Picky eating in children is significant and associated with more developmental difficulties
Research findings
|Published
The prevalence of avoidant and restrictive eating patterns in children is significant, and about 6% of children between the ages of 3 and 8 have persistent symptoms. This is shown in a new study using data from the Norwegian Mother, Father and Child Cohort Study (MoBa) at the Norwegian Institute of Public Health.
The study was led by researchers at the University of Oslo, the Norwegian Institute of Public Health, and Lovisenberg Hospital, and published in JAMA Pediatrics.
“Findings from this study show that both genetic and environmental factors play a role in the development of eating difficulties in children, and provide new knowledge about the specific genetic variants involved,” says researcher Ludvig Daae Bjørndal at the PsychGen Centre (Norwegian Institute of Public Health and Lovisenberg Hospital) and the PROMENTA Research Center (University of Oslo).
Avoidant and restrictive eating
Some children and adults have avoidant and/or restrictive eating patterns, meaning they eat very selectively and often have a narrow and limited diet. This can lead to low energy intake and nutritional deficiencies. Such behavior is the core symptom of avoidant restrictive food intake disorder (ARFID).
ARFID is a relatively new diagnosis. Therefore, little is known about how common such symptoms are, how they relate to children’s general development, and how they are linked to mental and physical health. There is also limited knowledge about genetic and environmental factors that may influence avoidant and restrictive eating patterns.
Prevalence and Developmental Characteristics
The researchers found that between 6% and 18% of children displayed symptoms of avoidant or restrictive eating of varying duration. Among 6% of the children, symptoms persisted from ages 3 to 8. Among children with symptoms, between 1% and 3% also had at least one indicator of clinically significant consequences associated with their eating patterns, such as delayed growth or weight loss.
Children with persistent symptoms also had greater challenges related to social, emotional, and behavioral development from 6 months to 14 years of age compared with those without symptoms. The prevalence of certain diagnoses recorded in specialist health services was also higher in this group, including autism, ADHD, and epilepsy.
Genetic Influence
Genetic analyses showed that between 8% and 16% of the variation in symptoms of avoidant and restrictive eating could be attributed to genetic factors. Researchers also identified specific genetic signals associated with these symptoms.
Implications
The study provides new insights into the prevalence and developmental challenges among children with avoidant and restrictive eating patterns. These patterns are relatively common and associated with greater difficulties across developmental domains. Children with symptoms persisting from ages 3 to 8 also had higher rates of certain neurodevelopmental and somatic diagnoses.
“The findings in this study highlight the importance of early assessment of eating patterns and targeted support for many children with avoidant and restrictive eating,” says Bjørndal.
About the Study
The study is based on data from around 35,000 children in the Norwegian Mother, Father and Child Cohort Study (MoBa), a population-based health study conducted by the Norwegian Institute of Public Health. This cohort study has followed parents and children from pregnancy into adulthood. The dataset includes information on, among other things, eating patterns at ages 3 and 8. Additionally, a range of developmental characteristics—such as neurodevelopment, language, behavior, and mental health—has been mapped throughout childhood.
The study was led by researchers at the PsychGen Centre, an interdisciplinary research environment at the Norwegian Institute of Public Health and Lovisenberg Diaconal Hospital, in collaboration with PROMENTA at the University of Oslo.
Reference
Bjørndal, L. D., Corfield, E. C., (…), Ask, H., & Havdahl, A. (2025). Avoidant restrictive food intake phenotypes: Prevalence, developmental characteristics, and genetic architecture. JAMA Pediatrics. https://doi.org/10.1001/jamapediatrics.2025.4786