The Interplay Between Picky Eating, Other Eating Behaviors, and Obesity Indicators in Preschool Children

Picky eating (PE) during early childhood strongly affects children's food preferences. This research aimed to assess the association of eating behaviors with obesity indices among preschoolers. Our cross-sectional analysis included 436 pre-school children. For data collection, parents were interviewed face-to-face, using the Child Eating Behavior Questionnaire and the Food Frequency Questionnaire for children eating behaviors and dietary intakes, respectively. Additionally, their BMI-for-age z-score, waist circumference, and waist-to-height ratio were measured. The association between eating behaviors and obesity indicators was evaluated via logistic regression models. The prevalence of overweight and obesity (OW/OB) was 12.4%. Higher intake of ultra-processed foods and lower intakes of energy and staple meals were found among children with high PE. PE was associated with 76%, 67%, and 60% lower risk of OW/OB, abdominal, and central obesity, respectively (OR = 0.238, 95% CI 0.135-0.420 OW/OB; OR = 0.332, 95% CI 0.220-0.502 abdominal obesity; OR = 0.398, 95% CI 0.278-0.571 central obesity). All food avoidance behaviors were negatively associated with the three obesity indicators. In contrast, food approach behaviors, except for desire to drink, had positive associations with obesity risk. All three obesity indicators were negatively associated with PE and food avoidance behaviors but positively associated with food approach behaviors. Since picky eaters commonly have unhealthy diets, being attentive to children's emotional and sensory challenges during mealtime could help nurture a healthier relationship with food.