Diet fortification for mild and moderate picky eating in typically developed children: Opinion review of Middle East consensus

Table 3 Symptoms generally distinguish a “picky eater” from a problem feeder

	Picky eaters	Problem feeders
Number of food that the child eats	Picky eaters generally eat at least 30 different foods	Problem feeders have a very restricted range or variety of foods and usually eat less than 20
What happens when people go on a food jag (eat the same food over and over, then suddenly stop eating it)?	Picky eaters will generally accept and eat that food after taking a 2-week break without eating it	Problem feeders will rarely ever accept that food again, even after taking a break, and this often results in a decrease in the number of foods in a child’s food range
Reaction to a new food on the plate	Tolerate new foods on their plate, and can usually touch or taste a new food, even if they do so very reluctantly	Cry, protest, and “fall apart” when presented with new foods. They completely refuse to do anything with the food
Do they eat at least one food from each nutrition (proteins, vegetables, etc.) and texture (purees, soft foods, chewy foods, etc.) categories?	Picky eaters eat at least one food from most food texture and nutrition groups	Problem feeders refuse entire categories of food textures or nutrition groups
Meal time	Frequently, they eat different foods at a meal than the rest of the family, but they usually eat with the family	They almost always eat different foods at a meal than the rest of the family and often don’t eat with the family (either eat at separate times or eat alone in a separate space)
How hard is it for them to learn about new foods?	Picky eaters will add new foods to their repertoire in 20-25 steps on the steps to eating hierarchy	Problem feeders add new foods in more than 25 steps on the steps to eating hierarchy
How often has the child been reported as a “picky eater” at well-child check-ups?	Picky eaters are sometimes reported by a parent as a “picky eater” at well-child check-ups. Picky eating has been happening for less than two years	Problem feeders are persistently reported by a parent as “picky eaters” across multiple well-child check-ups. Picky eating has been happening for more than two years