Food pickiness in the elderly: Relationship with dependency and malnutrition

• 23% of the elderly are picky eaters, and 36% among nursing home sample.
• An increase of food selectivity is correlated with an increase of malnutrition risk.
• Food selectivity in the elderly increases as dependency increases.
• 46% of culinary dependent elderly were malnourished or at risk of malnutrition.
• We developed a tool to measure food selectivity easy to administrate in the French elderly.

Among factors contributing to malnutrition in the elderly, the present study aimed at assessing the impact of food selectivity (also referred as food “pickiness”) on the nutritional status of the elderly. A survey with 559 French people over 65 years old was conducted to collect data on food selectivity, dependency and nutritional status. Food selectivity was assessed by asking respondents to tick each food they dislike among a list of familiar foods. Since some foods could be ticked as disliked because elderly people experience physical difficulties in eating these foods, the survey also included self-report assessment about difficulties encountered when eating. Results showed that an increase of food selectivity is correlated with an increase of malnutrition risk, parallel to the effect of eating difficulties on malnutrition. It seems that the eating difficulties have a stronger impact on malnutrition than the food selectivity. However, the prevalence of food selectivity appears to be higher than the prevalence of eating difficulties. Furthermore, we observed that food selectivity increased as dependency increased. Given the fact that food selectivity may increase the risk of malnutrition, and that the number of “picky” eaters is far from being negligible in nursing homes, it seems worthwhile to screen for pickiness when elderly people become culinary dependent (delegation of food-related activities to a caregiver or a home helper, meal home-delivery by a catering service, nursing homes). It may give an opportunity to improve food care dedicated to these persons and in fine to prevent malnutrition.