Open Access Open Badges Research

Toward an operative diagnosis of fussy/picky eating: a latent profile approach in a population-based cohort

Anne Tharner1*, Pauline W Jansen2, Jessica C Kiefte-de Jong1, Henriette A Moll34, Jan van der Ende2, Vincent WV Jaddoe134, Albert Hofman1, Henning Tiemeier12 and Oscar H Franco1

Author Affiliations

1 Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands

2 Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Rotterdam, The Netherlands

3 Department of Pediatrics, Erasmus University Medical Center, Rotterdam, The Netherlands

4 Generation R Study Group, Erasmus University Medical Center, Rotterdam, The Netherlands

For all author emails, please log on.

International Journal of Behavioral Nutrition and Physical Activity 2014, 11:14  doi:10.1186/1479-5868-11-14

Published: 10 February 2014



Definitions and assessment methods of fussy/picky eating are heterogeneous and remain unclear.

We aimed to identify an eating behavior profile reflecting fussy/picky eating in children and to describe characteristics of fussy eaters.


Eating behavior was assessed with the Child Eating Behavior Questionnaire (CEBQ) in 4914 4-year olds in a population-based birth cohort study. Latent Profile Analysis (LPA) was used to identify eating behavior profiles based on CEBQ subscales.

Results and discussion

We found a “fussy” eating behavior profile (5.6% of children) characterized by high food fussiness, slowness in eating, and satiety responsiveness in combination with low enjoyment of food and food responsiveness. Fussy eaters were more often from families with low household income than non-fussy eaters (42% vs. 31.8% respectively; Χ2(1) = 9.97, p < .01). When they were 14 months old, fussy eaters had a lower intake of vegetables (t [3008] = 2.42, p < .05) and fish (t [169.77] = 2.40, p < .05) but higher intake of savory snacks (t [153.69] = -2.03, p < .05) and sweets (t [3008] = -2.30, p < .05) compared to non-fussy eaters. Also, fussy eaters were more likely to be underweight at 4 years of age (19.3%) than non-fussy eaters (12.3%; Χ2(1) = 7.71, p < .01).


A distinct fussy eating behavior profile was identified by LPA, which was related to family and child characteristics, food intake, and BMI. This behavior profile might be used in future research and the development of interventions.

Fussy eating; Children; Latent profile analysis; Population-based cohort study; Dietary intake; BMI; Child and family characteristics