View

Berger P, Hohman E, Marini M, Savage J, Birch L . Girls' picky eating in childhood is associated with normal weight status from ages 5 to 15 y. Am J Clin Nutr. 2016; 104(6):1577-1582. PMC: 5118736. DOI: 10.3945/ajcn.116.142430. View

Chilman L, Meredith P, Kennedy-Behr A, Campbell G, Frakking T, Swanepoel L . Picky eating in children: Current clinical trends, practices, and observations within the Australian health-care context. Aust Occup Ther J. 2023; 70(4):471-486. DOI: 10.1111/1440-1630.12869. View

Oliveira A, Jones L, de Lauzon-Guillain B, Emmett P, Moreira P, Charles M . Early problematic eating behaviours are associated with lower fruit and vegetable intake and less dietary variety at 4-5 years of age. A prospective analysis of three European birth cohorts. Br J Nutr. 2015; 114(5):763-71. DOI: 10.1017/S0007114515002287. View

Taylor C, Emmett P . Picky eating in children: causes and consequences. Proc Nutr Soc. 2018; 78(2):161-169. PMC: 6398579. DOI: 10.1017/S0029665118002586. View

Kutbi H . Picky Eating in School-Aged Children: Sociodemographic Determinants and the Associations with Dietary Intake. Nutrients. 2021; 13(8). PMC: 8399397. DOI: 10.3390/nu13082518. View

Dubois L, Farmer A, Girard M, Peterson K, Tatone-Tokuda F . Problem eating behaviors related to social factors and body weight in preschool children: A longitudinal study. Int J Behav Nutr Phys Act. 2007; 4:9. PMC: 1855064. DOI: 10.1186/1479-5868-4-9. View

10.

Kamarudin M, Shahril M, Haron H, Kadar M, Safii N, Hamzaid N . Interventions for Picky Eaters among Typically Developed Children-A Scoping Review. Nutrients. 2023; 15(1). PMC: 9824123. DOI: 10.3390/nu15010242. View

11.

Bourne L, Bryant-Waugh R, Mandy W, Solmi F . Investigating the prevalence and risk factors of picky eating in a birth cohort study. Eat Behav. 2023; 50:101780. DOI: 10.1016/j.eatbeh.2023.101780. View

12.

Orsso C, Gonzalez M, Maisch M, Haqq A, Prado C . Using bioelectrical impedance analysis in children and adolescents: Pressing issues. Eur J Clin Nutr. 2021; 76(5):659-665. DOI: 10.1038/s41430-021-01018-w. View

13.

Cesar Machado B, Dias P, Lima V, Campos J, Goncalves S . Prevalence and correlates of picky eating in preschool-aged children: A population-based study. Eat Behav. 2016; 22:16-21. DOI: 10.1016/j.eatbeh.2016.03.035. View

14.

Kutbi H, Alhatmi A, Alsulami M, Alghamdi S, Albagar S, Mumena W . Food neophobia and pickiness among children and associations with socioenvironmental and cognitive factors. Appetite. 2019; 142:104373. DOI: 10.1016/j.appet.2019.104373. View

15.

Dovey T, Kumari V, Blissett J . Eating behaviour, behavioural problems and sensory profiles of children with avoidant/restrictive food intake disorder (ARFID), autistic spectrum disorders or picky eating: Same or different?. Eur Psychiatry. 2019; 61:56-62. DOI: 10.1016/j.eurpsy.2019.06.008. View

16.

Lazzeri G, Ahluwalia N, Niclasen B, Pammolli A, Vereecken C, Rasmussen M . Trends from 2002 to 2010 in Daily Breakfast Consumption and its Socio-Demographic Correlates in Adolescents across 31 Countries Participating in the HBSC Study. PLoS One. 2016; 11(3):e0151052. PMC: 4814074. DOI: 10.1371/journal.pone.0151052. View

17.

Taylor C, Wernimont S, Northstone K, Emmett P . Picky/fussy eating in children: Review of definitions, assessment, prevalence and dietary intakes. Appetite. 2015; 95:349-59. DOI: 10.1016/j.appet.2015.07.026. View

18.

de Barse L, Tiemeier H, Leermakers E, Voortman T, Jaddoe V, Edelson L . Longitudinal association between preschool fussy eating and body composition at 6 years of age: The Generation R Study. Int J Behav Nutr Phys Act. 2015; 12:153. PMC: 4678491. DOI: 10.1186/s12966-015-0313-2. View

19.

Darwish M, Al-Saif G, Albahrani S, Sabra A . Lifestyle and Dietary Behaviors among Saudi Preschool Children Attending Primary Health Care Centers, Eastern Saudi Arabia. Int J Family Med. 2014; 2014:432732. PMC: 4120486. DOI: 10.1155/2014/432732. View

20.

Antoniou E, Roefs A, Kremers S, Jansen A, Gubbels J, Sleddens E . Picky eating and child weight status development: a longitudinal study. J Hum Nutr Diet. 2015; 29(3):298-307. DOI: 10.1111/jhn.12322. View