Children who are picky eaters may have bigger problems than a lack of a well-balanced diet. A new study finds that kids who make a habit of shunning certain foods are more likely to have symptoms of depression, anxiety and other psychiatric disorders.

To be counted as picky eaters, children had to do more than shun broccoli and other foods that kids typically don’t like. If they limited their eating to a range of preferred foods, they were considered to have a “moderate” case of selective eating. If that range of foods was so narrow that it was hard for them to eat with other people, their selective eating was labeled “severe.”

Researchers from Duke University assessed the eating habits of about 1,100 preschoolers ages 2 to 5. Researchers visited these children in their homes and asked their parents or other caregivers a battery of questions about the youngsters’ behavior. In addition, the researchers checked in with a subgroup of nearly 200 of the kids annually.

Picky eaters were quite common, the team found: 18% of the children were moderate selective eaters and an additional 3% had a severe case of the condition. Those figures were in line with previous studies that found 14% to 20% of preschoolers were selective about the foods they ate at least some of the time.


Some doctors see these numbers are reassuring, and many of them tell parents that their children will simply outgrow their pickiness. But the Duke researchers said this is the wrong approach for dealing with selective eaters.

“The fact that a behavior is relatively common does not mean that it is harmless,” they wrote in an article published Monday in the journal Pediatrics.

Indeed, picky eating may be a sign that a young child has psychiatric problems that need to be addressed. In the study, children with severe cases of selective eating were about twice as likely as to be diagnosed with depression compared with kids who ate a normal range of foods. They were also 2.7 times more likely to be diagnosed with social anxiety, according to the study.

Selective eaters whose conditions were deemed moderate did not have an increased risk of being diagnosed with a psychiatric condition. However, compared with their less picky peers, they were more likely to have symptoms of depression, anxiety and attention deficit hyperactivity disorder, or ADHD.


By tracking some of the children over time, the researchers found that selective eaters faced an increased risk of developing anxiety problems as they got older, even when their initial symptoms were taken into account. The fact that picky eating could flag future psychiatric problems is “perhaps the most clinically significant finding” in the study, the authors wrote.

From a purely physical point of view, selective eaters did not grow as much as children who ate a normal range of foods, according to the study. Without a varied diet, kids may get enough calories but still lack some key nutrients, the researchers wrote.

All of this points to a need for new ways to help families of children with this type of eating disorder, according to the Duke team. “There is much to learn,” they wrote.

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