Fussy Eaters and What Vitamins They Are Missing Out On.

Fussy eating, particularly in childhood, is an incredibly common concern for parents. ‘Fussy eating’ is commonly defined as the regular rejection of specific food groups and new foods, however definitions do vary between studies and cases. (1) Providing meals to your child, only to have them rejected, can feel incredibly frustrating. It can also become increasingly stressful for parents who are concerned that their child may not be consuming adequate nutrients to thrive. 

Fussy eaters consume a less diverse range of foods, which may result in inadequate nutrient intake, or increased intake of discretionary foods. (1) This can lead to unwanted weight gain or loss, gastrointestinal disorders, poor growth status, and even the development of eating disorders. (1) The peak prevalence of fussy eating is generally around three years of age. (2)

A reduced intake of vegetables, whole-grain products, seafood, meat, unsweetened cereals, and fruits has been noted in fussy eaters in many studies. Fussy eaters have also been reported to eat increased amounts of savoury snacks, sugary cereals, and hot chips. (1) Either of these dietary patterns may lead to an unsatisfactory intake of certain nutrients, which are important for developing young bodies and minds. 

Nutrient Inadequacies to Watch Out for in Fussy Eaters

Iron

Iron is essential for brain development, growth, and providing energy for daily life. The most bioavailable (readily absorbed) version of iron is present in meats, poultry, and seafood as heme iron, however, you can also get iron from legumes, nuts, and tofu (non-heme iron). Due to many fussy eater’s reluctance to consume meat products, low iron is relatively common amongst this group. (1)

Signs of Low Iron

• Fatigue

• Breathlessness

• Behavioural problems

• Increased infections

• Loss of appetite

• Slowed growth rate

• Increased sweating

• Strange food cravings, for example, dirt or soap, known as pica. (3)

Zinc

Zinc is crucial for normal growth, cognitive function and function of the immune system. (4) Zinc is present in seafood, beef, poultry, grains and legumes, all of which are typically under-consumed in fussy eaters. (1) 

Signs of Zinc Insufficiency 

Fibre

Although sometimes not considered a nutrient per se, due to the fact that it is undigestible by the body, fibre is nevertheless important to consider due to its important role in healthy digestion and gut health. (2) Fibre is abundant in vegetables, fruits, seeds, nuts, and wholegrains, which are some of the key food groups lacking in the diets of fussy eaters. (2) 

Signs of Fibre Deficiency

• Constipation

• Hard stools

Vitamin A

Beta-carotene is the most important pro-vitamin A carotenoid and has been shown to be one of the nutrients most lacking in the diets of fussy eaters. (1, 5) Carotene is the pigment in plant foods that gives them their orange,yellow and red colours. Food sources of carotene include carrots, sweet potato, rockmelon, capsicum, mango, apricots, and tomatoes. (5)

Signs of Inadequate Vitamin A

What Can Be Done?

For fussy eaters who have otherwise typical development, parental modelling (i.e. eating the same meal at the table together) has been shown to help. Re-offering rejected foods multiple times, cooked or presented in different ways, may also help fussy eaters to accept new foods. (6) 

For children with sensory sensitivity, consider the role of smell, texture, sight, and taste as they can be fundamental to assisting clinical outcomes. (6)

For the majority of fussy eaters, it really is just a phase that will improve over time. Although fussy eaters typically consume lower levels of important nutrients in comparison to non-fussy eaters, studies show that the fussy eaters, in general, still meet the recommended daily requirements for energy, protein and many nutrients. 

For some fussy eaters, however, a supplement may become necessary to help with nutrient deficiencies. Keep an eye on your child’s general health and behaviour, and talk to a nutritionist or healthcare practitioner if concerned.

References

1. Taylor CM, Northstone K, Wernimont SM, Emmett PM. Macro-and micronutrient intakes in picky eaters: a cause for concern?. The American journal of clinical nutrition. 2016 Dec 1;104(6):1647-56.

2. Taylor CM, Emmett PM. Picky eating in children: causes and consequences. Proceedings of the Nutrition Society. 2019 May;78(2):161-9.

3. Better Health Channel. Iron Deficiency Victoria: Better Health Channel; 2021 [Available from: https://www.betterhealth.vic.gov.au/.

4. Mandal K, Lu H. Zinc deficiency in children. IJSIT. 2017;6:9-19.

5. National Institutes of Health. Vitamin A Fact Sheet for Health Professionals [Internet]. 2020 [cited February 26 2021]. Available from: https://ods.od.nih.gov/factsheets/VitaminA-HealthProfessional/

6. Smith B, Rogers SL, Blissett J, Ludlow AK. The relationship between sensory sensitivity, food fussiness and food preferences in children with neurodevelopmental disorders. Appetite. 2020 Jul 1;150:104643.

Written By Clare Carrick

Clare Carrick is an accredited nutritionist whose special interests involve gut health, diet and its effect on mental health, early childhood nutrition, and the impact that diet during pregnancy can have on the health of the offspring. Clare studied a BHSc (nutrition & health promotion) at Deakin University, and completed an internship at the Food & Mood Centre, which specialises in nutritional psychiatry.

Although Clare enjoys getting deep in the science behind nutrition, she is also all about balance! Life is busy for her with two daughters under five and a growing nutrition business and, in all honesty, coffee is often her 1st thought when the alarm goes off in the morning! Whilst the abundance and diversity of the Mediterranean diet is definitely a favourite way of eating for Clare, perhaps her favourite part of it is the bit where she gets to sink into the couch at the end of a long day with a glass of red and know that the polyphenols are doing good things for her microbes.