Lucy J Cooke

Great Ormond Street Hospital for Children NHS Foundation Trust | GOSH · Department of Child and Adolescent Mental Health (DCAMHS)

Beverage preferences are an important driver of consumption, and strong liking for beverages high in energy (e.g. sugar-sweetened beverages [SSBs]) and dislike for beverages low in energy (e.g. non-nutritive sweetened beverages [NNSBs]) are potentially modifiable risk factors contributing to variation in intake. Twin studies have established that b...

Feeding problems in young children are common and although they are a cause of significant worry to many parents, most will resolve without intervention by health professionals. Some of the most frequently reported problems are picky eating, neophobia (refusal to eat new foods), dislike of certain food textures or food groups (usually vegetables!)...

Purpose of review: This review examines the concepts of fussy eating and food neophobia in the context of key determinants of the development of children's food preferences. We discuss the evidence for genetic versus parental and other environmental influences on the ontogeny of these behavioural traits and the implications of current knowledge fo...

Table S1. Items on the CEBQ used to calculate Food Neophobia and Food Fussiness scores. Table S2. Parameter estimates (95% confidence intervals) for A, C, and E for males and females considering qualitative and quantitative sex differences in food neophobia. Table S3. Parameter estimates (95% confidence intervals) for A, C, and E for males and fe...

Appendix S1. STROBE statement – list of items that should be included in reports of cohort studies. Appendix S2. Flow of families through the Gemini study between 2007 and 2011.

Background: 'Food fussiness' (FF) is the tendency to be highly selective about which foods one is willing to eat, and emerges in early childhood; 'food neophobia' (FN) is a closely related characteristic but specifically refers to rejection of unfamiliar food. These behaviors are associated, but the extent to which their etiological architecture o...

On 5 May 2016, the British Nutrition Foundation (BNF) invited leading infant feeding experts to discuss and debate the strength of the evidence base on a ‘vegetables first’ approach to complementary feeding. Consensus was reached on the translation of the science into practical messages for parents/carers. In particular, it is known that familiaris...

Background: Food preferences vary substantially among adults and children. Twin studies have established that genes and aspects of the shared family environment both play important roles in shaping children's food preferences. The transition from childhood to adulthood is characterized by large gains in independence, but the relative influences of...

Obesity has reached epidemic proportions and research into its prevention is increasingly focusing on the earliest stages of life. Avidity of appetite has been linked to a higher risk of obesity, but studies in infancy were scarce. The Gemini twin cohort was established to investigate genetic and environmental determinants of weight trajectories in...

Background: Food fussiness (FF) is common in early childhood and is often associated with the rejection of nutrient-dense foods such as vegetables and fruit. FF and liking for vegetables and fruit are likely all heritable phenotypes; the genetic influence underlying FF may explain the observed genetic influence on liking for vegetables and fruit....

Background: Appetitive traits and food preferences are key determinants of children's eating patterns but it is unclear how these behaviours relate to one another. This study explores relationships between appetitive traits and preferences for fruits and vegetables, and energy dense, nutrient poor (noncore) foods in two distinct samples of Austral...

Research suggests that repeatedly offering infants a variety of vegetables during weaning increases vegetable intake and liking. The effect may extend to novel foods. The present study aimed to investigate the impact of advising parents to introduce a variety of single vegetables as first foods on infants' subsequent acceptance of a novel vegetable...

Background: The present study aimed to explore parental perceptions of overweight children and associated health risks after receiving National Child Measurement Programme (NCMP) weight feedback. / Methods: Fifty-two parents of overweight and obese children aged 4–5 years and 10–11 years enrolled in the NCMP programme in England in 2010–2011 partic...

Introduction: Fruit and vegetable (FV) consumption may reduce mortality risk but UK children’s intake is below recommendations. Identification of determinants of children’s FV intake may inform strategies to facilitate its increase. Methods: This cross-sectional study, conducted in 60 preschools and children’s centres in London in 2008, investigat...

Fussy eating is common in early childhood and is associated with unhealthy dietary patterns; in particular a decreased preference for vegetables and fruits. Food preferences and fussiness are heritable in childhood. Observed associations between these phenotypes could be because there are common genes that influence them all. To quantify the extent...

Fruit/vegetable consumption in childhood has wide ranging implications including decreased risk of childhood obesity. Few studies have sought to predict children's intention and behaviour related to fruit/vegetable consumption in the context of weight status. This study sought to test the utility of the Theory of Planned Behaviour (TPB) for the pre...

Research suggests that repeatedly offering infants a variety of vegetables early during weaning, increases intake and liking of these vegetables and may facilitate acceptance of novel foods. Sixty mothers of 4–6 month old infants were randomised to an intervention group who were given guidance on introducing vegetables as first weaning foods, or a...

Background The present study aimed to explore parental perceptions of overweight children and associated health risks after receiving National Child Measurement Programme (NCMP) weight feedback. Methods Fifty-two parents of overweight and obese children aged 4–5 years and 10–11 years enrolled in the NCMP programme in England in 2010–2011 participat...

Health professionals identify food provision in the home as a key influence on children's food preferences. In contrast, parents often perceive children's food preferences to be inborn. One explanation for this discrepancy could be that environmental and genetic influences vary by food type. We assessed genetic and environmental contributions to pr...

The Food Neophobia Scale (FNS) is widely used in different countries, however appropriate psychometric analyses are required to allow cross-cultural comparisons. To our knowledge, most studies have been conducted among children and adult populations, with no reference to pregnant women. The objective of this study was to translate and test the psyc...

Background: As dietary gatekeepers for young children, parents are often the proximal target of family-based dietary interventions. Habit theory offers a novel approach to modifying parental feeding, based on ‘context-dependent repetition’ to promote automatic responding and reduce decisional conflict. Objective: This exploratory trial (ISRCTN0991...

The diets of preschool children are a cause for concern, with low intakes of fruit and vegetables and high intakes of sugary foods and drinks. A poor diet in early life can have a substantial effect on a child's immediate and longer term health and contributes to broader health inequalities. The aim of this study was to develop, implement, and asse...

Repeated taste exposure, in combination with small rewards, has been shown to increase children's acceptance of disliked foods. However, previous studies have used direct contact with researchers or professionals for the implementation of the repeated exposure procedure. If mailed taste exposure instructions to parents produced comparable outcomes,...

Résumé présenté lors du 20e congrès international de nutrition à Grenade (Espagne) du 15 au 20 septembre 2013.

Résumé présenté lors du 20e congrès international de nutrition à Grenade (Espagne) du 15 au 20 septembre 2013

This review article aims to pull together the latest research and guidelines regarding weaning infants from breast or bottlefeeding onto solid foods. It summarizes the guidelines from the World Health Organisation, Department of Health and the British Dietetic Association. It also attempts to capture the changes to guidelines as the understanding o...

As dietary gatekeepers for young children, parents are often the proximal target of family-based dietary interventions. Habit theory offers a novel approach to modifying parental feeding, based on "context-dependent repetition" to promote automatic responding and to reduce decisional conflict. This exploratory trial evaluated an intervention promot...

Good nutrition in the early years of life is vitally important for a child's development, growth and health. Children's diets in the United Kingdom are known to be poor, particularly among socially disadvantaged groups, and there is a need for timely and appropriate interventions that support parents to improve the diets of young children. The Medi...

In a recent study, we showed that nonfood incentives combined with taste exposure increase children's acceptance of vegetables. However, the impact of children's previous experience of receiving food rewards is unknown. The present study investigated whether the experience of food rewards affects responses to an exposure-plus-reward intervention. O...

Objective: Misperception of social norms may result in normalising unhealthy behaviours. The present study tested the hypothesis that parents overestimate both the frequency of unhealthy snacking in pre-school children other than their own (descriptive norms) and its acceptability to other parents (injunctive norms). Design: A cross-sectional, s...

Strategies to achieve healthier diets for children are likely to benefit from an understanding of the determinants. We examined environmental and individual predictors of children's intake of 'core' foods (fruit and vegetables) and 'non-core' foods (snacks and sweetened beverages). Predictors included parental intake, home availability, parental fe...

The use of rewards to encourage children to eat healthily is controversial. However, researcher-led interventions have shown that incentives combined with taste exposure can increase both intake and liking. To date, this has not been tested in the home setting. The objectives were to test the hypothesis that parent-administered repeated taste expos...

Using rewards in child feeding is commonplace and viewed as effective by parents, although some express concern about using 'bribery'. Psychological and economic theorists emphasize the beneficial effects of rewards in enhancing performance, although, there is evidence that the offer of rewards undermines intrinsic motivation and decreases enjoymen...

Objective: To examine whether parents offering a sticker reward to their child to taste a vegetable the child does not currently consume is associated with improvements in children's liking and consumption of the vegetable. Design: A randomized controlled trial evaluated the effectiveness of exposure only (EO) and exposure plus reward (E + R), r...

Parental feeding behaviours are considered major influences on children's eating behaviour. However, many questionnaire studies of feeding neglect subtle distinctions between specific feeding strategies and practices in favour of eliciting general feeding goals, and do not take account of the context provided by parents' motivations. These factors...

An individual's experience of flavours contributes to their unique pattern of food preferences. Exposure to a specific flavour can increase familiarity and result in greater acceptance of this flavour over time. This paper describes the earliest occurrences of flavour exposure; first in utero, via amniotic fluid, and later through breast or formula...

Associations between appetite and adiposity have not been examined in clinical samples of obese children. The Children's Eating Behaviour Questionnaire (CEBQ) was used to compare appetite in community (n=406) and clinical (n=66) samples. Clear graded patterns were seen for food responsiveness and emotional overeating; levels increased with increasi...

Parents commonly use rewards to encourage children to eat healthfully, but this practice remains controversial because rewards are suspected of undermining children's intrinsic motivation. A cluster-randomized trial examined children's acceptance of a disliked vegetable over 12 daily taste exposures. These exposures were paired with a tangible rewa...

Research has documented an association between family mealtimes and higher dietary quality in school-aged children and adolescents. However, there is little understanding of the specific characteristics of mealtimes that are beneficial and a lack of research with preschool-aged children. This cross-sectional study conducted in the United Kingdom in...

The aim of this study is to explore mothers' perceptions of differences between their children in the eating behaviour domain. Twelve semistructured interviews were carried out with mothers who had at least two children aged between 6 and 15 years, to discuss feeding experiences, particularly around healthy eating. Interviews were recorded and tran...

A case of rumen acidosis in non-lactating cattle is reported. This was due to the fact that stale bread was fed ad lib, rather than concentrates. Of seventy animals, fourteen died or were slaughtered. The meat was declared unfit for human consumption in every case.

This study explored associations between child eating behaviors and maternal feeding practices, specifically testing the hypotheses that maternal "restriction" is associated with having a child with stronger food approach tendencies (eg, overresponsiveness to food), and maternal pressure to eat is associated with having a child with food avoidant t...

Parental control has been hypothesized to cause weight gain in children by weakening self-regulatory processes. However, most studies that link control with weight have been cross-sectional, and therefore causation is uncertain. It remains possible that parental control is a response to child overweight rather than a cause. We investigated the dire...

To determine whether controlling parental feeding practices are associated with children's adiposity and test the hypothesis that any associations are mediated by maternal perception of their child's weight. Children aged 7-9 years (n=405) were weighed and measured at school as part of the Physical Exercise and Appetite in CHildren Study (PEACHES)....

To evaluate the effect of social norms on intended fruit and vegetable intake. A two-stage design to i) compare the perceived importance of normative influences vs cost and health on dietary choices, and ii) test the prediction that providing information on social norms will increase intended fruit and vegetable consumption in an experimental study...

It is often assumed that heightened liking for energy-dense foods contributes to the development of obesity, however previous findings on the association between adiposity and liking among common foods are inconclusive in adults and there is limited research in children. Therefore the present study assessed the association between adiposity and lik...

Childhood obesity has increased steadily over recent years and has coincided with a general trend towards larger portions of foods consumed both inside and outside the home. A causal link between portion size and weight gain has not been established, although there is evidence of an association between larger portions and greater energy intake. The...

Interest in soft drink consumption has increased following a dramatic rise in intake over recent years. Research to date has focused primarily on general trends in consumption or on understanding the mechanism by which soft drink consumption may be linked to weight gain. It is clear however that there is considerable individual variability in the e...

Coronary heart disease is the leading cause of death worldwide affecting millions of people in both developed and developing countries. The dual aims of this book are to review the well-established and emerging risk factors in coronary heart disease (CHD) and to apply this knowledge to public health approaches to disease prevention. The book includ...

Omnivores have the advantage of a variety of food options but face a challenge in identifying foods that are safe to eat. Not surprisingly, therefore, children show a relative aversion to new foods (neophobia) and a relative preference for familiar, bland, sweet foods. While this may in the past have promoted survival, in the modern food environmen...

To examine changes in public perceptions of overweight in Great Britain over an eight year period. Comparison of data on self perceived weight from population surveys in 1999 and 2007. Household surveys of two representative samples in Great Britain. 853 men and 944 women in 1999, and 847 men and 989 women in 2007. Participants were asked to report...

Food neophobia in children has been associated with a low intake of fruit, vegetables, and protein foods. The design of effective interventions to improve children's diets would be facilitated by a better understanding of the determinants of neophobia. Our objective was to quantify the contribution of genetic and environmental differences to variat...

Children's food preferences are strongly associated with their consumption patterns. Identifying the factors that influence preferences is therefore crucial to the development of effective interventions to improve children's diets. Perhaps the most important determinant of a child's liking for a particular food is the extent to which it is familiar...

Background: Previous research has documented a negative association between maternal report of child food neophobia and reported frequency of consumption of fruit, vegetables, and meat. This study aimed to establish whether neophobia is associated with lower intake of these food types in naturalistic mealtime situations. Methods: One hundred and ni...

Previous research has documented a negative association between maternal report of child food neophobia and reported frequency of consumption of fruit, vegetables, and meat. This study aimed to establish whether neophobia is associated with lower intake of these food types in naturalistic mealtime situations. One hundred and nine parents of 4-5 yea...

Introduction It is estimated that at least 300 million people worldwide are obese and two to three times more are overweight [1]. Rates vary enormously from country to country, but the situation in the USA is particularly alarming: current figures suggest that over 65% of US adults are overweight, of whom over 30% are obese (body mass index [BMI] ≥...

Children and adolescents with obesity face stigmatization and discrimination in many areas of their lives, and it has been assumed that their psychological well-being will be compromised as a result. This chapter examines the most recent empirical evidence on the relationship between childhood obesity and body dissatisfaction, self-esteem and depre...

The present study was conducted to examine the developmental patterning of food preferences in a large sample of British schoolchildren and to investigate possible gender differences. Using a cross-sectional survey design, the study was carried out in three primary and three secondary schools in West London, UK. A total of 1291 children aged from 4...

To replicate the finding of a negative association between parental control and fruit and vegetable consumption in girls. To extend the investigation to boys and examine sex differences. To test the hypothesis that children's food neophobia explains this association. Cross-sectional questionnaire survey. The questionnaire included items assessing p...

To examine the contribution to fruit and vegetable eating in children of potential predictive variables within the domains of demographics, parental feeding practices and personality traits. Cross-sectional survey. Questionnaires were distributed to parents through 22 London nursery schools. Questionnaires were completed and returned by 564 parents...

The development of children's food preferences involves a complex interplay of innate, familial and environmental factors, not all of which are likely to promote a healthy and varied diet. Parents employ a variety of strategies to improve their children's eating habits some of which have been found to be counter-productive. Over-control, the offeri...

Despite considerable epidemiological evidence of the health benefits of a diet high in fruit and vegetables, consumption in pre-school children remains well below recommended levels. This study evaluated the effectiveness of an exposure-based intervention, carried out by parents in the home, in increasing children's liking for a previously disliked...

The aim of this study was to evaluate two interventions (one reward-based and one exposure-based) for increasing children's acceptance of an unfamiliar vegetable compared with a no-treatment control. It was predicted that the exposure condition would increase liking for, and consumption of, the vegetable relative to either the reward or control gro...

Lung function, adherence and denial were explored in asthma patients who possess a repressive coping style (repressors). Repressors (low trait anxiety, high defensiveness) and non-repressors were identified by their trait anxiety and defensiveness scores. Participants completed measures of self-reported adherence, denial, morbidity and demographic...

Editor—We are concerned that Abbasi's website of the week review on the article by Wright et al may have left both health professionals and the public with the erroneous impression that obesity in (peripubescent) childhood does not predict obesity in later life and is not a cause for concern.1,2

Introduction Global prevalence of obesity is increasing rapidly, with rates in low-and middle-income countries catching up with those in richer nations. In 2010, roughly 42 million children under five were estimated to be overweight or obese, of whom almost 35 million were from developing countries. 1 The simple explanation for the obesity epidemic...