Food selectivity is a behavior observed in both children and adults and involves the refusal or restricted acceptance of food. This behavior may be related to different factors, such as sensory aspects, past experiences, or even health conditions, such as autism. For nutritionists, dealing with patients with dietary selectivity requires a specific approach that considers physical, emotional, and behavioral aspects. In this article, we will explore the nutritionist's role in this process, who are the professionals involved in the treatment, and how to treat patients with dietary selectivity.

What is the nutritionist's role in dietary selectivity?

The nutritionist is a key player in the management of dietary selectivity, whether in children or adults. His role goes beyond prescribing diets: he acts as an educator, helping patients understand the importance of a varied diet for health. In addition, the nutritionist identifies nutritional deficiencies resulting from selectivity and works to correct them through strategies that respect the patient's individuality, limits, and preferences.

When dietary selectivity is associated with clinical conditions, as in the case of autism spectrum disorder, the role of a nutritionist becomes even more important, as these patients may have an even more complex relationship with food. Management needs to be sensitive and welcoming, taking into account the specificities that may interfere with the acceptance of new foods.

Which professionals work in food selectivity?

Although the nutritionist plays a central role, the management of dietary selectivity is often multidisciplinary. Professionals such as psychologists, occupational therapists, and speech therapists may be involved in treatment, especially in cases where selective eating behavior is related to emotional, pathological, behavioral, or sensory issues. This collaboration is essential for the patient to receive comprehensive care, considering not only nutritional aspects, but also psychological and motor aspects.

When is food selectivity a concern?

Dietary selectivity becomes a concern when it impacts the intake and nutritional quality of the diet, in addition to the patient's quality of life. In children, this can be manifested in growth retardation, nutritional deficiencies (such as anemia due to a lack of micronutrients), and difficulties in the family environment during meals. In adults, dietary selectivity may be associated with chronic health conditions, nutritional deficiencies and, consequently, with lower general well-being.

How to meet food selectivity?

When treating patients with dietary selectivity, the nutritionist must adopt an empathetic and patient approach. First, it is essential to carry out a detailed anamnesis, investigating not only accepted and rejected foods and textures, but also the history of dietary introduction, psychological and emotional factors, in addition to possible diagnoses or referrals to other health professionals that may impact eating behavior.

Active listening is critical to understanding the motives behind dietary selectivity. The patient or their caregivers must be involved in the decision-making process about dietary strategies, which may include the creation of a gradual plan for the introduction of new foods, different preparations that include foods with low acceptance, and the use of behavioral techniques, such as positive reinforcement.

How to treat food selectivity?

The treatment of dietary selectivity should be individualized and multidisciplinary whenever possible and necessary, taking into account the particularities of each patient. Some common strategies include:

• Gradual exposure: Introduce new foods little by little, combining them with foods already accepted by the patient.

• Texture modification: For patients who are sensitive to food texture, adjusting the consistency may facilitate acceptance.

• Positive reinforcement: Commend the patient's progress, even if small, creating a more positive relationship with food.

• Development of eating habits: Teach the importance of a varied and balanced diet through nutritional education.

• Encouragement to prepare: Inserting low-accepted foods into preparations that the patient accepts well is a great approach to carry out this introduction. (E.g. Insert zucchini into a chocolate cake).

In more complex cases, such as when autism is diagnosed, the nutritionist can work together with occupational therapists and psychologists to adjust the approach according to the patient's nutritional, physical, sensory, and emotional needs.

Main causes of food selectivity

The causes of food selectivity can be multifactorial. Some of the key factors include:

• Previous negative experiences: Episodes such as gagging can generate fear about certain foods.

• Sensory aspects: The texture, color, smell, or taste of food can be a decisive factor in refusing.

• Clinical conditions: Difficulty swallowing at some point in the patient's life or pathologies may contribute to selectivity.

• Learned behavior: In some cases, selectivity may be reinforced by family or social habits.

Food selectivity: tips for introducing foods

To assist nutritionists in managing patients with dietary selectivity, some practical tips for introducing new foods include:

• Offer foods in different formats (cooked, baked, raw) to explore the patient's sensory preferences.

• Include the patient in meal preparation, which may increase interest in trying new foods.

• Respect the patient's time: repeated exposure without pressure is more effective than forcing ingestion.

Dealing with dietary selectivity is a challenge, but with the right and integrative approach, nutritionists can help their patients develop a healthier and more varied relationship with food. For more technical content about clinical practice, explore the learning trails offered by Vitafor Science University.