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Linda G. Bandini, PhD, RD, Sarah E. Anderson, PhD, Carol Curtin, MSW, et.al.

J Pediatr 2010

FOOD SELECTIVITY (PICKY EATING)

> Young children Parental concern

>> ASDs

unusual eating habits

specific textures, colors, smells, and temperatures and rigidity with respect to specific brands of foods

to compare food selectivity in typically developing children and children with ASDs
to examine the relationship between food selectivity and nutritional adequacy

children with ASDs would exhibit more food selectivity than typically developing children food selectivity would decline with age in typically developing children, but would not be associated with age in children with ASDs food selectivity is associated with inadequate nutrient intake

PARTICIPANT CHAMPS S
3 11 y

INCLUSION CRITERIA EXCLUSION CRITERIA

Good health and free from diseases or disorders that could affect dietary and/or physical activity habits

the use of appetiteaffecting medications

Autism Diagnostic InterviewRevised

Vineland Adaptive Behavior Scales

ASDs

ADAPTIV E SKILLS

COGNITI VE ABILITY Differential Abilities Scale

BW/BH Seca wallmounted stadiometer

PARENTS
interviewed about their childs dietary habits and use of special diets completed a demographic/ medical questionnaire and a modified FFQ

instructed to complete a 3day food record

Definition of Food Selectivity

Food Frequency Questionnaire Modified YAQ (based on Harvard FFQ) contained 131 food items, compared with the original 126

Nutrient inadequacy
nutrients that were found to be low in a nationally representative survey of the diets vitamins or of calcium, US children D and E, iron, zinc, that and have been fiber reported to be low in studies of children with ASDs vegetables and fruits often are below vitamins recommendations A and C for US children

Statistical Analysis

SAS version 9.1

t test
x or Fisher exact tests Pearson correlation

comparisons between typically developing children and children with ASDs for continuous variables comparisons between typically developing children and children with ASDs for categorical variables the association between food refusal and limited repertoire, as well as the association of these aspects of food selectivity with age

Spearman correlation

the relationship between food refusal and limited repertoire with nutrient inadequacy

FOOD REFUSAL : children with ASDs refused more foods and refused more foods as a percentage of those offered compared with typically developing children

LIMITED FOOD REPERTOIRE : parents of children with ASDs recorded that their child ate significantly fewer types of foods over the 3-day period compared with typically developing children

HFSFI was rarely seen in children in either group

children with broader food repertoires refused fewer foods as a percentage of those offered than children with more restricted food repertoires the association between food selectivity and age did not depend on whether the child had an ASD or was typically developing

children with ASDs had a greater number of nutrients with inadequate intake compared with typically developing children

children with ASDs displayed more food refusal and exhibited a more limited food repertoire compared with typically developing children the commonly held belief that dietary pickiness is outgrown with age

NOT OBSERVE IN THIS STUDY

The operational anecdotal reports suggest definition that some children of consume HFSFI chosen for this with ASDs a certain food or foods nearly exclusively study might have masked some of the unique eating habits children with NOTof OBSERVE IN THIS ASDs STUDY

Cornish EA, 1998 Herndon AC, 2009

the association between limited repertoire and nutrient inadequacy suggests that a very limited diet may put any child at risk for nutritional deficiencies

This study

there was associations between nutrient inadequacy and limited food repertoire, but not with food refusal

THIS DISCREPANCY MAY BE EXPLAINED BY THE FACT THAT FOOD REFUSAL WAS DETERMINED FROM THE FFQ AND NUTRITIONAL ADEQUACY FROM THE 3DAY FOOD RECORD

Modified FFQ 3-d food record

some parents of children with ASDs offered a limited number of foods, which would preclude the child refusing those foods may not adequately capture the variety of the typical diet

Parents

parents who describe their children as picky eaters are often concerned that their childs lack of variety prevents them from getting optimum nutrition, and thus could be disproportionately attracted to a study

Longitudinal studies examining food selectivity are needed to explore whether food selectivity persists into adolescence and adulthood, the impact of prolonged food selectivity on nutritional status, and whether there are differences in persistence of this phenomenon between children with ASDs and typically developing children