Development and Modification of Childrens Food Preference

1
Development and Modification of Childrens Food
Preference

• Carrie ODonnell
• FCS 5154

2
Purpose

• To review influences affecting the development of
  food preferences
• Determine successful methods in modifying food
  preference for healthy eating behavior of
  children.
• Overall How do we get children to DESIRE
  healthy foods????????

3
Objectives

• To examine when and how food preferences are
  developed
• To determine successful feeding practices used in
  order to shape childrens food preference
• To demonstrate how these methods can be used to
  facilitate healthy eating among children.

4
Rationale

• Who Cares?

5
Childhood Obesity is High and Still Increasing
Rapidly
Health, United States, 2002, table 71 Overweight
children and adolescents 6-19 years of age,
according to sex, age, race, and Hispanic origin
United States, selected years 1963-65 through
1999-2000.
6
Current Diet of Children in the U.S.
According to Potter et al

• The average 6 to 11 year old eats only 3.5
  servings of fruits and vegetables per day
• Fewer than 15 of school children eat the
  recommended five servings of fruits and
  vegetables per day
• On any given day, 45 of children eat no fruit,
  and 20 eat less than one serving of vegetables
  per day.

Potter, J., Finnegan, J., Guinard, J., et al.
5 A Day for Better Health Program Evaluation
Report. Bethesda, M.D National Institutes of
Health, National Cancer Institute, 2000.
7
Food Consumption in New York City

• 693 Second Graders 704 Fifth Graders
• Mean FGP index
• (out of 50)
• Mean 5 A Day
• (out of 5)

Melnik, T.A., Rhoades, S.J., Wales, K.R., Cowell,
C., Wolfe, W.S. 1998. Food consumption patterns
of elementary schoolchildren in New York City.
Journal of American Dietetic Association, 98, 2,
159-164.
8
Age of Development Very Important

• Skinner et al reported recently that childrens
  food preferences at ages 2 to 4 years were highly
  predictive of their preferences later in life.
• Birch Fisher suggest that an enormous amount of
  learning about food and eating occurs during the
  transition from milk diet to omnivores diet.

Skinner, J.D., Carruth, B.R., Houck, K.S.
(1997). Longitudinal study of nutrient and food
intakes of infants aged 2 to 24 months. Journal
of American Dietetic Association, 97,
496-504. Birch, L.L Fisher J.O. (1998)
Development of Eating Behaviors Among Children
and Adolescents. Pediatrics, 101, 3, 539-556
9
Childhood Obesity leading to Adult Obesity

• According to Dietz
• identifying critical periods for the
  development of obesity may serve to focus
  preventative efforts
• nutritional alterations at critical periods of
  development entrain nutritional states, such as
  adult obesity

Dietz, W.H. 1994. Critical periods in childhood
for the development of obesity. American Journal
of Clinical Nutrition, 59, 5 955-959
10
Critical periods in childhood for the development
of obesity

• Critical period-
• Developmental stage in which physiologic
  alterations increase the later prevalence of
  obesity
• Prenatal Period
• Period of Adipose Rebound
• Adolescence

Dietz, W.H. 1994. Critical periods in childhood
for the development of obesity. American Journal
of Clinical Nutrition, 59, 5 955-959
11
Summary Of Discussion

• Over or Under Nutrition at any of these critical
  periods may increase the risk of adult obesity
• Further Research is needed to closely identify
  methods of prevention

Dietz, W.H. 1994. Critical periods in childhood
for the development of obesity. American Journal
of Clinical Nutrition, 59, 5 955-959
12
Outline for Todays Research Studies

• Sensory Development
• Genetic influences?
• Neophobic Effect
• Methods of feeding practices
• Modifying food preferences
• Conclusions
• Implications

13
Sensory Development in Children

• Taste and Smell are very important in food
  selection and intake
• Exact nature is unknown
• Only broad generalizations have been made.

14
Generalizations of Taste Perception

• Sweet is innate present at birth
• Bitter and Sour aversions are apparent early on
  and seem to be the same as adults by age 2
• Salt is less apparent or neutralpreference not
  appearing until age 2

Lawless H. Sensory development in children
research in taste and olfaction. Journal of
American Dietetic Association. 1999 85 (5)
577-582
15
The importance of sensory context in young
childrens acceptance of salty tastes

• 40 children
• 36-70 months old
• Well Baby Clinic in Pennsylvania Hospital
• 9 female
• 11 male

• ½ received plain and salted soup
• ½ received plain and salted water
• Three stimuli were placed in each of the salted
  substances

Cowart BJ, Beauchamp GK. The importance of
sensory context in young childrens acceptance of
salty tastes. Child Development. 1986 57
1034-1039.
16
Mean Intakes Water vs Soup
17
Best Accepted (intake)
18
Most Preferred (paired comparison)
19
Discussion

• By 3 years of age children reject salty water but
  prefer salted to unsalted soup
• They were able to distinguish the change of salt
  in the soup.
• This suggests the sensitivity as well as a
  preference for salt is present during these years
• Cowart Beauchamp also suggested the role of
  experience with food determines the preference

20
Outline for Todays Research Studies

• Sensory Development
• Genetic influences?
• Neophobic Effect
• Methods of feeding practices
• Modifying food preferences
• Conclusions
• Implications

21
Heritable Variation in Food Preferences and Their
Contribution to Obesity

• Reed et al 1997
• The preference for macronutrients is more
  heritable than for individual food items
• Carbohydrate and fat preference and their genetic
  determination

Reed DR, Bachmanov AA, Beauchamp GK, Tordoff MG,
Price RA. Heritable variation in food
preferences and their contribution to obesity.
Behavior Genetics. 1997 27 (4) 373-387.  
22
Macronutrients vs Individual Food Items

• Twin StudiesIndividual Foods
• Overall studies have shown that heritable
  component for individual foods is low
• Studies of family resemblance for individual food
  items have demonstrated no corelations between
  first-degree relatives

23
Cont.

• Twin StudiesMacronutrient Intake
• Reported heritabilities are generally higher than
  those for individual food items
• Difficult to determine if this is heritable or
  just a result of similar family enviornment

24
Conclusions

• Reed et al 1997
• Concluded Food preferences are largely
  determined by cultural transmission and
  individual experience.

Reed DR, Bachmanov AA, Beauchamp GK, Tordoff MG,
Price RA. Heritable variation in food
preferences and their contribution to obesity.
Behavior Genetics. 1997 27 (4) 373-387.  
25
Family resemblance in food and other domains the
family paradox and role of parental congruence

• Rozin 1991
• 118 College Students Parents
• Surveyed on family resemblance
• 59-item questionnaire
• 9 point hedonic scale

Rozin P. Family resemblance in food and other
domains the family paradox and the role of
parental congruence. Appetite. 1991 16 (2)
93-102.  
26
Results

• Pearson rmeasures co variation between any two
  family members

27
Discussion

• Higher correlation between Ma-Ch and Ma-Fa
• Suggests no heritability in food preference
• Role of the food preparer in food preference

28
Outline for Todays Research Studies

• Sensory Development
• Genetic influences?
• Neophobic Effect
• Methods of feeding practices
• Modifying food preferences
• Conclusions
• Implications

29
Food Neophobia

• Fear of New Food
• Children are predisposed to fear new solid foods
• This may influence food preference if not
  carefully considered

Birch LL. Development of food preferences.
Annual Review Nutrition. 1999 1941-62.
30
What kind of exposure reduces childrens food
neophobia? Looking vs. Tasting

• Birch et al 1987
• Compared two types of exposure
• 51 children ages 2-5
• Exposed foods 5, 10, or 15 times
• Looking vs Tasting

31
Results
32
Conclusions

• To obtain significant positive changes in
  preference, experience with food must include
  full involvement with the food
• Visual experience is not sufficient enough

33
Infants consumption of a new food enhances
acceptance of similar foods

• Birch et al 1998
• 39 infants
• Mean age of 24 weeks
• Criteriaonly fed infant cereal or breast milk

Birch LL, Gunder L, Grimm-Thomas K, Laing DG.
Infants consumption of a new food enhances
acceptance of similar foods. Appetite. 1998 30
(3) 283-295.
34
Method
In between pre and post exposure there was a
10-day exposure series Children were give the
target food for 10 days

• 4-day pre-exposure
• 1st-Target-Banana
• 2nd-Same-Banana
• 3rd-Similar-Peaches
• 4th-Different-Peas

• 5-day post-exposure
• 1st-Target-Banana
• 2nd-Same-Banana
• 3rd-Similar-Peaches
• 4th-Different-Peas

35
Results
36
Discussion

• Exposure of the target food significantly
  increased the consumption of that food
• Intake of a similar food enhanced the consumption
  
• Suggest possible causal factors, however more
  research is needed

37
Relationship between parental report of food
neophobia and everyday food consumption in 2-6
year old children

• Cooke et al 2003
• 564 mothers of 2-6 yr olds
• Completed questionnaires about feeding practices
  childs eating behavior
• Ex) How often does you/your child eat the
  following items?
• 10-point scale
• 1never 10more than once a day

38
Results
39
Discussion

• No association between parental and child
  neophobia
• This trait is adaptive rather than inherited
• Fear of toxic foods

40
Outline for Todays Research Studies

• Sensory Development
• Genetic influences?
• Neophobic Effect
• Methods of feeding practices
• Modifying food preferences
• Conclusions
• Implications

41
Restricting access to foods and childrens eating.

• Fisher Birch 1999
• Evaluated restriction of childrens access to
  snack foods
• 71 children ages 3-5
• Purpose to determine whether mothers and
  childrens reports of restricted access to 10
  palatable snack foods were related to childrens
  intake when foods were made freely available to
  children

Fisher JO, Birch LL. Restricting access to
foods and childrens eating. Appetite. 1999 32
(3) 405-419.
42
Measures

• Questionnaire-
• Mothers reports of restricting childrens access
  to snack foods
• Childrens perception of restricted access
• Childrens intake-free access procedure
• Comparison

43
Free access

• Children were provided free access to 10 snack
  foods
• Children had to indicate that they were full
• A preference assessment was used for each snack
  food prior to study
• Children were told they could eat any of the
  foods while the facilitator was not present

44
Results
45
Conclusions

• Striking differences in the childs intake when
  high levels of restriction were reported
• Boys and Girls may experience similar maternal
  restriction but may differ in their awareness and
  responsiveness
• Parental expectations of child behavior have a
  central role in determining their childs way of
  evaluating their own performance

46
Cont

• Parental control negatively affects childrens
  eating behavior
• RESTRICTION leads to thoughts of forbidden
  foods

47
Effects of a means-end contingency on young
childrens food preferences.

• Newman Taylor 1992
• Means end condition one food is eaten as a
  means of gaining the other (ex..eat an apple get
  a snickers)

48
Overview

• 86 school aged children from
• 36 females 50 males
• Mean age was 5 yrs
• Eight snacks were used
• Randomized design with repeated measures
• Three treatment conditions
• Means-End
• Temporal
• Mere Exposure

49
Pretreatment Phase

• Three cartoon faces were used to assess the
  childrens food preference for each food item
• Good
• Bad
• Just OK

50
Treatment Phase(1st Snack 2nd Snack)

• Means-End
• Only the reward snack was on the table
• Description

• Temporal
• Only told the subject of the snacks
• Description

• Mere Exposure
• Description

51
Post-treatment Phase

• Subjects were allowed to pick any snack that they
  wanted for their one more snack time
• The ranking of the item was recorded

52
Results-Pretreatment
53
Results-Post-treatment
54
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55
Conclusions

• Food used as a reward can negatively affect the
  preference for a food
• Children devalued the means snack relative to the
  reward snack and rated it lower
• If a food is offered as a reward for eating
  another the reward food item will become the
  preference

56
Increasing childrens acceptance of vegetables a
randomized trial of parent-led exposure.

• Wardle et al 2003
• Evaluated the effectiveness of an exposure-based
  intervention carried out by parents in the home,
  in increasing childrens liking of a previously
  disliked vegetable

57
Overview

• 156 children 87boys 69 girls
• Ages were 34-82 months
• Randomized control design
• Three Groups Exposure Information Control
• Pre-intervention taste test was used to determine
  which was the least preferred vegetable

58
Procedure

• Information Group
• Parents were informed of the 5-day
  recommendations
• Suggestions were given to increase consumption

• Exposure Group
• Parents offered veg. Every day for 14 days
• Encouragement to eat the veg was used
• No rewards were offered

• Control Group
• -Simply were told that they would be revisited in
  2 weeks

59
Measures

• Rated liking
• 3-point faces scale
• Smiley FaceI like it
• Neutral FaceIts OK
• Grimacing Face I dont like it

• Ranking of all
• Ranked the vegetables from least to most liking
• OneLeast
• SixMost

• A Target Vegetable was used to measure weight
  consumed and was the basis for Analyses

60
Results-Target Veg Intake
61
Results-Target Veg Ranking
62
Conclusions

• Daily exposure to the taste of a previously
  disliked vegetable would increase childrens
  liking and consumption
• Repeated exposure is KEY

63
Outline for Todays Research Studies

• Sensory Development
• Genetic influences?
• Neophobic Effect
• Methods of feeding practices
• Modifying food preferences
• Conclusions
• Implications

64
Conditioned flavor preferences in young children.

• Birch et al 1990
• Determine whether flavor preferences could be
  conditioned in children through repeated
  associations with high and low caloric density

65
Overview

• 11 children 5 males 6 females
• 38-59 months
• Two novel drink flavors
• Orange-chocolate
• Bubble gum
• High and low caloric density versions of each
  drink were used

66
Procedure

• Initial preference test
• Two-Flavor choice test
• Conditioning Trials

67
Results of Preference
68
Results of Consumption
69
Conclusions

• Overall consumption through repeated exposure
  increases
• The preferences for high caloric dense foods are
  more preferred after repeated exposure

70
Pass the Sugar, Pass the Salt Experience
Dictates Preference

• Sullivan Birch 1990
• To explore the role of experience with a novel
  food, eaten either sweetened, salty, or plain, on
  the development fo a preference for those
  versions of that food.

Sullivan SA Birch LL. Pass the sugar, pass
the salt Experience dictates preference.
Developmental Psychology. 1990 26 (4)
546-551.  
71
(No Transcript)
72
Overview

• 39 preschool children 21-boys 18-girls
• 44-71 months
• Children had repeated experience with one of the
  three novel foods (tofu) either
• Sweetened
• Salted
• Plain

• Preferences were measured prior to any treatment
• Training Period
• Pre-exposure assessment
• Exposure period
• Post-assessments

73
Results Compared Sweet/Salt/Plain
74
Results Combined all three
75
Conclusions

• Repeated exposure to initial novel food led to
  increased acceptance of that food
• This was regardless of whether that food was
  sweetened, salty, or plain
• 8 to 15 exposures were necessary to see this
  effect
• It was also noted that after exposure the other
  version of the food was less desired regardless
  of the flavored version present

76
Summary

• Research is still needed to determine exactly
  when and how preferences first develop
• It is very difficult to determine what is
  inherited and what is adaptive by nature due to
  all the enviornmental factors

77
Conclusions From This Review

• Mere exposure is a strong factor in food
  preference modification in children
• Ages 3-5 years seem to be the critical time where
  children gain preference through trying new foods
• Reward and Restriction are not good methods of
  feeding practice
• Children should be repeatedly exposed to all
  types of foods frequently
• Parents need to be informed of proper feeding
  practices to stop the trend of obesity in children

78
Implications

• Future research should focus on the exact age
  that preferences develop
• More family studies should be conducted
• Professionals need to focus on parent education
  of proper feeding practices to foster healthy
  food preferences in children
• There is a need for single case studies over a
  longer period of time to better identify with the
  development of food preferences

79
References

• Health, United States, 2002, table 71.
  Overweight children and adolescents 6-19 years of
  age, according to sex, age, race, and Hispanic
  origin United States, selected years 1963-65
  through 1999-2000.
• Potter J, Finnegan J, Guinard J. 5 A Day for
  Better Health Program Evaluation Report.
  Bethesda, M.D National Institutes of Health,
  National Cancer Institute, 2000.
• Melnik TA, Rhoades SJ, Wales KR, Cowell C, Wolfe
  WS. Food consumption patterns of elementary
  schoolchildren in New York City. Journal of
  American Dietetic Association. 1998 98 (2)
  159-164.
• 4.      Ogden CL, Flegal KM, Carroll MD,  Johnson
  CL. Prevalence and trends in overweight among US
  children and adolescents. 1999-2000. Journal of
  American Medical Association. 2002 288 1728-32.
  
• Skinner JD, Carruth BR, Houck KS. Longitudinal
  study of nutrient and food intakes of infants
  aged 2 to 24 months. Journal of American
  Dietetic Association.1997 97 496-504.
• Birch LL, Fisher JO. Development of Eating
  Behaviors Among Children and Adolescents.
  Pediatrics. 1998 101 (3) 539-556
• Dietz WH. Critical periods in childhood for the
  development of obesity. American Journal of
  Clinical Nutrition. 1994 59(5) 955-959
• Lawless H. Sensory development in children
  research in taste and olfaction. Journal of
  American Dietetic Association. 1999 85 (5)
  577-582.
• Cowart BJ, Beauchamp GK. The importance of
  sensory context in young childrens acceptance of
  salty tastes. Child Development. 1986 57
  1034-1039.
• Liern DG, Mennella JA. Sweet and sour
  preferences during childhood role of early
  experiences. Developmental Psychobiology. 2002
  41 (4) 388-395.
• Tumbull B, Matisoo-Smith E. Taste sensitivity to
  6-n-proplthiouracil predicts acceptance of
  bitter-tasting spinach in 3-6-y-old children.
  American Journal of Clinical Nutrition. 2002 76
  (5) 1101-1105.
• Reed DR, Bachmanov AA, Beauchamp GK, Tordoff MG,
  Price RA. Heritable variation in food
  preferences and their contribution to obesity.
  Behavior Genetics. 1997 27 (4) 373-387.
•  

80

• Johnson SL, Birch LL. Parents and childrens
  adiposity and eating style. Pediatrics. 1994
  94 (5) 653-661.
• Rozin P. Family resemblance in food and other
  domains the family paradox and the role of
  parental congruence. Appetite. 1991 16 (2)
  93-102.
•  
• Rozin P, Millman L. Family environment, not
  heredity, accounts for family resemblances in
  food preferences and attitudes a twin study.
  Appetite. 1987 8 (2) 125-134.
• Greene LS, Desor JA, Maller O. Heredity and
  experience their relative importance in the
  development of taste preference in man. Journal
  of Comparative and Physiological Psychology.
  1975 89 (3) 279-284.
• Birch LL. Development of food preferences.
  Annual Review Nutrition. 1999 19 41-62.
• Birch LL, McPhee L, Shoba BC, Pirok E, Steinburg
  L. What kind of exposure reduces childrens food
  neophobia? Looking vs. tasting. Appetite. 1987
  9 (3) 171-178.
• Birch LL, Gunder L, Grimm-Thomas K, Laing DG.
  Infants consumption of a new food enhances
  acceptance of similar foods. Appetite. 1998 30
  (3) 283-295.
• Cookie L, Wardle J, Gibson EL. Relationship
  between parental report of food neophobia and
  everyday food consumption in 2-6-year-old
  children. Appetite. 2003 41 (2) 205-206.
• Story M, Brown JE. Do young children
  instinctively know what to eat? The studies of
  Clara Davis revisited. The New England Journal
  of Medicine. 1987 316 (2) 103-106.
• Koivisto H. Factors influencing childrens food
  choice. Annals of Medicine. 1999 31 (1)
  26-32.
• Wardle J. Parental influences on childrens
  diets. The Proceedings of the Nutrition Society.
  1995 54 (3) 747-758.

81

• Casey R, Rozin P. Changing childrens food
  preferences parent opinions. Appetite. 1989
  12 (3) 171-182.
• Birch LL, McPhee L, Steinberg L, Sullivan S.
  Conditioned flavor preferences in young children.
  Physiology Behavior. 1990 47 (3) 501-505.
• Johnson SL, McPhee L, Birch LL. Conditioned
  preferences young children prefer flavors
  associated with high dietary fat. Physiology
  Behavior. 1991 50 (6) 1245-1251.
• Birch LL. Effects of experience on the
  modification of food acceptance patterns. Annals
  of the New York Academy of Sciences. 1989 561
  209-216.
• Wardle J, Cooke LJ, Gibson EL, Sapochnik M,
  Sheiham A, Lawson M. Increasing childrens
  acceptance of vegetables a randomized trial of
  parent led exposure. Appetite. 2003 40 (2)
  155-162.
• Wardle J, Herrera ML, Cookie L, Gibson EL.
  Modifying childrens food preferences the
  effects of exposure and reward on acceptance of
  an unfamiliar vegetable. European Journal of
  Clinical Nutrition. 2003 57 (2) 341-348.
• Fisher JO, Birch LL. Restricting access to foods
  and childrens eating. Appetite. 1999 32 (3)
  405-419.
• Newman J, Taylor A. Effect of means-end
  contingency on young childrens food preferences.
  Journal of Experimental Child Psychology. 1992
  53 (2) 200-216.
• Gillis L. Use of an interactive game to increase
  food acceptancea pilot study. Child Care,
  Health and Development. 2003 29 (5) 373-375.
• Story M, Faulkner P. The prime time diet a
  content analysis of eating behavior and food
  messages in television program content and
  commercials. American Journal of Public Health.
  1990 80 (6) 738-740.
• Kotz K, Story M. Food advertisements during
  childrens Saturday morning television
  programming Are they consistent with dietary
  recommendations? Journal of American Dietetics
  Association. 1994 94 1296-1300.
•