Examining the association of diet quality, emotional regulation and fussy eating in neurodivergent children aged 1-9 years: a systematic review of evidence

Nutrition plays a key role in brain development in the first 1000–2000 days of life. Furthermore, fussy eating is broadly defined as the inconsistent rejection and acceptance of both familiar and unfamiliar foods. Fussy eating is reportedly found in 10–15% of 2–3-year- old children, although typically starts to decrease in prevalence by 4 years old. Despite this decrease in the general population, children with neurodevelopmental disabilities, such as autism spectrum disorder, can see a protracted continuation of fussy eating and reject approximately 30% more foods than typically developing children. Consequently, for some children with neurodevelopmental disabilities maintaining adequate nutritional intake can be a challenge. Key nutrients for optimal neurodevelopment include iron, omega-3, protein, zinc and folate, and underconsumption of these nutrients can lead to poorer developmental outcomes in some children. Limited empirical evidence has been published on fussy eating in children with neurodevelopmental disabilities and no studies has examined the effects of poor diet variety on their emotional regulation. This study aims to systematically review current evidence to determine the association between fussy eating, diet variety and experiences of emotional regulation in children with neurodevelopmental disability.