Article

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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... During infancy and the toddler period, achievement of early feeding milestones is influenced by a variety of factors, including gestational age, birth weight, type of early feeding, and introduction of complementary feeding practices (ASHA 2010). Achievement of early feeding skills is also associated with the attainment of early fine and gross motor milestones to promote movement toward self-feeding (Carruth et al. 2004) and cognitive milestones to support greater independence and social participation during meals (Alford et al. 2019). Timing of food exposure and practice also appears critical, with the late introduction of beginner and lumpy foods (> 6 months and > 9 months, respectively) and finger feeding (> 9 months) shown to be predictive of later development of feeding difficulties (Sdravou et al. 2023). ...
... While key early feeding milestones unfold over the first 2 years of life (e.g., the transition from a milk-based diet to the introduction of solids of increasing texture; beginning self-feeding), feeding skill progress continues throughout ages of 2-5 years (Carruth et al. 2004;CDC 2023;Pathways 2023; Zero-to-Three n.d.), and refinement of skills continues in early childhood (Alvar et al. 2021;Arkenberg et al. 2023;Harris, Smith, and Harris 1984;IDDSI 2019). Infants, toddlers, and young children (in particular) and (to a certain extent) through middle childhood remain at increased choking risk due to the ongoing development of feeding skills (Figure 3). ...
... This has to come with education that those with PFD and ARFID may also present as normal and/or overweight, and one cannot rely on growth charts alone as a reflection of successful feeding. Awareness is also needed to promote the detection of significant detrimental outcomes associated with both conditions, including impaired cognitive and emotional functioning, complications related to chronic vitamin and micronutrient deficiencies (e.g., scurvy), high caregiver stress, and the need for recurrent hospitalizations to manage symptoms (Carruth et al. 2004;Kurz et al. 2015;Sdravou et al. 2023). ...
Article
Objective As diagnoses covering dysfunctional feeding and eating in pediatrics, avoidant/restrictive food intake disorder (ARFID) and pediatric feeding disorder (PFD) contain inherent areas of overlap in their diagnostic criteria. Areas of overlap include criteria regarding nutritional consequences associated with feeding/eating dysfunction and shared emphasis on possible psychosocial impairment associated with restricted food intake. Complicating the differential diagnosis process is a lack of guidance regarding when the two conditions occur independently, co‐qualify, and/or transition into the other. Feeding Matters' Research Initiatives Task Force planned and hosted a PFD‐ARFID consensus meeting, with the aim of reaching a consensus regarding diagnostic clarity on PFD and ARFID. Method Criteria for participation focused on US residents who either: (a) served as an author on the ARFID workgroup or PFD consensus papers, or (b) provided community representation via board or committee roles. The consensus process followed three stages: prework, the meeting, and post‐work/writing. Twelve participants were present for the meeting, with 14 involved in pre‐ and post‐work/writing. Results The final panel included four psychologists representing the ARFID community and seven multidisciplinary members representing PFD's four domains (medical, nutrition, skill, and psychosocial) plus a Zero‐to‐Three community representative and two representatives from Feeding Matters. Results yielded 10 consensus statements and visuals to support the consensus statements. Discussion The consensus process and results underscore an ongoing need to improve diagnostic systems and reinforce calls for strengthening healthcare expertise for both PFD and ARFID. Community‐based participatory research is recommended to advance both diagnoses and reduce ambiguity in practice settings.
... Table 1 highlights that 39% of the studies (n = 23/59) were conducted with Caucasian populations from Western nations (e.g., USA, UK, Australia). Most (n = 55/59) [6][7][8][9][10][11]33,34,[36][37][38][39][44][45][46][47][48][49][50][51][52][53][54][55][56]88 studies included girls and boys, with girls accounting for *51% of all study participants. Participants' age ranged from birth to 17 years, with studies classifying 0-24% of participants as underweight and 21-59% as overweight/obese. ...
... In total, 19 studies (n = 14 cross-sectional 9,11,[33][34][35][36][37][38][39]47,50,57,62,76 ; n = 5 prospective cohort) 5,10,53,61,74 provided 71 effect estimates. Cross-sectional and cohort study details are available in Supplementary Tables S11 and S12, respectively. ...
... In total, 16 studies (n = 11 cross-sectional; 9,11,[35][36][37][38][39]47,50,57,76 n = 4 prospective cohort; 5,10,61,74 n = 1 cross-sectional arm of a prospective cohort study) 33 provided 33 effect estimates. Cross sectional and cohort study details are available in Supplementary Tables S11 and S12, respectively. ...
Article
Aim: Picky eating is a common appetitive trait reported among children and adolescents and may have detrimental effects on their weight, vegetable, and fruit intake, impacting health status. However, an updated systematic review of the literature and summary of effect estimates is required. This study aims to explore the association between picky eating with weight, vegetable and fruit intake, vegetable-only intake, and fruit-only intake. Methods: A systematic literature search of six electronic scientific databases and data extraction was performed between November 2022 and June 2023. Original articles that examined picky eating in association with weight, vegetable and/or fruit intake were included. PRISMA guidelines were followed and meta-analytical and meta-regression analyses were conducted to compute summary effect estimates and explore potential moderators. PROSPERO registration: CRD42022333043. Results: The systematic review included 59 studies of which 45 studies were included in the meta-analysis. Overall, the summarized effect estimates indicated that picky eating was inversely associated with weight [Cohen's dz: -0.27, 95% confidence interval (CI): -0.41 to -0.14, p < 0.0001]; vegetable and fruit intakes (Cohen's dz: -0.35, 95% CI: -0.45, -0.25, p < 0.0001); vegetable-only intake (Cohen's dz: -0.41, 95% CI: -0.56, -0.26, p < 0.0001), and fruit-only intake (Cohen's dz: -0.32, 95% CI: -0.45, -0.20, p < 0.0001). Picky eating was positively associated with underweight (Cohen's dz: 0.46, 95% CI: 0.20, 0.71 p = 0.0008). Conclusion: Although effect sizes were small, picky eating was inversely associated with weight, vegetable, and fruit intakes, and positively associated with underweight in children and adolescents aged birth to 17 years.
... We found that PE was most common at age 5, but this remitted for the majority of children by age 10 years. Though prevalence estimates vary, our findings support those of previous studies which show that PE is often a typical phase of childhood development (Cardona Cano et al., 2015b;Carruth et al., 2004;Marchi & Cohen, 1990) and that PE behaviours tend only to persist beyond this stage for a small number of children. ...
... Further, there is no agreed definition for PE, or gold standard for the assessment of symptoms, so the main outcome for this study was operationalised using a single item posed to respondents at three study sweeps. While this is a limitation, it is consistent with prior research (Boquin et al., 2014;Carruth et al., 2004), and questions were selected from the GUS dataset that closely mirrored previous studies which assessed PE behaviours (Dubois et al., 2007;Mascola et al., 2010). Relatedly, GUS included a different question at age 10 compared to those asked at ages 2 and 5. ...
... As such, it may have missed children diagnosed after school entry or in secondary school, and those who will not receive a diagnosis. As there is evidence that certain groups (i.e., girls, children from more deprived backgrounds) are more likely to be underdiagnosed in childhood (Carruth et al., 2004), this could have biased our estimates if these groups also differed in terms of PE. Our estimates of autism prevalence are nevertheless in line with current evidence (Hosozawa et al., 2020). ...
Article
This study aimed to investigate the prevalence of childhood picky eating (PE) and to identify risk factors associated with different PE trajectories using data from the Growing up in Scotland research survey. PE was operationalised using three items across three study sweeps, at ages 2, 5 and 10 years respectively. We found 13.5 % of children with PE at age 2, 22.2 % at age 5, and 6.4 % at age 10. From these, we defined three PE categories: transient PE in early childhood (23.3 %), persistent PE into late childhood (3.7 %) and PE absent (73.0 %). Using multinomial logistic regression, we investigated associations between child and family characteristics and transient and persistent PE, adjusting for potential confounders. Various factors were associated with increased risk of persistent pickiness, including mothers who smoked during pregnancy and children whose mothers reported feeding challenges at 9-12 months. These findings support the view that PE behaviours are common and tend to remit by adolescence although a small number of children are at risk of experiencing longer term problems. Families of children who are exposed to such risks may benefit from preventative interventions.
... In instance, digestive issues may lead to more "picky/fussy" eating due to incorrect associations between recently consumed meals and constipation-induced abdominal aches. Moreover, Carruth et al., (2004) [7] . ...
... In instance, digestive issues may lead to more "picky/fussy" eating due to incorrect associations between recently consumed meals and constipation-induced abdominal aches. Moreover, Carruth et al., (2004) [7] . ...
... Ebeveynlerin %20-60'ı ise çocuklarının yeterince beslenemediğini düşünmektedir. 18 Ebeveynin yemek sırasındaki davranışları ile çocuğun yemek davranışları arasında bir ilişki olduğu belirtilmektedir. 19 Çocuğun gelişimi normal olmasına rağmen, ebeveyn tutum ve davranışı ve bazı kültürel inanışların yeme bozukluğuna neden olabileceği belirtilmek-tedir. ...
... Farklı kişisel ve kültürel faktörlerin çocuklarda yeme davranışını etkileyebileceği belirtilmektedir. 18 İzin verici ebeveyn tutumu ile vücut ağırlığının pozitif yönde ilişkili olduğu bulunmuştur. 21 Yürütücü işlev becerilerinin de ebeveynlik tarzı ve tutumları ile ilişkili bir beceri olduğu belirtilmektedir. ...
... A significant proportion of healthy young children experience periods of food refusal as they become more autonomous and food neophobia is part of the normal development of all omnivores. 17,19 Available research indicates that feeding difficulties are seen in 25%-45% of the general pediatric population, in 80% of children with developmental disabilities, and in 40%-70% of children with chronic medical conditions. 7 The occurrence of feeding difficulties within food-allergic children is also becoming increasingly recognized, but reported ranges, using different feeding difficulty terminologies, vary significantly. ...
... 7,47 Picky eating in healthy children has been reported to range between 14% and 50%. 19,48 As a result of this significant range of prevalence (14%-50%), it is challenging to ascertain which figure should be referenced when comparing healthy and food-allergic children. ...
Article
Full-text available
The term “feeding difficulties” refers to a spectrum of phenotypes characterized by suboptimal intake of food and/or lack of age‐appropriate eating habits. While it is evident that feeding difficulties are prevalent within healthy children, no consensus has been reached for those with food allergies. The aim of this study was to systematically review all the available literature reporting the prevalence of feeding difficulties within food allergic children. We searched eight international electronic databases for all published studies until June 2022. International experts in the field were also contacted for unpublished and ongoing studies. All publications were screened against pre‐defined eligibility criteria and critically appraised by established instruments. The substantial heterogeneity of included studies precluded meta‐analyses, so narrative synthesis of quantitative data was performed. A total of 2059 abstracts were assessed, out of which 21 underwent full‐text screening and 10 studies met the study criteria. In these, 12 different terms to define feeding difficulties and 11 diagnostic tools were used. Five papers included data of feeding difficulty prevalence in children with food allergies, ranging from 13.6% to 40%. Higher prevalence was associated with multiple food allergies. The current literature suggests that feeding difficulties are prevalent within food allergic children, particularly those with multiple food allergies. However, the heterogeneity of terminologies and diagnostic tools makes drawing conclusions challenging. Consensus guidelines for the diagnosis and management of feeding difficulties within food allergic children and further research on the development and perpetuation of feeding difficulties are needed to appropriately manage such patients.
... Cependant, la plupart des études portant sur les enfants difficiles (ou « chipoteur », Tableau 1) révèlent également qu'en proportion des apports énergétiques totaux, ils mangent moins de fruits et de légumes [33][34][35][36][37][38], mais aussi souvent moins de poisson ou de viande [37][38][39], ce qui se traduit également par un régime alimentaire moins varié. Une étude rapporte que les enfants difficiles consomment davantage d'en-cas à forte densité énergétique, salés ou sucrés [40]. L'association entre le caractère difficile et le statut pondéral montre généralement que les enfants difficiles sont plus susceptibles d'être trop minces (Tableau 1). ...
... La plupart des études soulignent que le comportement de réticence ou de méfiance envers les aliments nouveaux apparaît entre 18 et 24 mois [2,18,40,44], avec une expression très marquée entre 24 et 36 mois, pour se stabiliser jusqu'à l'âge de ∼6-8 ans [18,45]. Certains parents se sentent désemparés ou inquiets du fait que leur enfant mange de façon monotone, et peuvent interpréter ces difficultés comme une faille éducative, ou bien comme une manifestation d'opposition de leur enfant envers euxmêmes [46]. ...
... A seletividade alimentar infantil (SAI), consiste em uma complexa manifestação comportamental que se caracteriza pela recusa persistente de determinados alimentos ou grupos alimentares, limitando, assim, a diversidade e a qualidade nutricional da dieta da criança (Carruth, et al., 2004). O fenômeno tem sido objeto de estudos interdisciplinares, uma vez que sua etiologia abrange aspectos biológicos, psicológicos, sociais e culturais (Birch, 1998;Dovey, et al., 2008). ...
... . ResultadosA seletividade alimentar infantil é um fenômeno relevante que tem despertado considerável interesse na pesquisa científica devido às implicações diretas para a saúde, nutrição e crescimento das crianças. A SAI trata-se de uma manifestação comportamental identificada pela recusa persistente a determinados alimentos ou grupos de alimentos, impactando na oferta de nutrientes e no estado nutricional do público infantil(Carruth, et al., 2004).As causas associadas a SAI incluem fatores genéticos, predisposições sensoriais e preferências inatas por certos sabores e texturas. Além disso, fatores ambientais, como a exposição limitada a diferentes alimentos durante a primeira infância e a influência do ambiente familiar, também desempenham um papel importante na formação dos padrões seletivos de alimentação(Ramos & Coelho, 2017).Dentro dos fatores desencadeadores da SAI, encontra-se a introdução tardia de alimentos mastigáveis durante o processo de introdução alimentar(Emmett, et al., 2018;Taylor & Emmett, 2019). ...
Article
Full-text available
Objetivo: O artigo teve como objetivo analisar as principais causas associadas a Seletividade Alimentar Infantil (SAI) e discutir as estratégias de conduta utilizadas para o controle do quadro. Materiais e Métodos: Para a elaboração dessa revisão integrativa, foram selecionados artigos científicos publicados em periódicos indexados em duas bases de dados: SciELO (Scientific Electronic Library Online) e portal BVS (Biblioteca Virtual em Saúde). As buscas foram realizadas a partir dos termos feeding difficulties, food selectivity e picky eaters, adjunto as palavras children e childhood, no idioma inglês; e dificuldades alimentares, seletividade alimentar, exigências alimentares, adjunto as palavras crianças e infância, para o idioma português; tendo como operadores booleanos AND e OR. Resultados: Os resultados mostraram que as causas associadas a SAI incluem fatores genéticos, predisposições sensoriais e preferências inatas por determinados sabores e texturas. Fatores ambientais, como a exposição limitada aos alimentos na primeira infância e hábitos familiares, se mostraram relevantes. Essa condição pode ser controlada através da associação entre estratégias nutricionais e comportamentais, pautadas na introdução gradual de novos alimentos e o envolvimento da criança no processo de seleção e preparo das refeições. Conclusão: A SAI é um fenômeno multifacetado, influenciado por fatores biológicos, socioeconômicos e culturais. Sua abordagem deve ser multimodal e pautada na participação do profissional nutricionista, com o incentivo ao consumo de alimentos saudáveis e ainda, educação parental.
... Fussy eating most commonly begins in early toddlerhood (12 to 24 months) and peaks in intensity in later toddlerhood (24 to 36 months) [21,22]. The evidence suggests that most toddlers described as 'fussy eaters' by their parents are likely exhibiting developmentally typical eating behaviours that are likely to resolve as children age [20]. ...
... The target behaviours were feeding practices identified in the literature as helpful versus problematic in the context of fussy eating. Responsive behaviours to promote included: repeated exposure (exposing children repeatedly to a wide variety of healthful foods, even those they have previously refused) [22,46,47], family meals [48], role modelling [49,50], and meal and snack routines [51,52]. Nonresponsive practices to discourage included pressure [11,53], catering (offering children alternative foods when initial foods are rejected or offering a limited number of foods per child's current taste preferences [7,8,11,51,54], and using food to reward eating or good behavior [7,11]. ...
Article
Full-text available
Background Fussy eating is most often a developmentally typical behaviour, generally presenting during toddlerhood. However, up to half of parents of young children are concerned about fussy eating, and this concern may mediate the use of nonresponsive feeding practises, such as coercive or unstructured feeding and using food to reward eating. Despite the high prevalence of parental concern for fussy eating and the negative impacts nonresponsive feeding practises have on children’s health and diets, no previous digital intervention to improve the feeding practises of parents of toddlers concerned about fussy eating has been evaluated. Aim This article describes the protocol of a randomised controlled feasibility pilot aiming to evaluate Fussy Eating Rescue, a purely web app based intervention for parents of toddlers. The primary aim is to investigate feasibility and acceptability; secondary aims are to explore indications of intervention effect on parents’ feeding practises or children’s eating behaviours. Methods Fussy Eating Rescue features include: (1) a Tracker, that allows parents to track repeated offers of food, (2) Topics, providing information on fussy eating, effective feeding strategies, and general nutrition, (3) Rescues, containing quick references to material supporting Topics contents, (4) Recipes, and (5) SMS notifications. Parents of toddlers (12–36 months old, n = 50) who have concerns about fussy eating will be recruited via Facebook. Parents will be randomised to an intervention group, which receives access to the app for 6 weeks, or to wait-listed control. Outcomes will be assessed at baseline and 6 weeks after app use, using online questionnaires and app usage statistics. Primary outcomes include participant retention rate, intervention engagement, app usability, perceived ease in using the app, perceived usefulness of the app, and user satisfaction. Secondary outcome measures include parents’ feeding practises and children’s eating behaviours. Discussion Results will inform whether Fussy Eating Rescue is a feasible way to engage parents concerned for their toddler’s fussy eating behaviours. If feasible and acceptable to users, a larger trial will further examine the efficacy of the Fussy Eating app in improving parents’ feeding practises and children’s eating behaviours. Trial registration Prospectively registered with the Australian New Zealand Clinical Trials Registry on 15 July, 2021 (ACTRN12621000925842).
... Potential underlying causes can relate to the child, parent/caregiver and child-parent interaction, including factors such as heredity, breastfeeding duration, parental psychopathology and parental feeding practices (Ammaniti et al., 2004;Lucarelli et al., 2018;. Estimates of prevalence of picky eating in early childhood range from 5.6% (Tharner et al., 2014) to 50% (Carruth et al., 2004), and this wide range is presumably due to differences in eating culture and differences in methods to assess picky eating (Taylor et al., 2015). ...
... Another strength is that picky eating was determined with three questions from a validated questionnaire (Birch et al., 2001), and a high internal consistency (α = 0.74). This differs from some other studies that used only one (for children validated) question (e.g., Carruth et al., 2004;Mascola et al., 2010). Furthermore, the analyses were adjusted for relevant covariates, which may confound the relationship between picky eating and dietary intake frequency. ...
Article
Introduction: A relatively common deviant type of eating behaviour among children is picky eating. Research on associations between picky eating and dietary patterns later in life is limited, and studies examining long-term effects on growth have yielded mixed results. The present study aimed to examine longitudinal associations of picky eating in early childhood with consumption of various foods, and weight status (body mass index, BMI) in young adulthood. Methods: Data from the Dutch KOALA Birth Cohort was used. Picky eating was determined around age 4 (range 3-6 years) by a questionnaire completed by parents. At follow-up around children's age 18 (range 17-20 years), weekly food intake frequencies, weight and height were assessed with a questionnaire completed by the grown-up young adult children. In total, 814 participants were included. Multiple regression analyses were performed for food intake frequencies and weight status (BMI) with picky eating score as predictor, controlling for parental and child covariates. Results: The mean picky eating score at age 4-5 was 2.24 (range 1-5). A 1-point higher picky eating score was associated with eating fruit 0.14 days less per week, raw vegetables 0.14 days less per week, cooked vegetables 0.21 days less per week, fish 0.07 days less per week and dairy products 0.23 days less per week (P-values all <0.05). Associations between picky eating and intake frequencies of meat, eggs, various snacks, sweet drinks, and weight status (BMI) were not significant. Conclusion: Picky eating in childhood is associated with lower intake frequencies of various healthy foods among young adults. It is therefore recommended to pay sufficient attention to picky eating in young children.
... Feeding problems (FPs) in children can be understood as a spectrum, ranging from mild, transient difficulties, via picky or selective eating to severe behavioral and/or medical feeding disorders (FDs), including tube feeding dependency (1)(2)(3)(4). The age period up until 2 years of age is critical in feeding development, and FP typically starts early, at 6 months to 4 years of age (2,(5)(6)(7). FPs are common, but a plethora of definitions and classifications complicates comparing prevalence numbers (2,8). ...
... In line with other studies (7,8,14), there was no significant differences regarding socioeconomic factors and FPs in the present study. This is important when allocating public resources. ...
Article
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Abstract Objectives: To describe the prevalence of feeding problems (FPs) in children aged 10, 18, and 36 months who visited Swedish Child Health Services. Methods: Parents of children attending regular 10-, 18-, and 36-month visits at the child health care centers (CHCCs) in Sweden answered a questionnaire including a Swedish version of the Behavioral Pediatrics Feeding Assessment Scale (BPFAS) as well as demographic questions. CHCCs were stratified according to a sociodemographic index. Results: Parents of 238 girls (115) and boys (123) completed the questionnaire. Using international thresholds for FP detection, 8.4% of the children had a total frequency score (TFS) indicating FP. Based on the total problem score (TPS), the result was 9.3%. The mean score for all children was 62.7 for TFS (median 60; range 41–100), and 2.2 for TPS (median 0; range 0–22). Children aged 36 months had a significantly higher average TPS score than younger children, but TFS scores did not differ by age. There were no significant difference in gender, parents’ education, or sociodemographic index. Conclusion: Prevalence numbers found in this study are similar to those found in studies with BPFAS in other countries. Children 36 months of age had a significantly higher prevalence of FP than children aged 10 and 18 months. Young children with FP should be referred to health care specializing in FP and PFD. Creating awareness of FP and PFD in primary care facilities and child health services may facilitate early detection and intervention for children with FP.
... Due to differences in the definition of picky eating, tools to measure its prevalence also differ. This yields a wide range of results, some indicating the prevalence may be as high as 50% of all children at 2 years of age [13]. As a result, picky eating is thought of as a normal part of early childhood and is reported to be equal in prevalence between neurotypical children and those with ASD [6]. ...
Article
Full-text available
Sensory processing abnormalities are a hallmark of autism spectrum disorder (ASD) and are included in its diagnostic criteria. Among these challenges, food neophobia has garnered attention due to its prevalence and potential impact on nutritional intake and health outcomes. This review describes the correlation between novel odor perception and feeding difficulties within the context of ASD. Moreover, this review underscores the role of odor processing in shaping feeding behaviors within the ASD population. It examines the psychophysics of odor perception in individuals with ASD and evaluates the behavioral and neurophysiological assessments conducted using novel odor stimuli in mouse models relevant to autism and wild‐type mice. Additionally, we explore the mechanism on how odor novelty affects neuronal circuitry, shedding light on potential underlying mechanisms for the effect of odor novelty on ASD.
... Typically, foods must be offered at least 15 times to be accepted, as higher frequency of offering the new foods enhances acceptance in selective eaters. [14] For mildly selective children, simple strategies, such as hiding vegetables in other foods, modelling healthy eating, involving children in food preparation and so on, can be useful. [15][16][17][18] Children who are highly selective, particularly those with severe oral aversion or autism, would benefit from seeing a behavioural therapist and an oromotor therapist. ...
... Altta yatan organik hastalığı olmayan vakalarda, vitamin veya mineral eksikliği saptanmadıkça multivitamin desteği verilmemelidir. Literatürde davranışsal beslenme sorunlarında iştah arttırıcı farmakolojik tedaviler önerilmez, ancak belirli durumlarda siproheptadin kullanımı düşünülebilir (1,8,17,18). ...
Chapter
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... The children were categorised into nine AGs of 4-5, 6-7, 8-9, 10-11, 12-14, 15-17, 18-23, 24-30, and 31-36 months. The AGs were selected based on child feeding studies (1,26,36) as well as a reflection of the substantial changes in texture introduction and acceptance over this short period in recent research (19). These nine AGs were then used to analyse the role of age on texture introduction. ...
Article
Full-text available
The introduction of complementary food plays a fundamental role in dietary behaviours later in life. Little is known about the influences of age on food texture acceptance in young Indian children. Thus, the objective of this cross-sectional study was to describe the relationship between age and food texture experiences in young children aged 4–36 months in India from urban areas using a parental-reported survey. This study relies on a face-to-face parent survey, which was conducted comprising 306 children categorised into 9 age groups. Questions focussed on food texture experience considering 16 textures were analysed. Textures such as dissolvable, sticky, and soupy/liquidy were already accepted by more than half of 4–5-month-old infants. In India, soupy/liquidy is a more common base texture than pureed. Indeed, pureed was found to be introduced to a majority of infants only from 8 to 9 months onwards. Food textures such as rubbery, slippery, and foods with skin were more likely rejected by the youngest children. With increasing age, the refusal probability of food textures decreased. Our survey showed food texture experiences in Indian children aged from 4 to 36 months. It provides useful insights for parents and healthcare professionals by contributing to the understanding of texture acceptance during the transition to complementary foods.
... Trẻ ăn nhiều bữa (ăn vặt) trong ngày (92,6%), mỗi lần ăn với số lượng ít (75,5%). Trẻ được ăn bổ sung sớm trước 6 tháng tuổi (76,6%) và thức ăn đầu tiên là bột ăn liền (57,4%) hay bột đường (28,7%).Bảng 2. Mức độ biếng ăn dựa theo năng lượng ăn vàoNhận xét: Hầu hết là trẻ biếng ăn mức độ nhẹ (39,4%) và mức độ vừa (45,7%), biếng ăn mức độ nặng thấp (14,9%).3. Mối liên quan giữa mức độ biếng ăn và tuổiNhận xét: Có sự khác biệt rõ rệt về mức độ biếng ăn và lứa tuổi (p < 0,05). ...
Article
Mục tiêu: Mô tả thực trạng suy dinh dưỡng ở trẻ biếng ăn tại Bệnh viện đa khoa Đức Giang.Đối tượng và phương pháp: Nghiên cứu mô tả cắt ngang có phân tích 150 trẻ suy dinh dưỡng tại Bệnh viện đa khoa Đức Giang.Kết quả: Tỷ lệ suy dinh dưỡng ở trẻ nhẹ cân là 44,7%, thấp còi 38,3% và gầy còm chiếm 17,0%. Có sự khác biệt có ý nghĩa thống kê giữa mức độ suy dinh dưỡng và các thể suy dinh dưỡng (p < 0,05). Có 94 trẻ biếng ăn. Trong đó. biếng ăn mức độ nhẹ (39,4%) và mức độ vừa (45,7%), biếng ăn mức độ nặng (14,9%).Biến ăn gặp ở trẻ có độ tuổi ≥ 12 tháng (100%) và ở nam (64,9%) cao hơn ở nữ (35,1%). Tỷ lệ các thể suy dinh dưỡng nhẹ cân là 44,7%, thấp còi 38,3% và gầy còm chiếm 17,0%.Kết luận: Trẻ suy dinh dưỡng có tỷ lệ biếng ăn cao (62,7%), có sự khác biệt biếng ăn theo độ tuổi, giới tính và các thể dinh dưỡng (p < 0,05).
... It is defined as "a broad term that encompasses any problem related to feeding behaviors, ranging from parental misperceptions to actual eating disorders." 1 It has been estimated that between 25% and 40% of healthy children show symptoms of FDs during their growth and development. 2,3 However, in order to establish an epidemiological estimation of FDs, first of all, it is necessary to agree on which condition we are referring to. Kovacic et al., considering the broad definition of FD, reported an estimated annual prevalence in 2014 of 1 in 23/24 children seen in the public sector and of 1 in 37 children seen in the private sector in the under-5-year-old group. ...
Article
It has been estimated that between 25% and 40% of healthy children show symptoms of feeding difficulties (FDs) during their growth and development; many times, these are not adequately diagnosed. The objective of this study was to conduct a narrative review that collected the available information on feeding difficulties. Assessment and management algorithms were developed based on the bibliographic evidence. Most feeding problems in young children (feeding selectivity, loss of appetite, fear of feeding) are often concurrent, and a clinical risk assessment is necessary to plan an individualized intervention. Having standardized definitions and common terms to address these difficulties in an appropriate and multidisciplinary manner is one of the ways to optimize their treatment. The involvement of different health care providers and parents is critical to address feeding difficulties.
... Based on previous research [9,24,25], the presence or absence of FDs was addressed according to the perceptions of the mothers about the problem through the following question: "Do you think your child has FDs?". ...
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Background Feeding difficulties (FDs) are complex phenomena influenced by parental factors, feeding behaviour, and cultural factors. However, studies of the influences of these factors on FDs incidence are scarce. Thus, this study aimed to identify the associations between mothers’ perceptions of FDs in children and parental feeding styles, body mass index, and the consumption of fruits, vegetables and processed foods. Method Two hundred and fifty-seven mothers of children aged 1 to 6 years and 11 months participated in this cross-sectional study and self-completed electronic questionnaires on sociographic variables, parental feeding styles, the consumption of fruits, vegetables and processed foods and FDs. Nutritional status was classified by body mass index (kg/m²). Results The prevalence of FDs in children was 48.2%, and the mean age was 43.8 (± 17.6) months. The indulgent parental feeding style was the most common (40.1%), followed by the authoritative (31.1%), authoritarian (23.7%), and uninvolved (5.1%) styles. An indulgent parental feeding style (OR: 4.66; 95% CI: 2.20–9.85), a high body mass index (OR: 1.35; 95% CI: 1.09–1.68), and the consumption of processed foods (OR: 5.21; 95% CI: 2.85–9.53) were positively associated with increased odds of the absence of FDs in children. The associations of authoritarian and uninvolved parental feeding styles and the consumption of fruits and vegetables with FDs in children were not significant. Conclusion This study identified multiple factors that are possibly associated with feeding behaviours in young children. However, further studies need to be undertaken to evaluate how such behaviours affect FDs.
... (12) Carruth et al. conducted a crosssectional study of 3022 children without psychiatric or developmental problems and found that the percentage of children identified as picky eaters increased from 19% to 50% from four to 24 months. (16) Physicians must acknowledge that food selectivity (or picky eating) is a very common and normal part of child development, but in some severe cases it can be an important cause of feeding difficulties and possible failure to meet adequate nutritional or energy needs. (17) Benjasuwantep and colleagues described that energetic children with little interest in eating and limited appetite represented the second and third most common types of feeding problems, respectively, which is consistent with the present study's findings. ...
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Introduction: Feeding difficulties in early childhood are among the most common problems reported by parents and may reflect the child’s own characteristics or a relational problem. They are associated with problems in later life, such as behavioral disorders, cognitive deficits, and eating disorders. Materials and Methods: This study was a retrospective, descriptive analysis of sociodemographic and clinical data of children under six years of age with feeding or eating problems evaluated at a first consultation in a child psychiatry unit of a tertiary hospital between January 2019 and May 2021. Children with a diagnosis or suspected diagnosis of autism spectrum disorder were excluded. Results: Of a total of 647 children evaluated, 57 (8.81%) were classified as having feeding difficulties. Their median age was 24.5 months. Food selectivity was the most frequently reported problem (45.6%), followed by difficulties in self-regulation at mealtimes (43.9%) and decreased appetite (33.3%). Among the mothers, 21% had a history of depressive disorders and 7% had a history of anxiety disorders. Forty-nine percent of children had patterns of interaction with their primary caregiver that were considered worrisome or disruptive. Fifty-four percent of the therapeutic interventions provided were child-parent psychotherapy. Conclusions: Early identification and intervention are needed for children with feeding problems. Feeding problems are common in early childhood and a multidisciplinary approach must always be considered as they can affect several domains of the child’s health and development.
... Food preferences and appetite traits begin to develop from prenatal periods influenced by genetic predispositions and maternal food choices (Ventura and Worobey, 2013). Given that infants transition to adult foods during the first 2 years (Carruth et al., 2004), early food experiences could lay the foundation for food preferences (Domel et al., 1996;Gibson et al., 1998;Howard et al., 2012;Mura Paroche et al., 2017). One of the prominent obesogenic eating phenotypes is sensitivity to external food cues, which often results in overeating that potentially leads to obesity (Carnell et al., 2013). ...
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The present paper aims to provide the latest perspectives and future directions on the association between emotions and eating behavior. We discussed individual differences in the impact of negative emotions on eating, emotional eating as disinhibited eating decisions with heightened reward values of and sensitivity to palatable foods in response to negative emotions and social isolation, in addition to emotional eating as maladaptive coping strategies under negative emotion and stress, hedonic (pleasure-oriented) eating decisions mediated by the brain reward system, and self-controlled (health-oriented) eating decisions mediated by the brain control system. Perspectives on future directions were addressed, including the development of early eating phenotypes in infancy, shared neural mechanisms mediated by the ventromedial prefrontal cortex and the dorsolateral prefrontal cortex in emotion and eating decision regulation, possible roles of interoception incorporating hunger and satiety signals, gut microbiome, the insula and the orbitofrontal cortex, and emotional processing capacities in hedonic eating and weight gain.
... Escalating concern and anxiety at mealtimes evokes non-responsive or indulgent feeding practices, which do not improve children's acceptance of new or non-preferred foods [45]. Strategies which help a child try (and like) a variety of foods include serving a familiar and accepted food alongside a new or refused food, repeatedly offering foods, and having caregivers or others model enjoyment in eating the food [46][47][48][49][50][51]. As a child grows, food selectivity generally subsides. ...
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Purpose of review This review seeks to define caregiver practices that impact childhood eating behaviors and identify ways to utilize these relationships to prevent childhood obesity. Recent Findings Childhood obesity, which correlates with adult obesity and increased cardiovascular risk, is increasing in prevalence and severity. Caregivers play a significant role in shaping a child's eating behaviors and their predisposition to obesity. Maternal influences during pregnancy and infancy impact a child's future food preferences. Caregiver feeding styles (authoritarian, authoritative, indulgent, and uninvolved) are associated with distinct effects on children's eating behaviors and self-regulation. Authoritative feeding styles promote child autonomy while setting boundaries in the feeding environment. Early caregiver education and coaching regarding nutrition and feeding practices is beneficial to establishing healthy eating behaviors for children. Various caregivers, including parents, grandparents, siblings, teachers, and others, influence a child's eating habits at different stages of development. These caregivers can both positively and negatively impact a child's diet. Comprehensive interventions involving these various caregivers to promote healthy eating practices in children is ideal. Such interventions should be sensitive to cultural and environmental factors. Summary Childhood obesity is a complex issue with long-term health effects. Early intervention using comprehensive approaches including all caregivers, community support, and public policies to address the social determinants of health will be beneficial. Future research should focus on valid outcome measures and equitable interventions that encompass all aspects of a child's life.
... Factors affecting food neophobia include the food choices of parents and peers, hereditary factors, environment, sex, age, educational status, and place of residence [12][13][14][15]. Food neophobia is more prevalent among preschoolers and older people, while young individuals are more open to trying new foods [16,17]. Research suggests that there is a higher prevalence of food neophobia among males [18][19][20]. ...
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Food neophobia, known as an avoidance of the consumption of unknown foods, can negatively impact nutritional quality. In orthorexia nervosa, there is an excessive mental effort to consume healthy food. Individuals exhibiting symptoms of food neophobia and orthorexia nervosa may experience food restrictions. This study aimed to assess food neophobia levels and orthorexia nervosa tendencies among university students, investigate the potential association between the two constructs, and explore the effect of the demographic characteristics of the participants on the variables. This is a descriptive cross-sectional study. The study sample consisted of 609 students enrolled at Recep Tayyip Erdoğan University. The data were collected through Google Forms using a sociodemographic information form, the Food Neophobia Scale, and the ORTO-11 scale. Ethics committee approval and institutional permission were obtained for the study. Of the students participating in the survey, 71.9% were female, 14.6% were classified as neophobic, and 47.1% had orthorexia nervosa symptoms. The mean scores from the Food Neophobia Scale (39.41 ± 9.23) and the ORTO-11 scale (27.43 ± 5.35) were in the normal range. Food neophobia was significantly higher among those who did not consume alcohol. Orthorexia nervosa symptoms were significantly more common among married people. In the correlation analysis, no significant relationship was found between age, food neophobia, and orthorexia nervosa. It can be said that food neophobia in this study is similar to in other studies conducted on university students. In addition, about half of the participants had symptoms of orthorexia nervosa. This result is higher compared to other studies conducted with university students. The findings of this study indicate that the participants care about the healthfulness of food.
... Some limitations of studies should also be taken into account. Some studies simply use a parental description of picky eating [35,36]. Despite variation on the definition of problematic eating behaviours, these include food refusal (of certain types of foods), food fussiness or pickiness (refusal of new and familiar foods, accepting only a narrow range of foods), refusal of new foods (neophobia), grumpiness during mealtime and inadequate self-feeding skills [36][37][38][39]. ...
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Background Parental complaints about feeding difficulties (FD) during childhood are frequent in pediatrics. Behavioral factors about children’s feeding and parental aspects are fundamental in solving these problems, but research in this area lacks information considering the joint presence of fathers and mothers. Thus, this study aimed to investigate the features of children, parents and mealtime practices related to FD reported by fathers and mothers and to identify parenting styles, mealtime actions, practices and factors associated with FD in children. Methods 323 parents (226 mothers and 97 fathers) of children aged 1 to 7 years were recruited in the emergency waiting room at Sabará Hospital Infantil, in São Paulo, Brazil, and self-completed electronic questionnaires on parenting style (Caregiver’s Feeding Styles Questionnaire), parents’ mealtime actions (Parent Mealtime Action Scale), socioeconomic information, personal and children’s health data and routine meal practices. Results The prevalence of FD in children was 26.6%. Indulgent parenting style was the most frequent (44.2%), followed by authoritarian (25.1%), authoritative (23.8%), and uninvolved (6.9%) styles. Most parents (75.8%) reported presence during meals, and 83.6% used distractions. Regression analyses after adjustments showed, as factors associated with FD, female children (OR: 2.06; 95%CI: 1.19–3.58), parents’ FD history (OR: 3.16; 95%CI: 1.77–5.64), and greater frequency of parents’ behavior of offering many food options (OR: 2.69; 95%CI: 1.18–6.14). Parents with indulgent styles had decreased chances of reporting FD in their children (OR: 0.13; 95%CI: 0.06–0.27). Furthermore, the practice of children sharing the family menu (OR: 0.43; 95%CI: 0.18–0.99) and higher frequency of parents’ behavior of setting snack limits (OR: 0.44; 95%CI: 0.23–0.85) were inversely associated with FD. Conclusions This study reinforces the multifactorial aspects involved in the feeding difficulties context. It points out the importance of expanding knowledge of the individual role of fathers and mothers to compose a scenario that can guide future studies and interventions. Trial registration CAAE #99221318.1.0000.5567 with registration number 2,961,598.
... Alternatively, during meals, parents may need to invest more time feeding their later-born child, who may still require assistance with tasks such as using utensils. 58 Therefore, parents may be more inclined, for example, to allow their earlier-born child to wander around during meals. This finding further aligns with observational research by Moens and colleagues, 59 who reported that mothers of 4-to 12-year-old siblings tended to adopt a more permissive feeding style with their earlier-born child. ...
Article
Background: Research on feeding in early childhood has focused primarily on parent-child dyadic interactions, despite parents enacting these practices within the complex dynamic of the family system. Objective: Using a sibling design, this study aimed to assess how parents may adapt their food parenting practices for siblings in response to differences in their eating behaviours. Design: A cross-sectional online survey was conducted between October and December 2022. Participants/setting: Data were collected from parents (97.5% females) in Australia with two children aged 2 to 5 years (n=336 parents, n=672 children). Main outcome measures: Survey items were completed for each sibling, and included four subscales of the Children's Eating Behaviour Questionnaire (CEBQ) and seven subscales of the Feeding Practices and Structure Questionnaire-28 (FPSQ-28). Statistical analyses performed: Multiple linear regression models examined associations between within-sibling pair differences in child eating behaviours and food parenting practices, adjusting for differences in child body mass index z-score (BMIz), age, gender, and early feeding method. Results: Within-sibling pair differences in eating behaviours were associated with differences in some food parenting practices. For the fussier sibling, parents reported using more control-based practices, including persuasive feeding, reward for eating, and reward for behaviour, and less of the structure-based practice, family meal settings (ps<0.001). Similar directions of associations were found for persuasive feeding, reward for eating, and family meal settings with siblings who were slower eaters or more satiety responsive (ps<0.007); however, no significant differences in reward for behaviour were observed in relation to sibling differences in these eating behaviours. For the more food responsive sibling, parents reported using more control-based practices, including reward for behaviour and overt restriction (ps<0.002). Conclusions: Within families, parents may adapt certain practices in response to differences in their children's eating behaviours. Interventions promoting responsive feeding should be designed to acknowledge the integral role of siblings in shaping parents' feeding decisions.
... For example, 3 of the 6 apps that target nutrition and mealtime behaviors had predefined goal options on child consumption of specific healthy and unhealthy food options, such as increasing intake of vegetables, fruit, or water, and decreasing intake of junk food (eg, fast food and sugar-sweetened beverages). Promoting goals targeting these behaviors has the potential to positively influence child dietary patterns based on the existing scientific evidence related to these broad behaviors [23,[30][31][32][33][34][35]. Similarly, 4 apps offered predefined goal options for increasing physical activity (eg, general exercise, outdoor play, and practicing sports) and 2 apps included goal options for limiting screen time, reducing total screen time, and contingent access to electronic devices. ...
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Background Goal setting and tracking are well established behavior change techniques. Little is known about the extent to which commercially available mobile apps are designed to guide parents in using these strategies, their evidence base, and their quality. Objective This study aims to review commercially available apps that target parents in relation to setting and tracking behavioral goals for their children. The objectives were to classify the apps’ general characteristics, features, evidence base, and target behaviors and assess app quality overall and separately for apps that target health-related behaviors (HRBs) and apps without a health-related behavior (WHRB). Methods Apps were identified using keyword searches in the Apple App Store and Google Play in the United States. Apps were included if their primary purpose was to assist with setting goals, tracking goals, tracking behaviors, or giving feedback pertaining to goals for children by parents. App characteristics and common features were documented and summarized. Two reviewers assessed app quality using the Mobile App Rating Scale (MARS). Descriptive statistics summarized the MARS total score, 4 quality subscales, and 6 app-specific items that reflect the perceived impact of the app on goal setting and tracking, overall and with subgroup analysis for HRB and WHRB apps. Results Of the 21 apps identified, 16 (76%) met the review criteria. Overall, 9 apps defined and targeted the following HRBs: nutrition and mealtime (6/16, 38%), physical activity and screen time (5/16, 31%), sleep (7/16, 44%), and personal hygiene (6/16, 38%). Three apps targeted specific age groups (2 apps were for children aged 6-13 years and 1 app was for children aged ≥4 years). None of the apps provided tailored assessments or guidance for goal setting. None of the apps indicated that they were intended for the involvement of a health professional or had been tested for efficacy. The MARS total score indicated moderate app quality overall (mean 3.42, SD 0.49) and ranged from 2.5 to 4.2 out of 5 points. The Habitz app ranked highest on the MARS total score among HRB apps (score=4.2), whereas Thumsters ranked highest (score=3.9) among the WHRB apps. Subgroup analysis revealed a pattern of higher quality ratings in the HRB group than the WHRB group, including the mean MARS total score (mean 3.67, SD 0.34 vs mean 3.09, SD 0.46; P=.02); the engagement and information subscales; and the app-specific items about perceived impact on knowledge, attitudes, and behavior change. Conclusions Several high-quality commercially available apps target parents to facilitate goal setting and tracking for child behavior change related to both health and nonhealth behaviors. However, the apps lack evidence of efficacy. Future research should address this gap, particularly targeting parents of young children, and consider individually tailored guided goal setting and involvement of health professionals.
... Many parents are not aware of the prolonged process of food acceptance in children. In a study by Carruth et al. (2004) about 25% of the mothers reported offering a new food to their children once or twice and about half of the women offered a new food three-five times before they decided their children liked or disliked it. Home environment plays an important role in shaping children's eating habits. ...
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Parents can use food (sweets, junk food) and drinks to calm the child when their children are crying, bored, etc. With this method, children are more sensitive to external stimuli and prefer unhealthy foods more. Therefore this study was performed to reveal the use of food to soothe preschoolers and feeding behaviors of mothers having children aged 3–6 years. The study had a qualitative design and was conducted in preschools a western city part of Turkey. The study sample included 25 mothers having children aged 3–6 years. Data were collected at four focus group interviews. Two themes were emerged from the data analysis; i.e. reasons why mothers offer food to soothe their children and feeding behaviors. The mothers use food to regulate feelings of their children. They face problems while feeding their children and utilize several strategies to solve them. Mothers should be provided with information about using methods other than food to soothe their children when they whine or cry and with support to develop coping strategies. Preschools should offer education about child nutrition, feeding behaviors of parents and overcoming problems with feeding to parents and family members.
... In contrast, appetitive traits in which the child eats a limited amount of food and/or is unwilling to try new foods are also relatively common [12]. Picky eaters typically show persistent food refusal resulting in a lower dietary diversity [13] and a lower intake of specific foods, such as vegetables [14,15]. These strong food preferences often lead parents to provide the child with different food options from those eaten by other family members [14]. ...
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Purpose:Appetite can influence children’s dietary choices; however, this relationship in school-aged children is still unclear. We aimed to explore the prospective associations between child appetitive traits at age 7 and food consumption at 10 years of age. Methods: The study included 3860 children from the Generation XXI birth cohort, recruited in 2005/2006 in Porto, Portugal. The Children’s Eating Behaviour Questionnaire was used to evaluate children’s appetitive traits at 7 years. Food consumption was measured at 10 years through a validated Food Frequency Questionnaire. Logistic regression models were performed and adjusted for possible confounders. Results: Children with greater Enjoyment of Food at 7 years were 36% more likely to eat fruits ≥ 2 times/day and 54% more likely to eat vegetables > 2.5 times/day at 10 years compared to those with less frequent consumption. Children who ate more in response to negative emotions had higher odds of consuming energy-dense foods (OR = 1.33; 99% CI 1.13–1.58) and salty snacks (OR = 1.28; 99% CI 1.08–1.51) 3 years later. Those with less ability to adjust intake (higher Satiety Responsiveness) and more selective about foods (higher Food Fussiness) at 7 years were less likely to consume vegetables frequently, and were more likely to consume energy-dense foods and sugar-sweetened beverages. Conclusions: Children’s appetitive traits at 7 years were associated with the consumption of several food groups at 10 years of age. Eating more in response to negative emotions (Emotional Eating), with less ability to adjust intake (Satiety Responsiveness) and more food selectivity (Food Fussiness) were associated with worse dietary choices (in general, lower fruit and vegetables, and higher energy-dense foods and sugar-sweetened beverages consumption).
... Age was negatively associated with Appetite and Fear subscales but unexpectedly not with Picky Eating. Studies in picky eating trajectories indicated that picky eating is predominantly present in preschool children, and picky eating is usually a transient behaviour and part of normal development in preschool children (22)(23)(24). Prevalence of picky eating was highest at three years of age (27.6%) and lowest at six years of age (13.2%) in the population-based cohort (23). However, a prospective study reported that picky eating was often a chronic problem affecting 40% of children for more than two years (25). ...
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Background and aims: The current study aimed to evaluate the psychometric properties of a Turkish version of The Nine Item Avoidant/Restrictive Food Intake Disorder Screen Parent Report (NIAS-PR), which measures the avoidant/restrictive food intake disorder (ARFID) symptoms by parents. NIAS-PR includes three subscales picky eating, poor appetite/limited interest in eating, and fear of aversive consequences from eating. Also, our secondary aim was to assess the relationship between ARFID-related eating behaviours and emotional-behavioural symptoms of children and parents' psychological status. Methods: The NIAS-PR was translated into Turkish with standard procedures. Two hundred sixty-eight children (133 girls, 49.6%; mean age 8.62, age range from 2 to 18 years) and parents (175 mothers, 65.2%) were included in the study. The factor structure was confirmed using confirmatory factor analysis (CFA). The results were compared to the validated Turkish Children’s Eating Behavior Questionnaire (CEBQ) to determine the convergent validity. Internal consistency (Cronbach alpha coefficient) analysis was used to determine the reliability of the NIAS-PR. Results: The current study provided evidence for the validity of the translated Turkish version of the NIAS-PR in the pediatric population. The three-factor structure of the NIAS—Picky eating, Appetite, and Fear—was replicated in the Turkish NIAS-PR. The NIAS-PR subscales showed the expected patterns of correlations with the CEBQ subscales. The reliability of the Turkish version of NIAS-PR proved to be satisfactory (total Cronbach's alpha=0.90) in the pediatric population (2-18 years). Conclusions: This study demonstrated a good internal consistency of the Turkish version of the NIAS-PR. We confirmed the three-factor structure of the Turkish version of NIAS-PR. NIAS-PR is a brief, reliable instrument for ARFID research in Turkish children and adolescents. The NIAS-PR is developed as a screening questionnaire, so health professionals should use it to investigate ARFID-related eating behaviours further. It is worth mentioning that deepening these eating symptoms with clinical interviews is necessary.
... The prevalence of picky-eating in children is observed to be highest during the age range of 2-5 years, when it ranges from 10 to 50% [7,[10][11][12][13] in different published studies, globally. Picky-eating is defined variably in literature [12]; however, it includes aspects like lack of dietary diversity [14][15][16], the eating of inadequate amounts of food, strong food likes and dislikes [7,10], neophobia [10], and difficult mealtimes [17], causing major concerns for parents. Reduction in food consumption and low variety in diet predispose these children to various nutritional deficiencies [13,18,19], lower weights [7,13,20] and heights [7,20], and lower IQs [21]. ...
Article
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Nutrient inadequacies among picky-eaters have adverse effects on growth and development. Oral nutritional supplements (ONS) along with dietary counseling (DC), rather than DC alone as reported in our earlier publication, promoted growth among picky-eating Indian children aged from >24 m to ≤48 m with weight-for-height percentiles lying between the 5th and 25th (based on WHO Growth Standards) over 90 days. This paper presents the contribution of ONS to nutrient adequacy, dietary diversity, and food consumption patterns in children (N = 321). Weight, height, and dietary intakes, using 24-h food recalls, were measured at baseline (Day 1) and at Days 7, 30, 60, and 90. Nutrient adequacy, dietary diversity score (DDS), and food intake adequacy were calculated in both the supplementation groups (ONS1 + DC and ONS2 + DC; n = 107 in each group) and the control group (DC-only; n = 107). Supplements increased nutrient adequacy in both of the ONS + DC groups relative to control (p < 0.05). The proportions of children with adequate nutrient intakes increased significantly at Day 90 in the supplemented groups as compared to in the control group (p < 0.05), especially for total fat, calcium, vitamin A, vitamin C, and thiamin. Although no significant differences were observed in DDS in any of the groups, the percentage of children consuming ≥4 food groups in a day had increased in all the groups. Consumption of fruit and vegetables and cereals had increased significantly from baseline to Day 90. ONS along with dietary counseling was found to have improved nutritional adequacy without interfering with the normal food consumption patterns of picky-eating children at nutritional risk.
... Many parents consider their children picky eaters (1). In one cohort study that included 4,018 children, the prevalence of picky eating was 26% at 1.5 years of age, 28% at age 3, and 13% at age 6 (2). ...
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Background Pediatric feeding disorders (PFDs) are common, and their great phenotypic variability reflects the breadth of the associated nosological profiles. PFDs should be assessed and managed by multidisciplinary teams. Our study aimed to describe clinical signs of feeding difficulties in a group of PFD patients assessed by such a team, and to compare them with children in a control group. Methods In this case-control study, case group patients 1 to 6 years old were consecutively recruited through the multidisciplinary unit for the treatment of pediatric feeding difficulties based at Robert Debré Teaching Hospital in Paris, France. Children with an encephalopathy, severe neurometabolic disorder, or genetic syndrome (suspected or confirmed) were excluded. Members of the control group, consisting of children with no feeding difficulties (i.e., Montreal Children's Hospital Feeding Scale scores below 60) or severe chronic diseases, were recruited from a day care center and 2 kindergartens. Data from medical histories and clinical examination related to mealtime practices, oral motor skills, neurodevelopment, sensory processing, and any functional gastrointestinal disorders (FGIDs) were recorded and compared between groups. Results In all, 244 PFD cases were compared with 109 controls (mean ages: cases, 3.42 [±1.47]; controls, 3.32 [±1.17]; P = 0.55). Use of distractions during meals was much more among PFD children (cases, 77.46%; controls, 5.5%; P < 0.001), as was conflict during meals. While the groups did not differ in their members’ hand-mouth coordination or ability to grab objects, cases began exploring their environments later; mouthing, especially, was less common in the case group (cases, n = 80 [32.92%]; controls, n = 102 [94.44%]; P < 0.001). FGIDs and signs of visual, olfactory, tactile, and oral hypersensitivity were significantly more frequent among cases. Conclusion Initial clinical assessments showed that, in the children with PFDs, normal stages of environmental exploration were altered, and that this was often associated with signs of sensory hypersensitivity and digestive discomfort.
... Repeated taste exposure is an effective approach to increase acceptance of vegetables into a child's diet. However, up to 10 to 15 taste exposures may be necessary for a food to be accepted (Birch et al., 1982;Wardle, Cooke, et al., 2003,b) and parents tend to offer their child a food only three to five times before giving up (Carruth et al., 2004). Therefore, alternative strategies are required to support parents in increasing children's vegetable intake. ...
Article
Vegetable consumption in young children in the UK is well below the recommended five child-sized portions per day. Effective and practical strategies are therefore needed to encourage vegetable consumption in young children. In this exploratory study, we examine the effects of visual familiarization to foods via See & Eat ebooks, which show vegetables on their journey from ‘field to fork’. As part of a larger study, in which 242 British families completed a range of measures about their family's eating habits, child's food preferences and potential parent and child predictors of these (Masento et al., 2022), parents were invited to download a See & Eat ebook about a vegetable their child did not eat. Thirty-six families participated in the intervention, looking at the ebook with their child for two weeks and reporting on their child's willingness to taste, intake and liking of the vegetable targeted by the ebook and a matched control vegetable before and after the intervention period. Results showed significant increases in parental ratings of children's acceptance of the target vegetable. Willingness to taste and intake ratings improved for the target vegetable, but not the control vegetable, while liking was reported to increase for both vegetables. These results corroborate previous research demonstrating the benefits of familiarising children with vegetables before they are offered at mealtimes and suggest that ebooks can be added to the set of tools parents can use to support children's vegetable consumption.
... However, PE evaluation was used as a confounding factor or an outcome measure in eight of the eleven studies to assess the efficacy of the interventions. The instrument used for the assessment was the Child Eating Behavior Questionnaire (CEBQ) [31,37,39,41,42], the modified version of Carruth, et al. [46,51], the Lifestyle Behaviour Checklist (LBC) [39] and the Child Food Neophobia Scale (CFNS) [32,33,37,42], which were carried out by parents of the subjects. ...
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Picky eating in children is often a major source of concern for many parents and caregivers. Picky eaters (PEs) consume limited foods, demonstrate food aversion, and have a limited food repertoire, which hinders their growth and health. These behaviours are common in children with special health care needs despite the rise in typically developing children. This leads to less attention being given to intervention programmes for typically developing children. Therefore, this scoping review aims to investigate the key concept of an existing intervention programme for PE among typically developing children, primarily on the types and approaches selected. A thorough literature search was conducted on three primary databases (PubMed, Emerald In-sight, and Web of Science) using predefined keywords. The literature was then appraised using the Joanna Briggs Institute’s guidelines and protocols, and the PRISMScR checklist. Inclusion and exclusion criteria were also specified in the screening procedure. Results showed that the majority of the interventions in these studies were single-component interventions, with the sensory approach being the type that was most frequently utilised, followed by the nutrition approach and parenting approach. Single and multiple intervention components improved the assessed outcome, with a note that other components may or may not show a similar outcome, as they were not assessed in the single-component intervention. Given the evidence that picky eating is influenced by various factors, a multi-component intervention can provide a substantial impact on future programmes. In addition, defining picky eaters using standardised tools is also essential for a more inclusive subject selection.
... obsesivo-compulsivos, trastorno por déficit atencional y otros 4,10-12 . Por su parte, un estudio transversal reporta que las dificultades en comer en cantidad o calidad que emergen con mayor frecuencia son las que ocurren en las transiciones alimentarias 13 , lo que instala la importancia de los aspectos ambientales cotidianos. ...
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Objetivo: determinar asociación entre las estrategias parentales utilizadas en la alimentación, con la conducta de rechazo a los alimentos en niños/as ARFID. Pacientes y Método: Investigación de corte transversal. Para la selección de los participantes se utilizó un muestreo no probabilístico. Participaron 24 padres/madres cuyos hijos habían sido diagnosticados con un ARFID. Se consideraron los subtipos de ARFID segun criterios del DSM-5: Apetito limitado, Ingesta selectiva y Miedo a la alimentación. Criterios de exclusión fueron ARFID de causa orgánica y/o trastornos generalizados del desarrollo. Para la recolección de datos se utilizaron el Child Eating Behaviors Questionnaire y el Child Feeding Questionnaire. Resultados: Se evidenció una asociación entre la estrategia alimentaria parental de presión para comer con la conducta de rechazo a los alimentos, y con conductas alimentarias infantiles de subalimen tación emocional (p = 0,046), lentitud para comer (p = 0,016), rechazo frente a los alimentos (p = 0,019) y respuesta de saciedad (p = 0,003). Conclusión: Las conductas alimentarias frecuentemente percibidas por los padres con hijos diagnosticados con ARFID se relacionan con la dimensión de enfoque negativo hacia la comida, como respuesta de saciedad, rechazo alimentario, lentitud para comer y subalimentación emocional.
... 8 Kwon et al, 2017, observou a prevalência de alguns comportamentos alimentares específicos para que uma criança seja diagnosticada com seletividade, entre eles se encontram um comportamento neofóbico, comer em quantidades pequenas, recuso em comer grupos alimentares ou texturas específicas, além de apresentar preferência por um método de preparo específico de um alimento. 5 Brazilian Journal of Health Review, Curitiba, v. 5, n. 6, p. 24188-24197, nov./dec., 2022 ...
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‘Feeding problems’ is a term used to describe problems that may present typically in children. Problems with feeding during infancy can result in significant negative consequences for a child’s nutrition, growth, and brain development. This scoping review aims to map current research, provide summary of the available feeding problem assessment tools for children, and review current implications and the gaps between tools, providing information that academics, practitioners, and parents may find useful. Three electronic databases (PubMed, Science Direct, and ProQuest) were searched using terms related to feeding problem assessment tools in children, which included, but were not limited to, “feeding difficult*”, “eating problem”, “eating difficult*”, “tool”, “child*”, and “pediatric”. The following limits were implemented on the search: English language, age limit (<18 years old) and publication period (last 10 years). Data management and analysis carried out manually through discussion with the team. Authors 1 and 2 screened titles and abstracts, then full texts were discussed with the full team to identify articles that met inclusion and exclusion criteria. Data were charted into a matrix table based on these categories: author, year, population, assessment tools, usage and aspects. Thematic analysis was carried out to summarize the characteristics of the studies. There were 47 papers included in the study and analysis, in which 23 assessment tools were found. Pedi-EAT was the most frequent assessment tool used in the studies, with nine papers covering this feeding problem assessment tool. MCH–FS came in second for its chosen tool quantifying children’s feeding problems, with a total of seven papers covering this tool, along with BPFAS with seven papers. In this review, 23 assessment tools were validated and tested for reliability. Pedi-EAT, MCH-FS and BPFAS were commonly used instruments. However, it is clear that no single instrument covers comprehensively all aspects of feeding problems in children. In addition, usage of the tools and wide age range indicate that further research is needed to fill the gaps.
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BACKGROUND Picky eating is a commonly observed behavior among children globally, negatively impacting their physical and mental growth. Although common characteristics distinguish peaky eaters, including food selectivity, food neophobia, and food avoidance, there is no clear definition to assess this behavior. Due to the unavailability of data regarding picky eating, it wasn’t easy to estimate its prevalence. AIM To develop a regional protocol to help healthcare professionals identify and manage mild and moderate picky eating cases. METHODS A virtual roundtable discussion was held in April 2021 to gather the opinions of seven pediatricians and two pediatric dietitians from eight Middle Eastern countries who had great experience in the management of picky eating. The discussion covered different topics, including clearly defining mild and moderate picky eating, identifying the role of diet fortification in these cases, and the possibility of developing a systematic approach to diet fortification. RESULTS The panel identified picky eating as consuming an inadequate amount and variety of foods by rejecting familiar and unfamiliar food. Most of the time, moderate picky eating cases had micronutrient deficiencies with over- or undernutrition; the mild cases only showed inadequate food consumption and/or poor diet quality. Paying attention to the organic red flags like growth faltering and development delay and behavioral red flags, including food fixation and anticipatory gagging, will help healthcare professionals evaluate the picky eaters and the caregivers to care for their children. Although dietary supplementation and commercial food fortification play an important role in picky eating, they were no benefit in the Middle East. CONCLUSION The panel agreed that food fortification through a food-first approach and oral nutritional supplements would be the best for Middle Eastern children. These recommendations would facilitate identifying and managing picky-eating children in the Middle East.
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Aim This study aimed to describe current strengths and gaps in services for children with feeding needs in Southeast Queensland, Australia from the perspective of key professionals involved in service design and provision. Methods A web‐based survey was distributed to health professionals involved in providing services to children with feeding needs, staff who triaged/managed referrals, and/or service team leaders in Southeast Queensland. Results There were 79 responses to the survey, with 61 of these responses included in the analysis. Respondents identified several strengths in paediatric feeding disorder (PFD) service provision, particularly in the quality of care available for children who met service eligibility requirements. However, respondents also described services as disjointed, with limited coordinated multidisciplinary care available. Respondents frequently described service limitations relating to public service eligibility criteria, long waiting lists, and scant communication between services. Gaps were reported in the care available for children with ‘mild’ feeding difficulties and/or children who were not considered medically complex. Respondents also identified gaps in services secondary to a limited number of confident and trained professionals offering PFD care, particularly in the private sector. Conclusions This study described service providers' perceptions of available care for children with PFD in Southeast Queensland. Overall, the availability of PFD services appeared to be limited by eligibility criteria, service design, and staff capacity, suggesting that children with PFD are not receiving timely, multidisciplinary care in this geographical area. Further research into ideal service design is required to support preventative PFD care.
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Os vários fatores de início de vida têm vindo a ser associados aos comportamentos relacionados com o apetite em crianças. Para além disso, tem-se verificado uma relação entre estes comportamentos e o desenvolvimento do peso corporal na infância. Como tal, torna-se de extrema relevância estudar como os fatores de início de vida se podem relacionar com os comportamentos relacionados com o apetite em idades precoces. De forma a alcançar este objetivo, desenvolveu-se uma pesquisa nas bases de dados Medline (Pubmed) e Science Direct de janeiro a junho de 2022. De acordo com a análise da literatura efetuada compreendeu-se que as caraterísticas da mulher durante a gravidez, as caraterísticas da criança ao nascimento e os hábitos alimentares durante o primeiro ano de vida têm sido associados aos variados comportamentos relacionados com o apetite. Verifica-se uma maior tendência para os comportamentos de “aproximação à comida” se associarem com um maior risco de excesso de peso na infância, podendo perlongar-se para a vida adulta. A avaliação dos comportamentos relacionados com o apetite na infância e a sua possível associação com os fatores de início de vida são de extrema importância para compreender quais as melhores estratégias para planear ou modificar intervenções futuras de forma eficaz e orientada, para uma melhor promoção de comportamentos alimentares saudáveis e consequentemente da saúde e bem-estar dos indivíduos.
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Introduction: Assessing pediatric feeding difficulties (PFD) is essential for a child's development to prevent severe consequences. The assessment procedures for PFD may include parents' questionnaires such as the Montreal Children's Hospital Feeding Scale (MCH-FS). The aim of this study was the cross-cultural adaptation of the MCH-FS to the Greek language. Methods: 100 parents of Greek Cypriot children with PFD (clinical group) and 100 parents of healthy Greek Cypriot children (control group) aged six months to 16 years old participated in the study and completed the MCH-FS. World Health Organization (WHO) guidelines were implemented for translation and cultural adaptation. Results: The internal consistency was excellent α= 0.85 (ICC: 0.817-0.891). Content validity was significant (S-CVI=1) with an agreement equal to 14. A strong and significant correlation of MCH-FS was computed according to Principal Component Αnalysis (PCA) [14 items ranging between -0.6 and 0.7]. The Kaiser-Meyer-Olkin (KMO) Factor analysis was equal to 0.91 with substantial correlations (Bartlett's test= 0.001654804). The MCH-FS cut-off point between the two groups was 38.00 [AUC 0.901, (95% CI: 0.859-0.942), p<0.001; sensitivity= 0.800 and 1-specificity= 0.630]. A statistically significant difference between the two groups was observed for the MCH-FS total score, with the clinical group scoring higher [U= 992.00, p< 0.001]. Likewise, the same differences were observed among children with different PFD, H (3) = 96.715, p< 0.001. Conclusion: The MCH-FS had good psychometric properties in its current form in Greek. It is suggested that the MCH-FS can be used as a valid tool for children with PFD in the Greek Cypriot population.
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Preference for vegetables is influenced by various factors, including demographic, psychological, socio-environmental, and genetic factors. This study confirmed that age, pickiness, and perceptual attributes were predictors of preference for vegetables and examined how preference for vegetables and their perceptual attributes varies with age and pickiness. Children (8-14 years, n = 420), youth (15-34 years, n = 569), middle-aged adults (35-64 years, n = 726), and older adults (65-85 years, n = 270) were asked which vegetables they liked (or disliked) and which perceptual attributes of each vegetable they liked (or disliked). On the basis of their responses, an overall preference score and a preference sub-score for each perceptual attribute were calculated. Participants in each age group were classified into four statuses (non-, mild, moderate, and severe) according to their pickiness scores. Multiple regression analysis revealed that age and preference sub-scores for eight perceptual attributes (sweetness, sourness, bitterness, umami, pungency, orthonasal aroma, texture, and appearance) were positive predictors of overall preference score and that pickiness score and four perceptual attributes (saltiness, astringency, retronasal aroma, and aftertaste) were negative predictors. In addition, overall preference score and preference sub-scores for perceptual attributes other than saltiness increased with increasing age group and decreasing picker status; however, preference sub-scores for at least one of the six perceptual attributes (bitterness, astringency, pungency, orthonasal aroma, retronasal aroma, and aftertaste) exhibited negative values in children, youth, and pickers (mild, moderate, and severe). The increase in preference for these perceptual attributes might be an indicator of the adultization of food perception and the expansion of food acceptance.
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Parent feeding practices influence a child's dietary intake. Many studies examining how parents react to children's fussy eating behaviours have been limited to questionnaire measures, which assess a limited number of feeding practices. There is a lack of research exploring the range of strategies parents use when their child is being fussy and/or refusing to eat. Therefore, the aims of this study are to describe the strategies used by mothers when their child is being fussy or refusing to eat, and to assess differences in the strategies depending on the child's trait fussiness levels. In 2018, 1504 mothers of children aged 2-5 years completed an online survey. Trait fussiness was assessed using the Children's Eating Behaviour Questionnaire. Mothers were also asked the open-ended question "What are the strategies you use when your child is being fussy or refusing to eat?". Inductive thematic analysis was conducted using NVivo. Themes were compared by child trait fussiness levels. Seven main themes were identified: child-led feeding/trust in child's appetite, spectrum of pressure, home or family strategies, different types of food offerings, communication, avoid certain strategies, and never or rarely fussy. Mothers of children with severe trait fussiness levels reported more pressuring or persuasive strategies. This study provides novel information regarding the diverse range of feeding practices parents use in response to children's fussy eating behaviours. Mothers used more feeding strategies typically associated with unhealthy dietary intake for children of high levels of trait fussiness. It is important that future interventions tailor the information to provide support to parents of children with high levels of trait fussiness regarding the use of feeding practices recommended to support healthy dietary intake.
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Background Complementary foods are required to be given timeously, in adequate amounts, prepared safely and must be nutritious. Caregivers play a vital role in ensuring that the complementary feeding transition and beyond happens optimally to achieve normal growth and development in their children. Objective The aim was to explore what factors influenced the primary caregivers’ choices during the complementary feeding transition period. Methods A cross-sectional qualitative study was conducted using focus-group discussions and interviews with caregivers of children enrolled in the Optimal Child Growth and Development (OrCHID) study, which included participants from the Mother and Child in Environment (MACE) cohort and SONKE mother and child cohort. Results During the analysis of the focus-group discussions (FGDs) and interviews, nine themes were identified including: (i) starting complementary feeding; (ii) food choices; (iii) family meals; (iv) food preparation methods; (v) meal composition; (vi) texture; (vii) education source; (viii) food source; and (ix) nutrition knowledge. These themes and the key concepts associated with them were categorised into timing and transition, meal preparation, and knowledge and choices. Conclusion The caregivers relied largely on advice from family members who advised on their customs and cultural belief systems, which then impacted when the caregivers started complementary foods, food choices, texture, meal composition and transition to family meals. The caregivers sourced complementary foods based on accessibility, convenience and affordability. The caregivers described having a responsive feeding style, where their decisions were influenced by their sensitivity to how their child was responding emotionally and/or physically to the foods they were receiving. Keywords focus group discussion, complementary feeding practices, caregivers
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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)
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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.
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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.
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• 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)
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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.
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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.
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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.
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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.
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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.
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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.
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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.