Marion Hetherington

• BSc (Hons) DPhil
• Professor Emerita at University of Leeds

Promoting healthy eating improves both planetary and human health, aligning with sustainable development goals. Eating healthy, locally sourced foods that are rich in nutrients and low in energy density produces benefits for public health in the long term and enhances resource sustainability. Despite the importance of increasing intake of fresh fru...

Research shows that features of food packaging can help to promote healthy food choices. Laboratory‐based studies demonstrate that smart design of packaging facilitates portion control. However, the extent to which consumers notice packaging features for portion control is not known. Therefore, this study investigated how individuals interact with...

By 2050, it is predicted that one in four people in the United Kingdom will be aged 65 years and over. Increases in lifespan are not always translated into years spent in good health. Incidence rates for chronic diseases are increasing, with treatments allowing people to live longer with their disease. There is good evidence to support changes to l...

Evidence demonstrates that food packaging attracts consumers to purchase and has the potential to nudge consumers towards healthy choices, including reducing portion size. However, food purchasing decisions are often automatic and packaging features may go unnoticed. Therefore, it is important to understand what consumers identify as most salient a...

In order to increase vegetable intake by children, parents are encouraged to implement strategies that promote trying and eating vegetables at mealtimes. Qualitative studies have previously highlighted barriers parents face in implementing healthy eating practices, such as time, monetary costs and child factors (e.g. fussy eaters). This study aimed...

Purpose To determine the stability of appetitive traits during infancy and their association with early life exposures. Methods Participants were from the BiTwin birth cohort (longitudinal study of Portuguese infants). Appetitive traits at 3 months were measured using the Baby Eating Behaviour Questionnaire (n = 347) and at 12 months with the Chil...

Evidence confirms that parents know that they should limit non-core foods for their children since these tend to be high in energy density (HED), fat, salt and sugar. However, it is unclear how knowledge of portion size limits, such as the 100 kcal guide from Public Health England are applied in practice. To observe in real-time children’s home foo...

Background Many children would benefit from a diet richer in vegetables and fruit. ‘Flavour School’ is a programme of ‘sensory food education’, which aims to increase children’s confidence and curiosity in exploring foods and flavours, especially vegetables and fruit. This study will conduct a cluster-randomised controlled trial to assess the outco...

Background Childhood obesity rates more than double during primary school in England. Acquiring competent cooking skills is a key part of children’s education that can lead to improved knowledge of a healthy lifestyle and dietary behaviours. Evaluation of the impact of ‘PhunkyFoods’, a school-based food and nutrition education programme, will asses...

Background: Starting complementary feeding (CF) with vegetables only may improve vegetable acceptance throughout childhood. Objectives: We aimed to test whether exposure to vegetables only during the first 4 wk of CF increases later vegetable acceptance compared with a control group receiving fruit and vegetables. Methods: In this randomized,...

Purpose of Review To provide a rationale for promoting a vegetables first approach to complementary feeding (CF), building on prior exposure to vegetable flavours experienced in utero and via breastfeeding (chemosensory continuity). Recent Findings Vegetables confer selective health benefits but population intakes are below recommendations globall...

Decisions about what, how much and when to eat are complex processes influenced by many interconnected factors. Appetite traits are the drivers behind these processes, reflecting a complex combination of the internal signals of hunger and/or fullness, with environmental cues, such as attitudes and psychosocial factors related to food selection and...

Dr Leann Birch was a pioneer in conducting research on infant and child eating behaviour. At the beginning of her research career, Leann recognised a significant gap in the developmental psychology literature, namely that few studies had been conducted to understand infant eating and feeding behaviours. This seems an unusual omission given that foo...

The present study was designed to explore consumer perception of food packaging, to investigate specific features they associated with portion control, and to elicit design ideas to improve packaging to support healthy eating and portion control. Participant driven photo-elicitation (PDPE) and in-depth interviews were conducted with 25 adults livin...

Increasing childhood obesity rates in both the United States and worldwide demonstrate a need for better prevention and intervention strategies. However, little is understood about what factors influence children's ability to sense and respond to hunger and fullness cues, a critical component of self-regulation of energy intake and maintenance of a...

Early feeding practices have been related to child's body mass index (BMI), however, their role in establishing dietary patterns is less well understood. The aim of this study was to examine the association of parent-reported early feeding practices (breastfeeding duration, type of foods and timing of complementary feeding) and dietary patterns ide...

Consumers vary in the explanations they give for meal termination. The Reasons Individuals Stop Eating Questionnaire (RISE-Q) was developed to measure these satiation processes. Individual differences in satiation may be associated with a general capacity to recognise and respond to contextual and interoceptive cues. The aims of the present study w...

This study explored the relationship between eating behaviours and diet quality, from 7 to 10y. The sample included 3879 children evaluated, from the Portuguese birth cohort Generation XXI, with complete information on Food Frequency Questionnaire (FFQ) and the Children Eating Behaviour Questionnaire (CEBQ). A healthy eating index (HEI) (range:9–31...

Background: Many children would benefit from a diet richer in vegetables and fruit. ‘Flavour School’ is a programme of ‘sensory food education’, which aims to increase children’s confidence and curiosity in exploring foods and flavours, especially vegetables and fruit. This study will conduct a cluster-randomised controlled trial to assess the outc...

Associative learning predicts that children expect to eat vegetables together with foods high in carbohydrate and protein at mealtimes. However, choosing to eat and consume vegetables may be less likely if they are presented alongside more palatable, competing foods. This study examined food choices of children (N = 180, 8–11 years, 84 female) in a...

Nudge theory predicts that consumers will select smaller portions of high energy density (HED) foods and drinks when packaging presents physical or other limits. To test the feasibility and acceptability of packaging concepts designed to limit portion sizes for children, two mixed methods studies were conducted. Packaging with functional serving si...

Nutritional knowledge, attitudes and practice (KAP) may guide healthy meal choices. Here, nutritional KAP was compared across school students in Sabah based on locality and gender. A cross-sectional survey of students aged 15–19 years was conducted using multistage sampling. Nutritional KAP was measured via questionnaire. Anthropometric measures of...

Background Vegetables as first complementary foods for infants may programme taste preferences that lead to improved vegetable intake in children. Yet few studies have investigated the impact of a ”vegetables first” approach to complementary feeding, especially in New Zealand. The purpose of this randomised control trial is to investigate the effec...

Children eat too few vegetables and this is attributed to disliked flavours and texture as well as low energy density. Vegetables confer selective health benefits over other foods and so children are encouraged to eat them. Parents and caregivers face a challenge in incorporating vegetables into their child's habitual diet. However, liking and inta...

Chronic, excess energy intake contributes to overweight and obesity. Solutions are needed to guide consumers towards portion control, especially for high energy density (HED), palatable foods. Food packaging, a key element of the eating environment, offers a potential solution. To investigate whether packaging design influences measured food intake...

What a mother thinks about her child’s weight status, perceiving healthy or overweight might influence concern about child weight and in turn what and how she feeds her child. We examined the association between maternal perception, concern and dissatisfaction with child weight alongside feeding practices. Participants were from the Generation XXI...

This study explored strategies implemented by parents to encourage their children to eat vegetables, especially when children exhibit fussy eating. The study involved a mixed methods approach using semi-structured interviews with twenty parents of preschool children (aged 2-5 years) with a high and low level of food fussiness (established by questi...

A variety of factors can influence satiation, and individual differences in reasons for meal termination may help to explain variability in food intake and susceptibility to overconsumption. We developed and validated a questionnaire to characterize the Reasons Individuals Stop Eating (RISE-Q). The initial RISE-Q was created by reviewing the publis...

Children's vegetable consumption is generally below national recommendations in the UK. This study examined predictors of vegetable intake by children aged 1.5-18 years using counts and portion sizes derived from four-day UK National Diet and Nutrition Survey food diaries. Data from 6,548 children were examined using linear and logit multilevel mod...

Chronic excess energy intake contributes to the development of overweight andobesity. Solutions are needed to guide consumers towards reducing food intake,especially high energy density (HED) and highly palatable foods. Food packaging, akey element of the eating environment, offers a potential solution to assist consumersin portion control. To inve...

Mothers' responsiveness to hunger and fullness cues has been implicated in the development of infant overweight, and baby led weaning (BLW) is argued to be one way to protect against overfeeding. Whilst studies have examined maternal perceptions of hunger, fullness and adequate intake to some degree in traditional weaning (TW) contexts, less is kno...

Infants communicate complex aspects of appetite through a variety of behaviors. In newborn babies, mouthing and orientation towards odors from breast milk signal preference, whereas in older infants likes and dislikes are signaled via facial expressions. Infants communicate readiness to eat by sucking their hands and eliciting the hunger cry, and i...

Caregivers are mostly responsible for the foods young children consume; however, it is unknown how caregivers determine what portion sizes to serve. This study examined factors which predict smaller or larger than recommended snack portion sizes in an online survey. Caregivers of children aged 2 to 4 years were presented with 10 snack images, each...

Caregivers are responsible for the type and amount of food young children are served. However, it remains unclear what considerations caregivers make when serving snacks to children. The aim of the study was to explore mothers’ decisions and portion control strategies during snack preparation in the home environment. Forty mothers of children aged...

Large portion sizes have been identified as contributing to overweight and obesity, particularly in children and adolescents. This study examined predictors of portion sizes of high energy snack foods eaten by children aged 1.5–18 years. Specifically, we examined whether portion sizes were adjusted for age, and what external features of the environ...

Environmental cues, such as the colour of food and dishware, have been shown to influence food and drink consumption in adult populations. This proof of concept study investigated whether plate colour could be utilised as a strategy to reduce intake of high energy density (HED) snacks and increase intake of low energy density (LED) snacks in pre-sc...

Offering large portions of high energy dense (HED) foods increases overall energy intake in children, a potentially important contributing factor to childhood overweight and obesity. Packaging offers a simple heuristic to encourage healthy eating for nutrient dense foods and to downsize portions of HED foods. However, it is not clear how parents us...

Infants communicate complex aspects of appetite through a variety of behaviors. In newborn babies, mouthing and orientation towards odors from breast milk signal preference, whereas in older infants likes and dislikes are signaled via facial expressions. Infants communicate readiness to eat by sucking their hands and eliciting the hunger cry, and i...

Objective: Adolescents and young adults select larger portions of energy-dense food than recommended. The majority of young people have a social media profile, and peer influence on social media may moderate the size of portions selected. Methods: Two pilot interventions examined whether exposure to images of peers' portions of high-energy-dense...

Background. People with developmental disorders (DD) often display high levels of selective eating, which can result in micronutrient deficiencies. It is therefore essential to explore ways to increase dietary variety in this population. Aims. To identify different types of interventions promoting increased acceptance of new foods or dietary variet...

Background: Most children eat fewer vegetables than recommended. Storybooks and sensory play may increase vegetable intake. Objective: This study tested the effects on intake of learning about an unfamiliar vegetable (celeriac) through storybooks and sensory play. It was predicted that an illustrated, congruent storybook would increase intake of...

Food material properties play an important role in sensory perception and consumer acceptance of foods. However, the actual oral processing behavior may depend on both the material properties of the food that is being consumed and individuals' oral capabilities. This study aimed to examine the relationships between intrinsic (oral capabilities of h...

Background: Intake of vegetables in children remains low. Objective: To compare taste exposure (TE), nutrition education (NE) and TE+NE together on intake of an unfamiliar vegetable (mooli/daikon radish) in preschool-aged children. Design: Children attending 11 preschools in England were randomly assigned by clusters to four intervention condi...

The portion size effect (PSE), where more is eaten when large amounts are offered, is robust, reliable and enduring. Although it is not known what drives the PSE, amount served may act as a guide to how much should be eaten. Over time, consumers become accustomed to particular amounts of food as the ‘social norm’ and so large portion sizes are trea...

Visual cues such as plate size, amount of food served and packaging are known to influence the effects of portion size on food intake. Unit bias is a well characterised heuristic and helps to determine consumption norms. In an obesogenic environment where large portions are common place, the unit or segmentation bias may be overridden promoting ove...

Background: Although most children do not meet vegetable intake recommendations no clear universal guidelines exist on the best method of introducing and promoting vegetables in infants. Objective: To identify strategies to promote vegetable acceptance in children from the start of complementary feeding until 3 years of age. Design: A comprehe...

Abstract Objective: Adolescents and young adults select larger portions of energy-dense food than recommended. The majority of young people have a social media profile, and peer influence on social media may moderate the size of portions selected. Methods: Two pilot-interventions examined whether exposure to images of peers’ portions of high-energ...

As overeating, overweight and obesity remain public health concerns, it is crucial to design satiety-enhancing foods that suppress appetite and lower snack intake. Existing research identifies oro-sensory targets to promote satiation and satiety, yet it remains unclear as to whether it is ‘chewing’ or ‘oral lubrication’ that might amplify satiation...

Abstract The examination of specific characteristics of eating habits in childhood and its influence on eating behaviours is needed to better understand the establishment of appetite-related eating behaviours. This study aimed to assess the association between eating frequency (EF) (main meals vs. snacks) at 4 and 7y and problematic eating behavio...

Large portions of energy dense foods promote overconsumption but offering small portions might lead to compensatory intake of other foods. Offering a variety of vegetables could help promote vegetable intake and offset the effect of reducing the portion size (PS) of a high energy dense (HED) food. Therefore, we tested the effect on intake of reduci...

Infant gaze serves as a measure of attention to food cues in adults and children and may play a role in signalling infant hunger and satiation. Maternal responsiveness to infant satiation cues, including gaze, supports healthy appetite development and may reduce obesity risk. However, mothers often experience difficulty in interpreting feeding cues...

Large portions of high energy dense (HED) snacks are offered to children from a young age and are pervasive in our food environment. This study aimed to explore the feasibility, acceptability, and preliminary efficacy of two strategies of snack portion control: reduction and replacement. Forty-six mother-child dyads aged 22–56 months (36.6 ± 9.5 m,...

Influence of both chewing and lubrication during oral processing of hydrogels on hunger and energy intake - Volume 77 Issue OCE4 - E.M. Krop, M.M. Hetherington, S. Miquel, A. Sarkar

It is widely accepted that oral processing is an important factor in the regulation of food intake, with slow eating rate, high number of chews, longer oro-sensory exposure, smaller bites and harder food textures being recommended for decreasing the energy intake(1). However, the effects of oral lubrication remain unclear. This study aimed to deter...

Children's vegetable consumption in the UK remains lower than national recommendations, presenting potential long-term health risks. It is known that repeated exposure promotes intake of novel vegetables and that offering children variety and choice can also encourage intake. The current study aimed to compare the impact of offering variety over si...

The aim of this study was to understand the relationship between rheological, tribological and sensory properties (n = 11 panellists) of hydrogels differing in hydrocolloid type, concentration and degree of inhomogeneity. Fracture properties of hydrogels containing different ratios of κ-carrageenan (κC) and/or locust bean gum (LBG), sodium alginate...

Objectives: The study had two main objectives: (a) track changes in self-esteem, eating behaviours and body satisfaction from early pregnancy to 24 months postpartum and (b) to compare changes by context (Israel vs. UK) and maternal body mass index (BMI). Background: High maternal BMI is associated with negative body image and restrained eating, wh...

As overeating, overweight and obesity remain public health concerns, it is crucial to design satiety-enhancing foods that suppress appetite and lower snack intake. Existing research identifies oro-sensory targets to promote satiation and satiety within the “satiety cascade” yet it remains unclear as to whether it is ‘chewing’ or ‘oral lubrication’...

As overeating, overweight and obesity remain public health concerns, it is crucial to design satiety-enhancing foods that suppress appetite and lower snack intake. Existing research identifies oro-sensory targets to promote satiation and satiety within the “satiety cascade” yet it remains unclear as to whether it is ‘chewing’ or ‘oral lubrication’...

Overfeeding in infancy may lead to overweight and obesity in later childhood. Mothers are advised to "tune in" to their infant's hunger, appetite and satiation cues to prevent overfeeding. The present study aimed to 1) assess stability and change in infant hunger and satiety cues (first two years of life) taken at six monthly intervals; 2) track th...

In a 1987 paper, addressing questions about factors that influence the initiation, maintenance, and termination of food intake, we wrote, "development of systematic procedures to measure eating behaviour is essential if descriptive and inferential statistics are to be applied to answering such questions, giving them power and replicability" (Hether...

Offering large portions of high-energy-dense (HED) foods increases overall intake in children and adults. This is known as the portion size effect (PSE). It is robust, reliable and enduring. Over time, the PSE may facilitate overeating and ultimately positive energy balance. Therefore, it is important to understand what drives the PSE and what migh...