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When A Child's Picky Eating Becomes More Than A Nuisance

DAVID GREENE, HOST:

Next, not so much a discovery but something to think about if your kids are really picky eaters. Here's NPR's Richard Harris.

RICHARD HARRIS, BYLINE: Lots of kids won't eat their broccoli and a few other unpopular foods. But about 20 percent of kids are actually so picky that it's a big struggle to get them to try anything that's not on their short list of OK foods. Nancy Zucker, director of the Duke University Center for Eating Disorders, says doctors usually reassure parents not to worry. Kids usually outgrow this.

NANCY ZUCKER: I think that for some children - and we're trying to get a better handle on who those children are - that the picture might be more complicated.

HARRIS: Zucker and her colleagues have just published a study in the journal Pediatrics that looks at picky eaters ages 2 to 6. About 3 percent of the children in the study with extremely limited diets were also at higher risk for mental health problems.

ZUCKER: They were twice as likely to have a depressive disorder diagnosis and seven times as likely to have a diagnosis of social anxiety.

HARRIS: So parents who experience an extremely picky eater should be aware that it could be a sign of some deeper issue, Zucker says. Now, most picky eaters aren't that extreme, but Zucker says it's worthwhile understanding what's going on with them as well.

ZUCKER: They're more sensitive to taste, to smell, to texture, to visual cues, like, things like light. They were also had higher levels of anxiety symptoms and depressive symptoms.

HARRIS: What should a parent do in a situation where a kid really does have this limited palate? Should they worry that this kid is on the slippery slope to more severe anxiety or whatever - or mental illness?

ZUCKER: I would say they can be alert but not panicked. So the way I think of these kids as these are sensitive kids, right? They're sensitive to their external world. They're sensitive to their internal world. They have a - potentially a richer, more vivid life experience - right? - that's not pathological, but it could be a vulnerability, you know, if it crosses a threshold where it starts to impair them.

RACHEL BRYANT-WAUGH: I think this study is a really important one.

HARRIS: Rachel Bryant-Waugh is an eating disorders researcher in London and was on the committee that helped redefine eating disorders for the American Psychiatric Association's diagnostic manual. She says picky eating has been a neglected subject, but the Duke study shows that it can be more than a nuisance, especially when it affects the whole family.

BRYANT-WAUGH: So it's really important to assess the impact of the child's feeding on the parents as well.

HARRIS: Even though most children outgrow this, the journey can be unpleasant. And, she says, fighting about picky eating at mealtimes can actually make matters worse. Richard Harris, NPR News. Transcript provided by NPR, Copyright NPR.

Award-winning journalist Richard Harris has reported on a wide range of topics in science, medicine and the environment since he joined NPR in 1986. In early 2014, his focus shifted from an emphasis on climate change and the environment to biomedical research.