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Prevalence of picky eaters among,Infants and toddlers and their caregivers' decisions about offering a new food

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Abstract

To determine the prevalence of infants and toddlers who were considered picky eaters, the predictors of picky eater status and its association with energy and nutrient intakes, food group use, and the number of times that caregivers offered a new food before deciding their child disliked it. Cross-sectional survey of households with infants and toddlers (ages four to 24 months) was conducted. National random sample of 3,022 infants and toddlers. Data included caregiver's socioeconomic and demographic information, infants' and toddlers' food intake (24-hour recall), ethnicity, and caregivers' reports of specified times that new foods were offered before deciding the child disliked it. For picky and nonpicky eaters, t tests were used to determine significant mean differences in energy and nutrient intakes. Logistic regression was used to predict picky eater status, and chi(2) tests were used for differences in the specified number of times that new foods were offered. The percentage of children identified as picky eaters by their caregivers increased from 19% to 50% from four to 24 months. Picky eaters were reported at all ages for both sexes, all ethnicities, and all ranges of household incomes. On a day, both picky and nonpicky eaters met or exceeded current age-appropriate energy and dietary recommendations. Older children were more likely to be picky. Those in the higher weight-for-age percentiles were less likely to be picky. The highest number of times that caregivers offered a new food before deciding the child disliked it was three to five. Dietetics professionals need to be aware that caregivers who perceive their child as a picky eater are evident across gender, ethnicity, and household incomes. When offering a new food, mothers need to provide many more repeated exposures (eg, eight to 15 times) to enhance acceptance of that food than they currently do.

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... Literature reviews indicate that picky eating is prevalent among children, especially in high income countries. Estimated prevalence of picky eaters in high income countries was 21% among children aged 3 -4 years old in USA by Jacobi C [9]; 19% to 50% among children aged 4 -24 months old by Carruth [10]; 44.6% among toddlers 12 -47.9 months old by Klazine van der Horst [11]; 14-17% among pre-schoolers in Canada by Dubois L [12]; 31% in Australia by Rebecca Byrne [13]; 39% of children 12-72 months old in Turkey by Orun E [14]; while Charlotte M Wright (2007) found a much lower prevalence in United Kingdom (8%) [15]. ...
... At present, as there is no consistent definition of picky eating, there is no unified and well-defined method of assessment [6]. Several different measures have been developed to assess picky eating, ranging from a simple single question ("Is your child a picky eater?" [10,25]) to more complex multi-item sub-scales in larger questionnaires, generally related to eating behaviours [7,[25][26][27][28]. Due to different assessment methods, prevalence of picky eating is variable, ranging from 20 to 60% in all children [29]. ...
... The scale was developed from three themes derived from observations and the scoring of the scale was quite consistent with the study by Huynh Van Son, implemented in the same country [21]. Prevalence of picky eaters in our study was 25.3%, much lower than prevalence's reported from previous studies with only one question "Is your child a picky eater?" [10,25]. ...
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ARTICLE INFO abstract Background and objectives: Picky eating is the rejection of a number of foods and low intake in children and is linked to nutritional problems. This study aimed to describe the prevalence and characteristics of picky eating as well as to explore the relationship between picky eating and nutritional status among Vietnamese children under five years of age in Hue, central Vietnam. Methods: Children under five years of age and their parents/caregivers were selected using a multistage sampling technique. The Picky Eating Scale (PES) previously developed in Vietnam was used with parents to estimate the prevalence of picky eaters. Using WHO Anthro software for nutritional status assessment. Statistical analyses were performed using SPSS 20.0. Data was reported as mean ± standard deviation (SD), numbers and percentages. Comparisons between groups were tested for statistical significance using Fisher's exact 2-tailed tests or 2-tailed t tests for independent samples as appropriate. Values of p<0.05 were considered statistically significant. Results: Seven hundred and seventy-two (772) children under five years of age were recruited. The mean age was 34.2 ± 15.5 months old. Half (50.8%) of the children were male. Prevalence of picky eaters was 25.3%. The most common signs of picky eating were eating less (63.6%), mealtime lasting for too long (62.1%), retaining food in the mouth for a long time (57.4%), and pressure eating (45.1%). Prevalence of underweight, stunting and wasting were 2.2%, 11.6% and 2.2%, respectively. There were negative relationships between picky eating and nutritional status, especially stunting and wasting (p<0.01). Conclusion: Picky eating was relatively prevalent among Vietnamese children under five years of age and might result in stunting and wasting.
... Picky eating is a common eating behavior among children [1][2][3][4][5][6], often causing considerable stress to parents and caregivers [6]. Children exhibiting picky eating behavior often demonstrate strong food preferences and rejection of particular foods or food texture [7], which may lead to limited dietary variety and possibly inadequate or unhealthy diet [8,9]. ...
... Therefore, a substantial body of literature has examined the relationship between picky eating and food intake among children. A common theme is that picky eaters tend to demonstrate unhealthy dietary behaviors as compared to non-picky eaters; they have lower intake of vegetables and fruits [3,8,[10][11][12], meat, and fish [10,12] than non-picky eaters, and higher intakes of savory snacks, sweets, sugary drinks, and French fries [3,10,13]. However, there is no clear evidence that nutrient intakes of picky eaters differ than that of non-picky eaters. ...
... Therefore, a substantial body of literature has examined the relationship between picky eating and food intake among children. A common theme is that picky eaters tend to demonstrate unhealthy dietary behaviors as compared to non-picky eaters; they have lower intake of vegetables and fruits [3,8,[10][11][12], meat, and fish [10,12] than non-picky eaters, and higher intakes of savory snacks, sweets, sugary drinks, and French fries [3,10,13]. However, there is no clear evidence that nutrient intakes of picky eaters differ than that of non-picky eaters. ...
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Children exhibiting picky eating behavior often demonstrate strong food preferences and rejection of particular foods or food texture, which may lead to limited dietary variety and possibly inadequate or unhealthy diet. Yet, the relationship between picky eating and nutrient intake in school-aged children has not been established previously. This study aimed to investigate the sociodemographic determinants of picky eating and the associations between picky eating and dietary intake in children. Data of 424 healthy Saudi children aged 6–12 years were collected from their mothers. A child’s picky eating habits were captured using a validated questionnaire. Sociodemographic characteristics of the children were assessed. Dietary data, including 24 h dietary recalls and frequency of fruit, vegetable, and milk consumption, were collected by dietetic professionals using phone-administered interviews. Compared to those of normal-weight mothers, children of mothers with obesity had higher odds of being in the highest tertile of picky eating (OR = 1.93; 95% CI 1.02, 3.63). Children exhibiting higher levels of picky eating consumed less fruits (B = −0.03; 95% CI −0.06, −0.01), vegetables (B = −0.05; 95% CI −0.07, −0.02), and protein (B = −0.21; 95% CI −0.33, −0.09), and had higher consumption of trans fatty acid intake (B = 1.10; 95% CI 0.06, 2.15). Children with higher levels of picky eating presented unhealthy dietary behaviors. Future studies are needed to examine the long-term effect of picky eating on cardiovascular health. Dietary behaviors of mothers with obesity must be taken into consideration when designing intervention programs aiming to improve eating behaviors of children.
... Food neophobia refers to the reluctance to eat or even try foods that appear novel (Pliner & Hobden, 1992). Most researchers agree that food neophobia peaks between 2 and 6 years of age (Carruth et al., 2004;Cashdan, 1994;Dovey et al., 2008;Dubois et al., 2007;Lafraire et al., 2016a;Mascola et al., 2010). Before the neophobic onset, children are very willing to accept foods, even new ones, especially from caregivers. ...
... Cooke, 2007;Wardle et al., 2003). This is a number greater than most parents are willing to provide (Carruth et al., 2004). ...
... Further analysis of this data revealed that childhood severe food rejection was associated with increased risk for anorexia nervosa compared to less severe and more transient food rejection (Herle et al., 2019). On the other hand, it has been argued that since food rejection significantly reduces the consumption of fruits and vegetables, food neophobia and pickiness may, instead, lead children to restrict themselves largely to palatable, energy-dense, high-fat, high-sugar foods, which in turn could put children at risk for excess weight gain (Carruth et al., 2004). Recent evidence from Finnish (Knaapila et al., 2015) and Italian (Proserpio et al., 2018) adults populations suggests that participants suffering from obesity were significantly more neophobic (food neophobia was measured using the Food Neophobia Scale, Pliner & Hobden, 1992) compared to a healthy control group. ...
Thesis
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Food neophobia and pickiness are two strong psychological obstacles to young children’s consumption of fruits and vegetables, which are necessary components of a diet that facilitates normal and healthy development. It is therefore of critical importance to investigate the cognitive underpinnings of these two kinds of food rejection to promote the adoption of healthy eating behaviors. Food acceptance and rejection appear to be partly conditioned by children’s knowledge of the food domain. Knowledge allows children to recognize a given food, categorize it, and make inference-based decisions on its properties and possible consequences of consumption. Underdeveloped knowledge may cause food stimuli or situations to appear uncertain. Uncertainty will increase the likelihood of food being rejected, regardless if it is edible or previously accepted under another method of preparation. To tackle food rejection, interventions had, thus, aimed to increase children’s familiarity and knowledge through educational-based programs or repeated exposures to target foods.However, despite overall successes, such interventions had limited benefits for highly neophobic and picky children. High levels of food rejection have been associated with strong emotional and physiological responses, similar to reactions found in phobias. This fear may inhibit children’s learning ability. Consequently, neophobic and picky children may be unable to develop their knowledge of the food domain. Previous evidence, indeed, demonstrated that children’s food rejection was inversely related to their knowledge of food categories.In this context, the first objective of the present thesis was to investigate the twofold driver of food rejection: the gaps in food knowledge and the fear-conditioned withdrawal strategies in uncertain food situations. The food processing variable was also manipulated to test the hypothesis that children could rely on visual cues such as slicing to overcome their fear. The results revealed that food rejection was related to decreased categorization performance and heightened caution. Neophobic and picky children over-executed caution and, compared to their more neophilic and less picky counterparts, did not rely upon the variable of food processing as a safety cue. To develop the knowledge of children with high food rejection, it might be first necessary to overcome their fear of the learning situation.The second objective was to investigate whether executive functions (i.e., working memory, inhibition, and cognitive flexibility) were implicated in food rejection. Underdeveloped executive functions would explain neophobic and picky children’s difficulties to extract information from food-related learning opportunities, rigid behaviors toward dietary variety or meal preparations, and appropriate use of previous knowledge. This investigation revealed negative relations between food rejection and executive functions, more precisely decreased inhibition and cognitive flexibility in highly neophobic and picky children. Cognitive flexibility was also found to mediate the relationship between food rejection and categorization abilities. The results add to the body of evidence that executive functions play an important role in food-related behaviors.The thesis contributes to the understanding of the development of food rejection in young children and sheds light on different factors influencing children’s learning ability in the food domain. This contribution is valuable for our understanding of neophobic and picky children’s difficulties to learn and to act appropriately about foods and the development of interventions aiming at improving their eating habits.
... From the post-weaning period, children become more involved in food-decision making and exert greater selectivity in their consumption of foods (Addessi et al., 2005;Cashdan, 1994;Cooke et al., 2003). Witnessed in concomitance to this increased independence, is a greater level of food rejection in children (Carruth et al., 2004;Levene & Williams, 2017). The two correlated dispositions of food neophobia and food pickiness heavily account for food rejection tendencies in children between 2 and 7-years-old (Carruth et al., 2004;Levene & Williams, 2017). ...
... Witnessed in concomitance to this increased independence, is a greater level of food rejection in children (Carruth et al., 2004;Levene & Williams, 2017). The two correlated dispositions of food neophobia and food pickiness heavily account for food rejection tendencies in children between 2 and 7-years-old (Carruth et al., 2004;Levene & Williams, 2017). ...
... Intake of fruits and vegetables is alarmingly low in young children, and dietary variety is problematic in the early years (Carruth et al., 2004;Levene & Williams, 2017). Food neophobia and food pickiness are two of the greatest barriers to food acceptance and dietary variety, but the mechanism underpinning these dispositions remains elusive. ...
Thesis
Insufficient dietary variety in children leads to significant nutrient deficiencies and health issues, both in childhood and later life (DeCosta et al., 2017). Cognitive mechanisms, such as categorization and conceptual knowledge, play an important role in understanding and appropriately accepting or rejecting foods (Mura Paroche et al., 2017). The food domain lends itself to many concepts and categories, such as taxonomic (i.e., lamb is meat), thematic (i.e., lamb goes on a plate), or script (i.e., lamb is eaten at dinner). Such knowledge aids accurate recognition, understanding, and appropriate interaction when confronted with foods situated in context. If conceptual knowledge is underdeveloped, the possibility to understand food and eating situations is mired. When faced with such uncertainty in the food domain, children with increased food rejection tendencies are likely to reject a substance, regardless of whether it is edible or not. It thus stands to reason that impoverished conceptual knowledge in the food domain will lead to increased displays of food rejection in children. Previous evidence demonstrated that food rejections (food neophobia and picky/fussy eating) are associated with impoverished knowledge of taxonomic categories in the food domain (such as the food groups: fruits or vegetables). However, young children have access to other forms of conceptual knowledge to help interpret situations and objects, such as script categories (i.e., breakfast foods) or thematic associates (i.e., soup and spoon). The overarching aim of my research, beginning in October 2018, was to expand upon these previous findings by determining whether food rejection is related to deficits in specific knowledge structures (script and thematic categories), or a global deficit in knowledge of food. The first step of the research required determining at what age children acquire certain types of knowledge and categories in the food domain. The second step was to determine how food rejection influences such knowledge acquisition. Four empirical studies were conducted over the past three years with children between 3 and 7 years old. My findings show that young children first master functional and co-occurring food relations (i.e., soup and spoon), and later master food scripts (i.e., food to expect at breakfast). This indicates that children as young as 3 and 4 years old may already rely on common cooccurrence to guide their food acceptance in eating situations, while older children may depend on script norms. As with taxonomic knowledge, children with poorer conceptual knowledge of both script and co-occurring relations in the food domain exhibit increased levels of food rejection. The research findings provide compelling evidence that educating children about conceptual knowledge and food norms could be an effective strategy for increasing familiarity and subsequently promoting greater food acceptance. The research concludes by suggesting opportunities for developmental psychologists and public health professionals to develop educational initiatives to improve children’s knowledge of food and foster increased dietary variety.
... Feeding disturbances can occur even in the absence of problems with nutritional intake [1][2][3] and only 1-5% of TD children below 3 years of age exhibit severe feeding problems resulting in failure to thrive [4]. In early childhood, feeding problems range from transient and relatively minor difficulties at mealtimes to life-threatening food refusal and severe feeding disorders (FDs) that could lead to important health and psychosocial consequences and become stable traits [5,6]. In particular, FDs are characterized by chronic feeding problems and their prevalence in US children is between one in twenty-three and one in thirty-seven children under five years of age [7]. ...
... (4) Eating only while asleep. (5) Failure to transition to solid food. (6) Eating only when specific conditions imposed by him/ her are fulfilled by caregivers (e.g., in front of television with a specific program, with toys and stories). ...
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Purpose To provide a description about a cohort of preschoolers with feeding disorders (FD) recruited from the therapeutic nursery “Cerco Asilo” of a tertiary care University Hospital, and to evaluate the short-term clinical outcome after 6 months of multidisciplinary treatment. Methods The present inception cohort study was based on an observational longitudinal research design comparing families who underwent the multidisciplinary treatment and those who did not. 42 children (47.6% female; 52.4% males—mean age 36.7 months, SD 17.2, range 2.3–65 months) underwent FD assessment according to the DC-0-3R diagnostic criteria (T0). At the end of the assessment, 62% of families with FD children agreed to be included in the family-based treatment. Both treated and untreated children with FD underwent a follow-up clinical evaluation after 6 months (T1) from baseline. Comparison of clinical features at T0 between groups of subjects resolving or not the FD was performed. To evaluate baseline factors associated with FD resolution, principal components analysis (PCA) was used to identify new synthetic variables that were then used in a logistics analysis. Moreover, clinical differences between T1 and T0 were compared with a t test. Results Two third of the cases (66.7%) resolved the FD, while one third (33.3%) did not. Children who had the FD resolved displayed at T0 significant differences in clinical features with respect to those who did not. Specifically, the FD subtype Feeding Disorder of Caregiver-Infant Reciprocity was strongly associated with resolution, while the subtype Infantile Anorexia was not. In addition, the component depicting “Anxious-Depressed”, “Mood” and “Isolation” problems was independently associated with a significantly higher probability of resolution, similar to children having FD other than anorexia. Conclusions FD in preschoolers are associated with problems in emotional development and in the relationship with parents. These difficulties tend to accentuate if the disorder persists. The study suggests the need to investigate the maintaining factors of FD in preschool age. Level of evidence Level IV: Evidence obtained from multiple time series with and without the intervention.
... Neophobia or new food refusal (ranging from severe rejection to a moderate manifestation) is a common behaviour in children and should be carefully considered due to the important implications on the current and future health status of the infants [1][2][3]. Parents, caregivers and health professionals are concerned about infant food neophobia and picky eating, since it can derive in an inadequate diet [4,5]. The American Psychiatric Association described food neophobia as 'avoidance and/or restriction to food based on the extreme sensitiveness to the appearance, colour, smell, texture, temperature or taste' [6]. ...
... Hay et al. [7] described a 0,3% prevalence in the Australian population over 15 years of age and showed an association to socio-economic disadvantaged groups and obesity. Although there is limited prevalence data, it is known that clinically significant feeding and eating difficulties are common in early childhood, with estimates of 5-25% in young children [1,8]. Neophobia has been linked to poor growth and deficient development [9,10]. ...
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Background Children usually refuse to eat and taste fruits and vegetables; and turning unhealthy eating habits around is an important social challenge in industrialized countries. The Dastatuz project aims to study children food neophobia and to enhance fruit and vegetable acceptance. Methods A quasi-experimental, multicentre, controlled and prospective intervention study is proposed, in which early factors influencing new food acceptance will be studied. Mothers in the third trimester of pregnancy ( n = 144) and their infants will be the study population. Experimental groups will be established based on mothers´ fruit and vegetable intake (standard or high intake) and weaning method (baby lead weaning vs spoon feeding). The project will assess the possible impact of maternal diet and complementary feeding on infants eating behaviour until 18 months of age. Outcome measures will comprise maternal diet and psychological features during pregnancy and breast-feeding (validated questionnaires). Compositional and physicochemical analysis of milk during breastfeeding will also be carried out. During weaning, until 18 months of age, children’s diet will be assessed with 24 h recalls and acceptance of new fruits and vegetables will be studied using video recording. Discussion If the intervention is effective, this research work would have a high potential to be transferred to future public health programs or nutrition guidelines, as a feasible solution to achieve a higher intake of fruits and vegetables among children. Trial registration This study is registered at ClinicalTrials.gov. Identifier: NCT04262102 . Registration date: February 10, 2020 - Retrospectively registered.
... The reported prevalence of picky eating was within a wide range in various studies. Tharner et al. reported a prevalence of 5.6% [7], Micali et al. reported 7.3% [8], and Machado et al. found a prevalence of 25.1% [9], whereas Carruth et al. found picky eating ranging from 17% to 47% for males and 23% to 54% for females [10], and Xue, Lee et al. reported a prevalence of 59% [11]. The current consensus is that the development of picky eating is influenced by range of factors including the absence or short duration of exclusive breastfeeding and early introduction of complementary foods (before six months) [12], genetic factors [13], personality factors [5], parental practices and feeding styles [5], paternal controlling feeding [14], or other pressures to eat [5,15,16]. ...
... Some of the studies also found that picky eaters ate fewer calories than non-picky eaters. Specifically, less total energy, less protein, and fewer total fats were consumed, and picky eaters had a smaller intake of fruit and vegetables, meat, and other protein sources [7,10,18] and sweets [16]. Moreover, the picky eaters were found to have a lower mean intake of carotene, iron, and zinc [19]. ...
Article
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Objective: This study aimed to evaluate whether preschool children identified as picky eaters showed differences in anthropometric characteristics (weight and height) from their non-picky peers at 15 years of age. Design: This study was performed among the cohort members of the EL- SPAC-CZ study, a longitudinal study of pregnancy and childhood. The analysis included 2068 children (997 girls and 1071 boys) followed between births and 15 years of age. Picky eaters were identified at 1.5, 3, and 5 years of age. Anthropometric characteristics were measured at 15 years of age (15 years). Results: Picky eaters (n = 346; 16.7%) had a lower weight and height than non-picky eaters (n = 1722; 83.3%) at 15 years. This difference in weight and height was maintained after controlling for sex of the child, birth weight, birth length, maternal education, family structure at 15 years, and maternal age at childbirth. The picky children were on average 2.3 kg lighter and 0.8 cm shorter than non- picky children at 15 years. Conclusions: Persistent picky eating in preschool children is related to lower weight and height at 15 years of age in ELSPAC-CZ study.
... Food fussiness, described as the consumption of an inadequate variety of foods through the rejection of both familiar and unfamiliar foods is frequently reported by parents as a challenge (Carruth, Ziegler, Gordon, & Barr, 2004;Mascola, Bryson & Agras, 2010). Food fussiness adversely influences dietary variety, quality and optimal nutritional intake (Carruth et al, 1998;Jacobi, Agras, Bryson & Hammer, 2003;Jacobi, Schmitz & Agras, 2008;Tharner et al. 2014;Volger et al. 2017). ...
... Preschool-aged children (3-4 years) were recruited as part of a larger study called the 'Watch Them Grow' (WTG) project (Dodd et al, 2020), which focused primarily on preschool predictors of anxiety when children start school. This age range was selected due to its association with increased parental perception of food fussiness (Carruth et al., 2004;. Recruitment for the WTG project took place via local Facebook groups, advertising through nurseries and paid magazine advertising. ...
Article
The present study investigated associations between children’s sensory reactivity and food fussiness to determine whether these associations remained after controlling for child temperament. Data regarding children’s sensory processing was obtained from 79 mother- child dyads via observation (children were presented with sensory stimuli) and maternal-report. Mothers also completed questionnaires measuring child temperament and food fussiness. Correlation analyses showed that high sensory reactivity in taste, olfactory and tactile sensory modalities were significantly positively associated with food fussiness. Hierarchical regression analyses revealed that taste, olfactory and tactile reactivity explained a significant proportion of variance in food fussiness over and above emotional temperament. There was no significant interaction between emotionality and sensory reactivity in predicting food fussiness across any measured sensory modalities.
... The HUT in the present study was developed for greater ecological validity by addressing and improving upon the challenges faced by previous feeding studies (Musso et al., 2018). Many previous food texture studies have been conducted using surveys (Carruth, Ziegler, Gordon, & Barr, 2004;Demonteil et al., 2018). Studies have also been conducted in central locations such as schools (Wardle, Herrera, Cooke, & Gibson, 2003), day care facilities (Werthmann et al., 2015) or other defined research settings (Demonteil et al., 2019;Lundy et al., 1998). ...
... Liking and acceptance of new foods in children increase with repeated exposures (Cooke, 2007;Nederkoorn et al., 2018;Wardle et al., 2003). In a study of 3,022 infants and toddlers (ages 4-24 months), 6-9% of caregivers offered a new food to their child more than 6 times (Carruth et al., 2004). And $25% of the caregivers offered new foods only 1-2 times before they decided their child disliked the food. ...
Article
This paper describes the development of a method to evaluate the acceptance of different snack food textures by children with food texture sensitivities, including children with and without Down syndrome (DS). An in‐home use test (HUT) was developed to reflect recent taste study and allow greater recruitment. In this study, parents with children (ages 11 to 60 months) with DS (CWDS) and without (typically developing, CTD) were recruited and based on responses to several questions, children were categorized as food texture sensitive (TS) or non‐texture sensitive (NTS). In total, 111 CWDS (49 TS and 62 NTS) and 107 CTD (42 TS and 65 NTS) participated. To select the food products for assessment, a trained panel profiled commercially available infant and toddler solid snack foods (n = 41), from which 16 products were selected and sorted into four flavour groupings. For the HUT, participating children evaluated each food product once per day for 6 days. Parents recorded their children's reactions to each food product; a panel of trained coders coded each video for verbal and non‐verbal behaviours using a novel coding scheme. Parent prompts were also coded. Several challenges were experienced during this study, including poor‐quality videos, and standardization of the home environment during the feeding sessions. However, the high degree of successful completion of the HUT (96%) was attributed to the high motivation of the parents involved, as well as the close interaction between the experimenters and the participants on an individual family level. This article is protected by copyright. All rights reserved.
... and "My child prefers one texture of food." For the question regarding being a "picky eater," the term was not defined for the caregiver rather it was the caregivers' perception that was used (Carruth, Ziegler, Gordon, & Barr, 2004). ...
... In the future, more extensive measures should be included to elucidate more of the complexity of the relationship among food and texture preferences and other child and parental variables (Wolstenholme, Kelly, Hennessy, & Heary, 2020). Extensive research has established the importance of early feeding behavior and a high-quality feeding environment for healthy feeding outcomes (Carruth et al., 2004;Coulthard, Harris, & Emmett, 2010;van der Horst et al., 2016). Parenting feeding practices have also been shown to influence feeding (Berge, Trofholz, Schulte, Conger, & Neumark-Sztainer, 2016;Boquin, Moskowitz, et al., 2014;Goodell, Johnson, Antono, Power, & Hughes, 2017;Russell & Worsley, 2013;Taylor, Wernimont, Northstone, & Emmett, 2015;Trofholz, Schulte, & Berge, 2017;Wolstenholme et al., 2020). ...
Article
Understanding food texture sensitivity in children is important in guiding food selection. The objective of this work was to develop a short questionnaire that could be completed by parents in non‐clinical settings to provide a categorization for food texture sensitivity in children. This study evaluated the distribution of children as TS (texture sensitive) or NTS (non‐texture sensitive), and the predictive validity of these questions to explain rejection of specific food textures. Three sets of survey data were examined, including data from a home‐use test (HUT) in children with and without Down syndrome (DS), and lingual tactile sensitivity measured by grating orientation task (GOT). From three parent‐completed surveys, the use of the questionnaire yielded a similar distribution of children in the TS category (16‐22%) as previously reported. TS children (4‐36 months) were more likely to reject specific food textures, including chewy, hard, lumpy, and “tough meat” (p<0.05). A higher percentage of children with a diagnosis of DS were TS (36.9%). Children who were TS showed increased negative behaviours to foods and ate less than NTS children. In older children (5‐12 years), TS children were fussier than NTS children (p<0.001). Lingual tactile sensitivity was not significantly different by TS/NTS categorization (p=0.458). This study demonstrated the use of these five questions specific to food texture provides a useful tool in categorizing a child as TS/NTS, with this information being useful in selecting preferred food textures. Future studies involving these TS questions should perform psychometric assessments and measures of criterion validity using other questionnaires.
... This is despite evidence that children may require up to 10-15 exposures to increase liking for, and consumption of, a previously disliked food (Wardle et al., 2003). Parents' reluctance to repeatedly offer a previously disliked or rejected food has been demonstrated previously, with many parents not persisting beyond five attempts (Carruth et al., 2004). This may indicate that parents have unrealistic expectations of how quickly responsive feeding practices will address fussy eating. ...
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The development of healthy eating habits in childhood is essential to reducing later risk of obesity. However, many parents manage fussy eating in toddlerhood with ineffective feeding practices that limit children's dietary variety and reinforce obesogenic eating behaviours. Understanding parents' feeding concerns and support needs may assist in the development of feeding interventions designed to support parents' uptake of responsive feeding practices. A total of 130 original posts by parents of toddlers (12–36 months) were extracted from the online website Reddit's ‘r/Toddlers’ community discussion forum over a 12‐month period. Qualitative content analysis was used to categorise the fussy eating topics that parents were most concerned about and the types of support they were seeking from online peers. The most frequently raised fussy eating concerns were refusal to eat foods offered, inadequate intake (quantity and quality), problematic mealtime behaviours and changes in eating patterns. Parents were primarily seeking practical support (69.2%) to manage emergent fussy eating behaviours. This consisted of requests for practical feeding advice and strategies or meal ideas. Nearly half of parents sought emotional support (47.7%) to normalise their child's eating behaviour and seek reassurance from people with lived experience. Informational support about feeding was sought to a lesser extent (16.2%). Fussy eating poses a barrier to children's dietary variety and establishing healthy eating habits. These results suggest parents require greater knowledge and skills on ‘how to feed’ children and support to manage feeding expectations. Health professionals and child feeding interventions should focus on providing parents with practical feeding strategies to manage fussy eating. Supporting parents to adopt and maintain responsive feeding practices is vital to developing healthy eating habits during toddlerhood that will continue throughout adulthood.
... and the prevalence of pickiness in the study marked the highest (59.3%) among the included studies. Similarly, much higher prevalence of fussiness was observed in toddlers (50%) and 3-5-year-old children (21%) when a single item was used compared to studies using questions with multi-items (Carruth, Ziegler, Gordon, & Barr, 2004;Jacobi, Agras, Bryson, & Hammer, 2003). This study with high prevalence showed no significant difference in the associations between birth weight and pickiness, unlike all the other studies which found negative relationships between birth weight and food fussiness. ...
Article
Children’s biological characteristics are a crucial element in understanding the mechanisms and pathways of their eating behaviors and development. However, the role of biological characteristics in food fussiness has not been systematically examined. The aim of this review was to search, collate and summarize the evidence on associations between food fussiness and biological characteristics in children’s fussy eating behaviors. A systematic review was performed with two main search concepts, food fussiness and biological characteristics in children, with 46 articles included. Mixed Methods Appraisal Tool was used for quality assessment with the included articles ranging from medium-high to high quality. Food fussiness was associated with diverse biological characteristics including age, sex, temperament, heritability, birth weight, sensory sensitivity, eating rate, leptin level and chemosensory receptor genes. While the strength and direction of associations varied across studies, the most consistent evidence was for negative associations between fussiness and birth weight, eating rate, leptin level and inhibitory control and positive associations with sensory acuity, emotionality, negative affect and shyness. This review has highlighted that many biological characteristics are related to food fussiness, yet there is inadequate attention directed to understanding mechanisms and pathways linking the biological characteristics with food fussiness as well as advancing conceptualization and measurement of fussiness.
... this is when solid food feeding habits are established, 24 and studies have demonstrated stability in feeding problems across early childhood. 19,22 In a subgroup, we explored associations between feeding problems at 30 months and performance on a standardized developmental test at 4 years. ...
Article
Objective To determine if feeding problems are an indicator of developmental delay. Study design In this prospective longitudinal cohort study, mothers of 3,597 children (49% female, 35% multiples) reported on their children’s feeding problems and developmental delays (using the Ages and Stages Questionnaire, ASQ) when children were 18, 24, and 30 months of age. Average scores of feeding problems were computed at each age, as well as a categorical score indicating persistently high feeding problems ≥90th percentile across time. The Battelle Developmental Inventory (BDI-2) assessed development in 5 domains for a subset of children at 4 years. Results In adjusted analyses, feeding problems (per point increase) were increasingly associated with six ASQ domains from 18 months (Odds Ratios (ORs) ranged from 1.30 to 1.98) to 24 months (ORs = 2.07 – 2.69) to 30 months (ORs = 3.90 – 5.64). Compared with children who never experienced feeding problems, children who experienced high feeding problems at one or two time points were more than twice as likely to fail all ASQ domains (ORs = 2.10 – 2.50), and children who experienced high feeding problems at all three time points were four or more times as likely to fail all ASQ domains (ORs = 3.94 – 5.05). Children with one-point higher feeding problems at 30 months scored 3-4 points lower on all BDI-2 domains at 4 years. Conclusions Frequent feeding problems, especially those that persist into the third year, could be used to identify children at risk for developmental delay for more targeted screening.
... The source of nutrition for infant aged 0-6 months is breast milk or formula milk. When the infant is 6 months old, they should start getting their first food or also called complementary food because breast milk is no longer able to provide energy, protein, iron, vitamins D and A. The absence of a good recognition of infants in complementary foods would lead to feeding difficulties in children under three years of age [1][2][3]. ...
... Such behavior can lead to overeating or detestation of food. This in turn can subsequently result in obesity or eating problems [6,21]. ...
Article
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Eating problems are common in childhood and being seen in 25%-45% of healthy children. The period following the first year of life up to five years is when eating problems are most frequently reported and also when the child acquires eating habits. Several studies have shown that eating behavior is affected by the family environment, and by parental eating habits and modes of feeding their children. The purpose of this study was to investigate the eating behavior characteristics of children in early childhood, to determine the frequency of problematic eating behaviors, and to compare these with the family’s sociodemographic characteristics. The study consisted of 255 children aged 1-5 years, with no chronic disease, presenting to İzmir Tepecik Education and Research Hospital Child Health and Diseases Department general pediatric clinics between February and April, 2017, together with their parents. In the study, 39 questions were asked to parents related to children’s demographic characteristics and eating behaviour. Problematic eating behavior was present in 43.9% of the study group. Analysis identified feeding bottle use, feeding with the use of an assistant object, eating lasting longer than half an hour, and the child not feeding itself as the most frequent eating problems. Malnutrition was present in 104 (65.8%) of the children with problematic eating behavior. Examination of unhealthy eating behavior in the light of the study findings showed no significant association between eating behaviors and variables such as type and time of delivery, maternal education level, maternal employment status, maternal age, or the number of children in the family. In terms of nutrition status, Turkey appears to exhibit problems associated with both developed and developing countries. Public nutrition in Turkey fluctuates significantly depending on the region, the season, socioeconomic levels, and differences between urban and rural settlements. Early-onset of eatingrelated problems can have a negative effect on children’s subsequent physical, emotional, and social development. Determination in the early period of eating problems seen in children and investigation of the causes thereof is important in terms of identifying a potential solution. It is important to work with the family to that end, and for children to be followed-up by pediatricians at regular intervals.
... Feeding problems occur commonly in childhood (Mascola et al., 2010). Children who experience early feeding and eating problems eat fewer fruits and vegetables (Howard et al., 2012;Perry et al., 2015), have poorer dietary quality and variety (Bell et al., 2018;Perry et al., 2015) and slower growth (Carruth et al., 2004). Children with Down syndrome have been reported to experience more feeding problems than typically developing (TD) children but there is a lack of research on the relationship with eating behaviours and parental feeding practices. ...
Article
Background Research investigating feeding problems in children with Down syndrome is scarce. This study investigated feeding problems, eating behaviours and parental feeding practices in children with Down syndrome (n = 40), and typically developing (TD) children of the same age and sex (n = 40). Method Parents of children aged 6-months to 5-years in the UK completed questionnaires assessing their child's feeding problems and eating behaviours and parental feeding practices. Results For children with Down syndrome, feeding problems were: significantly greater than for TD children; negatively associated with breast milk duration and appetite during exclusive milk feeding; and positively associated with drinking more slowly. For both groups, feeding problems were significantly correlated with more food avoidant eating behaviours. Conclusions This study provides new information about the relationships between feeding problems and eating behaviours in early development. Longitudinal research is needed to further investigate these relationships, so that effective support can be developed for families.
... It has been suggested that mothers tend to play the primary roles in caregiving of their children (Belsky, 1979;Clarke-Stewart, 1978). For example, a national random research showed that 91% of American mothers are primarily responsible for choosing and preparing food and caregiving of their infants (Carruth et al., 2004). Moreover, on average mothers spend far more time with their children than do fathers. ...
Article
Purpose The study was conducted to explore the degree to which caregiver burden is associated with sleep quality in parents of children with autism spectrum disorder, and to determine a statistically valid cutoff score for the Caregiver Burden Inventory (CBI) in order to identify parents of risk of poor sleep quality. Design and methods We conducted a cross-sectional analysis. We assessed caregiver burden with the CBI, sleep quality with the Pittsburgh Sleep Quality Index, emotional status with the Hospital Anxiety and Depression Scale, and impact on family with the Impact on Family Scale. Caregiver burden was evaluated with a logistic regression analysis. The best fit model was used in a receiver operating characteristic analysis. Likelihood ratios and post-test probabilities were calculated. Results A total of 116 parents were included in this study. Higher caregiver burden was associated with a reduction in sleep quality in the logistic regression analysis (p < 0.001). The area under the curve for the univariate burden test model (best fit) was 76.70 (p < 0.001). The cutoff score for poor sleep quality was caregiver burden ≥26.50. The post-test probability of poor sleep quality increased to 82.02% from a pre-test probability of 76.72%. Conclusions Our findings suggest that caregiver burden is associated with sleep quality among parents of children with autism spectrum disorder. The findings suggest that a CBI cutoff score of 26.50 may help to detect risk of poor sleep quality in parents of children with autism spectrum disorder.
... 12,13 Children are more willing to accept a healthy diet if parents use encouraging behavior at mealtimes. 14,15 Although parents value feeding their children a healthy diet, it is one of the most difficult parental responsibilities, 16,17 warranting further exploration. ...
Article
Objective To use the Theory of Planned Behavior (TPB) to assess mothers’ behavioral intentions to provide toddlers with a healthy diet and see if the addition of the parental role construction (PRC) variable strengthened the TPB. Design An online survey using data gathered from preliminary research and a previously validated survey. Participants The final sample consisted of 148 mothers. The mean age was 32.8 (SD = 6.16) years. Most participants were married (87.2%), had earned a college degree or higher (79.7%), held part-time or full-time employment (60.8%), and White (90.3%). Main Outcome Measures The TPB constructs, PRC, and the mothers’ behavioral intentions surrounding toddler feeding. Analysis The determinants of intention per the TPB were explored using descriptive statistics and multiple linear regression. Results The TPB model predicted 53% of the variance in mother's behavioral intention to provide their toddler with a healthy diet. The addition of the PRC variable added 6% more predictive power to the model. Conclusions and Implications Mothers’ behavioral intentions surrounding feeding their toddlers were strongly influenced by the TPB constructs and their perceptions of the maternal role. Health promotion efforts should aim to increase the mother's sense of behavioral control and parental responsibility rather than focusing on the benefits of healthy eating.
... The second assessment of PE in the survey was a single five-point item to assess parental perception of the child's PE status. Many authors have noted that the literature lacks a consistent definition and measurement tool for PE [1,3,9,17,39]; however, caregiver response to a single question has been shown to predict PE behaviour [40][41][42]. Despite this, at least one review has indicated that the use of one question to assess PE is a concern [39], thus we assessed the relationship between the 4-item CFNS and the PE question. ...
Article
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The objective was to assess the relationship between children’s picky eating (PE) status and nutrient intake from home-packed school lunches. The lunches of 321 students, aged 7–10 years, were quantified via cross-sectional direct observation. Children were classified as having PE (n = 155) or not (non-PE; n = 166) based on food neophobia scores and parental perceptions of PE. The PE group consumed significantly less protein, folate, magnesium, potassium, zinc, and vitamins B1, B2, B3, B6, D, and E than the non-PE group; however, both groups consumed amounts exceeding Dietary Reference Intakes (DRIs) for protein, carbohydrates, sugar, sodium, iron, and vitamins B1, B2, B3, B6, B12, and C. Conversely, both groups consumed amounts significantly lower than DRIs for calcium, fibre, folate, magnesium, potassium, zinc, and vitamins A, D, E, and K. The PE group ate significantly less meat and alternatives, vegetables and fruit, and fruit than the non-PE group, and did not meet any of Canada’s Food Guide (2007) recommendations. The non-PE group met recommendations for meat and alternatives only. PE impacts the dietary intake of children’s home-packed lunches; however, many packed lunches were of low nutritional quality. Focus should be placed on provision of nutritionally complete school lunches for all children.
... Our findings additionally align with child care providers' reporting that children's refusal to taste new foods, or "picky eating," is a significant barrier to serving healthful food items [22,53]. While children exposed to a higher variety of foods are more likely to consume a higher variety of food items overall [7,8], many FCCH providers are not aware that children need a minimum of 8-15 exposures to a food before acceptance [54]. Thus, FCCH providers should be encouraged to continue serving high-quality foods to children, while implementing healthful practices during mealtime to encourage children's consumption. ...
Article
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Child care environments foster children’s healthy eating habits by providing exposure to healthy foods and feeding practices. We assessed the healthfulness of nutrition environments, menu/meal quality, and the achievement of Child and Adult Care Food Program (CACFP) guidelines and best practices in Oklahoma CACFP-enrolled family child care homes (FCCHs) (n = 51). Two-day classroom observations were conducted. Healthfulness of classroom nutrition environments was assessed using the Environment and Policy Assessment and Observation (EPAO). Foods served to and consumed by children were quantified using the Dietary Observations in Child Care (DOCC) tool. Nutrient analysis was performed to determine total energy for foods listed on menus, served to, and consumed by children. Menu and meal food variety and CACFP Guideline Achievement Scores were determined. Average nutrition environment score was 11.7 ± 1.2 (61.5% of maximum possible score). Energy (kcals) from menus and consumed by children was insufficient to meet two-thirds of their daily reference intake. Children were exposed to 1.7 vegetables and 1.3 fruits per meal. CACFP Guideline Achievement Scores were 66.3% ± 7.8 for menus and 59.3% ± 7.6 for mealtimes. Similar to previous research, our findings indicate a need for improved FCCH nutrition practices. Tailored interventions for FCCHs are needed.
... The children (N = 328) were categorized into the five AGs of 4-8 months (65 children), 9-12 months (53 children), 13-18 months (61 children), 19-24 months (74 children), and 25-36 months (75 children). These AGs were selected based on other relevant child feeding studies (Carruth, Ziegler, Gordon, & Barr, 2004;Demonteil et al., 2019;Smith-Simpson, Fries, & Ross, 2019;van der Horst, Deming, Lesniauskas, Carr, & Reidy, 2016 foods (defined as any food other than breast milk or formula). Participants were also asked about their child's teething status. ...
Article
The question of what to feed becomes a new challenge as an infant reaches the transition to complementary foods. Limited information is available that provides a texture progression map for complementary food introduction. Thus, the objective of this study was to determine the relationship between age and food texture experiences (FTE) in young children aged 4-36 months in the United States. A parent-reported survey was fielded with 328 children categorized into five age groups (AGs): 4-8 mo (AG1), 9-12 mo (AG2), 13-18 mo (AG3), 19-24 mo (AG4), 25-36 mo (AG5). The present study analyzed four questions focused on food texture experiences, with statistical analyses including probit and logit models, and analysis of variance. Results showed that all 16 food textures were tried at least once (>50%) by AG3. The question answered by participants, “How well does your child manage a specific texture” showed that significant differences existed among AGs for the management of ten food textures (including chewy, hard, soft), whereas teething alone had no effect. The most refused textures by the children were: AG1 - crispy (27%), AG2 - leafy (23%), AG3 - leafy (40%), AG4- tough meat (52%), and AG5 - leafy (51%). With increasing AG, the refusal probability of nine food textures, including chewy, leafy, and rubbery, also increased (p<0.05). The refusal probability of cold food temperatures decreased with increasing age (p<0.05). This study observed FTE in children across AGs and provides useful information to parents and practitioners as they introduce food textures into children's diets. This article is protected by copyright. All rights reserved.
... Although repeated exposure may improve children's target vegetable consumption, caregivers abandon efforts as they believe that the child will not eat the food after 3-to-5 exposures (23) . Additionally, ECE teachers have reported limited financial resources to buy fresh foods for hands-on nutrition education rather than for consumption (24) . ...
Article
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Objective To determine whether the ‘Read for Nutrition’ program would increase liking and consumption of broccoli (a target vegetable) in preschool children and test acceptability and practicality of the program. Design Pilot pre-post intervention study, where childcare teachers received training and coaching followed by reading the book “Monsters Don’t Eat Broccoli” multiple times with the children during a three-week intervention Setting Five classrooms of Educare (blinded for peer review) in 2018. Participants Sixty-nine (11 to 16 children per classroom) preschool-aged children and sixteen teachers (minimum, three per classroom). Results Average total consumption of broccoli increased 35% (0.14 ounces or 0.05 th cup) after the ‘Read for Nutrition’ program ( t =2.66; p = .01; 95% CIs [0.035, 0.246]) for all children. Proportional consumption increased for children who received ≥ five exposures to the book ( t 46 =2.77; p = .008). Exposures to the book predicted proportional consumption ( β =.365; p =.002). Liking of broccoli increased ( W 69 =2.2, p =.03) as well. Teachers rated the program as acceptable, practical, and enjoyable to children and to themselves. Conclusions Programs such as ‘Read for Nutrition’ have the potential to improve children’s vegetable liking and consumption in ECE settings with only book readings and no exposure to a real vegetable.
... presents between the age of 12-24 months and peaks in intensity between 2 and 4 years of age (Carruth et al., 2004;Dovey et al., 2008), the r/toddlers subreddit, a forum where parents of children 2-36 months old discuss 'everything about the toddler years, was selected for extraction and analysis. Posts and comments made on the r/toddlers subreddit were extracted using Structured Query Language and Python programmes created and executed in Jupyter Notebooks (Kluyver et al., 2016). ...
Article
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Food fussiness is associated with non-responsive parent feeding practices, such as persuasive and instrumental feeding. Although most children described as 'fussy eaters' are likely exhibiting developmentally typical behaviours, up to half of the parents of children 2-5 years old express concerns. Concern for fussy eating may mediate the use of non-responsive feeding practices and so must be addressed in parent feeding interventions. Therefore, it is critical to better understand parents' concerns and how they may relate to feeding practices. This study aimed to explore how parents' feeding practices and the social cognitive factors that may drive them clustered based on parents' concern for fussy eating. Data were collected from parent discussions of fussy eating on a Reddit forum (80,366 posts). Latent Dirichlet allocation was used to identify discussions of fussy eating. Relevant posts (1542) made by users who identified as a parent of a fussy eater (n = 630) underwent qualitative coding and thematic analysis. Five clusters of parents were identified, ranging in size from 53 to 189 users. These were primarily characterised by parents' degree of concern and feeding practices: (1) High concern, nonresponsive; (2) Concerned, nonresponsive; (3) Low concern, responsive; (4) Low concern, mixed strategies; (5) Low concern, indulgent. Parents who used responsive practices tended to be less concerned for fussy eating, have greater trust in their child's ability to self-regulate hunger, have longer-term feeding goals, and exhibit greater ability for personal self-regulation. Future research should further examine how these constructs may be leveraged in parent feeding interventions.
... Feeding problems in children could be defined as the inability or refusal of children to eat certain foods [2,3]. Approximately 20-50% of normally developing children [4][5][6][7][8][9][10] and 70-89% of children with developmental disabilities, [11][12][13] are reported to experience some type of feeding problems. The consequences of an untreated feeding difficulty can include failure to thrive, nutritional deficiencies, impaired parent/child interactions and chronic aversion with socially stigmatizing mealtime behaviour [14]. ...
Article
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The objective of this study is to assess feeding problems among under-two children in Ibadan South West Local Government Area in Oyo state, Nigeria. Method: Two hundred and seventy mother-child pairs were recruited for the study from selected primary health-care centres in Ibadan South West local government Area. A semi-structured questionnaire was used to collect information on socioeconomic characteristics, feeding patterns and feeding behavior of children and mothers' perception and coping feeding behavior. Results: The mean age of the children surveyed was 11.03± 4.21months with 52.2% being males. The average age of mothers was 29 years (29.7 ± 5.77), 92% married, 54.1% had secondary education and 37.0% were traders. The most common feeding problems observed among the surveyed children were picky eating, food nephobia, intake of limited variety, food refusal, under-eating and over-eating. About 31.5% of the children had one or more feeding problems. Force-feeding and the use of rewards were the major coping strategies used by the mothers. Conclusion: There exists a spectrum of feeding problems among infant and children in this study population. There is a great need for early detection of feeding problems in children and provision of all round support to children with feeding problems and their mothers to be able to achieve success in feeding.
... This trait could indicate a lower intake of main meals and being fussy about eating certain food groups, such as meat, cheese [37], fruit and vegetables [38]. However, individuals may not be selective with regard to ultra-processed foods [39], sweets, sweetened beverages and desserts [40]. This behavior seems to measure a different food avoidant trait and it is important to mention that it is not protective against excessive weight gain in obesogenic food environments [19]. ...
Article
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The Adult Eating Behavior Questionnaire (AEBQ) is a tool developed in the UK, used in the investigation of appetitive traits in adults and adolescents, and later validated in a number of countries. To date, the validity of the AEBQ has not been tested on Portuguese-speaking popula-tions. The aim of this study was to validate the AEBQ in a sample of Portuguese adolescents. Participants were 4483 13-year-olds enrolled in the population-based cohort study Generation XXI. Appetitive traits were self-reported by adolescents through the AEBQ and parents also reported adolescent eating behaviors. Confirmatory and exploratory factor analyses were conducted. Construct validity was tested through correlations between AEBQ subscales and parent-reported eating behaviors, and linear regressions between AEBQ subscales and adolescent body mass index z-scores were performed. Adequate internal consistency and several associations with parent-reported eating behaviors and measured adolescent body mass index z-scores were found. This study supports the validity of a five-factor AEBQ (Food Responsiveness and Enjoyment of Food; Slowness in Eating; Food Fussiness; Emotional Over- and Undereating) to measure appetitive traits among Portuguese adolescents and provides a convenient and easy-to-use tool to be used in large-scale research.
... There is a growing awareness that picky eating can have psychological and physiological consequences for parents and their children. The literature on picky eating has focused upon incidence and prevalence (Carruth et al., 2004), and physiological correlates (Taylor et al., 2016), rather than psychological and social experiences. Although some studies have examined parenting picky eaters generally (Wolstenholme et al., 2020), there has been no research to examine the experience of having a child with sensory sensitivities and picky eating. ...
Article
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"Picky eating" is a common behaviour seen in childhood in both clinical and nonclinical populations. Sensory processing difficulties have been repeatedly associated with food refusal and picky eating behaviours. The aim of this study was to explore the lived experiences of parents/caregivers who have a child displaying both sensory processing differences and picky eating behaviours utilising Interpretative Phenomenological Analysis (IPA). Participants were recruited from social media support groups for parents of picky eating children. Pre-selection criteria utilised an adapted short sensory profile questionnaire to ensure the children displayed probable/definite taste-smell, audio-visual and tactile sensory sensitivities. Twelve participants fulfilling the required criteria were interviewed face to face utilising a semi-structured interview schedule. Interviews were transcribed and analysed following IPA guidelines and three common themes are presented here: Battling for control of the sensory environment, Living with stigma and, disapproval, and Staying positive and moving forward. The findings show the very considerable day-to-day challenges of parenting a child with sensory issues with food, including a lack of support and criticism from others. It was apparent that the parents in our study gradually adopted a positive and accepting attitude to their child's eating. This acceptance allowed them to have positive interactions around food with their child such as cooking and playing with food, suggesting that experiential activities serve an important purpose in this population. Further research should examine whether parental interventions based on acceptance of child eating behaviour, and commitment to gradual positive food interactions would be the best strategy to support parents and children.
... The limited variety presentation can be initially mistaken for selective or 'picky' eating, which is common in early childhood [38,39]. Even where this selective eating reaches the threshold for ARFID diagnosis, individuals tend not to be underweight [13] but instead they may suffer from micronutrient malnutrition [15]. ...
Article
Full-text available
Avoidant/restrictive food intake disorder (ARFID) was introduced in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Unlike anorexia nervosa, ARFID is characterised by avoidant or restricted food intake that is not driven by weight or body shape-related concerns. As with other eating disorders, it is expected that ARFID will have a significant genetic risk component; however, sufficiently large-scale genetic investigations are yet to be performed in this group of patients. This narrative review considers the current literature on the diagnosis, presentation, and course of ARFID, including evidence for different presentations, and identifies fundamental questions about how ARFID might fit into the fluid landscape of other eating and mental disorders. In the absence of large ARFID GWAS, we consider genetic research on related conditions to point to possible features or mechanisms relevant to future ARFID investigations, and discuss the theoretical and clinical implications an ARFID GWAS. An argument for a collaborative approach to recruit ARFID participants for genome-wide association study is presented, as understanding the underlying genomic architecture of ARFID will be a key step in clarifying the biological mechanisms involved, and the development of interventions and treatments for this serious, and often debilitating disorder.
... Parents reported that they learned a lot from participation in the Facebook group, and they found posts about picky eating as one the most useful types of information presented. Although definitions and measures of picky eating vary, between 14-50% of parents identify their preschool-aged child as a picky eater [28][29][30]. Picky eating can also increase mealtime stress and impact meal preparation [31]; therefore, it is not surprising that picky eating tips were found to be the most helpful in the current study. Together, these data suggest that it is advantageous to teach parents, especially parents who perceive their child to be a "picky eater", that healthy food like fruits and vegetables can be low-cost, convenient, and liked by children [32]. ...
Article
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This study examined the use of Facebook to provide education on food resource management and healthy eating on a budget to parents of preschool aged children participating in Head Start. A convenience sample of 25 parents participated in a Facebook group based on Sesame Street’s Food for Thought: Eating Well on a Budget curriculum over a 3-week period. Parent engagement was assessed by examining views, likes, and comments on posts. Qualitative data were used to assess knowledge, attitudes, and barriers experienced related to healthy eating on a budget. The results suggest that parents were engaged throughout the intervention, as evidenced by views, likes, and comments on Facebook posts, as well as by study retention (90%). Interactions with the intervention materials varied by post content, with discussion questions having the highest level of interaction. Facebook was found to be a feasible platform for delivering the intervention, and the Facebook-adapted version of the Sesame Street curriculum was shown to engage Head Start parents living in rural areas. Further research should explore the use of social media platforms for delivering nutrition education interventions to rural populations that are otherwise difficult to reach.
Article
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This study examined the associations between the two main kinds of food rejection, neophobia and pickiness, and executive functions in young children. Caregivers of children (n = 240) aged 3-6 years completed measures of their children's food neophobia and pickiness. A battery of tests measured children's executive functions and world knowledge. Children with higher levels of neophobia and pickiness had lower cognitive flexibility scores than children with lower levels of food rejection. Moreover, the association between food neophobia and cognitive flexibility was stronger than the association between food pickiness and cognitive flexibility. Working memory, inhibition, and world knowledge were not related to children's food rejection. These findings unraveled for the first time the negative relationship between cognitive flexibility and the main psychological barriers to dietary variety. These results contribute to a better understanding of the set of cognitive factors that are associated with food rejection in young children.
Chapter
Failure to thrive (FTT), or growth faltering, is a common manifestation of medical, psychosocial, and behavioral issues. This chapter discusses the definition of FTT, as well as its causes, consequences, and treatment.
Chapter
Infant and toddler nutrition sets the stage for future health and development. Infancy, considered as the time of birth until erect posture is assumed, is a highly vulnerable period of life, especially where nutrition is concerned. Growth rate peaks. Infants, at least until 4-6 months, rely on a single nutrient source. Toddlers, described in this chapter as children aged 1 to 3 years, have less rapid growth, but rapidly changing diet. They rely on the provision of all necessary nutrients to achieve optimum health. Feeding toddlers requires attention to their budding concepts of like, dislikes, and willingness to accept new foods. This chapter reviews the nutrients necessary for infants and toddlers to achieve their growth and developmental potential.
Article
RESUMO Objetivo compreender como é a formação, o conhecimento, a demanda e a atuação clínica dos fonoaudiólogos do estado do Rio Grande do Sul na temática de distúrbios alimentares pediátricos. Métodos estudo transversal, descritivo, de abordagem quantitativa. A população foi composta por profissionais de Fonoaudiologia atuantes nas instituições de saúde e educação dos 42 municípios de abrangência da Macrorregião Centro-Oeste do Rio Grande do Sul. O contato com os participantes ocorreu a partir de um cadastro disponibilizado pelas Coordenadorias Regionais de Saúde dessa macrorregião. A coleta de dados ocorreu por meio de um questionário online disponível na plataforma Formulários Google. Resultados o conhecimento para a atuação junto à população pediátrica com distúrbio alimentar mostrou-se insuficiente para a adequada condução dos casos. As maiores dúvidas das fonoaudiólogas foram a respeito da etiologia e tratamento da doença, além de 74,1% das participantes referirem insegurança para avaliar e tratar os pacientes com esse quadro. Conclusão a maioria das fonoaudiólogas da Macrorregião Centro-Oeste do Rio Grande do Sul sente insegurança para atuar com o distúrbio alimentar pediátrico e relata pouco conhecimento sobre o tema. Portanto, considera-se necessário o investimento em formação continuada para as profissionais, a fim de favorecer a criação de saberes comuns, fornecendo subsídios científicos e elementos técnicos para a replicação nos seus locais de trabalho.
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Nowadays, children have lots of diseases, esp in field of nutrition. The purpose of this study is to determine the status of anemia and zinc deficiency of children with anorexia aged 6-59 months at the Department of Nutrition Counseling No2, National Institute of Nutrition in 2014. Through using proper research methods and subjects such as cross-sectional study and the description was conducted on 466 children with anorexia aged 6-59 months at the Department of Nutrition Counseling No2, National Institute of Nutrition in 2014. Research results indicate that 47% of anorexia children had anemia and 43.8% Anorexia children have zinc deficiency and 21% of anorexia have both anemia and zinc deficiency.
Article
Selective eating is a common childhood feeding problem associated with family stress and micronutrient deficiencies. While there are empirically-supported behavioral strategies for addressing selective eating, there are significant systems-level barriers to implementing them. The aim of this study was to develop and test a self-administered intervention for parents of children with selective eating. Participants were 156 parents of children with selective eating ages 18 months-6 years who were randomly assigned to either the handout + video condition (8-module video intervention and detailed handout) or handout condition (detailed handout only). Outcome measures were administered pre-intervention and 4 weeks post-intervention. . Only 23 % of participants in the handouts plus video condition played more than one video module. Both groups had significant decreases in maladaptive mealtime parenting practices, undesired child mealtime behaviors, and number of foods offered. No significant effect of study condition was found on the outcome measures. Further research is needed to determine how to encourage engagement of parents with self-administered intervention materials.
Article
Introduction Children with sensory food aversions (SFAs) are at risk for nutritional problems and occupational dysfunction during daily meals. To facilitate optimal occupational performance for children with SFAs, it is critical that clinicians understand child behaviour and caregiver strategy use to manage child behaviour during meals. The purpose of this paper is to examine the reliability of a novel coding scheme, the Behavioural Mealtime Coding System (BMCS) and identify associations among child acceptance of preferred and targeted foods, child food exploration and caregiver use of strategies to manage child behaviour. Methods Twenty‐one children (aged 18–60 months) with SFAs and their caregivers were recruited using a convenience sample. An observational video coding system was developed to code mealtime behaviour in 63 typical mealtime videos recorded by caregivers in the home environment. Inter‐rater reliability, descriptive statistics and bivariate correlations were calculated. Results The BMCS demonstrated excellent inter‐rater reliability (ICC = .95). Child bites of targeted foods were associated with mealtime duration (rs = .51, p = .02) and events of the child licking food (rs = .57, p = .007). Caregiver use of threats was positively associated with child age (rs = .48, p = .03) and negatively associated with caregiver education level (rs = −.49, p = .03). Conclusion For children with SFAs, increasing mealtime duration by embedding positive activities to encourage food exploration may improve acceptance of healthy targeted foods. Future research is needed to better understand the complex relationships among caregiver strategy use, mealtime duration and child mealtime behaviour.
Article
Objectives Viewing electronic media at mealtime is a common coping strategy for feeding difficulties, but its impact on food consumption is not known. We studied the prevalence of electronic media use at mealtime, its association with food intake, and associated factors. Methods 138 healthy 18- to 30-month-old children were classified according to the presence of feeding difficulties using the Thai language version of the Montreal Children's Hospital Feeding Scale. Electronic media use and 3-day food intake history were collected. Each child's mean energy intake and time spent eating were compared between meals consumed with and without electronic media. Results 58% of children watched electronic media while eating. Children with feeding difficulties ingested significantly more energy per meal when they watched media (184.0 ± 104.0 vs 152.7 ± 67.0, p = 0.04). Children without feeding difficulties spent significantly more minutes per meal when watching media (29.9 ± 10.1 vs 26.2 ± 7.6, p = 0.001). Longer total daily screen time (p = < 0.001) and presence of feeding difficulties (p = 0.006) were associated with regular media use. Children who regularly used media at mealtime were significantly more likely to have a BMI-for-age z score classification as obese (16.7% VS 0.9%, p < 0.001). Conclusion Media use during feeding is associated with greater energy intake and longer meal duration. Thai children who regularly use media at mealtime were significantly more likely to be obese. Children with longer total daily screen times, and those with feeding difficulties are more likely to regularly use media at mealtime.
Article
Background We examined differences in food selectivity by gender and parent race/ethnicity in children with intellectual disabilities. Method A convenience sample of 56 children with intellectual disabilities was analysed. A modified Youth/Adolescent Food Frequency Questionnaire and a 3‐day food record were used to measure child food refusal rate and food repertoire, respectively. Results Boys were about twice as likely to refuse total foods (rate ratio = 2.34, 95%CI = 1.34–4.09) and fruits (rate ratio = 2.03, 95%CI = 1.04–3.95) and 54% more likely to refuse vegetables (rate ratio = 1.54, 95%CI = 0.93–2.54). Children with Hispanic parents were twice as likely to refuse vegetables compared to children with non‐Hispanic White parents (rate ratio = 2.00, 95%CI = 1.03–3.90). In analyses stratified by the presence or absence of co‐occurring probable autism spectrum disorder, boys had greater food selectivity than girls. Conclusions This study expands our understanding of food selectivity in children with intellectual disabilities.
Article
Resumen Objetivos La prevalencia de niños con dificultades en la alimentación (NDA) o malos comedores es alta en nuestro medio, si consideramos la opinión de los padres. Aunque en la mayoría no observamos enfermedad orgánica o repercusión nutricional, es frecuente que este problema repercuta en la dinámica familiar. Nos proponemos estimar su impacto en el estrés, la calidad de vida y el estado de salud psicológica familiar. Métodos Estudio de casos (NDA) y controles (controles sanos y controles con trastornos digestivos o controles enfermos). Se evaluó el estrés parental y el riesgo de afectación psicológica en estas familias, mediante escalas validadas (Parent Stress Index Short Form y General Health Questionnaire de Goldberg) y una encuesta de opinión a los padres. Resultados Se recogieron un total de 238 encuestas: 102 correspondientes a controles sanos, 88 con trastornos digestivos y 48 de NDA. El 45,8% de los padres de NDA se consideraban desatendidos por su pediatra y el 47,9% no estaban de acuerdo con sus recomendaciones. El 54,2% de ellos encuentra limitaciones en su vida social, el 25% problemas de pareja, el 47,9% se sienten juzgados por los demás (12,5% por sus propias parejas) sobre cómo manejan la alimentación de su hijo y un 37,5% habían solicitado o considerado ayuda psicológica. Todos estos problemas fueron significativamente más frecuentes que en los controles. Padres y madres de los NDA presentaron con mayor frecuencia riesgo de ansiedad/depresión según el General Health Questionnaire de Goldberg: un 54,2% según valores de referencia (odds ratios ajustadas frente a controles sanos 4,18; intervalo de confianza del 95% [IC95%]: 1,96 a 8,87; frente a controles enfermos odds ratio 6,25; IC95% 2,79 a 13,98) y un 33,3% según los valores de nuestros controles sanos. Asimismo, presentaron mayores puntuaciones de estrés (Parent Stress Index Short Form) que los controles sanos (diferencia de medias ajustada 21; IC95% 12,19 a 29,81) y controles enfermos (diferencia de medias ajustada 20; IC95% 9,81 a 30,19). Conclusiones Los padres y madres de los NDA tienen niveles elevados de estrés y riesgo de ansiedad y depresión, con repercusión a nivel social, familiar, de pareja y laboral. Además, la relación con el pediatra puede verse afectada.
Article
Vegetable consumption falls well below recommended levels for children in the UK. Previous research has found that repeated non-taste sensory exposure over the course of several days increases young children's willingness to touch and taste vegetables. The current study examined the impact of a one-off multisensory non-taste exposure intervention that took place on a single day on children's willingness to taste and intake of the exposed vegetables. Children (N = 110) aged 3- to 4-years-old were assigned to one of three intervention groups or to a control group. Children in all groups participated individually in a single activity session delivered in their nursery. Children in the intervention conditions took part in fun activities that provided either (a) visual exposure, (b) smell and visual exposure, or (c) smell, touch and visual exposure to six raw and prepared vegetables. Children in the control group engaged in a visual exposure activity with non-food items. After the exposure activities, all children were offered the prepared vegetables to eat; their willingness to taste and intake of the vegetables were measured. Results confirmed previous findings of sensory exposure activities increasing children's willingness to taste and intake of vegetables and revealed linear trends in both measures of acceptance with the number of senses engaged; children who took part in smell, touch and visual activities showed the highest level of acceptance. Findings suggest that multisensory exposures are effective in increasing consumption of vegetables in young children and that the effect of sensory exposure to healthy foods may be cumulative, with the more senses engaged prior to offering a food, the better.
Article
An infant's early eating experiences influence later growth and health. However, motivators for mothers' complementary feeding decisions for their infants, such as the process of introducing solid foods, remains unclear. This qualitative study identified maternal perceived threats surrounding complementary feeding and strategies mothers use to mitigate perceived threats of adverse feeding-related health outcomes for their infants. Twenty-seven mothers participated in private, semi-structured interviews. Inductive and deductive qualitative content analysis revealed three primary themes of maternal perceived threats: a) choking, b) allergic reaction, and c) pickiness. Within each primary theme were sub-themes that further delineated the perceived threats and outlined specific and focused complementary feeding practices (CFPs) mothers used for each type of perceived threat. Findings suggest mothers have difficulty with estimating the likelihood and severity of risks and rely on elevated threat perception to guide their feeding decisions. CFPs used to prevent perceived threats were disproportionate to risks, and, at times, actually introduced additional, alternative risks.
Article
Full-text available
Psychiatric comorbidities are common among individuals with ARFID and may contribute to a failure to establish an accurate diagnosis, delayed diagnosis, and poor long‐term prognosis, especially among children and adolescents. Psychiatric comorbidities are common among individuals with ARFID and may contribute to a failure to establish an accurate diagnosis, delayed diagnosis, and poor long‐term prognosis, especially among children and adolescents.
Article
Introduction The aim of this systematic review is to identify existing pediatric feeding screening tools that have been shown to be valid and reliable in identifying feeding dysfunction in children. Method A database search produced 5862 relevant articles to be screened based on pre-determined inclusion/exclusion criteria. After full text review of 183 articles, 64 articles were included in the review. Results Forty-four studies detailed development and validation of unique feeding screening tools for the pediatric population. The remaining twenty studies were validations studies of already developed screening tools. Discussion Multiple screening tools identified were effective in determining feeding dysfunction in children. Several tools employed excellent techniques to measure reliability and validity for diverse pediatric populations. Careful consideration of the tools listed in this review will help practitioners determine the best method for feeding screening in their facility.
Chapter
This chapter explores infant feeding during the introduction of complementary foods and beverages and transition to solid foods. This chapter discusses how responsive feeding during this developmental stage can promote infants’ preferences for healthy foods and development of eating behaviors that support effective self-regulation of intake. In particular, novel implications of infants' increased motor skills and autonomy are examined within the context of responsive feeding, and best practices for promoting infants' preferences for healthy foods will be outlined. The concepts of the Division of Responsibility During Feeding and Baby-Led Weaning are introduced as effective conceptualizations of the principles of responsive feeding during this developmental period. This chapter concludes with recommended action items for promoting responsive feeding during the transition to solid foods.
Article
Development of eating habits and patterns during childhood can have life-long effects on weight and health status. Family structure, functioning, and interactions during mealtimes may influence the development of eating behaviors among children. The objective of this study was to examine the association between sibship composition and child eating behaviors among preschoolers in Saudi Arabia. One hundred and fifteen mothers were recruited through various preschools around the city of Jeddah, Saudi Arabia. A previously validated Arabic version of the Children's Eating Behavior Questionnaire (CEBQ) was completed over the telephone along with questions assessing sibship composition and demographic characteristics. Spearman correlations and adjusted linear regression models were examined to assess the association between sibship composition and child eating behaviors. Adjusting for covariates, number of older siblings was positively associated with emotional over eating, food responsiveness, and the desire to drink. Number of older sisters was positively associated with the desire to drink but negatively associated with food fussiness. Having a greater number of older (rather than younger) siblings may be associated with food-approach eating behaviors. Having a greater number of older sisters may be associated with less food fussiness. Focusing on older siblings in encouraging healthy eating habits and appropriate food choices may be beneficial in promoting adaptive eating behaviors and prevention of excessive energy intake and weight gain. Future longitudinal and mixed-methods research studies with larger sample sizes are needed in order to better understand the underlying mechanisms for the associations between sibship composition and child eating behaviors.
Article
Background: Feeding problems are common in early childhood, and some evidence suggests that feeding problems may be associated with psychopathology. Few prospective studies have explored whether toddler feeding problems predict later psychopathology. Methods: Mothers of 1,136 children from the Upstate KIDS cohort study provided data when children were 2.5 and 8 years of age. Food refusal (picky eating) and mechanical/distress feeding problems and developmental delays were assessed at 2.5 years. Child eating behaviors (enjoyment of food, food fussiness, and emotional under and overeating) and child psychopathology (attention-deficit/hyperactivity (ADHD), oppositional-defiant (OD), conduct disorder (CD), and anxiety/depression) symptoms were assessed at 8 years. Results: Mechanical/distress feeding problems at age 2.5, but not food refusal problems, were associated with ADHD, problematic behavior (OD/CD), and anxiety/depression symptoms at 8 years in models adjusting for eating behaviors at 8 years and child and family covariates. Associations with mechanical/distress feeding problems were larger for ADHD and problematic behavior than anxiety/depression symptoms, though all were modest. Model estimates were similar for boys and girls. Conclusions: Much of the research on feeding problems focuses on picky eating. This study suggests that early mechanical and mealtime distress problems may serve as better predictors of later psychopathology than food refusal. Parents and pediatricians could monitor children with mechanical/distress feeding problems for signs of developing psychopathology.
Article
Full-text available
It was examined whether caloric conditioning or social learning strategies dominate in taste preference acquisition in children. The caloric learning paradigm predicts that eating or drinking artificially sweetened products, which deliver virtually no energy, will not lead to a taste preference whereas the social learning paradigm predicts that seeing important others modelling the eating and drinking of these 'light' products will induce a preference for the taste of light products in the child. In a 2 x 2 between subjects factorial design, the amount of energy and social modelling was varied. The study was undertaken at primary schools in Maastricht, The Netherlands. Forty-five children participated and six children dropped out. The 39 children who completed the study (14 boys and 25 girls) had a mean age of 67 months (range 51--81, s.d. 5.6). Each subject took part in nine conditioning trials with an individually selected tasting yoghurt which was not preferred very much at the pre-test. The children in the combined caloric and social condition showed an increase in their preference for the conditioned taste which was larger than a regression-to-the-mean effect (P=0.007), whereas children in the other groups did not. Caloric and social learning combined, ie modelling the consumption of energy-rich foods or drinks, is the best way to establish taste preferences. Children more easily learn a preference for energy-rich food that is eaten by significant others than for food that is low in energy and eaten by significant others.
Article
The purpose of this exploratory study is to determine the strength and direction of relationships between Moos Family Environment Variables and family food intake. The sample consisted of 42 young families with children who were mailed questionnaires following telephone interviews. Findings indicate that there is a significant negative relationship between the family's dysfunctional environment (as indicated by high conflict, control, and organization) and family dietary intake (as indicated by a high Nutritional Adequacy Reporting System score). A significant positive relationship was found between the family's cohesive and independent environments and dietary intake. On the basis of this first study, it appears that further investigation is justified in order to verify a link between dysfunctional family environments and a predisposition to eating disorders, such as anorexia nervosa. Findings from this first study are tentative but reinforce the systems view and indicate that family members do exhibit the nature of the family environment through their own eating behaviors. Further study is in process.
• To develop programs that effectively promote breast-feeding in the United States, information is needed on when mothers decide to breast-feed or formula feed and on trends in infant-feeding practices. Our surveys showed that 85% to 92% of mothers decided on a feeding method before the end of the second trimester of pregnancy, that only 5% to 7% were undecided in the third trimester, and that 96% to 97% fed their infants as previously planned. Surveys of mothers of young infants from 1976 to 1980 showed changes in infant-feeding practices to 6 months of age as follows: increase in incidence and duration of breast-feeding, decrease in newborn infants receiving formula, increase in use of formula rather than cows' milk when breast-feeding is discontinued early, and later introduction of supplementary foods for both breast-fed and formula-fed infants. (Am J Dis Child 1983;137:719-725)
Article
This research examined variables associated with young children's feeding problems. Mothers of 79 children ranging in age from 2 years to nearly 7 years completed extensive questionnaires with items pertaining chiefly to their children's feeding histories and past and current eating habits, their own (mothers') practices related to their children's eating habits, and the children's psychological problems. In addition, the mothers completed questionnaires supplying information about their own food likes and dislikes as well as those of their children and husbands. Children whose eating behavior was relatively problematic differed from other children in our study in several respects. They had less exposure to novel foods, and they were more likely to be prodded and rewarded to eat and punished for not eating. In addition, they had higher scores on 3 of the variables indicative of behavioral/psychological problems: aggressive behavior, toileting difficulties, and fearfulness. Finally, the problem eaters were more likely to have developed a conditioned taste aversion.
Article
Parents frequently employ contingencies in attempts to regulate children's food intake. To investigate the effects of instrumental eating on food preferences, each of 45 preschool children was assigned to either an instrumental eating or a control condition. In the instrumental conditions (N = 31), children consumed an initially novel beverage to obtain a reward. To test predictions regarding the contributions of (1) an extension of the response deprivation theory of instrumental performance, and (2) extrinsic motivation theory in accounting for negative shifts in preference noted in a previous experiment, 4 instrumental eating conditions were generated by crossing 2 levels of relative amount consumed (baseline, baseline plus) with 2 levels of type of reward (tangible, verbal praise). To control for the effects of exposure on preference, 2 groups of children (N = 7 per group) received the same number of snack sessions, but with no contingency in effect. Preference data obtained before and after the series of snack sessions demonstrated a significant negative shift in preference for the 4 instrumental groups, while the control groups showed a slight but not significant increase in preference. The implications of the data for child feeding practices are discussed.
Article
Information on infant feeding practices was obtained for 226 children of 90 migrant Mexican‐American mothers. Of children born during 1975–1981, 56 per cent were breastfed at birth, 38 per cent at 3 months, 21 per cent at 6 months, and 3 per cent at 12 months. Thirty percent of breastfed children were given a supplementary bottle from birth. A variety of nonmilk liquids and semisolids were also given by bottle. Breast‐feeding incidence increased from 41 to 58 per cent between 1975–78 and 1978–81 among children born in the U.S., paralleling national trends. Children born after their parents came to the U.S. were less likely to be breastfed than those born before the first move, even if they were born in Mexico on a subsequent return trip. In contrast, birthplace of the child was not related to incidence or duration of breastfeeding among children born after their parents first came to the U.S. Although maternal employment was not statistically related to decreased breastfeeding, it was a stated reason for bottle‐feeding 33 per cent of children born in the U.S. Thus, both cultural and economic pressures influence infant feeding decisions of Mexican‐American migrants.
Article
How children acquire preferences for added sugar and salt was examined by investigating the effects of repeated exposure to 1 of 3 versions of a novel food (sweetened, salty, or plain tofu) on children's preference for those and other similar foods. Participants were 39 4- and 5-yr-olds assigned to taste only 1 of 3 flavored versions 15 times over several weeks. Preferences for all versions were obtained before, during, and after the exposure series. Preference increased for the exposed version only. Experience with 1 flavored version did not produce generalized liking for all 3 versions of the food. Experience with 1 version (flavored or plain) actually produced a decline in preference for the other version. This was true whether children had experience with plain or flavored versions of the food. The acquired preference was restricted to the particular food/flavor complex; through exposure, children seemed to learn whether it was appropriate to add salt or sugar to a particular food. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
Although all infants begin life on a milk diet, the diets of adults differ dramatically. These differences are well established by 5 or 6 years of age. This paper focuses on the contribution of early learning and experiences to the development of food acceptance patterns, some of which have been linked to individual differences in children's adiposity and eating disorders. (C) Williams & Wilkins 1996. All Rights Reserved.
Article
Approximately 500,000 teens become mothers every year, and 90% keep their babies. Problems are associated with adolescent parenting, including poor parenting skills and inappropriate infant/child feeding practices, which have developmental and health implications for the children. The purpose of this qualitative study was to identify the range of infant/toddler feeding practices among 20 pairs of Anglo and Mexican-American adolescent mothers and their mothers. Grandmothers were included to assess their involvement in child care. Teens often cited recommended practices but failed to follow through. Early weaning, cereal in the bottle, and providing high-fat foods and sweets were common practices. Few understood the importance of modeling appropriate eating behavior. More Anglos had conflict with their mothers, whereas Mexican Americans had more cooperative relationships. As grandmothers were sources of dietary information, conflicts were common over this issue. Including grandmothers in nutrition education efforts may benefit adolescent mothers and their children.
Article
The purposes of this study were to document mealtime communication behaviors used by 98 Caucasian infants who were studied longitudinally from 2 to 24 months of age and to describe how these behaviors changed in the group over time. Using both closed- and open-ended questions in personal interviews, these middle and upper socioeconomic status mothers reported how their infants communicated hunger, satiety, and food likes and dislikes. Mothers also reported their own response behaviors when they believed that their infants had not eaten enough. Only a few mealtime communication behaviors were common to all infants, suggesting that infants use various behaviors to communicate similar messages. Food likes were most often communicated by mouth/eating behaviors, such as opening the mouth as food approached, eating readily, or eating a large amount of food. Food dislikes were communicated by mouth/eating behaviors, by facial expressions, and by body movements, such as turning the head or body away from food or throwing disliked food. When the mother perceived that the child had not eaten enough, most mothers offered alternative choices, either at mealtime or shortly thereafter.The results indicate that most infants are communicating via behaviors in feeding situations throughout the 2- to 24-month period.
Article
To determine the food preferences of toddlers and the concordance with preferences of their family members, 118 children, ages 28 to 36 months, were assessed with a written questionnaire completed by their mothers. The questionnaire included 196 foods commonly eaten across the U.S. Response categories were [food] never offered, never tasted, [child] likes and eats, dislikes but eats, likes but does not eat, and dislikes and does not eat. Similar questionnaires were completed by mothers (n = 117), fathers (n = 96), and an older sibling (n = 47) of the child. Results indicated strong concordance (82.0–83.3%) of food preferences between the child and other family members. Similarity between foods never offered to the child and the mother's dislikes was significant at p = .005. On the average, children had been offered 77.8% of the 196 foods and liked 81.1% of the foods offered to them. Foods liked and eaten by over 95% of the children included French fries, pizza, potato chips, apple juice, bananas, saltine crackers, spaghetti, biscuits, rolls (white), and popcorn. No single food was disliked and not eaten by a majority of the children. Results suggest that the most limiting category related to food preferences were those foods never offered to the child.
Article
Adults presented unfamiliar foods to 14- to 20- and 42- to 48-month-old children individually in their homes. More children put the food in their mouths when the adults also were eating than when the adults simply were offering the food. More children put food in their mouths when their mothers were the source than when the source was a friendly adult “visitor”. However, even when alone with a child, the visitor's eating elicited reliably more tasting. Analysis of requesting behavior indicated that the adults' eating aroused a desire to eat in the children. There were no consistent sex differences or interactions between sex of visitor and sex of child in children's food acceptance. There was a suggestion that younger children were more affected by repeated offerings than were older children. It is concluded that a relatively “low level” form of observational learning—“social facilitation”—can account for the data.
Article
To determine if toddlers who were considered "picky eaters" had lower dietary scores than non-picky eaters, and if family environment and socioeconomic status were significantly related to picky eater status and dietary scores. An incomplete block design provided two interviews at randomly assigned times (24, 28, 32, or 36 months) of Caucasian mothers from upper socioeconomic (n=74) and lower socioeconomic status (n=44). Using trained interviewers, 6 days of food intake, two administrations of a questionnaire about toddler's eating behavior, and one administration of the Family Environment Scales were collected in the home. MANOVA, discriminant function analysis, and logistic regression procedures were used to determine significant differences between picky and non-picky eater groups. Picky eaters had lower dietary variety (p=.03) and diversity scores (p=.009) than non-picky eaters. Mothers of picky eaters compared to those of non-picky eaters used persuasion (p=.0001) and ranked their child's eating behaviors as more problematic (p=.0001). Toddlers perceived by their mothers as picky eaters had significantly lower dietary variety and diversity scores. Parents need information and strategies to increase the number of foods acceptable to their toddlers and to develop a sound feeding plan.
Article
This study of 198 urban breastfeeding women examined the psychosocial, demographic, and medical factors identified prenatally that may be associated with longer breastfeeding duration and may serve as suitable areas for prenatal breastfeeding promotion interventions. Of 11 psychosocial and demographic factors examined, 5 were important influences on breastfeeding duration: anticipated length of breastfeeding, normative beliefs, maternal confidence, social learning, and behavioral beliefs about breastfeeding. Methods of multivariate linear regression were used to identify prenatal factors that influenced anticipated length. Of the 10 factors entered into the regression model, parity, plans to return to work or school by six months postpartum, and maternal confidence were the most significant factors affecting anticipated length of breastfeeding. Our data suggest several factors amenable to intervention during the prenatal period that appear to influence breastfeeding duration. Prenatal promotion efforts could easily incorporate strategies that influence factors such as normative and behavioral beliefs and maternal confidence.
Article
Factors influencing changing patterns in introducing nonmilk foods (beikost) to infants are reviewed. Currently, developmental readiness based on individual needs is favored. Caregivers may receive conflicting advice from women who cared for infants when very early introduction of beikost was widely practiced.
Article
To determine whether the ad libitum addition of solid foods to the diet of exclusively human milk-fed infants will increase energy intake and reverse the decline in weight-for-age percentiles observed during the exclusive breast-feeding period. Weekly or biweekly measures of growth were made longitudinally on a cohort of infants from birth to 36 weeks of age, and monthly measures of nutrient intake were made from 16 weeks of age until 10 weeks after solid foods were introduced into the diet. Volunteer mother-infant pairs from middle and upper income groups who met entry criteria, including the intention to breast-feed exclusively for at least for 16 weeks; 58 pairs entered and 45 pairs completed the study. Solid foods were introduced at a time determined by the mother and the pediatrician; solid foods from controlled lot numbers were provided for each infant. After solid foods were added, daily human milk intake declined at a rate of 77 gm/mo (p less than 0.001). Milk composition did not change during the observation period. Daily total energy intake increased 29 kcal/mo, but no changes were noted in energy intake when consumption was normalized for body weight. Weight (National Center for Health Statistics percentiles) at 28 weeks was 13 percentiles lower than that at birth, and length at 28 weeks was 1 percentile lower than at week 1. Weight and length percentiles at 28 weeks, when compared with peak values at 8 weeks, had dropped 19 and 14 percentiles, respectively. Energy intake of human milk-fed infants did not increase after solid foods were added to their diet but was maintained at approximately 20% below recommended levels. Energy intake appeared to reflect infant demands. These data suggest that the recommendations for the energy requirements of infancy should be reevaluated. The growth pattern of exclusively breast-fed infants differs from that of the National Center for Health Statistics reference population. These observations raise questions about the adaptive response of human milk-fed infants to different levels of energy intake and about the estimations of energy requirements based on the sum of basal metabolism, activity, growth, and diet-induced thermogenesis.
Article
A nutrient database that contains current, reliable data is a prerequisite for accurate calculation of dietary intakes. Most nutrient databases are expanded from data supplied by the U.S. Department of Agriculture and may include additional foods or nutrients or data from more recent analyses, food manufacturers, or foreign food tables. Guidelines must be established for selection of reliable values from appropriate sources. A system for precise documentation of data sources provides a means for determining whether individual nutrient values were derived from chemical analyses, recipe calculations, or imputations. This article identifies data sources used by the Nutrition Coordinating Center at the University of Minnesota for its nutrient database and describes the procedures used to select and document nutrient values.
Article
Feeding practices have been analyzed prospectively in a sample of 1,112 healthy infants selected from families using an HMO. Data were collected at well-child visits during the first year of life regarding breast-feeding, formula feeding, and use of solid foods and cow's milk. Seventy percent of all infants were breast-fed, with the mean duration of breast-feeding being almost 7 months. Factors positively associated with breast-feeding included education and marriage, whereas maternal employment outside the home and ethnicity (being Hispanic rather than Anglo-American) were related to bottle feeding. Solid foods were introduced earlier by Hispanics and, also, among less well educated and single women; maternal employment was unrelated to the introduction of solid foods. Multiple regression analysis indicated different patterns for the two ethnic groups: education and employment were related to almost all feeding practices for Anglo-Americans, whereas education and employment predicted few feeding practices for the Hispanics. These findings suggest that the effects of ethnicity are independent of those of education.
Article
To determine the relative effectiveness of two different types of exposure on young children's preference for initially novel foods, 51 two- to five-year-old children received either "look" or "taste" exposures to seven novel fruits. Foods were exposed five, 10 or 15 times, and one food remained novel. Following the exposures, children made two judgments of each of the 21 pairs: one based on looking, the other on tasting the foods. Thurstone Case V scaling solutions were correlated with exposure frequency, and these were significant for the visual judgments of the looked at foods (r = 0.91), the visual judgments of the tasted (and looked at) foods (r = 0.97) and the taste judgments of the tasted foods (r = 0.94). The only non-significant relationship was for the taste judgments of the looked at (but never tasted) foods (r = 0.24). The results indicate that to obtain significant positive changes in preference, experience with the food must include experience in the modality that is relevant for the judgments. While visual experience produced enhanced visual preference judgments, visual experience was not sufficient to produce significantly enhanced taste preferences. This finding is consistent with a "learned safety" interpretation of the exposure effects noted in the taste judgments: experiences with novel tastes that are not followed by negative gastrointestinal consequences can produce enhanced taste preference.
Article
Taste acceptability, determined by volume of taste substances consumed during brief presentations, was assessed in 63 black 2-year-old children who had previously been tested at birth and at 6 months of age. Intake of sucrose solutions during taste tests was related to prior dietary exposure to sugar water. Children who had been regularly fed sugar water by their mothers consumed more sucrose solutions but not more water than did children whose mothers did not feed them sugar water. However, when these children were tested with sucrose in a fruit-flavored drink base, prior exposure to sugar water was unrelated to consumption of sweetened or unsweetened fruit-flavored drink. Thus, the apparent effects of dietary exposure on sucrose acceptability were specific to the medium in which sucrose was dissolved. Studies with sucrose solutions also revealed a significant correlation between sucrose acceptability determined at 6 months and at 2 years of age. Another series of tests evaluated response to salt with soup and carrots. Individual children who ingested more salty than plain soup also tended to ingest more salty compared with plain carrots. However, measures of salt consumption and salt usage obtained from mothers were unrelated to individual differences in acceptability of salty foods.
Article
To develop programs that effectively promote breast-feeding in the United States, information is needed on when mothers decide to breast-feed or formula feed and on trends in infant-feeding practices. Our surveys showed that 85% to 92% of mothers decided on a feeding method before the end of the second trimester of pregnancy, that only 5% to 7% were undecided in the third trimester, and that 96% to 97% fed their infants as previously planned. Surveys of mothers of young infants from 1976 to 1980 showed changes in infant-feeding practices to 6 months of age as follows: increase in incidence and duration of breast-feeding, decrease in newborn infants receiving formula, increase in use of formula rather than cows' milk when breast-feeding is discontinued early, and later introduction of supplementary foods for both breast-fed and formula-fed infants.
Article
The relationship between frequency of exposure to foods and preference for those foods was investigated in two experiments. Participants in both studies were two-year-old children. In Experiment 1, each of six children received 20, 15, 10, 5 or 2 exposures of five initially novel cheeses during a 26-day series of familiarization trials in which one pair of foods was presented per day. In Experiment 2, eight children received 20, 15, 10, 5 and 0 exposures to five initially novel fruits, following the same familiarization procedures, for 25 days. The particular food assigned to an exposure frequency was counterbalanced over subjects. Initial novelty was ascertained through food history information. Within ten days after the familiarization trials, children were given ten choice trials, comprising all possible pairs of the five foods. Thurstone scaling solutions were obtained for the series of choices: when the resulting scale values for the five stimuli were correlated with exposure frequency, values of r = 0·95, p < 0·02; r = 0·97, p < 0·01; and r = 0·94, p < 0·02 were obtained for the data of Experiments 1, 2, and the combined sample, respectively. A second analysis, employing subjects rather than stimuli as degrees of freedom, revealed that 13 of 14 subjects chose the more familiar stimulus in the sequence of ten choice trials at greater than the level expected by chance, providing evidence for effects within subjects as well as consistency across subjects. These results indicate that preference is an increasing function of exposure frequency. The data are consistent with the mere exposure hypothesis (Zajonc, 1968) as well as with the literature on the role of neophobia in food selection of animals other than man.
Article
Three experiments are reported on the effects of "taste" or nutrition information on willingness to try novel foods. "Taste" information improved responses to four out of the five foods examined. There was a consistent, but not statistically significant, trend for nutritional information to be effective. In experiment I, conducted with 3- to 8-year-old children in a laboratory setting, and in experiment II, conducted with 10- to 20-year-olds in a cafeteria, there were strong age effects. Older subjects responded more positively to novel foods than did younger subjects. There were no significant interactions between information and age and there were no sex differences. It is commonly assumed that novel foods are rejected because they are thought to be dangerous. However, the fact that dangerous foods are good tasting should be irrelevant to willingness to taste them. Our results are consistent with the idea that, in settings like laboratories and cafeterias, culture has already defined foods as being safe. Perhaps rejection in such settings is based on fear of a negative sensory experience.
Article
The authors examined the breastfeeding duration and management of two groups of mothers with different exposures to services of a Certified Lactation Consultant (CLC). One group of mothers, at hospital H1 (n = 46), had access to a CLC, while mothers at hospital H2 (n = 115) did not. Results showed that: (a) mothers at H1 had significantly (t = 2.33, p < .02) longer durations of breastfeeding (M = 3.1 months, SD = 1.2) than peers at H2 (M = 2.4 months, SD = 1.2); (b) a significantly greater proportion of mothers at H1 attained their intended duration of breastfeeding compared to mothers at H2 (Mann-Whitney U, one-tailed test, Z = 1.94, p < .05); and (c) in a stepwise multiple regression analysis, intended length of breastfeeding accounted for 18% of the variance in duration of breastfeeding, mothers' age 9%, and mothers' education 3%. The results support the theory of reasoned action and the theory of patient education.
Article
In order to construct a behavioral neophobia measure for children, we had 5-, 8- and 11-year-olds choose from ten novel and ten familiar foods which ones they were willing to taste. Meanwhile, their parents indicated their own willingness to taste each of the foods, predicted the children's willingness, estimated the number of times they and their children had eaten the foods, and completed trait measures of food neophobia for themselves and the children. The children's levels of behavioral neophobia were significantly related to both their levels of trait neophobia and their parents' predictions of their willingness to eat the foods (r = 0.38 and 0.34, respectively; p < 0.001). In addition, children's and parents' behavioral and trait neophobia scores were significantly related (both r = 0.31; p < 0.001). Finally, parents but not children were more neophobic with respect to foods of animal (vs. vegetable) origin.
Article
The aims of the study were to investigate family members' reasons for rejection of foods served in the family, the reasons for not serving specific foods, children's reasons for liking/disliking foods and the use of parental mealtime practices to encourage child eating. Also, the relationships between child/parental neophobia and (1) the reasons for not serving specific foods and (2) the use of mealtime practices were studied. A group of randomly selected families (n = 370) with children aged 2-17 years from two Swedish towns (stratified, 185 from each) were invited and 57 participated. The results are based on an ad hoc food-frequency questionnaire, a mealtime-practices questionnaire, the Food and Neophobia Scale (Pliner & Hobden, 1992), parental ratings of child food neophobia and on a child interview. The main reason for family members rejecting the foods and the main reason for children's dislikes was "distaste". The most frequent reason for children's likings was "good taste". The most frequent reasons for not serving the specific foods were "distaste", the "food did not occur to me", "seasonal/availability" and "habit". The mothers' total Food Neophobia score was significantly correlated with "did not occur to me". Parental ratings of child food neophobia were significantly correlated with mealtime-practice factors "postpone meals" and "child decides portion".
Article
The aims were to investigate the occurrence of food and general neophobia in Swedish families with children 2-17 years of age, parent-child correlations with respect to neophobia and the relationships between neophobia and the reported serving of specific foods in the family. A group of 370 randomly selected families from two Swedish towns (stratified, 185 from each) were invited and 57 (15%) participated. The results are based on the Food and General Neophobia Scales (Pliner & Hobden, 1992), parental ratings of child food neophobia and an ad hoc Food Frequency Questionnaire. The overall levels of neophobia were relatively low for both children and parents. There were only a few significant gender differences with respect to Food Neophobia but fathers and boys scored numerically higher than did mothers and girls on several items in the Food Neophobia Scale. The children, particularly boys, showed significantly higher Food and General Neophobia than their parents. Both Food and General Neophobia tended to decrease with increasing age among the children. Families were divided according to whether specific foods had been served or not. This classification showed virtually no relationship with the degree of food neophobia of family members. However, the higher the food neophobia in mothers and children, the fewer of the listed uncommon foods had been served in the family.
Article
The aims were to study food and general neophobia in Swedish families, age and gender differences and familial resemblance. Also, the relationships between the level of food neophobia of individual family members and earlier experience with and the likelihood of future tasting of specific foods were investigated. A group of randomly selected families (nation-wide, stratified, N=1593) with children age 7-17 years were invited and 722 participated. The results are based on the Food and General Neophobia Scales and an ad hoc Food Frequency Questionnaire. The overall levels of food and general neophobia were low. Fathers showed significantly higher total food neophobia scores than did the mothers, and children were significantly more neophobic than their parents. The younger children had higher food and general neophobia scores than the older children. Nine-year-old boys had higher food neophobia scores than 9-year-old girls. Some evidence was found for familial resemblance with respect to both food and general neophobia. Gatekeepers' (the person who takes the greatest responsibility for food purchase and preparation) self-reported serving of the foods and mothers', fathers' and children's self-reported consumption of foods were correlated with their respective levels of food neophobia. The strongly neophobic subjects in all groups of family members were less likely to have eaten the listed foods than were the less neophobic. Thus, food neophobia seems to be related to everyday food choice.
Article
The number of feedings needed to increase intake of a novel target food was investigated, and whether exposure effects generalized to other foods in a sample of 4 to 7-month-old infants (N=39). Other foods varied in their similarity to the target food, including the same food prepared by another manufacturer, similar foods (other fruits for infants receiving a target fruit) and a different food (e. g. vegetables for infants receiving a target fruit). Infants were fed the target food once a day for 10 days. Intake was used to indicate acceptance. Results revealed that exposure dramatically increased infants' intake of the target food, from an average of 35-72 g. Intake of the different food was unchanged. Same and similar food intake increased with target food exposure. Intake of the target, same and similar foods nearly doubled to 60 g after one exposure to the target food. These rapid increases in intake contrast the slower changes seen in young children. Results for the other foods suggest that infants may have difficulty discriminating among many foods.
Article
Infant feeding practices are integral parts of individuals' ethnic and cultural beliefs, with culturally-based feeding beliefs influencing how individual mothers in various ethnic groups make decisions. Strongly held feeding beliefs have led to resistance against nationally and internationally established recommendations upon infant feeding practices. The context for mothers' beliefs changes for women who immigrate to another culture and geographic region where practices differ. The authors investigated whether Asian-Indian (AI) mothers who immigrate to the US change their infant feeding beliefs from those held in India, and how the infant feeding beliefs of Anglo-American (AA) mothers differ from those held by Asian-Indian-American (AIA) mothers. Survey responses from 141 AA mothers and 133 AIA mothers living in the southeastern US, and 101 AI mothers living in Coimbatore, India, are presented. The mean ages of the ethnic groups were similar, all 3 groups were relatively well educated, and the AIA mothers had lived in the US for a median of 5.9 years. The infant feeding beliefs of the AIA and AI mothers indicate that they are especially in need of services provided by dietitians and other health care providers. Otherwise, differences in beliefs were found between the 3 groups, except that all 3 groups believe that a baby should not take a bottle to bed.
Article
E. Rozin and P. Rozin have suggested that one of the functions of "flavor principles" (the distinctive seasoning combinations which characterize many cuisines) is to facilitate the introduction of novel staple foods into a culture by adding sufficient familiarity to decrease the neophobia ordinarily produced by a new food. We tested this idea experimentally, predicting that the addition of a familiar flavor principle to a novel food would increase individuals> willingness to taste it, in comparison to their willingness to taste the same food in the absence of the flavor principle. Since people have little reluctance to approach familiar foods, addition of a familiar flavor principle to a familiar food should have little effect on willingness to taste it. In a pilot study, subjects selected from a list, a sauce which was high in familiarity and liking for them. They then rated their willingness to taste one novel and one familiar food with the sauce and one of each with no sauce. Subjects did not actually see any foods-the familiar and novel foods were simply described-and they were aware that they would not actually be tasting any foods. In the study proper, subjects rated their willingness to try each of the four food/sauce combinations described above. In this study, they actually saw the foods they were rating and were under the impression their ratings would determine what they would taste later in the study. In both studies, the addition of a familiar sauce to a novel food increased subjects> willingness to taste it (in comparison to the same food with no sauce) while the addition of a sauce to a familiar food either had no effect or decreased subjects> willingness to taste it. In the pilot study, the "flavor principle" effect interacted with subjects> levels of food adventurousness.
Article
Although Social Cognitive Theory (Bandura, 1997) suggests that teacher modeling would be one of the most effective methods to encourage food acceptance by preschool children, opinions of experienced teachers have not yet been sampled, teacher modeling has rarely been examined experimentally, and it has produced inconsistent results. The present study considers opinions of teachers and conditions under which teacher modeling is effective. Study 1 was a questionnaire in which preschool teachers (N=58) were found to rate modeling as the most effective of five teacher actions to encourage children's food acceptance. Study 2 and Study 3 were quasi-experiments that found silent teacher modeling ineffective to encourage either familiar food acceptance (N=34; 18 boys, 16 girls) or new food acceptance (N=23; 13 boys, 10 girls). Children's new food acceptance was greatest in the first meal and then rapidly dropped, suggesting a "novelty response" rather than the expected neophobia. No gender differences were found in response to silent teacher modeling. Study 4 was a repeated-measures quasi-experiment that found enthusiastic teacher modeling ("Mmm! I love mangos!") could maintain new food acceptance across five meals, again with no gender differences in response to teacher modeling (N=26; 12 boys, 14 girls). Study 5 found that with the addition of a competing peer model, however, even enthusiastic teacher modeling was no longer effective to encourage new food acceptance and gender differences appeared, with girls more responsive to the peer model (N=14; 6 boys, 8 girls). Thus, to encourage children's new food acceptance, present results suggest that teachers provide enthusiastic modeling rather than silent modeling, apply such enthusiastic modeling during the first five meals before children's "novelty response" to new foods drops, and avoid placing competing peer models at the same table with picky eaters, especially girls.
Article
To determine whether children with food neophobia (unwillingness to try new foods) have more restrictive diets than children without neophobia. Seventy children were classified into 3 groups based on scores obtained on the Food Neophobia Scale: neophobic group, score greater than 41; neophilic group, score less than 27; and average group, score of 28 to 40. Dietary data were collected and analyzed for 3 days selected randomly. The dependent variables measured were energy and nutrient intakes, servings of each Food Guide Pyramid group, and Health Eating Index (HEI) scores. chi 2, 1-way analysis of covariance, and Scheffé multiple comparisons tests were conducted. The 3 groups were similar with respect to the number of children meeting two thirds of the RDA/DRI for energy and most nutrients. The exception was vitamin E: fewer neophobic children met two thirds of the recommended value for this nutrient than average and neophilic children. The overall HEI score was significantly lower for the neophobic group compared with the average and neophilic groups. The HEI index showed that children with neophobia had a higher intake of saturated fat and less food variety than children without food neophobia. Dietitians should emphasize increased food variety for children within the context of a healthful diet. Research should be conducted to determine the effects of dietary variety on quality of diet and health of children.