Literature Review

Food neophobia and 'picky/fussy' eating in children: A review

Article· Literature Review (PDF Available)inAppetite 50(2-3):181-93 · March 2008with 4,962 Reads 
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DOI: 10.1016/j.appet.2007.09.009 · Source: PubMed
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Two factors have been shown to contribute to rejection or acceptance of fruits and vegetables: food neophobia and 'picky/fussy' eating. Food neophobia is generally regarded as the reluctance to eat, or the avoidance of, new foods. In contrast, 'picky/fussy' eaters are usually defined as children who consume an inadequate variety of foods through rejection of a substantial amount of foods that are familiar (as well as unfamiliar) to them. Through understanding the variables which influence the development or expression of these factors (including age, personality, gender, social influences and willingness to try foods) we can further understand the similarities and differences between the two. Due to the inter-relationship between 'picky/fussy' eating and food neophobia, some factors, such as pressure to eat, personality factors, parental practices or feeding styles and social influences, will have similar effects on both magnitude and duration of expression of these behaviours. On the other hand, these constructs may be differentially affected by factors such as age, tactile defensiveness, environment and culture. The effects of these variables are discussed within this review. Behavioural interventions, focusing on early life exposure, could be developed to attenuate food neophobia and 'picky/fussy' eating in children, so promoting the ready acceptance and independent choice of fruits and vegetables.
Appetite 50 (2008) 181–193
Research Review
Food neophobia and ‘picky/fussy’ eating in children: A review
Terence M. Dovey
, Paul A. Staples
, E. Leigh Gibson
, Jason C.G. Halford
Department of Psychology, Staffordshire University, College Road, Stoke-on-Trent, Staffordshire ST4 2DE, UK
Department of Psychology, University of Derby, Western Road, Mickleover, Derby DE3 9GX, UK
Clinical and Health Psychology Research Centre, School of Human and Life Sciences, Whitelands College, Roehampton University,
Holybourne Avenue, London SW15 4JD, UK
Kissileff Laboratory for the Study of Human Ingestive Behaviour, School of Psychology, University of Liverpool, Eleanor Rathbone Building,
Bedford Street South, Liverpool L69 7ZA, UK
Received 18 August 2006; received in revised form 1 June 2007; accepted 24 September 2007
Two factors have been shown to contribute to rejection or acceptance of fruits and vegetables: food neophobia and ‘picky/fussy’
eating. Food neophobia is generally regarded as the reluctance to eat, or the avoidance of, new foods. In contrast, ‘picky/fussy’ eaters are
usually defined as children who consume an inadequate variety of foods through rejection of a substantial amount of foods that are
familiar (as well as unfamiliar) to them. Through understanding the variables which influence the development or expression of these
factors (including age, personality, gender, social influences and willingness to try foods) we can further understand the similarities and
differences between the two. Due to the inter-relationship between ‘picky/fussy’ eating and food neophobia, some factors, such as
pressure to eat, personality factors, parental practices or feeding styles and social influences, will have similar effects on both magnitude
and duration of expression of these behaviours. On the other hand, these constructs may be differentially affected by factors such as age,
tactile defensiveness, environment and culture. The effects of these variables are discussed within this review. Behavioural interventions,
focusing on early life exposure, could be developed to attenuate food neophobia and ‘picky/fussy’ eating in children, so promoting the
ready acceptance and independent choice of fruits and vegetables.
r2007 Elsevier Ltd. All rights reserved.
Keywords: Children’s eating; Food neophobia; ‘Picky/fussy’ eating; Social facilitation
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 182
Food neophobia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 183
Food neophobia and age . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 183
Food neophobia, personality and gender. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 184
Food neophobia, social facilitation and social influence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 185
Food neophobia and willingness to try novel foods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 187
Picky/fussy eaters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 187
Measuring ‘picky/fussy’ eaters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 187
Development of the ‘picky/fussy’ eater . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 188
The diet of ‘picky/fussy’ eaters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 189
Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 189
Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 190
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 190
0195-6663/$ -see front matter r2007 Elsevier Ltd. All rights reserved.
Corresponding author. Department of Psychology, Staffordshire University, College Road, Stoke-on-Trent, Staffordshire ST4 2DE, UK.
E-mail address: (T.M. Dovey).
Despite comparative wealth and general affordability of
foodstuffs in the Western world, concern has arisen over
the composition and lack of diversity seen in some
children’s diets. Some authors have suggested that the lack
of dietary variety in children’s diets is directly associated
with intake of certain foodstuffs. Specifically in these
children, intake of fresh produce such as fruits and
vegetables is replaced by unhealthy processed foods
characterised by their high hedonic value that results from
their sugar, fat and salt content (Dennison, Rockwell, &
Baker, 1998;Fisher & Birch, 1995). This limited but energy
dense (and presumably) hyper-caloric diet is widely
considered to be a key contributing factor to the rise in
the rates of childhood obesity (Falciglia, Couch, Gribble,
Pabst, & Frank, 2000;Rigal et al., 2006) as well as the
increase in the prevalence of non-communicable diseases
(e.g. type II diabetes) in children (Kaufman, 2002). Thus,
Western health care systems are faced with the strange
paradox of excessive childhood weight gain accompanied
by essential nutrient deficiency in a substantial part of their
patient population (Carruth et al., 1998).
Although the recommended daily intake of fruit and
vegetables varies between countries, the general suggestion
is that children, as well as adults, should consume at least
five portions a day (Lassen, Thorsen, Trolle, Elsig, &
Ovesen, 2003;Steinmetz & Potter, 1996). However, the
consistent picture is that many children do not consume the
recommended number of portions of fruit and vegetables
and therefore are not getting sufficient micronutrients and
fibre essential for normal healthy development. Worry-
ingly, there appears to be no sign of an improvement in
consumption of fruits and vegetables by children, despite
ubiquitous 5-a-day messages and small increases among
some adult populations (Cockroft, Durkin, Masding, &
Cade, 2005;Sproston & Mindell, 2006). Not only is the diet
of these children deficient, but they may also be learning
inappropriate feeding behaviours and food choices from
significant others (Cullen, Rittenberry, Olvera, & Bara-
nowski, 2000). Given that these early eating habits may be
predictive of those in adulthood (Kelder, Perry, Klepp, &
Lytle, 1994), they will ill-protect the child now, and, in the
future, from the obesigenic environment into which they
have been born.
In an effort to deal with this issue, both Government
and media have focused on increasing the fruit and
vegetable consumption of children. This focus has gen-
erally raised awareness of the benefits of healthy consump-
tion of fruit and vegetables within Western populations.
However, attempts to instil more appropriate feeding
behaviour in children can prove difficult. Infants’ innate
food preferences and their development of taste perception
provide an inbuilt barrier to the acceptance of certain
types of foods. Thus, it may often be counterproductive
to push a child to consume when they are rejecting
novel foods offered to them (Galloway, Lee, & Birch,
2003). A stressful feeding encounter is not likely
to stimulate a positive response from the child to novel
and/or aversive tasting foods (Fisher & Birch, 1999;
Francis, Hofer, & Birch, 2001;Johnson & Birch,
1994). Indeed, positive parental child-feeding style is
integral to overcoming a child’s natural rejection of novel
To persuade any child to adopt healthier food choices
requires interventions that consider the complex interplay
between innate and rapidly acquired taste preferences
(Desor & Beauchamp, 1986;Rozin, 1979;Visser et al.,
2000), cognitive ability or attention span (El-Chaar,
Mardy, Wehlou, & Rubin, 1996), cultural norms (Kannan,
Carruth, & Skinner, 1999), parenting style/pressure (Gallo-
way, Fiorito, Lee, & Birch, 2005), parental dietary
preferences and eating behaviours (Fisher, Mitchell,
Smiciklas-Wright, & Birch, 2002;Gibson, Wardle, &
Watts, 1998). However, arguably the strongest psycholo-
gical barriers to increasing a child’s dietary variety are food
neophobia (Birch & Fischer, 1998;Falciglia et al., 2000)
and ‘picky/fussy’ eating (Galloway et al., 2003). This
review will focus on these concepts and in what way they
affect a child’s diet.
Food neophobia has been identified as an inherent
adaptive personality trait (Milton, 1993). It is defined as the
rejection of foods that are novel or unknown to the child,
while ‘picky/fussy’ eating is the rejection of a large
proportion of familiar (as well as novel) foods resulting
in a habitual diet characterised by the consumption of a
particularly low variety of foods. Essentially, food neo-
phobia is an integral constituent part or a subset of the
‘picky/fussy’ eating. Evidence within the literature suggests
that they are behaviourally distinct, with different factors
predicting the severity and expression of these two
constructs (Galloway et al., 2003;Potts & Wardle, 1998;
Raudenbush, van der Klaauw, & Frank, 1995); however,
some papers suggest they are highly related (Pelchat &
Pliner, 1986;Pliner & Hobden, 1992). Operational defini-
tions for these two behaviours will be offered in each of the
following sections. Although they both have been sug-
gested to be independent personality traits, food neophobia
and ‘picky/fussy’ eating have also been shown to be state
dependent, i.e. depending on age and environment (Pelchat
& Pliner, 1995). This age-specific influence on an alleged
stable personality trait (Monneuse et al., 2004) may suggest
it is not a trait at all; rather it might be an age-dependent
state (Rigal et al., 2006), which with the proper instruction
could be discarded as the child develops.
The need to influence children’s food choices demands
an understanding of the developmental factors that impede
their acceptance and consumption of fresh fruit and
vegetables. Integral to developmental influences are factors
such as food neophobia and ‘picky/fussy’ eating. The
nature of the interaction between these two behaviours
needs to be understood, along with the identification of
their constituents. Finally, consideration about what
factors sustain ‘picky/fussy’ eating through the different
T.M. Dovey et al. / Appetite 50 (2008) 181–193182
stages of childhood must also be understood before
suitable interventions can be devised.
Food neophobia
It is evident that most individuals lose bitter taste
aversions and eventually learn to enjoy, to a greater or
lesser extent, vegetables and beverages that are predomi-
nantly bitter (Stein, Nagai, Nakagawa, & Beauchamp,
2003), thus allowing an adaptive increase in dietary variety
in omnivores (Raynor & Epstein, 2001). This is particularly
the case for fruits and vegetables from the citrus and
brassicaceae family, and presumably reflects learned taste
acceptance brought about by repeat exposure (Birch &
Marlin, 1982;Pliner, 1982;Rolls, 1994). It is now known
that some of these foods contain high levels of phyto-
chemicals that are associated with a lower risk of
developing certain forms of cancer (reviewed by Birt,
Hendrich, & Wang, 2001). Therefore, the identification and
investigation of the mechanisms that reverse the aversion
to these types of tastants is essential in improving illness
prevention through healthier diets. Integral to this goal is
ensuring that acceptance of these learned-to-be-liked foods
occurs as early in life as possible, as childhood may contain
a critical period which informs adult consumption of all
fruits and vegetables. Food neophobia is one important
factor that can interfere with getting children to accept
these foods (Kelder et al., 1994).
Food neophobia is often described as the reluctance to
eat, or the avoidance of, new foods (Birch & Fischer, 1998).
The term was derived from the earlier work of Rozin’s
‘omnivore’s dilemma’ (Rozin, 1979;Rozin & Vollmecke,
1986): a process described as an evolutionarily beneficial
survival mechanism to help children avoid ingesting
noxious or toxic chemicals once they are adept and mobile
enough to consider, pick up and consume ‘objects’ found in
their immediate environment but outside of their parental
guidance (Birch, Gunder, Grimm-Thomas, & Laing, 1998;
Cashdan, 1998;Wright, 1991). In order to avoid eating
potentially poisonous plants (Glander, 1982), children will
naturally reject bitter tasting foods (McBurney & Gent,
1979), which has been suggested to be reliant on hedonic
neurobiological mechanisms that are present at birth
(Steiner, 1979) and can persist into adulthood (Stein
et al., 2003). Food neophobia aids this avoidance mechan-
ism through the child naturally rejecting potential food
sources that they have no experience with. Presentation of
a novel item of any kind may initiate a fear (or avoidance)
response within the individual (Zajonc, 1968). Thus,
rejection does not occur during tasting of the food, which
would risk poisoning; rather it happens primarily within
the visual domain. Therefore, foods that do not ‘look right’
to the child will be initially rejected based on vision alone—
for example, green vegetables (Harris, 1993). Evidence for
this rejection of foods by neophobic individuals based on
visual cues can be inferred from data on willingness to try
food items (Ba
¨m, Pirttila
¨-Backman, & Tuofila, 2004;
McFarlance & Pliner, 1997). Within this paradigm,
participants are asked if they would be willing to taste
different food items. In the absence of the food items
themselves, it shows that people who have higher food
neophobia are more likely to reject food items before
tasting them, although it is accepted that previous
experiences of other tasted food items may also be being
utilised to make this judgement (Pliner, Pelchat, &
Grabski, 1993). The inference here is that children build
up schemata of how an acceptable food should look, and
perhaps smell, and so foods not sufficiently close to this
stimulus set will be rejected.
Inevitably, if the food is recognised and accepted within
the visual domain, it will be tasted. The taste will then be
assessed for its subjective value (either positive or negative
to the individual), which in turn is associated with the
visual image. Successful and continuous positive experi-
ences with the food item will lower the child’s reluctance
to eat it. It would appear that up to 15 positive experiences
may be required for successful acceptance of the food
item into the child’s habitual diet (Birch, McPhee, Shoba,
Pirok, & Steinberg, 1987;Wardle, Carnell, & Cooke, 2005;
Wardle, Cooke et al., 2003), although there are only limited
data on this point. This does appear also to have an age-
dependent component, with children within their first year
of life needing only one exposure of a novel food item to
double consumption (Birch et al., 1998). Essentially, the
highly food neophobic child will have a larger fear reaction
to a novel food item. This fear reaction will be by its very
nature a negative experience, which, together with likely
consequent negative emotions from the adult feeder, will be
transferred to encoding of the exposed item (Burgess &
Sales, 1971). Therefore, the highly food neophobic child
will have a larger negative experience to overcome
following presentation of novel food items than their
neophilic peers. The result of this interaction with novel
food items may lead to a different habitual diet (Skinner,
Carruth, Bounds, Ziegler, & Reidy, 2002), as extended
periods of exposure are required with food neophobic
children that parents report cannot be achieved within their
modern day time constraints (Birch et al., 1987).
Food neophobia and age
Although arguments about the exact nature of the
development of food neophobia are ongoing, it has been
shown that expression of this behaviour decreases with age
(Koivisto-Hursti & Sjo
¨den, 1997), with most authors
reporting that, from a low baseline at weaning, it increases
sharply as a child becomes more mobile, reaching a peak
between 2 and 6 years of age (Addessi, Galloway,
Visalberghi, & Birch, 2005;Cashdan, 1994;Cooke,
Wardle, & Gibson, 2003). This trait then decreases as the
individual ages until it is at a relatively stable zenith in
adulthood (McFarlane & Pliner, 1997). Contention in the
literature can be found, with some authors reporting a
general decrease until early adulthood (Koivisto-Hursti &
T.M. Dovey et al. / Appetite 50 (2008) 181–193 183
¨den, 1996;Rigal et al., 2006), while others suggest that
food neophobia is stable from adolescence (13 years old)
(Nicklaus, Boggio, Chababnet, & Issanchou, 2005). It is
likely though that food neophobia continues to decrease
throughout childhood, adolescence and adulthood. Not to
decrease would be maladaptive to survival and reproduc-
tive rates in our species, as the omnivorous nature of
humans means we have diverse nutritional needs that
can only be gained from an equally varied diet (Raynor
& Epstein, 2001). The gradient at which this loss of
neophobia occurs is probably less pronounced within
adolescent and adult populations in comparison to
children. As children age, their experiences with foodstuffs
are more varied and frequent; therefore they will become
less neophobic because fewer things are novel to them and
they will have developed varied likes and dislikes (Cooke &
Wardle, 2005).
Interestingly, it has also been shown that older people
may exhibit increases in food neophobia (Otis, 1984;
Tuorila, La
¨ki, Pohjalainen, & Lotti, 2001). A
proposed lifespan model of food neophobia is shown in
Fig. 1. Currently it is not known whether the senior citizen
is attempting to avoid foods that they do not know and
therefore have a perceptually higher probability of causing
illness (particularly gastric discomfort) or whether the
relatively lower food neophobia in younger generations is a
modern development brought about by the increase in and
distribution of new food markets over the last century. If it
is a response to a weakening health state (a natural
progression as the person ages) then this form of food
neophobia may be related to perception of health state and
status (including dental health). The stronger (in terms of
health) the senior citizens believe they are, the less food
neophobic they may be and the more perceived ‘risks’ with
novel foods they may take. In addition to this perception, it
is well known that the elderly have difficulty with their
senses, showing weaker abilities to detect (Cain & Stevens,
1989;Cowart, 1989) and differentiate (Murphy, 1985) food
odours. This weakened state may lead to distrust and thus
nutrient deficiency (Betts, 1988). However, there is evidence
that suggests that having poor olfaction may result in
increased consumption of novel foods, because they will
not be put off by the novel smell (Pelchat, 2000).
Conversely, a second explanation could be that the food
neophobia is somehow fixed during adulthood. Exposure
to novel foods after this fixation time may not result in an
increased acceptance of these foods into the everyday diet
of the individual.
The increase in the ability to store foods for longer and
move them quicker means it is now logistically possible to
draw on food markets from around the globe. Over recent
decades, there has also been a substantial increase in ethnic
restaurants in many towns and cities. Therefore, the
increased food neophobia in the older generation may be
a by-product of that generation itself. Early life exposure of
these more ‘ethnic’ foods within the older generation would
be much lower and, therefore, they may have more food
neophobia towards them. Either way, this would suggest a
cognitive involvement that is not as pertinent in childhood
food neophobia and thus predictive of fruit/vegetable
consumption (Havas et al., 1998;Perry, Bishop et al., 1998;
Perry, Lytle et al., 1998;Sorensen et al., 1999;Wardle,
Cooke et al., 2003). As such, a differing mechanism to that
of the previously proposed evolutionary one is more likely
within senior citizen populations. However, data on food
neophobia in older people are relatively scarce and the
issue requires more research focus.
Food neophobia, personality and gender
Although it has been repeatedly proposed that food
neophobia is related to age (McFarlane & Pliner, 1997),
individual differences do impinge on the acceptance of
novel foods through an attenuation of the magnitude,
duration and age of onset of highest levels of food
neophobia in the child. The most obvious personality trait
that has been offered is that of sensation seeking (Zucker-
man, 1979). Individuals who are more sensation seeking by
Childhood Adolescents Adulthood Old Age
Life Span
Food Neophobia
Plinth variable between ages 2-6
Food neophobia may increase in
old age possibly due to health
concerns. More research required.
Fig. 1. A potential lifespan model for levels of food neophobia in humans.
T.M. Dovey et al. / Appetite 50 (2008) 181–193184
nature tend to have much lower levels of food neophobia
(Galloway et al., 2003;Pliner & Melo, 1997;Walsh, 1993)
probably through lower general neophobia (Pliner &
Hobden, 1992). Recently, other personality factors have
also been positively associated with food neophobia,
including trait anxiety (Galloway et al., 2003;Loewen &
Pliner, 1999), openness (McCrae et al., 2002) and neuroti-
cism (Steptoe, Pollard, & Wardle, 1995).
Of greater theoretical importance, though, is the
involvement of emotion and emotivity (MacNicol, Murray,
& Austin, 2003) in food neophobia. It would appear that
food neophobia is related to feelings of disgust, and
individuals who attribute a feeling of disgust to novel
foodstuffs are likely to be less willing to try them (Martins
& Pliner, 2005)—at least after the age of four as younger
children seem to be less affected by this association (Fallon,
Rozin, & Pliner, 1984;Rozin, Millman, & Nemeroff, 1986).
Feelings of disgust, and associated facial expressions, may
be related to foods that are bitter and/or potentially
harmful in nature (Martins & Pliner, 2005;Steiner, 1973).
Therefore, if the food ‘looks’ bitter (through the food
offered sharing visual characteristics with previously
experienced bitter foods) or is emotionally associated with
subjective feelings of disgust, the child will reject it. It is
essential to understand that the concept of food neophobia
only extends to the point where the individual picks up the
food and places it in his mouth. Once the food is in the
mouth, it is understood that the ‘phobia’ to the new food
has been, in essence, overcome. This has been shown with a
significant negative association between ‘expected pleasant-
ness’ of novel foods and food neophobia (Raudenbush
& Frank, 1999;Tuorila, Meiselman, Bell, Cardello, &
Johnson, 1994), which is subsequently lost once the food
has actually been tasted (Pliner & Hobden, 1992). It is
understood, however, that food neophobia to a particular
food item can be reinforced from a negative experience
within the initial series of exposures.
Essentially, the acceptance or rejection of the food once
its novelty has been removed is outside the realm of food
neophobia, which is the rejection of the food based on
visual presentation, odour and amount of exposures
required to accept it. The rejection of the taste itself is
the remit of ‘picky/fussy’ eating research and flavour/
consequence learning. Although exposure is integral to
food neophobia, ‘picky/fussy’ eating and flavour/flavour or
flavour/nutrient learning, the distinction between the fields
is the point of acceptance of the food itself. The reluctance
to try (or continue to try within the initial exposure
episodes) novel foods is a neophobic behaviour, whereas
the reluctance to accept the taste involves other processes.
It is therefore important that researchers do not confuse
these two issues.
To limit the perception of disgust, it is suggested that
novel food is presented in a positive light, including
highlighting the fun of preparation and cooking food.
Foods highlighted positively have been shown to be more
likely to be accepted (Martins, Pelchat, & Pliner, 1997;
McFarlane & Pliner, 1997;Pelchat & Pliner, 1995).
Importantly, a parent who creates pressure to consume a
novel food offered, through frustration at the rejection of
the item or by any other cause, may be adversely affecting
the child’s emotional state leading to attribution of feelings
towards the novel food. It has been consistently shown that
parental pressure to consume foods is associated with
higher expression of food neophobia (Fisher et al., 2002;
Galloway, Fiorito, Francis, & Birch, 2006;Galloway et al.,
2005;Wardle et al., 2005), although there may be some
instances where this may not be the case (Bourcier, Bowen,
Meischke, & Moinpour, 2003). Consequently, future
presentations of the food will be associated with the
parents’ exasperations and the child will continue to reject
the food (Pliner & Loewen, 1997). As mentioned above,
exposure to a novel food does generalise to other non-
exposed food items (Birch et al., 1998;Pliner et al., 1993).
Therefore, it would be logical to suggest that an equally
negative exposure episode will be generalised too. Further
research is required to substantiate this belief, especially as
evidence is available to show that this generalisation may
not occur (Hobden & Pliner, 1995).
In terms of sex differences, some studies have found
differences (e.g. women more neophobic; Frank & van der
Klaauw, 1994) and others have not (e.g. Koivisto-Hursti &
¨den, 1997). Similarly, a large Finnish survey reported
higher neophobia in men than women (Tuorila et al.,
2001). Yet, it has recently been shown that there are no
differences in food neophobia between the sexes in young
adults, and if anything females are more disgust sensitive
than males (Nordin, Broman, Garvill, & Nyroos, 2004). In
addition, food neophobia has been shown to be weakly
associated with disgust sensitivity (Nordin et al., 2004). The
confusing picture offered by these initial studies suggests
that there is a complex interplay between sex and food
neophobia that has yet to be uncovered. It would appear
that more research into gender effects is still needed in
order to be sure of the magnitude of the effect, if any, of sex
on food neophobia, and other variables which may interact
with it.
Food neophobia, social facilitation and social influence
Clayton (1978) defines social facilitation as an increase in
the frequency of a familiar behaviour pattern in the
presence of others displaying the same behaviour pattern
at the same time. In terms of eating behaviour, social
facilitation will lead to an increase in the amount of food
consumed by each individual depending on the increasing
amount of people present (de Castro, 1997, 2001, 2002;de
Castro & Brewer, 1992). The effect social facilitation has
on food neophobia appears to be to decrease (acute)
duration of expression (Visalberghi & Addessi, 2000).
Therefore, the more the people around the child consuming
the novel food, the more willing the child will be to try it.
One person will have a limited effect on the child’s
willingness to try the novel food (Harper & Sanders,
T.M. Dovey et al. / Appetite 50 (2008) 181–193 185
1975); however, for the greatest effect it is better if every
person around the child is eating it at the same time (Birch,
1980). This would suggest that a young child learns to
accept foods through observing significant others, rather
than linguistic reasoning. However, the picture appears to
be becoming increasingly more complex, with parental
observation (Birch & Fisher, 1998), parental style (Birch &
Fisher, 1995), parental encouragement (Wardle, 1995), and
in the case of older children peer negative comments
(Cullen et al., 2000) and influence (Cullen et al., 2001), all
affecting uptake of healthy food choices.
For a child, the first social interaction they experience is
with their primary caregiver. Several factors of the primary
caregiver (usually evident as the mother) have been shown
to affect food neophobia expression in children. Parental
food neophobia (Carruth & Skinner, 2000;Pelchat &
Pliner, 1986, 1995;Pliner, 1994), social economic status
(SES) (Flight, Leppard, & Cox, 2003;Giskes, Turrell,
Patterson, & Newman, 2002;Lien, Jacobs, & Klepp, 2002)
and education level (Vereecken, Keukelier, & Maes, 2004)
have all been shown to affect childhood food neophobia
and eating behaviours. Parental influence on food neopho-
bia is generally considered to be through food modelling,
mealtime structuring and parental style (reviewed else-
where by Nicklas et al., 2001); however, it is important to
remember that some parents have to overcome genetic
expression of food rejection. Although evidence for this is
usually based on tastants (Breen, Plomin, & Wardle, 2006),
learned association of tastes and appearance, based on the
child’s perception that ‘foods that look similar might taste
similar’ (Raynor, Polley, Wing, & Jefrey, 2004), may
exacerbate behavioural expression of food neophobia in
certain ‘phenotypic’ children who have strong taste
aversions (Glanville & Kaplan, 1965). This would manifest
in a diet that is lower in food items that have tastes linked
to inherited dislikes, including but not specific to fruits
and vegetables (Drewnowski, Henderson, Hann, Berg, &
Ruffin, 2000;Drewnowski, Henderson, Levine, & Hann,
1999; for a review of genetic influences see Birch, 1999;
Faith, 2005). Indeed, in a study of adults varying in genetic
predisposition to taste the bitter substance, 6-n-pro-
pylthiouracil, only ‘tasters’ who were also food neophobic
showed a dislike for bitter or pungent foods (Ullrich,
Touger-Decker, O’Sullivan-Maillet, & Tepper, 2004).
Importantly, a recent study of family and twin samples in
Finland and the UK found that about two-thirds of
variation in food neophobia is genetically determined
(Knaapila et al., 2007). In support of this, it is notable
that food groups for which acceptance is most hindered by
food neophobia, such as meat and fish, and fruit and
vegetables (Cooke, Carnell, & Wardle, 2006;Cooke et al.,
2003), are also those for which children’s preferences show
greater heritability (Breen et al., 2006).
Nevertheless, environmental influences on food accep-
tance can be found very early in a child’s life. For example,
evidence is available that children who are breastfed are
familiar with the flavours of foods eaten by the mother, as
the mother’s diet is reflected in alterations to the flavour of
her breast milk (Mennella & Beauchamp, 1999;Sullivan &
Birch, 1994), although undoubtedly appearance of the food
will still remain novel to the child. Interestingly, a positive
influence of breast feeding has been shown to be limited to
fruit intake rather than vegetable intake (Cooke et al.,
2003), which suggests there is differentiation in acceptance
of these foods. Taken together, a child’s expression of food
neophobia can be determined from an early stage via
parental behaviours, diets and practices.
It is clear that research into parental influences is integral
to understanding the developmental process and expression
of food neophobia. Although the influence of the parent
seems to be limited to childhood, it does have the potential
to define magnitude and duration of food neophobia. What
is not so well understood is whether parents can influence
children to adopt different behaviours from their own, as
research has not been able to disassociate completely
whether the child models parental behaviour or parental
wishes. It is likely that the child is actually modelling
behaviour, but with the right approach (i.e. non-pressured,
non-threatening, non-authoritarian) it may be possible
to get the child preferentially to choose foods that the
caregiver does not like. However, a heavy investment of
time and energy from the adult is required, as it appears
that a large number of repeat exposures are needed for the
child to accept the food (Wardle, Herrera, Cooke, &
Gibson, 2003).
Research has suggested that this social influence is also
attenuated by age of the child. Birch (1980) found that
younger children (p3 years old) are more influenced by
others than older children (X4 years old), although this is
not a universal finding, with other authors suggesting there
is not a difference between older and younger children in
terms of social facilitation/influence (Harper & Sanders,
1975). Once the child reaches adolescence, peer pressure
appears to be more dominant in getting them to eat fruits
and vegetables (Shepard & Dennison, 1996). Therefore,
during childhood the social importance of others in
decreasing food neophobia switches from the caregivers
and siblings to friendship circles and individuals perceived
to be more socially important for modelling acceptable
One contentious aspect of the social influences on food
neophobia is that of sex. Some researchers have suggested
that girls respond more to social pressures and peer models
than boys (Hendy & Raudenbush, 2000). However, others
have found no differences (Birch, 1980;Harper & Sanders,
1975). This sex difference would make theoretical sense, as
it has been demonstrated that girls, on average, develop
more complex social interaction awareness skills earlier
than boys (Black, 1992;Neppl & Murray, 1997), although
inconsistencies are available within developmental studies
too (Duveen & Lloyd, 1988). Moreover, boys have higher
tendencies to reject others’ opinions and ideas (Black,
1992). Condensed down, this would point to a role of sex in
changing food neophobia through social facilitation. By
T.M. Dovey et al. / Appetite 50 (2008) 181–193186
adolescence though this difference is not present, suggest-
ing that boys have caught up on social awareness and are
equally responsive to peer pressure and social influence in
terms of overcoming food neophobia (Meiselman, Mas-
troianna, Buller, & Edwards, 1999;Pliner & Melo, 1997).
Children do not grow up within an environment devoid
of social influences other than the parent, family and peer
group. Children also learn to prefer foods that are typical
of their cultural environment (Birch, Johnson, & Fisher,
1995). Although culture is a product of those individuals
within it, the environment itself, either virtual (television)
(Halford, Gillespie, Brown, Pontin, & Dovey, 2004)or
geographical (e.g. urban or rural environments) (Flight
et al., 2003;Tuorila et al., 2001), may play a significant role
in food choice. Flight et al. (2003) have shown that degree
of urbanisation can affect food neophobia with rural
children being more neophobic than their urban counter-
parts. This is explained through increased cultural diversity
in urban areas and/or degree of isolation (Tuorila et al.,
2001). However, recently we found in a pilot study that
food neophobia was not related to urbanisation in England
(Dovey & Shuttleworth, 2006). This may suggest that it is
not only being in a rural environment that can increase
food neophobia, but access to urban environments that is
also important. In Britain, even the most remote rural
environment can have access to an urban area within an
hour. Therefore, in densely populated, culturally diverse,
countries the same environmental influences may not be as
Food neophobia and willingness to try novel foods
The development of the concept of food neophobia was
to assess a person’s willingness to consume novel foods
offered to them (Pliner & Hobden, 1992;Raudenbush &
Frank, 1999).
However, most studies into willingness to try novel foods
have suggested that the correlations between this factor
and food neophobia were weak (Flight et al., 2003;Tuorila
et al., 2001) usually having a low correlation coefficient.
The reason for the significant result in these cases is due to
the relatively large sample sizes that have been investigated.
Previous observations suggest that children may be using
their best guess or ‘what does it look like most’ in order to
try and predict the potential taste of the offered food (Birch
et al., 1998). We have anecdotally noted that many children
in our studies confuse locally available fruits and vegeta-
bles with each other (i.e. courgette/zucchini and cucumber),
but, instead of saying they do not know what it is, they
offer their best guess. In this way, the associations the child
has with this other food may be informing them about their
willingness to try the food presented. Therefore, visual and
other sensory aspects of the food are not necessarily
entirely novel to the child. It appears that their experiences
of other foods that look similar could be conflicting with
their willingness to try the novel foods presented (Birch
et al., 1998).
Picky/fussy eaters
‘Picky/fussy’ eating is behaviourally and theoretically
distinct from food neophobia (Pelchat & Pliner, 1986;
Pliner & Hobden, 1992). Measures for ‘picky’ eating are in
their infancy, making it hard to quantify this construct
accurately (Kauer, Rozin, & Pelchat, 2002). ‘Picky/fussy’
eaters are usually defined as children who consume an
inadequate variety of foods through rejection of foods that
are familiar (and unfamiliar) to them (Birch, Johnson,
Andresen, Peters, & Shulte, 1991;Galloway et al., 2005,
2003;Smith, Roux, Naidoo, & Venter, 2005;Story &
Brown, 1987), although as a definition it has also included
consumption of an inadequate amount of food (Rydell,
Dahl, & Sundelin, 1995). Furthermore ‘picky/fussy’ eating
can extend further than food neophobia through children
rejecting food textures and not just a particular food
(Smith et al., 2005). Therefore, unlike food neophobia,
‘picky/fussy’ eating can extend into the realm of the flavour
and feel of foods, as these children are inappropriately
rejecting food textures, which can only be completely
determined within the child’s mouth.
In its basic form, ‘picky/fussy’ eating is differentiated
from food neophobia through the novelty value of the food
presented. Food neophobia can remain as a part of a picky
eater’s behavioural profile (Pelchat, 1996), while ‘picky/
fussy’ eating is not a part of food neophobia. As such,
everything discussed above about food neophobia could be
attributed to the picky/fussy eater; although the prevalence
of food neophobia will differ between individual children.
It is important to note that these constructs are related
(Potts & Wardle, 1998;Raudenbush et al., 1995), with one
concept having an effect on another, but an increase in
one does not necessarily lead directly to an increase in the
other. Therefore, it is theoretically possible to have a child
that has no problem trying new foods, but will still reject
them every time they are presented. Equally, it is also
possible to have a child that is neophobic to new foods, but
once this is overcome then they will readily accept them. In
reality, this latter type of child would be more common, as
this is a natural developmental progression; however, the
first type of extremely ‘picky/fussy’ child is more likely to
be problematic to nutritionists and psychologists. This first
type of child may be nutritionally deficient and less
responsive to dietary interventions than others, yet may
not be considered neophobic as they are rejecting foods
they are familiar with. Such cases are still largely
theoretical as studies exploring ‘picky/fussy’ eating are
relatively recent and few in number. A possible theoretical
interaction of ‘picky/fussy’ eating, food neophobia and
exposure is shown in Fig. 2.
Measuring ‘picky/fussy’ eaters
Due to its recent theoretical development, pickiness has
been disparately measured in different papers, which may
have added to the confusion of what the concept actually is
T.M. Dovey et al. / Appetite 50 (2008) 181–193 187
(Potts & Wardle, 1998). Some studies have attempted to
characterise ‘picky/fussy’ eating using the Child-Feeding
Questionnaire (Birch et al., 2001;Galloway et al., 2005,
2003), through simply asking the caregiver if they
considered their child a picky eater (Carruth, Ziegler,
Gordon, & Barr, 2004), or by designing a questionnaire of
their own for the specific study (Kauer et al., 2002;Smith
et al., 2005). Differences in measuring the ‘picky/fussy’
construct will only lead to further confusion and proble-
matic theoretical interpretation. Therefore, it is essential
that a more applicable measure is offered and validated in
children as quickly as possible. The first steps are in place
to achieve this (Kauer et al., 2002), but until progressions
in these psychometric tools are undertaken a full theore-
tical interpretation based on research cannot be offered.
Development of the ‘picky/fussy’ eater
From a very young age, a child can communicate his/her
likes and dislikes to their caregiver. Younger children will
communicate through body language (e.g. moving away
from the food offered or it away from them) or, if the
caregiver is persistent at making the child eat, through non-
linguistic verbalisations (e.g. groaning or screaming). As
the child ages, his/her communication with their caregiver
becomes more linguistic, with the child able to verbalise
his/her likes and dislikes. Interestingly, preliminary evi-
dence is available to suggest that parents have an increased
perception of their child’s ‘pickiness’ as they get older
(Carruth et al., 2004) (from 25% at 7–8 months to 35% at
12–14 months to 50% at 19–24 months). Although this
cannot be completely disassociated from food neophobia,
as this measure was not taken in this study, this may
suggest that, as the child has the ability to verbalise his/her
dislikes, the parent perceives the rejection of a common
food as being stronger. Alternatively, the parent may be
more willing to compare an older child’s rejection of
familiar foods to their own preferences. Inevitably, this
acceptance of familiar foods will be perceived as much
lower in the child compared to the adult. Equally, it could
be an inappropriate understanding of the importance of
duration and frequency in exposing their child to foods
(Wardle, Herrera et al., 2003) to overcome both his/her
food neophobia and ‘pickiness’. In reality, it is probably a
combination of all of these factors alongside the confusion
between food neophobia and ‘pickiness’ that is accounting
for this perceptual increase in ‘picky/fussy’ eaters rather
than a differential age of onset.
A recent study has also suggested that children who are
overly ‘picky/fussy’ eaters may also be tactilely defensive
(Smith et al., 2005). Tactile defensiveness is characterised
as an overreaction, or offence, resulting in withdrawal from
the sensation of being touched, either by another person, or
by something in their environment, which most would
consider inoffensive (Royeen, 1986;Wilbarger, 2000). This
separate construct may allow researchers independently to
define those with clinical levels of ‘picky/fussy’ eating, or
indeed may allow a latent measure for ‘picky/fussy’ eating
itself. Being tactilely defensive may mean that the child is
overly sensitive to oral touch (Smith et al., 2005) leading to
the rejection of foods with certain textures. This rejection
of food texture can also be informed through individual
differences, as one child may reject ‘softer’ foods while
another would reject ‘harder/ crunchier’ foods (Wilbarger,
2000). In either instance, understanding this texture
rejection in ‘picky/fussy’ eating may allow the parent to
Refusal of food
After 15 Exposures
First viewing of
the novel food
First taste of
the novel food
‘Picky/Fussy’ Child
Food Neophobic Child
Fig. 2. Likelihood for acceptance of fruits and vegetables in food neophobic and ‘picky/fussy’ eating children.
T.M. Dovey et al. / Appetite 50 (2008) 181–193188
present foods that will not be rejected on these grounds.
This interaction between tactile defensiveness and picky
eating should be investigated further.
The diet of ‘picky/fussy’ eaters
The nutrient intake of ‘picky/fussy’ eaters appears to
reflect that of non-‘picky/fussy’ eaters on most aspects of
their diet. There are, however, some distinct differences
between the two groups. ‘Picky/fussy’ eaters consume fewer
amounts of foods containing vitamin E, vitamin C, folate
and fibre, probably due to their lower consumption of
fruits and vegetables (Galloway et al., 2005) compared to
non-‘picky/fussy’ eaters. Lower levels of these specific
nutrients may lead to cell damage (Burton & Traber, 1990;
Royack, Nguyen, Tong, Poot, & Oda, 2000), immunolo-
gical weakness (Hemila
¨, 2003) and digestive problems
(Bosaeus, 2004). The digestive problems, in particular, may
increase ‘picky/fussy’ eating through inappropriate asso-
ciations with foods they have just eaten to abdominal pains
brought on by constipation. Furthermore, Carruth et al.
(2004) reported that ‘picky/fussy’ eaters were less likely to
consume dishes that were mixed together, like many pasta
dishes. This makes the parent’s job harder, as ‘picky/fussy’
eaters will also reject foods that they can see; therefore,
trying to increase acceptance through ‘hiding’ fruits and
vegetables within other more liked foods may be proble-
matic within ‘picky/fussy’ eaters but not food neophobic
children. This may be another way to differentiate these
two concepts.
In contrast to food neophobia, it does not appear that
‘picky/fussy’ eaters compensate for the lack of fruits and
vegetables through consuming higher amounts of fat
(Galloway et al., 2005). Indeed, some evidence suggests
that ‘picky/fussy’ children have lower BMIs then non-
‘picky/fussy’ eaters and yet are not underweight (Marchi &
Cohen, 1990). However, other research groups have
suggested the opposite (Carruth & Skinner, 2000).
Although an interesting finding, caution is advised when
referring to these children as having a behavioural defence
to the obesogenic environment. ‘Picky/fussy’ eating is
associated with essential nutrient deficiency (Galloway
et al., 2005) and other inappropriate forms of environ-
mental processing such as tactile defensiveness (Smith et
al., 2005). It has also been negatively associated with
months spent in breast feeding and the caregiver’s
vegetable intake (Galloway et al., 2003), although it is
noted that the predictive value of the model for these last
two variables was weak. Furthermore, evidence is available
that ‘picky/fussy’ children may consume more sweetened
foods (Carruth et al., 2004). This may suggest an over-
reliance on hedonic value, i.e. acceptance encouraged by
children’s innate liking for sweetness. Consequently, there
is a risk that such children may establish a habit of over-
consumption of energy dense, highly palatable foods,
eventually culminating in excessive weight gain. However,
so far there are no longitudinal data to support this.
In summary, food neophobia and ‘picky/fussy’ eating
are related constructs that are theoretically and behaviou-
rally different. Food neophobia is part of, but does not
account for the entirety of, a ‘picky/fussy’ eater’s beha-
vioural profile. It is a constituent of ‘picky/fussy’ eating
limited to willingness to try novel foods. The impact of
food neophobia is limited to the point where the child
places the food in his/her mouth, but may continue to have
a negative effect on willingness to try foods for up to 15
daily exposures, or if a negative event is successfully
associated with the novel food item within these initial
exposures. The influence of food neophobia on a person’s
willingness to try novel foods diminishes from the first taste
processed as a positive experience. After this time, rejection
of the taste itself is not part of a food neophobic child’s
behavioural profile. Persistent rejection, or an increased
need for exposure in order for a child to accept a particular
food, must be considered as part of ‘picky/fussy’ eating.
This differentiation may explain the previous weak
correlations between food neophobia and foods that are
actually tasted.
Due to the inter-relationship between ‘picky/fussy’
eating and food neophobia, some factors such as pressure
to eat, personality factors, parental practices/styles and
social influences will have similar effects on both magni-
tude and duration of expression. Whereas these constructs
may be differentially affected by factors such as age, tactile
defensiveness, environment and culture, it is likely that
both ‘picky/fussy’ eating and food neophobia are person-
ality traits, with substantial genetic contributions. Their
developmental aspects are associated with child mobility,
resulting in a slower maturation time period in ‘picky/
fussy’ eating compared to food neophobia. This is
suggested because the ‘picky/fussy’ child must have
experience with a variety of foods and food textures before
they can be defined as ‘picky/fussy’. The need for the child
to develop safely within his/her environment without the
risk of poisoning, as well as to learn what is edible and
what is not, means that food neophobia will be higher until
experiences are fully consolidated. However, it is important
to note that this early childhood phase of increased food
neophobia and ‘picky/fussy’ eating can inform adult
dietary variety and nutrient intake and so should be
handled with informed care.
Differential characterisations of children who are ex-
treme ‘picky/fussy’ eaters and have a low level of food
neophobia (if this is indeed possible) may allow a better
understanding of what discriminates these two concepts.
One such factor, exposure, which has been well researched
in food neophobia, may suggest differences between ‘picky/
fussy’ eating and this concept, especially as one is defined
as the rejection of novel foods while the other is rejection of
familiar (and unfamiliar) foods. It is likely that the ‘picky/
fussy’ eater will require many more exposures in order to
accept the food in comparison to a ‘normal’ food
T.M. Dovey et al. / Appetite 50 (2008) 181–193 189
neophobic child. Another factor that may prove beneficial
is the non-clinical measurement of tactile defensiveness in
children who are ‘picky/fussy’ eaters. It may be possible, in
some cases, to overcome ‘picky/fussy’ eating through
addressing this factor.
It is clear that children are not consuming enough fruits
and vegetables during childhood, which if left unchecked
will lead to a generation of unhealthy nutrient-deficient
adults. It appears that overcoming food neophobia and
‘picky/fussy’ eating is integral to getting children to adopt a
healthy diet and eat fruits and vegetables. To overcome this
problem, further research is needed to understand these
concepts, and to deliver a multi-faceted approach to get
children independently to choose and to include fruits and
vegetables in their diets. Although ‘picky/fussy’ eating
research is in its infancy, it is possible to draw on evidence
from food neophobia studies to show the potential benefit
that this behavioural manipulation can have on children’s,
adolescents’ and the future adults’ health and eating habits.
Unfortunately, the current access to and preference for
highly hedonic, energy dense foodstuffs mean that, without
adequate provision and early intervention, achieving this
will be an uphill struggle.
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  • ... In USA, an estimated 45% of children are affected by such problems and the incidence is increasing worldwide (2). The most important concerns in such children are food refusal and late diagnosis of selectivity (3) which usually obstacles complementary nutrition (4,5). The child is often underweight or obese and this could raise the parent's concern (1, 6). ...
    Abstract Background and purpose: Maternal depression and anxiety can cause nutritional problems in offspring. Despite the numerous literature, the knowledge regarding the impact of maternal mental health on child’s eating disorder is still limited. This study explored the impact of maternal depression and anxiety on eating disorders among children aged 6 to 36 months in Tehran, Iran. Material and Methods: A total number of 320 children aged 6 to 36 months old and their mother were enrolled. To collect the data, the inventory of problematic eating behaviors for 36-month old children, Beck Depression Inventory (BDI-II) questionnaire, Beck Anxiety Inventory (BAI) questionnaire, and demographics information questionnaire were used. To examine the relationship between maternal depression and anxiety with childhood feeding problems, bivariate and multivariate analyses were employed. Results: The mean mothers’ depression and anxiety scores were 15.97 (SD = 12.08) and 14.26 (SD = 11.87), respectively. There was a significant association between the mother’s severe depression and child’s eating disorder [OR = 5.7; CI (95%) = 2.92-11.43]. Although this association attenuated for the moderate level of depression in mothers, it was still statistically significant [OR= 2.25; CI (95%) = 1.05-4.8]. There was also a significant association between the moderate level of anxiety in mother and child’s eating disorder [OR = 2.17; CI (95%) = 1.15-4.10]. Conclusion: It appeared that the children of mothers with higher level of depression experience more eating disorders during childhood. Furthermore, middle maternal anxiety level was associated with more feeding abnormalities in children. Therefore, screening and addressing the mental health issues in mothers at the early stages could prevent from future eating disorders in offspring.
  • ... Striving for autonomy is thought to bring about 2 food-related behaviors that present a particular challenge to responsive, nondirective feeding: food neophobia (wariness of trying new foods) and food fussiness/"picky" eating (a more general selectivity regarding which foods are consumed). 124 Both of these behaviors can be associated with children eating a more limited, often less unhealthy diet, and with weight status (Table). 19,21,51,125 Food fussiness and neophobia can involve a disgust response to disliked foods, the rejection of foods on sight, and for some children a contamination response, where disliked foods touching or hidden under liked foods may lead to rejection of the whole meal. ...
    Full-text available
    A substantial body of research suggests that efforts to prevent pediatric obesity may benefit from targeting not just what a child eats, but how they eat. Specifically, child obesity prevention should include a component that addresses reasons why children have differing abilities to start and stop eating in response to internal cues of hunger and satiety, a construct known as eating self-regulation. This review summarizes current knowledge regarding how caregivers can be an important influence on children's eating self-regulation during early childhood. First, we discuss the evidence supporting an association between caregiver feeding and child eating self-regulation. Second, we discuss what implications the current evidence has for actions caregivers may be able to take to support children's eating self-regulation. Finally, we consider the broader social, economic, and cultural context around the feeding environment relationship and how this intersects with the implementation of any actions. As far as we are aware, this is the first American Heart Association (AHA) scientific statement to focus on a psychobehavioral approach to reducing obesity risk in young children. It is anticipated that the timely information provided in this review can be used not only by caregivers within the immediate and extended family but also by a broad range of community-based care providers.
  • ... In novel environments, it is adaptive for animals to exhibit initial anxiety-like behavior (neophobia) that gradually transitions to exploratory behavior (neophilia) once the environment has proven to be non-threatening (Barnett 1958;Dulawa et al. 2005;Osorio-Gómez et al. 2018). Novelty-seeking and novelty-fearing personality traits correlate with substance abuse and anxiety disorders, respectively (Bardo et al. 1996;Dovey et al. 2008;Marcontell et al. 2003;Tulving et al. 1994;Weierich et al. 2010). In animal models of psychiatric disease, behavioral responses to novel environments are also strong predictors of drug-seeking and anxiety-like behavior (Dulawa 2009;Pawlak et al. 2008;Walker et al. 2009;Wingo et al. 2016). ...
    Full-text available
    Rationale: In rodents, exposure to novel environments elicits initial anxiety-like behavior (neophobia) followed by intense exploration (neophilia) that gradually subsides as the environment becomes familiar. Thus, innate novelty-induced behaviors are useful indices of anxiety and motivation in animal models of psychiatric disease. Noradrenergic neurons are activated by novelty and implicated in exploratory and anxiety-like responses, but the role of norepinephrine (NE) in neophobia has not been clearly delineated. Objective: We sought to define the role of central NE transmission in neophilic and neophobic behaviors. Methods: We assessed dopamine β-hydroxylase knockout (Dbh -/-) mice lacking NE and their NE-competent (Dbh +/-) littermate controls in neophilic (novelty-induced locomotion; NIL) and neophobic (novelty-suppressed feeding; NSF) behavioral tests with subsequent quantification of brain-wide c-fos induction. We complimented the gene knockout approach with pharmacological interventions. Results: Dbh -/- mice exhibited blunted locomotor responses in the NIL task and completely lacked neophobia in the NSF test. Neophobia was rescued in Dbh -/- mice by acute pharmacological restoration of central NE with the synthetic precursor L-3,4-dihydroxyphenylserine (DOPS), and attenuated in control mice by the inhibitory α2-adrenergic autoreceptor agonist guanfacine. Following either NSF or NIL, Dbh -/- mice demonstrated reduced c-fos in the anterior cingulate cortex, medial septum, ventral hippocampus, bed nucleus of the stria terminalis, and basolateral amygdala. Conclusion: These findings indicate that central NE signaling is required for the expression of both neophilic and neophobic behaviors. Further, we describe a putative noradrenergic novelty network as a potential therapeutic target for treating anxiety and substance abuse disorders.
  • ... Similar patterns of behavior for plant foods in the context of food neophobia and the broader category of plants early in ontogeny suggests that there may be common mechanisms guiding human interactions with both types of entities. It has been shown that avoidance of new foods applies particulatly to plant foods like vegetables (Cashdan, 1998;Dovey et al., 2008;Fletcher et al., 2017;Perry et al., 2015) and both neophobia and plant avoidance are likely to effectively protect young children from risk of poisoning (1998( , Cashdan, 1994Pliner & Hobden, 1992;Rozin, 1979: Wertz, 2019. Additionally, in line with studies showing that tactile information is an important factor in reducing plant food avoidance (Blossfeld, Collins, Kiely, & Delahunty, 2007), our findings show that an adult making contact with a plant is a signal for infants that the plant is indeed safe to touch. ...
    Plants have been a fundamental component of human diets over evolutionary time. However, plants pose dangers to humans due to the variety of toxic chemical and mechanical defenses they manufacture. Accordingly, recent developmental work has shown that infants exhibit a reluctance to touch plants—a behavioral strategy that is an effective way of mitigating plant dangers. A similar protective avoidance strategy occurs in the food domain, food neophobia, which can be reduced by social facilitation. In the current study we investigated whether infants modify their behavior toward plants when social information is present. We presented 8- to 18-month-olds with plants and control objects after an adult conveyed information about each object and measured infants’ touch behavior. The results provide the first evidence that social information reduces infants’ reluctance to touch plants and converge with previous findings that social facilitation reduces food neophobia. This provides a broader evolutionary framework for understanding food learning and food rejection early in life.
  • ... Including indicators of socioeconomic status such as parental education (which was not included in analyses because it was only available for subsets of participants from two of the four samples) and income, and information about family composition (e.g., number of parents, number of siblings) in the models might have explained remaining variance in SE. For example, children from lower-SES backgrounds have been found to demonstrate higher levels of SE compared to peers (e.g., Dovey, et al., 2008), although it is unclear how SES interacts with neurobehavioral predictors like sensory sensitivity and cognitive rigidity. ASD diagnosis in the ASD sample was based on parent-report of an existing clinician provided diagnosis and meeting AQ-10 screening criteria, but was not confirmed by a diagnostician; we also did not collect information on intellectual or verbal functioning in this (or any) sample. ...
    Objective: Selective or “picky” eating (SE) refers to rejection of a wide range of familiar and unfamiliar foods based on aversions to their sensory properties. When severe, SE can cause symptoms of avoidant/restrictive food intake disorder (ARFID), including weight loss, nutritional deficiencies, and/or psychosocial impairment. SE is highly prevalent in autism spectrum disorder (ASD) compared to both typical development and other developmental disorders. A possible explanation for the high prevalence of SE in ASD is the effect of core ASD symptoms, repetitive/restrictive behaviors (e.g., rigidity), and sensory sensitivity on feeding behaviors. These traits are found not only in ASD but also in other clinical groups and the general population, albeit often at subclinical levels. Identifying mechanisms of SE across various populations is critical to inform intervention approaches. Methods: In 263 unselected children ages 5–17, 534 unselected college students ages 18–22, 179 children with anxiety/obsessive spectrum disorders ages 5–17, and 185 children with ASD ages 4–17, we explored the unique contributions of sensory (i.e., oral texture and olfactory) sensitivities and rigidity as predictors of self/parent-reported SE. Results: In each sample, rigidity and oral texture sensitivity, controlling for olfactory sensitivity, age, and gender, emerged as significant, independent predictors of SE. Conclusions: This is the first study to highlight the importance of cognitive/behavioral rigidity to SE, and one of the first to illustrate the domain-specificity of the relationship between sensory sensitivity and SE.
  • ... Em geral, esse mecanismo biológico evita o consumo de alimentos tóxicos (Beauchamp & Mennella, 2011). A neofobia alimentar parece aumentar a partir dos 2 anos de idade, diminuindo durante a fase final da infância e da adolescência (Dovey et al., 2008). Essas alterações podem ocorrer, em maior ou menor grau, dependendo da exposição a novos alimentos, provas sensoriais diversas e constantes, além de uma efetiva educação alimentar e nutricional (Howard et al., 2012). ...
    Full-text available
    O objetivo do trabalho foi desenvolver oficinas de culinária utilizando alimentos menos preferidos por escolares e avaliar sua aceitabilidade sensorial e composição físico-química. Participaram 1.010 crianças (7 e 10 anos), matriculadas em 10 escolas públicas de Guarapuava, PR. A preferência alimentar das crianças foi avaliada por meio de um questionário autoaplicável. Foram elaboradas preparações alimentícias contendo os 10 alimentos menos preferidos pelas crianças. Oficinas de culinária foram aplicadas com esses produtos, sendo avaliados em relação a sua aceitabilidade sensorial e composição físico química. Os alimentos menos preferidos pelas crianças foram a berinjela (77,6%) e o melão (52,5%). O brigadeiro de chuchu, o cupcake de abobrinha e a mousse de melão receberam as maiores notas em todos os atributos sensoriais e para a aceitação global. Todas as preparações apresentaram índices de aceitabilidade elevados (> 70%). Maiores teores de umidade e menores de cinzas, carboidrato, calorias e fibras foram constatados na mousse de melão. Maiores teores de cinzas, proteína e carboidrato foram verificados para o chips de berinjela, enquanto a empada de agrião e a torta de acelga tiveram os maiores teores de lipídio. O chips de berinjela e o hambúrguer de lentilha apresentaram as maiores quantidades de fibras. Conclui-se que alterações na forma de preparo aumentam a aceitabilidade sensorial de alimentos nutritivos que apresentam elevada taxa de rejeição por crianças em fase escolar, como as hortaliças e as frutas. Esse efeito ocorre principalmente quando essas alterações estão associadas a uma estratégia de aprendizagem como a oficina de culinária.
  • Chapter
    Good nutrition plays a key role in promoting physical and mental health throughout the lifespan. In exploring the link between nutrition and health, research confirms that dietary practices are particularly important during the early years of life. Good nutrition promotes immune function and supports the rapid growth that occurs during the childhood years, while helping children to develop healthy lifelong behaviours. In addition to positive health outcomes, there is evidence that good nutrition enhances brain function. For example, a healthy diet supports optimal learning capacity and cognitive ability, and enhances concentration, IQ scores and academic achievement. Despite this, many Australian children are consuming a diet that is characterised by increased consumption of foods with limited nutrient content. Disparities in nutrition and educational outcomes across diverse population groups also prompts consideration of broader social determinants of health. For example, strong scientific data indicates correlations between socio-economic disadvantage and poorer diets amongst children. The interconnectedness between nutrition and educational outcomes provides opportunities for teachers and schools to support and promote the role of nutrition for learning. Learning for nutrition equally shapes the work of teachers and schools. In considering the interdependence between nutrition and learning, and the broader factors that shape Australian children’s diets, this chapter investigates the importance of nutrition for learning, as well as learning for nutrition. In particular, we focus on diverse skills and competencies that can be developed across the primary years within the classroom. We then conclude with a brief discussion of the role of schools in promoting nutrition, through the promotion and availability of healthy food options for all children.
  • Article
    Purpose This pilot study is aimed to explore the potential problem of picky eating (PE) among university students majoring in food and nutrition as prospective nutrition professionals. Design/methodology/approach The current pilot study included a total of 87 South Korean students majoring in food and nutrition. The self-designed Food Bridge program was applied to identify the underlying causes of PE and examine the possibility of overcoming it. The program included planning and practicing stepwise exposures to target foods that were the subject of PE. Descriptive statistics were calculated, and distributive differences between the success and failure groups in the program were analyzed using a chi-squared test. Findings Vegetables were the most commonly disliked foods (74.7%). About 46% of all students mentioned negative experiences as a reason for food dislikes. Almost half (45%) of these negative experiences were due to external coercion: forced eating (30.0%) and vomiting after forced eating (15.0%). About 66% of the students achieved relatively positive results in overcoming PE. The proportion of failures tended to be higher when the reasons for food dislike included negative experiences. Originality/value As the current study implied, students majoring in food and nutrition can be subject to PE. Despite study limitations, this study is meaningful in that it raises concerns over the potential problem of PE and its treatment among prospective nutrition professionals. This study is also expected to serve as a basis for further research on adult PE.
  • Article
    Full-text available
    International students may have difficulties in dietary acculturation. This study aimed to evaluate the knowledge, attitude and practices (KAP) of diet and health during the acculturation of international students. A cross-sectional survey was conducted among a convenience sample of 473 international students in Dublin. Knowledge, attitude and practices towards diet and health were evaluated by a questionnaire with open- and closed-ended questions. It was found that 45.3% of participants had a broad concept of a healthy diet, while few knew its specific contents. Furthermore, 75.3% of participants could explain the term functional food, and among them, 62.1% knew the appropriate definition of functional food. Participants who perceived their health very good and excellent were more likely to believe that their health status was determined by their own control. The consumption rate of functional food varied among regions and South and Central America students had the highest usage rate (44.5%) and Asian students had the highest daily usage rate (52.7%). Participants who were younger, single, from African and South and Central American countries, or who were in Ireland for less than one year were more likely to report dietary change after immigration. In conclusion, insufficient knowledge and self-perception towards diet and health as well as unhealthily dietary changes exist among international students living in Dublin.
  • Chapter
    Childhood appetite includes an understanding of satiety levels and their ability to respond to see, smell or taste food. Children who consume more junk food are at risk of being obese in adulthood through hunger hormones such as leptin and ghrelin, which can affect body mass index (BMI). The eating attitude depends on the feeding pattern of the parents to their children. Employed parents have difficulty giving attention to the proper diet of their children, which can lead to health disorders such as obesity, intellectual disability and stunted growth. The prevalence of obesity is increasing worldwide, which leads to a shortage of sleep, overeating and weight gain among children and adults. Sleep is an important modulator of neuro, endocrine and glucose metabolism in children. Due to the reduction of sleep, there is a dramatic increase in obesity with the decrease in glucose tolerance, the high sympathovagal balance, the increase in cortisol concentration at night, the reduction of leptin, the elevation of ghrelin. It is important that parents incorporate positive eating habits, a healthy diet, which has the potential to keep the child’s appetite in a normal range and avoid unnecessary childhood obesity and other eating disorders, thus creating a change in society.
Literature Review
  • Article
    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 nine parents of 4–5 year olds completed questionnaires which included a six-item version of the Child Food Neophobia Scale (CFNS). The children took part in a series of 3 test lunch meals at weekly intervals at school at which they were presented with: chicken, cheese, bread, cheese crackers, chocolate biscuits, grapes and tomatoes or carrot sticks. Food items served to each child were weighed before and after the meal to assess total intake of items in four categories: Fruit and vegetables, Protein foods, Starchy foods and Snack foods. Pearson Product Moment Correlations and independent t tests were performed to examine associations between scores on the CFNS and consumption during lunches. Results: Neophobia was associated with lower consumption of fruit and vegetables, protein foods and total calories, but there was no association with intake of starch or snack foods. Conclusion: These results support previous research that has suggested that neophobia impacts differentially on consumption of different food types. Specifically it appears that children who score highly on the CFNS eat less fruit, vegetables and protein foods than their less neophobic peers. Attempts to increase intake of fruit, vegetables and protein might usefully incorporate strategies known to reduce the neophobic response.
  • Article
    British students were tested three times per year immediately after entering university on a battery of tests, including eating behavior scales (Variety Seeking Tendency Scale, Food Neophobia Scale, and the Restrained Eating scale of the Dutch Eating Behavior Questionnaire). Repeated testing indicated high stability of the measured eating behavior scales over the study period of 1-2 years. Thus, food attitudes remained stable even during a major period of change in people's lives when young people left home. The stability of the average measures of the three eating behaviors scales indicates that groups can be characterized by their scores. There was no gender effect for Variety Seeking Tendency or Food Neophobia but there was for Restrained Eating, as previously reported. Test-retest correlations for the same subjects were generally in the range 0.6-0.8. The correlation between Variety Seeking Tendency Food Neophobia was -0.6. (C) 1999 Published by Elsevier Science Ltd.
  • Article
    Factors associated with willingness to taste 12 unusual foods were examined among 42 mature university students in a realistic taste testing situation. Low or nonsignificant correlations were found between subjects' willingness to taste the different foods and their scores on personality measures of sensation seeking as well as their ratings of familiarity with each food. Unexpectedly, age was a significant factor, with the older subjects being somewhat more willing to taste the unusual foods. Only a scale of items dealing specifically with food habits was highly correlated with subjects' willingness to try the unusual foods. The results suggest that food adventurousness is best accounted for by highly specific attitudes about food rather than general personality measures.
  • Article
    The structure and predictive ability of social representation of new foods were investigated and compared with instruments measuring relevant attitudes and traits using a questionnaire quantifying these aspects, completed by 743 respondents. Based on their rated willingness to try, new foods were categorized as modified dairy products, genetically modified (GM), organic, and ethnic products (two examples, snails and passion fruit, were treated separately). The social representation (SR) consisted of five dimensions: suspicion of novelties, adherence to technology, adherence to natural food, eating as an enjoyment, and eating as a necessity. The SR dimensions were strong predictors of willingness to try GM foods (predicted by adherence to technology) and organic foods (predicted by adherence to natural foods). Low food neophobia predicted the rated willingness to try snails and passion fruit. Thus, different constructs predicted willingness to try different categories of new foods, and as a whole, SR dimensions markedly improved the prediction.