Food Neophobia and Adherence to Dietary Recommendations Among Children and Adolescents with Obesity Attending a Tertiary Pediatric Center in Western Romania: A Cross-Sectional Study

Background/Objectives: Food neophobia, the reluctance to try unfamiliar foods, may restrict dietary variety and complicate the dietary treatment of pediatric obesity. We described caregiver-reported food neophobia in children and adolescents with obesity recruited from the Pediatric Endocrinology and Obesity Outpatient Service of the “Louis Țurcanu” Emergency Clinical Hospital for Children, Timișoara, a tertiary referral center serving Western Romania, and examined its association with adherence to standardized dietary recommendations. Methods: In this cross-sectional study, caregivers of 90 children and adolescents (2–18 years) completed the 10-item Romanian Food Neophobia Scale (FNS) and rated adherence three months after the recommendations had been given. Associations were tested with non-parametric tests (Holm-adjusted) and logistic regression, with penalized, ordinal and multiple-imputation sensitivity analyses. Results: The mean FNS score was 37.0 ± 9.6 (median 39.0); internal consistency was moderate (α = 0.68). FNS was inversely correlated with adherence (ρ = −0.334; p = 0.002; n = 83). Each 10-point FNS increase was associated with higher odds of poor adherence after adjustment for age, sex and residence (OR 4.26; 95% CI 1.72–10.55; n = 81), with consistent estimates in Firth-penalized (OR 3.62), ordinal and multiple-imputation (OR 3.95; n = 90) analyses and after adjustment for parental education. FNS was not associated with sex or BMI-for-age z-score; exploratory associations with rural residence and paternal education did not survive correction for multiple testing. Conclusions: Caregiver-reported food neophobia was associated with poorer caregiver-reported adherence to dietary recommendations. Because of the cross-sectional design and the shared informant, whether assessing neophobia can improve dietary treatment requires prospective validation.