The Relationship Between Picky Eater and The Nutrional Status of Preschool Children at Gotong Royong Kindergarden in Surabaya, Indonesia
One of the eating behavior disorders in preschool children is picky eater, a behavior that is picky about food so that children experience limited consumption of a variety of foods. This impacts the nutritional status of children, which can affect their health. Therefore, this study aims to determine the relationship between children's eating behavior disorders (picky eaters) and the nutritional status of preschool children at Kindergarten Gotong Royong Surabaya, Indonesia. This was an observational analytical research with a cross-sectional research design. The sampling method used purposive sampling technique. Data were collected by filling out the CEBQ (Child Eating Behavior Questionnaire) questionnaire and anthropometric measurements of body weight and height, as well as measuring nutritional status using the indicators BB/TB (0-6 months) and BMI/U (>60 months). All data were processed using IBM SPSS v25.0 software with the Spearman rank correlation test. The results of the study showed that 53.6% of preschool children at KB-TK Gotong Royong Surabaya had eating behavior disorders (picky eaters), 46.4% of the children were non-picky eaters, 41.0% had poor nutritional status, and 43.6% had normal nutrition who were mostly non-picky eaters. The bivariate analysis results of the correlation test obtained a p-value of 0.001 (α>0.05). These data showed a relationship between picky eating disorders and the nutritional status of preschool children at Kindergarten Gotong Royong Surabaya.
INTRODUCTION
Nutritional problems in children are still a matter of public concern today This happens because children's eating patterns or eating behavior are still problematic, especially preschool children often experience eating problems. Preschool children often experience eating behavior disorders, which can affect their nutritional status. One of the eating behavior disorders that often occurs is picky eating. Eating behavior disorders are considered normal for some parents because children at preschool age (3-6years) are active consumers. They only choose foods that they recognize and like11.
Children with picky eater behavior have limited food variety by refusing new foods and consuming less protein and fibre, such as fruit and vegetables, than non-picky eater children. Meanwhile, preschoolers are in the "Golden Age", where children are in the growth phase, so that they require adequate nutrition22.
The incidence of picky eaters in China, according to research by Kwon et al (2017)33, was 54% of 1628 picky eater children aged 3-6 years, while in Indonesia, as many as 33.6% of children experienced picky eater eating disorder44, then increased to 44.5%, experienced nutritional deficiencies. In Putri and Muniroh's research (2019), the prevalence of picky eaters in Surabaya was 54.7%55. Picky eater behavior is related to nutritional status. Based on 2018 Riskesdas (Basic Health Research) data, it was found that the prevalence of malnutrition was 17.75%, which still exceeded the reduction target of the 2015-2019 National Medium Term Development Plan (RPJMN)66. In 2020, the only predicted reduction in stunting was 26.9%. In 2021, the nutritional status in Indonesia showed that stunting percentage was 24.4%, wasting 7.1%, and underweight 17.0%. The results of Indonesian Nutritional Status Study (SSGI) found that in Surabaya, East Java, the nutritional status was low on the weight/age index. Weight for age (BB/U): 6,200 cases, height for age (TB/U): 6,722 cases, weight for height (BB/TB): 6,551 cases. Even though there has been a decline, nutritional problems need more treatment so that malnutrition does not increase again77.
Picky eaters can cause nutritional deficiencies in normal and abnormal development conditions, especially micronutrients88. Picky eaters in preschool children cause problems that affect their growth and development. Apart from that, a lack of nutritional intake due to children being picky about food can affect the child's nutritional status. There will be an increased risk of illness, decreased body weight, risk of excess nutrition and even obesity. There can be delays in children's growth and development, decreased intellectual intelligence, digestive disorders and infectious diseases that can cause death99. It can also cause children to experience a lack of red blood cells (anaemia), which can lead to stunting1010. Wijayanti & Rosalina (2018)1111and Nadhirah & Taufiq (2021)1212.showed a significant relationship between picky eater behavior and nutritional status in preschool children.
The aim of this study was to discover more about the relationship between picky eating disorders and the nutritional status of preschool children.
MATERIALS AND METHODS
This study used a cross-sectional design. The minimum number of samples obtained from the Issac & Michael formula calculation was 88 respondents. Sampling was taken using a purposive sampling technique that had been adjusted to the inclusion criteria and exclusion criteria. The inclusion criteria were children aged 3-6 years or 36-72 months, healthy and mothers willing to be respondents, no food allergies, no history of digestive tract infections, especially internal diarrhea, and in the last 1 week, the children were not on cancer treatment or therapy.
The sample obtained was 110 students from a total population of 113 students. The instrument used was a mother and child identity questionnaire, a CEBQ (Child Eating Behavior Questionnaire) sheet containing 35 questions with 8 subscales filled in with a 1-5 Likert scale for each question. This questionnaire had been tested for validity in various countries and had been translated by researchers and tested for validity (0.01-0.04) and reliability (0.937).
Nutritional status was measured by the KEMENKES (ministry of health) standard anthropometric table; the index used was BW/BH (age 36-60 months) and BMI/A (age >60 months). Univariate data analysis is a frequency distribution table, while bivariate analysis used the Spearman rank correlation test with significant correlation is 0,05.
RESULTS
The following is the frequency distribution of child and mother charac-teristics and eating behavior disorders (picky eaters) from 110 respondents. The majority of preschool children were 61-72 months old and male. The average age of the research subjects' mothers was 26-30 years. Most mothers' last education was high school. Mother's employment status was not working. The income level of the parents was high. Based on the number of children, the mothers were included as multiparous mothers, and the number of family members at home was the same size as that of small and medium families.
Most of the students had picky eating behavior, as much as 53.6%. In the cross-tabulation data between charac-teristics and picky eater behavior disorder, it was found that around 47.3% were aged 61-72 months, and the majority were male, with 64 students (58.2%) who experienced picky eating, 53.6%.
No | Child Characteristics | (N) | (%) |
| 1 | Age | ||
36-47 Month | 34 | 30.9 | |
48-60 Month | 24 | 21.8 | |
61-72 Month | 52 | 47.3 | |
| 2 | Gender | ||
Boy | 64 | 58.2 | |
Girl | 46 | 41.8 | |
No | Characteristics Mom | (N) | (%) |
| 1 | Mom's Age | ||
20-25 Years old | 10 | 9.1 | |
26-30 | |||
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