Food neophobia, beyond the "capricious" child with food

FRIDAY, OCTOBER 16TH, 2020.-


Food neophobia (literally the "fear of trying new foods") is a restrictive eating disorder that mainly occurs in childhood. Unlike their neophiliac peers, these children reject new foods (often moved by sensitive aspects such as colors, textures, smells... Although there may be a lot of stories behind it).) Experts consider it a "habitual" behavior between the age of 2-6, but if prolonged beyond, the nutritional consequences can be very negative

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Food neophobia is a type of eating disorder that prevents the consumption of certain foods (and was introduced in the last edition of DSM-5, the Diagnostic and Statistical Manual of Mental Disorders edited by the American Psychiatric Association).

It is also known as "disorder that restricts and/or prevents food intake" or "selective eating disorder" (ARFID or SED respectively).

It is characterized by the rejection of food for reasons of appearance, taste, smell, texture, brand, presentation, or negative experiences with food in the past (for example, having experienced a choking situation after ingesting a particular food).

Those few foods that thicken the food neophobic list can be limited to certain types of food and even specific brands. Among the excluded, these may include whole food groups, such as fruits or vegetables.

Although very little research has been done on this disorder, it is known to occur mainly in childhood, although it may persist or appear in adulthood.

Edurne Maíz, a diploma in human nutrition and dietetics from UNAV and a degree in psychology from EHU/UPV, has been focusing her research for years on the psychology of food and, especially, on restrictive eating disorders of fruit and vegetables in childhood.

As the researcher explains, neophobic behavior is very common in the development of children, between the age of 2-3, and tends to subside towards the age of 6. "What's important to keep in mind is that food neophobia can become a problem when at this stage, where it's usual, it's not managed well," he says.

Studies on this disorder find that food neophobia has an impact on different foods, especially poor fruit and vegetable intake and more fat. "It's not usually a prosthetic intake problem, although there may be cases, it's not the most common," says Maíz.

"The omnivorous dilemma"

Food neophobia has its raison d'e view in human evolution. Three decades ago, psychologist Paul Rozin, a researcher at the University of Pennsylvania, first used the term "neophobia" to explain the "omnivorous dilemma."

Omnivorous beings, designed to explore new food parcels, needed to diversify, innovate and, to do so, try to incorporate new plants into their diet.

However, the omnivorous, wary of the novel, learned to be prudent and doubt the unknown since, any new food could pose a risk or threat.

It is an instinctive behavior, a defense mechanism developed by our ancestors to protect against possible poisonous foods or toxins. Hence, children naturally refuse foods with which they have had no previous experience.

Thus, while food neophobia seems to be the product of a strategy developed by humans during its evolution, we turn away from our diet what does not look "good."

Likewise, our taste buds predispose us to innately prefer the sweet taste and to stay away from bitter, sour, or sour (we have 25 receptors for bitter flavors and only two for sweets).

Faced with food neophobia "positive experiences must be generated"

Deficiency in fruit and vegetable intake (or other foods, as the case may be), may pose a risk to the child's correct nutritional health. But beyond the negative dietary consequences, these children or teens have high levels of anxiety and low self-esteem.

"You have to be very patient, knowing that it is normal in the development of the child. When the child says he doesn't want to try something, what you don't have to do is force him, because that makes them more neophobic," she says.

Early exposure to food and flavors is known to have long-term effects. A poor diet in childhood will be the anteroom of a poor diet in adulthood.

Often, when the child starts saying 'no' to many foods, parents press them in an act to desperately, which is a mistake. "The child relates his rejection to an obligation or anger of the father or mother, does not enjoy food, and negative experiences are generated with the food that they will lead to not wanting to prove it," she argues.

The learning of flavors is achieved by repeated exposure of them. Presenting rejected foods repeatedly on the table will lead them to become more familiar with it and will eventually generate what is known as a 'habituation phenomenon'.

The child is much more likely to want to try the food if he prepares it. It is essential that children participate in the feeding process (from the purchase, through the cooking and ending with the employee).

How to generate positive experiences with food? It is recommended to take them to make the purchase with the parents; teach them in the supermarket the different fruits and vegetables that exist; cook the food together; engage them (see how it is baked, how it is prepared...); cook recipes that carry that food even if it's not main (instead of putting a plate of chickpeas with spinach, put a spinach cake that carries cheese on top, cream, egg... That is, mix those "controversial" foods with others they like).

On the other hand, Maíz states that the neophobic should not be confused with one who has a "capricious" or "fussy" behavior with food. While both fall within the same problem, that of food rejection.

While the child with food neophobia refuses to eat new foods, those defined as capricious or fussy are characterized by having an unvaried diet and rejecting foods both new and those already familiar to them.

In any case, both eating disorders should be warned and corrected in time so as not to generate health problems related to low consumption of those rejected foods.

Finally, it also emphasizes that "children with food neophobia do not have a concern for their image; at no point is there a cognitive distortion in terms of your image and you don't want to lose weight."

When speech therapy comes into action

Children who resoundingly refuse to try anything new and parents 'overwhelmed' by the situation. This is how the Paquita González logopda is found to be the parents and children who arrive in the Early Childhood Eating Disorders Unit (under 0 to 6 years) of the Children's Hospital Universitario Niño Jesús.

Paquita, 60 years old, has been focused on food issues for decades and since 2005 has worked with the pediatrician Consuelo Pedrón and the psychologist Beatriz Saiz in this unit attended by children derived from different parts of the country (usually because of serious pathologies, carriers of nasogastric tubes or gastrostomies).

"The speech therapist is responsible for assessing the structures and functions involved in the feeding process and is the one that presents the food and 'accompanies' the child to take that step that costs him so much," says González.

Paquita says that when the child rejects a food, parents should continue to offer it and not remove it. "In 10-15 times they present it to them, they usually accept it. It should not be helped, we must insist a little, but without forgetting that we all have some food that we do not like."

Therefore, he recommends that they should be offered new foods gradually, suitable for their age. He adds that we should not forget that children learn by imitation and will show interest in the foods they see their parents eat.

Another advice he gives is that "if we match foods that dislike us with others that are more familiar to us, we will create a positive partnership, and we will end up appreciating those new foods on our own."

Children who treat from this unit of eating disorders come to the hospital once a week. They usually carry out individualized treatments, although there are also in groups of 3-4 to "facilitate their socialization".

Parents, who are present during therapy, "see how their child is able to taste a food and that can be obtained." In this way, they are given guidelines to implement at home.

"Parents ask me, but Paquita, does this have a solution? And I always tell them, of course he does. But it's a long process."

However, he makes a positive message: "We all go through that stage when we have to try new foods and some children have more trouble than others, but as one more stage in their development, they will get it accompanied by their parents."

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