Natalie Rigal

A Review of Methods to Assess Parental Feeding Practices and Preschool Children's Eating Behavior: The Need for Further Development of Tools

We reviewed tools developed to measure parental feeding practices and eating behavior and food intake or preferences of children aged 0 to 5 years. Two electronic literature databases (Medline and Psycinfo) were used to search for both observational and experimental studies in human beings. The articles selected for review were those presenting tools with data on internal consistency and/or test-retest reliability and/or construct validity. A total of 3,445 articles were retrieved, and further searching of reference lists and contact with experts produced an additional 18 articles. We identified three tools on the qualitative dimension of childrens eating behavior, two tools on food intake or preferences, and one tool on parental feeding practices with rigorous testing of internal consistency, construct validity, and test-retest reliability. All other tools presented in this review need further evaluation of their validity or reliability. Because major gaps exist, we highlight the need for more tools on parental attention to childrens hunger and satiety cues, and the need to evaluate the degree of control allowed to children younger than age 2 years in feeding events. Food avoidance (ie, behaviors or strategies to take away and to reject food) and food approach (ie, attractiveness for food stimuli) have not been assessed in children aged 12 to 24 months. Food preference tests based on sensory aspects rather than nutritional quality may be worth investigating. We identified a need for further evaluation of quality, especially test-retest reliability and construct validity, for most tools developed for use in studying children aged 0 to 5 years.

Food neophobia in the context of a varied diet induced by a weight reduction program in massively obese adolescents

Previous studies in humans have shown that short to middle-term pre-exposure to multiple foods can reduce the negative response to novel foods (neophobia). In order to explore the effects of a long-term exposure to varied foods on food neophobia, we studied a population of obese adolescents observed in a longitudinal protocol in which the multiple food experiences are induced by a residential weight reduction program (WRP) that encourages the consumption of a wide variety of foods. Seventy-two massively obese adolescents (22 boys) filled the food neophobia scale (FNS, [Pliner, P., & Hobden, K. (1992). Development of a scale to measure the trait of food neophobia in humans. Appetite 19, 105-120]) and an ad hoc food familiarity and liking questionnaire at the beginning and at the end of the program (mean duration: 8.9 months). Their scores were compared to those of a control group of 51 adolescents (14 boys) tested within a similar period. FNS results show a decrease of food neophobia, without significant difference between the control group and the WRP subjects, although only WRP have encountered new foods experiences as attested by the familiarity and liking results. Methodological considerations, concerning the characteristics of the participants, the nature of the multiple food exposure and the food neophobia measurements, will be proposed to explain differences among studies.

Links between maternal feeding practices and children’s eating difficulties. Validation of French tools ☆

The main objectives of the present study were to validate measures of young childrens eating difficulties and maternal feeding practices in a French sample, as well as to assess the links between these practices and childrens eating difficulties. Mothers (n=502) of French children aged 20-36 months completed four questionnaires that were validated using a Structural Equation Modelling approach. Links between children and maternal components were investigated using a PLS regression. The Childrens Eating Difficulties Questionnaire yielded a 4-dimension solution: Neophobia, Pickiness, Low Appetite and Low Enjoyment in food. The Feeding Style Questionnaire assessed three dimensions: Authoritarian, Authoritative and Permissive Styles. The Feeding Strategy Questionnaire, designed to evaluate strategies used by mothers to make their child taste rejected foods, resulted in four factors: Coercion, Explanation, Contingency and Preference. The Questionnaire relating to Parental Motivations when buying food for children presented a 6-dimension solution: Convenience, Weight-control, Natural, Health-concern, Preference and Price. The factors associated positively with the four dimensions of the Childrens Eating Difficulties Questionnaire were on the one hand Permissive Style and Practices to fulfil childs desires, and on the other hand Authoritarian Style, Contingent and Coercive Practices aimed at forcing children to taste rejected foods.

Taste acuity of obese adolescents and changes in food neophobia and food preferences during a weight reduction session.

The relationship between taste acuity and food neophobia, food familiarity and liking has been studied in the context of a residential weight reduction session (WRS; mean duration: 10 months) in 39 obese adolescents. Taste acuity was assessed using recognition thresholds for sucrose, citric acid, sodium chloride and 6-n propylthiouracil (PROP) and supra-threshold perceived intensities for sucrose, sodium chloride and PROP. Food neophobia was assessed by using the food neophobia scale at the beginning and at the end of the WRS. At these time points we used also a food familiarity and liking questionnaire to assess changes in food familiarity and likes or dislikes for different food categories. Taste acuity appeared to mediate behavioural food-related changes during the WRS. High taste acuity was associated with limited reductions in food neophobia; less sensitive subjects showed greater increases in the acceptability of healthy foods, especially fruits and vegetables. Therefore, taste perception (and particularly PROP perception) appears to be a predictor of the magnitude of food-related behavioural change achieved during a WRS.

Measuring willingness to try new foods: a self-report questionnaire for French-speaking children.

The study was designed to develop and validate a self-report questionnaire on food neophobia in French children. We evaluated food neophobia in a specific cultural context, examining an age group that has hardly been studied (5- to 8-year-olds). The questionnaire items were based on methods known for changing neophobic behavior (imitation, information, flavor principle and external stimulation) in order to diversify food presentation situations. In addition, we used colored pictures of food for seven items. Thirteen items that referred to acceptance of unfamiliar food were selected out of 25 items tested in an earlier stage. Six hundred and three children filled out the food neophobia questionnaire and a food task used to check its predictive validity was given to 503 of them. A factor analysis emphasized the one-dimensional structure of the questionnaire. Results showed satisfactory internal consistency and good test-retest reliability. The childrens choices and their willingness to try new types of food were significantly correlated with the questionnaire scores. Food neophobia conceived as a personality trait was discussed.

Early determinants of food liking among 5y-old children: a longitudinal study from the EDEN mother-child cohort

BackgroundIdentifying the determinants of child’s liking for different foods may help to prevent future choices of unhealthy food.ObjectiveTo study early-life food-related characteristics associated with child’s liking for different foods at 5y with a longitudinal study.Design1142 5y- old children completed a liking test for “fruit and vegetables”, “meat, fish and eggs”, desserts and cheese. Data related to maternal food intake before pregnancy, infant feeding during the first year of life, maternal feeding practices at 2y, child’s food intake at 3y, and child’s food neophobia from 1 to 4y were collected prospectively from the mother. The associations between these factors and child‘s liking for each category of foods were analyzed using structural equation modelling.ResultsHigh food neophobia at 4 y was related to lower child’s liking for all food groups. Maternal feeding practices at 2y were associated with liking for dessert: negatively for the practices allowing child to control his/her own food intake, positively for restriction of child’s food intake for weight reasons. Moreover, child’s food intake at 3y was positively associated with child’s liking for “fruit and vegetables” as well as for cheese. Finally, adherence to the infant feeding pattern “long breastfeeding, later introduction of main meal components and use of home-made products” was positively associated with child’s liking for meat/fish/eggs.ConclusionsFor all food groups, food neophobia was a common determinant of child’s liking for food at 5y, whereas other factors were associated with food liking for specific food groups.

Diversification alimentaire et construction du goût

Before the age of two years, children have very adaptive behaviors in the food domain: they feel pleasure to consume what is nourishing, are attracted by the smells with which they were familiarized in utero or during breastfeeding and are not picky. This period of openness is thus ideal to teach to the child to appreciate a wide variety of foods. Beyond two years of age, most of the children cross a normal phase of neophobia during which they are reluctant to appreciate unknown foods and vegetables. The most effective method to help them to exceed this phase of closure is to propose these rejected foods in a repeated manner. It seems moreover that the more the children would have consumed a wide variety of food during the phase of openness, the less they would elicit neophobia during the phase of closure.

COMPORTEMENTS ALIMENTAIRES DE L'ENFANT ET ATTITUDES PARENTALES : LE POINT DE VUE DE LA PSYCHOLOGIE EXPÉRIMENTALE*

Resume L’enfant presente tout au long de son developpement une attirance marquee pour les produits alimentaires a forte densite energetique, notamment s’ils sont gras et/ou sucre, ce qu’une majorite de parents desapprouvent dans le contexte actuel de l’obesite et de la pregnance du modele de la minceur. Cette attirance presente cependant une valeur adaptative si l’enfant n’a pas perdu au cours de son developpement sa capacite d’ajustement calorique. Des travaux, bien que peu nombreux, semblent indiquer qu’un trop fort controle exerce sur les choix alimentaires des enfants participe a la deregulation de la capacite d’ajustement calorique et que des pratiques educatives associant la prescription de regles et l’ajustement aux demandes des enfants favorisent l’emergence de comportements alimentaires adaptes sur le plan de la diversite alimentaire et de la regulation du poids.

Parental concerns and attributions of food pickiness and its consequences for the parent–child relationship: A qualitative analysis

A qualitative study was conducted to identify how parents describe and attribute their toddler’s food pickiness, a common pediatric problem during childhood. Parental strategies to respond to picky behaviors were also explored in this study. Focus groups were used with 38 parents of children aged 18–38 months. Results highlighted several consequences of child pickiness such as parental concerns about child’s growth and health, conflicts at mealtime, and feelings of guilt. Parents attributed food pickiness mainly as a manifestation of opposition and assertiveness by their child. Some strategies known to be effective were applied by parents (such as repeated exposure, modeling, co-preparing meals, and using a flavor-based approach) but some strategies that are counterproductive were also highlighted (such as rewards for eating). Parents need to be better informed about food pickiness and the strategies that help to overcome it. Understanding parental beliefs may help pediatricians to offer appropriate guidance adapted to parental experiences and feelings.