The impact of picky eating behavior on the nutritional status of preschool children

Yurten E. B. The Impact of Picky Eating Behavior on the Nutritional Status of Preschool Children. Başkent University, Institute of Health Sciences, Department of Nutrition and Dietetics, Master's Thesis, 2024. Picky eating behavior is a feeding disorder that particularly emerges during the complementary feeding period and in the preschool years. This behavior can be quite challenging for parents, and if left unaddressed, it may negatively affect children's nutritional status, growth, and possibly their future health. This study was conducted to identify preschool children with selective eating behavior, examine how this behavior affects their nutritional status, and investigate the impact of maternal attitudes on this behavior. The study was carried out with the mothers of 120 children aged 3-6, including 16 boys and 104 girls, enrolled in three different preschools in Ankara during the 2022-2023 academic year. A face-to-face interview technique was used to administer a questionnaire to the mothers of the children. The questionnaire consisted of sections on general information, family and health information, a 3 day food consumption record, the Pediatric Feeding Behavior Assessment Scale (PFBAS), and the Feeding Process Maternal Attitudes Scale (FPMAS). The Turkish-adapted version of PFBAS consists of 24 items. A higher score on the scale indicates an increase in feeding problems and unhealthy eating habits in children. FPMAS consists of 27 items. An increase in the score indicates an increase in problems related to the attitudes of mothers towards feeding their children. Accordingly, the mean total score of PFBAS for girls was 59.5±14.53, and the mean total score of FPMAS was 60.6±6.42; for boys, the mean total score of PFBAS was 54.7±12.10, and the mean total score of FPMAS was 58.3±5.22. There was no significant difference in total scale scores by gender (p>0.05). The total score of PFBAS for students by age according to body mass index (BMI) Z score was 53.0±10.4 for severely underweight, 56.8±17.2 for underweight, 60.2±14.34 for normal weight, 54.8±14.47 for overweight, and 58.3±8.54 for obese groups. There was no significant difference in the total scores of PFBAS among children according to BMI Z scores by age (p>0.05). According to the BMI Z score by age, the mean total score of FPMAS for mothers of severely underweight children was 59.7±5.03, for underweight children was 62.0±5.44, for normal weight children was 60.6±6.62, for overweight children was 57.8±5.77, and for obese children was 58.0±4.16. There was no significant difference in the total scores of PFBAS among children according to anthropometric values (p>0.05). It was determined that whether the parents were together or separated affected the early rejection of lumpy foods by children, and it was found that the children of separated parents had a higher PFBAS total score of 6.8±2.49 for rejecting lumpy foods (p<0.05). When the education levels of the mothers were examined, it was found that the majority had a bachelor's degree (62.5%); those with a master's or doctoral degree were 25.8% and 5.8%, respectively, while those with vocational school education or below were 5.9%. The mean total attitude score towards feeding for mothers with a bachelor's degree was lower than for mothers with other levels of education (p<0.05). The total scores of FPMAS for mothers of children with food allergies and mothers of children without health problems were determined as 55.7±5.8 and 60.4±6.25, respectively (p<0.05). Mothers who made efforts to prepare fun plates had higher attitude scores regarding inadequate and unbalanced nutrition compared to those who did not make efforts (p<0.05). A positive correlation was found between the total scores of FPMAS and PFBAS for participants (p<0.05). Accordingly, an increase in the mother's FPMAS score is associated with an increase in incorrect attitudes, leading to increased food selectivity in children (p<0.05). In conclusion, it was found that the mother's feeding attitude is associated with the child's food selection behavior. It is considered important to raise awareness among parents about eating habits, and to organize education on healthy eating and child nutrition in order to prevent selective eating behavior in this age group. Keywords: feeding behavior; childhood feeding and eating disorders; attitude