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Providing perspectives on recent research into vitamins and nutritionals


What to do with Picky Eaters? An Approach to Fill Nutrient Gaps

By Michael McBurney

Nutrition experts recommend getting essential vitamins and minerals from a balanced diet – one with plenty of fruits, vegetables, whole grains, and dairy products. The challenge is that we don’t always make good choices. Reasons include: time costs, sensory and physical aspects, access, and perceived value.  People with lower incomes eat fewer servings of vegetables and fruits.  Food preferences. Even Presidents can shun nutrient-rich foods such as Brussels sprouts, liver and tomatoes.  ‘Trigger’ foods can subvert choices. Consequently, millions of Americans are deficient in vitamins A, B6, B12, C, E, folate, or iron.

Sheng and colleagues identified young children (30-60 months) in China whose weight-for-height was ≤ 25th percentile according to the WHO Child Growth Standards and were identified as ‘picky eaters’ by their caregivers. Picky eating was defined as a child consuming a limited number of foods and/or exhibiting strong preference for a limited number of foods; being unwilling to try new foods, eating slowly, lacking interest in eating, and/or not eating enough. Children (n=153) were randomized to nutrition counseling or counseling with a nutritional milk supplement for 120 days. Study visits were conducted at 30, 60, 90 and 120 days. 142 children completed the study.

Kids in both groups grew. Not surprisingly. Weight-for-height was significantly higher in the supplemented group at 30 and 90 but not 120 days. It was optimistic to expect growth differences between groups in only 3 months, especially when calcium, iron, zinc, and vitamins A, C, and D intakes were well below requirements (37 – 69% Recommended Nutrient Intake) at baseline. However, supplementation significantly increased mean energy, protein, carbohydrate, docosahexaenoic acid (DHA), arachidonic acid, calcium, phosphorus, iron, zinc and vitamins A, C, D, E and B6 intake.

For a multitude of reasons, people often favor certain foods and limit their intake of others.  While food choices may be ‘filling’, they are not always nutritious. Nutrition education and behavior modification are important tools to improve eating habits of children and adults. Today’s research demonstrates an important role of supplementation to fill nutrient gaps.

Main Citation

Sheng X, Tong M, Zhao D, Leung TF, Zhang F, Hays NP, Ge J, Ho WM, Northington R, Terry DL, Yao M. Randomized controlled trial to compare growth parameters and nutrient adequacy in children with picky eating behaviors who received nutritional counseling with or without an oral nutritional supplement. 2014 Nutr Metab Insights doi: 10.4137/NMI.S.15097

Other Citations

Krolner R, Rasmussen M, Brug J, Klepp K-I, Wind M, Due P. Determinants of fruit and vegetable consumption among children and adolescents: a review of the literature. Part II: qualitative studies. 2011 Intern J Behav Nutr Phys Act 8:112

Dehgnan M, Akhtar-Danesh N, Merchant AT. Factors associated with fruit and vegetable consumption among adults. 2011 J Hum Nutr Diet doi: 10.1111/j.1365-277X.2010.01142.x

Hanks AS, Just DR, Wansink B. Trigger foods: the influence of ‘irrelevant’alternatives in school lunchrooms. 2012 Agric Resource Econ Rev