Frequency of Picky Eaters among Egyptian Preschool Children and its Association with Iron Profile

Background: Picky eating (PE) behavior is a prevalent feeding issue among preschool children, often characterized by a limited dietary variety, food refusal, and food neophobia. It may contribute to nutritional deficiencies and negatively impact growth, particularly during the critical developmental years of early childhood. Iron deficiency, a common concern in this age group, may be associated with picky eating behavior, yet the relationship has not been extensively explored in the Egyptian pediatric population. Objective: To determine the frequency of picky eating among Egyptian preschool children aged 1 to 5 years and to assess its association with socio-demographic characteristics, anthropometric measures, dietary habits, and iron profile parameters including serum iron, total iron-binding capacity (TIBC), and ferritin. Methods: A cross-sectional study was conducted on 100 preschool children attending the pediatric outpatient clinic, Ain Shams University Hospitals selected by simple random method during the period from August 2024 to February 2025. Data collection included detailed history taking, anthropometric measurements, child eating behavior questionnaire (CEBQ), and laboratory analysis of iron profile parameters. Statistical analysis was performed using SPSS, and significance was considered at p < 0.05. Results: Among the studied children, 53% were identified as picky eaters. Significant differences were observed between picky and non-picky groups in terms of age, height, weight, BMI, and several iron-related biomarkers. Picky eaters had significantly lower values in serum iron (median 46 vs. 62 µg/dL, p = 0.013), ferritin (median 13 vs. 19 ng/mL, p = 0.005). Conclusions: Picky eating behavior is common among Egyptian preschool children and is significantly associated with poorer growth metrics and lower iron profile. These findings underscore the need for early screening and nutritional intervention strategies in this population to prevent potential long-term developmental consequences.