Does your young child turn up his nose at just about every meal you offer him? Lack of interest in food can turn households into war zones. “Why won’t you eat it? I made it the way you told me you liked it,” says Mom. “I don’t like it,” says the child, as he pushes it away.

Such battles are common in homes where young children have been diagnosed with ADHD. There are several links between attention deficit and picky eating:

Studies have shown that children with attention deficit disorder (ADHD or ADD), whose brains show low levels of dopamine activity, are more predisposed to crave sugar, due to the surge of dopamine that sugar delivers to the brain. A child may push away many nutritious foods, such as vegetables and fish, since they do not deliver the sugar that the ADHD brain craves.
Kids with ADHD can also exhibit sensory defensiveness and/or have some of the motor challenges that are seen in autism spectrum disorders. Picky eaters usually have high levels of food sensitivity. A certain taste, smell, or the look of food can make these children feel as if the sensory experience is “hurting” them. The sense can be so overwhelming that they are literally repulsed, panicked, or sickened by exposure to it.
Researchers at Duke University found a high correlation between selective eating problems and ADHD.

[Free Download: 5 Ways to Cook Up ADHD-Friendly Meals]

Triggers for Picky Eating

Picky eating is common in younger kids. However, most children outgrow the habit and develop an appetite for a wider range of foods. The children who do not outgrow picky eating, or who start off with limited food options, are worrisome to parents. Research shows that many children who are picky eaters have parents who are, or were, picky eaters, suggesting both genetic and environmental contributors. Lack of experience early on with a variety of tastes, textures, and smells can lead to picky eating later in life.

When your child says that something doesn’t taste “right” or “good,” he may be telling the truth. We are all wired differently in what appeals to our senses and palate. It may be that picky eaters represent a population of children who are hypersensitive to certain aspects of eating. For example, one study found that middle-ear infections (which children with ADHD are prone to) make cruciferous vegetables, like cauliflower, cabbage, and broccoli, taste bitter to some children. Such infections can damage the nerve that carries taste information from the tongue to the brain.

You don’t have to put up with picky eating. You can change a child’s half-hearted reaction to foods. Here’s how.

Involve your child in food preparation. It will give him ownership of, and pride in, the meal. Think about taking your child grocery shopping as well, but do not buy anything you do not want your child to eat.

[9 Nutrition Tricks for Picky Eaters]

Keep food in the house that you want your child to eat. You should never have to say, “I’m not making macaroni and cheese again.”

Eat according to a schedule. This way, the child can predict the routine and feel more comfortable. Set the scene with relaxing music and by turning off the television. Eat together and engage in good conversation at the dinner table.

Serve water as the only beverage at the table. Picky eaters tend to fill up on high-sugar fruit juices, chocolate milk, or soda.

Teach your child to eat mindfully. Ask her, “What are five things you can tell me about this food?” This shifts the focus from the taste or texture of the food she is fixated on.

Pick your battles. If your child will only eat apples with the skin off, and if you feel up to it, go ahead and peel them. Don’t force your child to eat. This will lead to power struggles over food, which can set the stage for an eating disorder. Do not make special meals for the child. It is important that they be guided to eat what they are avoiding.

Give the food a cool name. Stimulate interest in “boring” (but healthy) foods. A few examples are “strong spinach,” “x-ray vision carrots,” or “power potatoes.”

Add foods they avoid to the foods they will eat. For example, add spinach to tomato sauce.

When exposing a child to new foods, ask her about foods she would feel least anxious eating and create a hierarchy with her input.

Praise your child if he bites, licks, smells, or tastes a new food.

Don’t bribe or reward your child with food, especially dessert. This turns dessert into the “good” food that can be enjoyed after the “yucky” food is eaten first.

Don’t be concerned with convention. It’s OK to have chicken for breakfast and eggs and bacon for dinner.

Remember that, on average, a child needs to be offered a new food about 15 times before she may eat it.

Engage in deep breathing at mealtimes, and also at various times during the day. Have the child visualize a positive image associated with eating the feared foods.

Assertiveness training can be helpful. Outside of mealtimes, kids may be compensating for being shy at school and using food as an outlet for being assertive.

Parents should stay calm and engage in relaxation training. Although it is frustrating when your child is a severe selective eater, keep your emotions in check.

Parents should lead the way by eating a variety of foods. If these strategies do not work, contact your child’s pediatrician. Your child may have to see a therapist and nutritionist to understand and manage the problem.

Policing Food Challenges

Picky eating can be an aspect of one’s unique wiring, but it may be a part of a larger condition:

Autism Spectrum Disorders: Children on the autistic spectrum often show high levels of sensory defensiveness, problems with oral-motor coordination (which eating can place stress on), and are wedded to stereotyped routines and a need for sameness.

Eating Disorders: Picky eating can be an early sign of eating disorders, particularly those characterized by food restriction, a fear of fatness, or a high need for control.

Obsessive-Compulsive Disorder: A child with this condition may avoid certain foods for fear of contamination.

Anxiety Disorders: Picky eating may be due to phobias or other anxiety disorders. The fear of vomiting or gagging, social anxiety over the thought of a food making one burp or pass gas, or a phobic response to a food that has been linked to a threat can result in idiosyncratic, picky eating.

[ADDitude Asked: Outsmarting a Picky Eater]

Roberto Olivardia, Ph.D., is a member of the ADDitude ADHD Medical Review Panel.

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