Helen Coulthard

Fruit and vegetable consumption in children and their mothers. Moderating effects of child sensory sensitivity.

A cross-sectional study was carried out to ascertain the relative contribution of food neophobia and taste sensitivity to the amount of fruit and vegetables consumed in a typical day by 73, 2-5-year-old children attending nurseries in the South Birmingham area, UK. Sensory processing, parental control, child food neophobia and fruit and vegetable (FV) consumption of both mothers and children were measured. Parental and child FV consumption in the sample were positively associated (p<0.001). Moderated regression analyses showed that taste/smell sensitivity, but not food neophobia or tactile sensitivity, moderated the relationship between maternal and child FV consumption. In particular, children who were sensitive to taste/smell stimuli ate fewer fruit and vegetables, regardless of their mothers FV consumption. This finding implies that those children, who are sensitive to taste/smell stimuli, may be less likely to model maternal FV consumption. For these children, a more gradual route to encouraging acceptance, with attention to small sensory changes in foods, may be necessary to increase FV consumption.

Long-term consequences of early fruit and vegetable feeding practices in the United Kingdom.

OBJECTIVE To describe fruit and vegetable (FV) feeding practices at 6 months, and to examine whether these practices predict childrens FV intake at 7 years of age. DESIGN A prospective, longitudinal design was adopted. The mothers completed self-reported questionnaires at 6 months and 7 years postpartum, containing questions about their childs FV intake. SETTING The study was carried out on a geographically representative population of infants born in Avon, UK, from 1991 to 1992, as part of the Avon Longitudinal Study of Parents and Children. SUBJECTS Information was collected from 7866 mothers of infants. RESULTS Hierarchical linear regressions were used to predict FV consumption at 7 years from the early feeding variables. Children who were given home-cooked fruit or vegetables more often at 6 months were more likely to be eating a higher proportion of FV at 7 years, than those who were given home-cooked FV less often. There was no positive difference found in consumption of FV at 7 years according to how often ready-prepared fruits or vegetables were given at 6 months. The age of introduction to home-cooked vegetables moderated the relationship between frequency of consumption at 6 months and 7 years. CONCLUSIONS The findings support the concept that exposure to FV is important in the early weaning period. The finding that consumption of ready-prepared FV was not positively associated with later FV consumption needs to be further investigated, with reference to theories of exposure, modelling and parental food choices. If vegetables are introduced later in weaning, they need to be fed frequently, to ensure adequate exposure.

Early food refusal: The role of maternal mood

A prospective, longitudinal study was carried out to investigate the relationship between maternal mood and feeding problems, in particular food refusal. A total of 116 mothers and infants were visited at 1 month, 5 months and 11 months postpartum. Mothers filled in the EPDS and the STAI at each of the three visits, and reported whether the infant had undergone a period of solid food refusal between 5 and 11 months postpartum. No differences in maternal anxiety and depression scores were found according to whether or not an infant underwent a period of food refusal. When the food refusal group was divided according to whether or not food refusal had been resolved by 11 months, several differences emerged. In particular, mothers whose infants were still refusing to eat some or all types of food at 11 months had significantly higher state anxiety and depression scores at 1 and 11 months than did the rest of the sample. These results suggest that some mothers, who respond to feeding problems with anxiety or depression, may prolong or worsen the problem. The implications of these results for intervention with mothers of infants with food refusal will be discussed.

Relationships between sensory sensitivity, anxiety and selective eating in children

The present study examines whether parental reports of child selective eating are associated with child anxiety and sensitivity to sensory stimuli in their environment. Parents of 95 children aged 5-10 completed questionnaires about child eating behavior, child anxiety and sensory sensitivity. Results indicated that both anxiety and sensory sensitivity were associated with selective eating. In addition, child sensory sensitivity fully mediated the relationship between anxiety and selective eating in children suggesting that it is greater sensitivity to sensory information which explains why more anxious children are more likely to be selective eaters. Further research is necessary to better understand these relationships and indicate whether gradual exposure interventions with children who are sensory sensitive may help to prevent or reduce selective eating.

Association between tactile over‐responsivity and vegetable consumption early in the introduction of solid foods and its variation with age

The main aim of the current study was to test the hypothesis that early reactions to a vegetable in infants may be associated with sensory processing, in particular, tactile over-responsivity. A secondary aim was to see whether the relationship between sensory over-responsivity and vegetable consumption would be moderated by the age of the infant. A sample of 61 infants was recruited from childrens centres and playgroups in South Birmingham, UK. Infants acceptance of carrot was measured in grams during the first week of complementary feeding in one testing situation. Mothers filled in self-report measures of infant sensory processing, as well as their own fruit and vegetable consumption. Infant carrot consumption in the first week of solid food consumption was negatively associated with total sensory over-responsivity across different sensory domains (P < 0.01). Across the sensory domains only tactile over-responsivity predicted carrot consumption, accounting for 10.7% of the variance in consumption scores. Across the sample as a whole, the relationship between carrot consumption and tactile over-responsivity varied according to the age of introduction to solid foods. In particular, those who were weaned later and had high tactile over-responsivity ate less carrot (P < 0.001). Infants who were weaned early ate a similar amount of carrot, regardless of their tactile responsivity (P > 0.05). This study constitutes some of the first evidence to suggest that sensory processing styles be associated with early vegetable acceptance; however, more research is needed to evaluate the best strategies to use when feeding infants who are sensitive to tactile information.

Evaluation of a pilot sensory play intervention to increase fruit acceptance in preschool children

Recent research has found an association between dislike of messy play and higher levels of food neophobia in children. The aim of the present study was to pilot and assess a five week intervention with preschool children, to examine whether engagement in tactile sensory tasks leads to increased fruit acceptance. Interventions were carried out to examine whether weekly sessions of sensory play combined with fruit exposure, would increase acceptance and enjoyment of fruits to a greater extent than two non-sensory play conditions featuring fruit exposure or normal play activities alone. One hundred children aged 18 months to four years were recruited from ten playgroups in the Midlands area of the United Kingdom (UK) of which 83 completed the interventions. Participants were randomly assigned to one of four conditions: combined sensory play (fruit and non-food), non-food sensory play, fruit taste exposure, and control play. There were baseline differences in child fruit acceptance, so this was entered as a covariate into subsequent analyses. It was found that children in both the combined sensory play and non-food sensory play conditions enjoyed significantly more fruits at follow up than children in the control play condition, whilst children in the non-food sensory play group also enjoyed significantly more fruits than the fruit exposure group. These findings suggest that sensory play, with fruit and/or non-food substances, combined with exposure may be an effective strategy to increase tasting and fruit acceptance in children.

Self-disgust within eating disordered groups: Associations with anxiety, disgust sensitivity and sensory processing.

This study aimed to assess the relationship between self-disgust and sensory processing within eating psychopathology. Five hundred and ninety-one women with a self-reported diagnosis of anorexia nervosa, bulimia nervosa or who had no previous history of an eating disorder completed a battery of online questionnaires measuring disgust, emotion and sensory variables. Those with an eating disorder reported significantly higher rates of self-disgust than those with no history of disordered eating. In groups of women with self-reported bulimia, self-disgust was associated with sensation avoidance and sensation seeking. Within the group with anorexia nervosa, self-disgust was associated with low registration and sensation seeking. This report is the first to examine the expression of the emotion self-disgust within eating psychopathology and examine associations of this factor with sensory processing. The emotion self-disgust needs to be further examined to understand its possible role in the onset and maintenance of disordered eating. Copyright

Engagement in sensory play in preschool children as a predictor of food acceptance

Previous research has shown that parental reports of food neophobia and sensory sensitivity are associated with lower fruit & vegetable (FV) intake in children. This study aimed to pilot a behavioural measure of sensory play in young children. The primary aim of the study was to see whether children’s enjoyment of sensory play could predict children’s FV consumption, as well as child food neophobia scores. Seventy 2–5 year old children and their parents were recruited through children’s centres in the Leicester region. Children’s engagement in two sensory play tasks was rated by both the researcher and parent. Parents were asked to complete a series of questionnaires measuring FV consumption, food neophobia, and sensory processing. The child’s average daily FV consumption, was predicted by parental FV portions, but not sensory play. However, a moderated regression showed that sensory play moderated the relationship between child and parental FV consumption, with children who did not enjoy sensory play being significantly less likely to model parental FV consumption. In addition, sensory play scores significantly predicted child food neophobia scores. A significant difference was discovered in the children’s willingness to try an unfamiliar fruit based on their child food neophobia scores. The findings strengthen the idea that sensory processing may be associated with the acceptance of food variety, but not the total amount of FV consumed. This holds implications for developing sensory play in order to increase children’s fruit range and potentially improve their health. Overall, the findings generated from this study can be utilised to provide a theoretical basis for the promotion of sensory play.

Music listening as a potential aid in reducing emotional eating: An exploratory study

Emotional Eating (EE) is understood as a maladaptive self-regulation strategy to satisfy emotional needs instead of hunger. Consequently, EE has been associated with negative health consequences. Enjoyment of food and music share similar neural activations in the brain and are both used by people for regulating affect. This suggests that music listening could potentially be a healthier alternative to EE. The present study was designed to investigate associations between EE, disordered mood, and music-related mood regulation. A total of 571 participants completed measures of EE, music listening strategies, and disordered mood. Associations between seven different music listening strategies and EE were examined, and also whether these regulation strategies were associated with depression, anxiety, and stress. Finally, we explored associations between music listening and EE in people with low and high (non-clinical) levels of disordered mood (depression, anxiety, and stress). The findings of this research indicated that music listening for discharge (releasing anger or sadness through music that expresses these same emotions) and EE were positively associated with one another. In addition, EE and the music listening strategies of entertainment, diversion or mental work were associated in people with low levels of disordered mood. When disordered mood was high, EE was higher, but was not associated with music listening strategies. These associations point towards the possibility of some music listening strategies being useful as healthier alternatives for EE.