Assessing the Body Composition of “Picky Eaters” Using Body Impedance Analysis: An Experience From a Tertiary Care Center

BACKGROUND: Picky eating might be associated with a higher risk of being
underweight and poor growth. This study aimed to investigate if picky eaters
aged between three and 12 years showed differences in height, weight, and body
composition compared to their non-picky peers using a body impedance analysis
(BIA).
METHODS: This cross-sectional study was conducted between March 1, 2022, and
July 31, 2022, on children aged three to 12 years who presented to the
outpatient pediatric clinics at Al Habib Ar Rayyan in Riyadh, Saudi Arabia. Body
composition was measured using BIA after manually inserting the height, gender,
and age into the machine, where body mass index (BMI), fat mass, and skeletal
muscle mass were recorded. Participants were classified as under/normal/over for
each body composition measurement.
RESULTS: A total of 2234 children were entered into the final data analysis. Our
analysis showed that 1917 (85.8%) were Saudis and 1117 (50%) were males. The
mean age of participants was 6.08±2.01 years and 1151 (51.5%) were in the
pre-school age. The reported prevalence of picky eaters was 1684 (75.4%), of
whom, 606 (27.0%) were selective eaters, 365 (16.2%) were low appetite eaters,
and 723 (32.2%) were both selective and low appetite eaters. Being underweight
was significantly more common among the picky eaters 487 (28.9%) compared to
those non-picky eaters 55 (10.0%) (p<0.001). Significantly, 1280 (76%) picky eaters had below-average skeletal muscle mass compared to 151 non-picky eaters (27.5%) (p<0.001). The low appetite picky eater group had more under skeletal muscle mass children 277 (75.9%) compared to the selective picky eater group 412 (68.0%) (p=0.009). Additionally, the low appetite group possessed lower muscle ratios (p=0.012) and were more underweight than the selective group (p<0.001). Furthermore, the low appetite group showed a higher percentage of children below the 3rd percentile in the height for age category (p=0.003) compared to the selective group. CONCLUSION: This study is the first of its kind in Saudi and globally to evaluate body composition using BIA among children. The study showed that picky eating is more associated with underweight children and low muscular mass. Despite the normal BMI, height, and weight of a picky eater, their skeletal muscle mass might be less than average, which could be associated with an increased risk of morbidity. Copyright © 2024, Sleiman et al. DOI: 10.7759/cureus.60538 PMCID: PMC11181006 PMID: 38887328 Conflict of interest statement: The authors have declared that no competing interests exist.