Public Health

’Picky eating’ is a loosely used term to describe features such as having a small appetite (eating small or perceived small quantities of food), being selective about the types of foods eaten, and fussy mealtime behaviours. Studies have shown that picky eaters tend to have lower intake of meat and protein-rich foods, less vegetables and less energy from mixed dishes. Picky eaters also tend to have a lower overall food consumption and skewed nutritional intake because of the lack of variety in the food they eat. Thus, these children tend to have lower mean BMI, were more often underweight and tend to have micronutrient deficiencies. One of the important factors in managing picky eaters is the relationship between the child and the parent or caregiver at mealtimes. Clinicians should remind parents to cultivate good eating behaviours and provide a pleasant environment for meals and snacks. Children with picky eating behaviours should be closely monitored to ensure adequate nutrition to support the rapid growth and development that occur during infancy and early childhood. It is well known that early nutritional status is linked to health later in life; appropriate dietary intake throughout childhood is critical in reducing the risk of noncommunicable diseases.

Growth is an indicator of health and nutritional status. Notably, it has been reported that about 30% of Singaporean parents were unable to correctly gauge whether their child was underweight or overweight based on body mass index (BMI). This is a concern because when a normal weight infant or child is perceived by its parents to be underweight, there is a tendency to overfeed, potentially putting the child at risk of obesity. Growth monitoring helps ensure that children receive adequate and appropriate nutrition to support optimum growth and development. Children with non-organic feeding disorders (NOFEDs) should be supplied with adequate calories, protein, and other nutrients (nutritional rehabilitation). In children with NOFEDs, oral nutritional supplementation (ONS) can also help if they are unable to meet their nutritional requirements with normal foods alone. Energy- and nutrient-enriched infant formulas have been shown to improve nutrient intake, weight gain and linear growth.

The prevalence of gestational diabetes mellitus (GDM) in Singapore is on the rise and the complications of GDM may have long-term health impacts on a woman and her child. Professor Tan Kok Hian, vice president, Perinatal Society of Singapore, urges the healthcare professionals to play their part to improve the pre- and post-delivery care for our Singaporean mothers and children.