Feeding and Swallowing Clinic

Food Selectivity

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What is Food Selectivity?

     
  • A child is considered food selective if he does any one of the following:  
       
    • Avoids an entire food group. (See list of food groups below)
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    • Avoids all foods with a certain texture (for example, will only eat soft foods or only crunchy foods).
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    • Avoids all foods of a certain type (avoids all red foods or green foods, etc).
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    • Avoids all solid foods and will only drink liquids.
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    • Eats 5 or fewer foods.
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  • For example, selective eaters may avoid all cereals, all meats, all cold foods, all foods with red color, all crunchy foods, all fruits and vegetables, etc.
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The Four Food Groups

     
  • Cereals, Grains, and Starches
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  • Protein Foods (meats, eggs, cheese, legumes)
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  • Fruits and Vegetables
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  • Dairy Products.
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What causes food selectivity?

     
  • History of or ongoing reflux or food allergies.
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  • Difficult medical history that interfered with interest or ability to eat.
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  • Chronic constipation.
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  • Altered sensory perceptions of food.
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  • Sensory integration problems.
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  • Certain diagnoses: autism predisposes many children to food selectivity.
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  • Medications-some can alter sense of taste or texture.
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  • Unintentional parental reinforcement of selective behavior.
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How Do You Help A Food Selective Child Overcome His Selectivity?

     
  • Through behavioral psychology strategies. Children should be evaluated by trained behavioral psychologists who can develop appropriate treatment plans to introduce new foods.
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Does Food Selectivity Lead to Eating Disorders?

     
  • Not usually. Their underlying causes are quite different and treatment is also different:
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  • Young people with eating disorders (anorexia nervosa or bulimia nervosa) are obsessed with appearance and losing weight. They will restrict the amount or kind of food they eat, but only so they can lose weight.
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  • Treatment for anorexia or bulimia involves extensive psychological counseling to help young people improve their self-esteem and self-images.
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  • Treatment of food selectivity focuses on strategies to help children overcome the discomfort and stress they experience when they eat.
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What is the difference between a "Picky" Eater and a "Selective" Eater?

     
  • Picky eaters eat at least one food from each food group. They have more balanced diets than selective eaters.
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  • Toddlers very commonly go through a "picky" phase where they eat only a few types of foods. This is normal.
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  • Any child who eats a balanced diet over a 2-3 week period is not food selective or picky.
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How Do You Help A Picky Eater Overcome His "Pickiness?"

     
  • Through patience and repetition. Continue to offer the food. Try different presentations and recipes (raw versus cooked, plain versus casserole, etc). Praise and reward the child when he does try a new food.
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  • However, don't expect a child to eat foods you don't eat!
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What About "Bad" Diets and "Pickiness" in Older Children and Teenagers?

     
  • Continue to make healthy foods available and encourage your child or teenager to eat properly.
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  • Studies have shown that when parents model good eating behavior and continue to provide their teenagers with healthy foods, those teens eat significantly more fruits and vegetables and other "good" foods than their peers.
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Are There Any Food Groups That Can Be Avoided Without Compromising Health?

     
  • Yes:  dairy products.
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  • Dairy products contain calcium and vitamin D. These nutrients can be found in the other three food groups, and from sunlight (for vitamin D).
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  • But- a child who does not eat dairy products must eat enough calcium and vitamin D containing foods from the other three food groups to make up for the lack of dairy products. This can be difficult to do.
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  • If your child does not drink or eat any dairy products, you should consult a dietitian to make sure he is meeting his nutrient needs for calcium and vitamin D.
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  • Note that even though children can meet their nutritional needs without eating dairy products, any child who voluntarily avoids dairy products still has food selectivity.
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Are There Any Other Food Groups That Can Be Avoided Without Compromising Health?

     
  • NO!!
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  • But there are smaller groups of foods that can be avoided without compromising health. For example:  
       
    • Meats can be avoided as long as there are other good sources of protein present in the diet.
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    • Fruits can be avoided if a variety of vegetables are eaten daily.
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    • Cereal can be avoided if bread and other starchy foods are eaten. Bread can be avoided if cereal and other starchy foods are eaten.
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My Child Eats Dairy Products But Entirely Avoids Another Food Group. Is He At Nutritional Risk?

     
  • YES!! See a dietitian!!
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