The purpose of this study was to determine the correlation between young children's picky eating behavior and mother's attitudes, beliefs and practices regarding the eating habits of children. Using a sample of 304 mothers of four or five year-old children, confirmatory factor analysis was conducted to test a 7 factor model, which included mother's beliefs and practices related to the feeding of their children. Following this, a t-test was conducted to examine the differences between the feeding behaviors of mothers of both of picky and non-oicky eaters, respectively. The results indicated that picky eater's eating behaviors were positively related to the pressures exerted by mothers and negatively related to the mother's concerns about their child's weight and child's BMI. These findings suggest that the pressures mothers exert upon their children to eat, their child's weight and picky eating behaviors are correlated to each other.
This study was conducted to develop a nutrition education workbook to improve picky eating in children and to evaluate the effect of nutrition education using this developed workbook. The developed workbook focused on 2nd and 3rd grade students and consisted of five units. The contents included: multi-grain, vegetables (2 units), fish, and milk. The activities, including observation, and learning the roles and names of the foods, were developed mainly to increase motivation for eating a balanced diet. This workbook was developed from April to December 2008, and was applied at 15 elementary schools containing 1,674 students from April to September 2009 in Changwon City, Korea. We evaluated changes in knowledge before and after education on nutrition, eating behavior, dietary habits, and educational activities using self-administered questionnaires. The children demonstrated significant improvements in nutritional knowledge (P<0.001), eating behavior (P<0.001), and dietary habits (P<0.001). Most of the children answered that the education program was helpful and exciting. Based on these results, we believe that the developed workbook is suitable for children picky eaters, and hope it will be used in the field of child nutrition education.
Objectives: The purpose of this study was to develop and evaluate booklets and video clips to prevent children from picky eating. Methods: Based on a survey conducted on food preferences of preschool children aged 2 to 5 years, 14 kinds of less preferred vegetables were selected. Accordingly, educational videos, activity books, and teaching-learning guides were produced for preschool children using the 'food bridge' theory, and the educational materials were named "Friendly vegetables". Educational materials were distributed to childcare institutions, and their effectiveness was investigated for preschool children who were instructed on these materials once every 30 days from March to November, 2019. The children were examined for changes in their knowledge of names, colors, taste/texture, methods of cultivation, and preferences for vegetables before and after the instructional course. Results: The awareness of vegetables increased significantly in younger children and the picky eating group. When the assessment was carried out in terms of vegetable knowledge, it was observed that the younger the age or the pickier the in eating food, the more effective the education is compared to the counter part. The preference for vegetables also increased after the instruction compared to the pre-instruction period, but significant changes were seen only in the 2~3 year age group for boys and girls. Also, only the picky group of girls showed changes in preference. The children's average interest in the education materials was 3.85 points out of 5 points. Conclusions: Through this study, we have developed educational materials for standalone use in childcare facilities and confirmed that they have a significant effect on improving awareness and preferences related to vegetables. In summary, the younger the age or the pickier the child in eating food, the more effective the education. It is believed that additional education on mealtime guidance is needed which can alter the eating behavior of preschool children and improve their diet. It is proposed to widen the scope of use of the materials by collecting diverse opinions from child care teachers.
The purpose of this study was to provide basic information for developing nutrition education programs for preschool children and their families. The subjects were 291 parents whose children went to daycare centers in Uiwang. The questionnaire contained 15 items for children's dietary habits and six items for parents' nutritional attitudes. The results of frequency analysis of children's dietary habits were as follows: 63.9% of children ate meals regularly, however breakfast (46.4%) was usually skipped; 44.0% of children ate a snack more than twice per day; 56.7% did not have late night meals; 49.5% ate out once to twice per week; 89.7% had dinner with family more than three times per week; and 43.6% had picky eating habits. The percentage of children who did not eat vegetables and seaweed was the highest among other food groups. Intake frequencies were low in fatty foods, instant foods, and fast foods. Some correlations were observed between picky eating habits and other dietary habits by cross-tabulation analysis. Intake frequency of non-picky eating children was lower for late night eating and fatty foods but higher for vegetables and seaweed compared to picky eating children. Parents answered that their nutritional knowledge level was normal (72.2%), and nutritional information was collected using the Internet (36.0%). Nutritional value was the most considered point in meal preparation of parents (43.3%), and the most difficult factor in child's diet management was lack of time due to working (36.1%). Parents cited method of creating a menu (27.0%) and table manners (25.3%) as topics of nutrition education by professionals. Therefore, various nutrition education programs need to be developed to improve healthy dietary habits for children and their families.
Eating behaviour disorder during early childhood is a common pediatric problem. Many terminologies have been used interchangeably to describe this condition, hindering implementation of therapy and confusing a common problem. The definition suggests an eating behaviour which has consequences for family harmony and growth. The recent Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition does not cover the entire spectrum seen by pediatricians. Publications are substantive but level of evidence is most of the time low. This purpose of this review is to clarify terminology of eating behaviour problems during early childhood; including benign picky eating, limited diets, sensory food aversion, selective eating, food avoidance emotional disorder, pervasive refusal syndrome, tactile defensiveness, functional dysphagia, neophobia and toddler anorexia. This tool is proposed only to ease the clinical management for child care providers. Diagnostic criteria are set and management tools are suggested. The role of dietary counselling and, where necessary, behavioural therapy is clarified. It is hoped that the condition will make its way into mainstream pediatrics to allow these children, and their families, to receive the help they deserve.
This study was conducted to investigate how child-care teachers participate, practice mealtime instruction, and perceive difficulties in food service, focusing on comparison between the teachers caring two different age groups: children younger than three years (Younger Group) and those three years or older (Older Group). Questionnaires were distributed to 151 child-care centers in Kwanak-gu, Seoul, Korea during December, 2011. Only the data from 25 child-care centers, where two respective teachers in charge of Younger Group and Older Group completed the questionnaires, were analyzed. The results showed that there was no difference in terms of child-care teachers' participation in food service practice between the two groups, except for serving method; 'Pre-plated' serving was used significantly more often in Younger Group, whereas 'Line-up' serving was used in Older Group. Approximately, three quarters of the child-care centers had policies or guidelines on mealtime instruction. During mealtime, child-care teachers tended to use frequently verbal instructions such as "sit up straight when you eat" about eating manner, "don't be picky with your food" about eating habit, and "wash your hands before eating" about eating procedure in both the groups. There was no statistically significant difference regarding child-care teachers' perceived difficulties in food service between the two groups. These results indicated that child-care teachers' participation and mealtime instruction in food service did not differ between the two age groups, although children's development of digestion and eating skill differed by age. Therefore, training should be provided to child-care teachers about food service practices and mealtime instruction appropriate to children's age.
Purpose: To identify the relationship between dietary habits and childhood gastroesophageal reflux disease (GERD) in preschool children. Methods: We performed a questionnaire study to analyze the relationship between dietary habits and GERD in 85 preschool children with GERD and 117 healthy children of the same age. Results: Irregular and picky eating were more p-revalent in the GERD group than in the control group (odds ratio [OR], 4.14; 95% confidence interval [CI], 1.37-12.54 and OR, 4.96; 95% CI, 1.88-13.14, respectively). The snack preferences and the late night eating habits were significantly more prevalent in the GERD group than in the control group (OR, 3.83; 95% CI, 1.23-11.87 and OR, 9.51; 95% CI, 2.55-35.49, respectively). A preference for liquid foods was significantly more prevalent in the GERD group (OR, 9.51; 95% CI, 2.548-35.485). The dinner-to-bedtime interval was significantly shorter in the GERD group than in the control group ($157.06{\pm}48.47$ vs. $174.62{\pm}55.10$, P=0.020). In addition, the time between dinner and bedtime was shorter than 3 hours in 47 children (55.3%) of the GERD group and 44 (37.6%) of the control group. This difference was statistical significance (P=0.015). Conclusion: Dietary habits such as picky and irregular eating, snack preference, a preference of liquid foods, late night eating, and a shorter dinner-to-bedtime interval had a significant correlation with GERD. Further large-scale studies are necessary to confirm our results.
This study investigated the demand of nutrition education programs among preschooler's parents. Focus group interview was conducted four times with 29 parents of preschool children. Most subjects appeared to have interest in nutrition education; 'very interested' (58.6%), 'somewhat interested' (20.7%). Sources of nutrition information were 'internet' (35.1%), 'books' (21.6%), 'newspaper or magazines' (13.5%), 'family or relatives' (13.5%), 'media' (8.1%), 'preschool' (5.4%) and 'hospital or public health center' (2.7%) in order. The most frequently mentioned health problems related to dietary behavior were atopy and obesity. Major concerns for children's dietary behavior was picky eating habits, and having questions for how to deal with this problem. Most subjects had trouble with obtaining an adequate amount of dietary supplements for their children. Nutrition education for parents about food labeling and information on processed foods was in demand. Preferred methods of nutrition education for children were playing games with stickers, gardening vegetables, and participating in cooking. Attitudes toward computer-assisted education materials, one of the methods of nutrition education, appeared to be ambivalent. Some preschool parents showed negative attitudes towards exposing their children to electronic devices at an early age, whereas others showed positive attitudes. Subjects were interested in meal-planning and ways to balance nutrients for their child. Parents preferred attending professional lectures to receive reading materials or searching websites as an adult nutrition education method. Results of this study have implications on providing basic information for developing nutrition education programs for preschoolers and their parents. Future research should focus on developing nutrition education programs for both preschools and the home.
Purpose: Treatment of chronic constipation and fecal impaction is usually outpatient and requires high or frequent doses of laxatives. However, there are children who fail outpatient treatments, sometimes repeatedly, and are ultimately hospitalized. We sought to compare the characteristics of the children who failed outpatient treatment and needed inpatient treatment vs those who achieved success with outpatient treatment, in an effort to identify attributes that might be associated with a higher likelihood towards hospitalization. Methods: In this retrospective cohort study, we reviewed the medical records of all patients aged 0 to 21 years, with chronic functional constipation and fecal impaction seen in the pediatric gastroenterology clinic over a period of 2 years. Results: Total of 188 patients met inclusion criteria. While 69.2% were successfully treated outpatient (referred to as the outpatient group), 30.9% failed outpatient treatment and were hospitalized (referred to as the inpatient group). The characteristics of the inpatient group including age at onset of $3.6{\pm}3.6years$ (p=0.02); black ethnicity (odds ratio [OR] 4.31, 95% confidence interval [95% CI] 2.04-9.09); p<0.001); prematurity (OR 2.39, 95% CI 1.09-5.26; p=0.02]; developmental delay (OR 2.20, 95% CI 1.12-4.33; p=0.02); overflow incontinence (OR 2.26, 95% CI 1.12-4.53, p=0.02); picky eating habits (OR 2.02, 95% CI 1.00-4.08; p=0.04); number of ROME III criteria met: median 4, interquartile range 3-5 (p=0.04) and $13{\pm}13.7$ constipation related prior encounters (p=0.001), were significantly different from the outpatient group. Conclusion: Identification of these characteristics may be helpful in anticipating challenges and potential barriers to effective outpatient treatment.
To determine food preferences and nutrients intake of nursery school children, 199 children, ages 1 to 6 years, were assessed with a structured questionnaire completed by their mothers. The questionnaire included questions related to dietary habits, mother's interest in the child's health, family history of diseases, etc. The nutrients intake was measured by 24-hour recall method. Children's weight and height were measured by trained investigators on the same day. For analysis purposes, the subjects were grouped into underweight, normal and overweight groups based on the z-score of weight for height. Only 58.3% of the subjects were grouped into the normal weight group. On the other hand, 19.1% were in the underweight group and 22.6% were in the overweight group. Forty four percent of them showed unbalanced dietary habits such as preference for picky foods, 40.0% of them disliked vegetables, and 46.7% disliked minor grains other than rice. Children in the underweight group showed a higher score of inappropriate dietary habits compared to those of normal or obese groups. The level of nutrients intake of the subjects was higher than the Korean RDA value in general, except for Ca, calories, and Zn. However, 87.4% of the children showed a higher intake level than 125% of KRDA in protein, and 18.2% and 41.4% of them showed a lower intake level than 75% of KRDA in Fe and Ca, respectively. Children in the underweight group showed a higher percentage of eating less than 75% KRDA in niacin compared to those of the normal or overweight group (p<0.05) and we found a similar tendency in Fe, Zn and Vitamin $B_1$ intake.
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