Sandrine Monnery-Patris

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.

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.

Infants’ hedonic responsiveness to food odours: a longitudinal study during and after weaning (8, 12 and 22 months)

BackgroundOlfaction is a highly salient sensory modality in early human life. Neonates show keen olfactory sensitivity and hedonic responsiveness. However, little is known about hedonic olfactory responsiveness between the neonatal period and 2 years of age. In an attempt to fill this gap, this longitudinal follow-up study aimed at investigating hedonic responses to food odours in infants during the first 2 years of life. The second objective was to evaluate whether gender has an influence on hedonic responses during this early period. Four control stimuli and eight odours (four rated by adults as a priori pleasant and four a priori unpleasant) were presented in bottles to 235 infants at 8, 12 and 22 months of age. The infant’s exploratory behaviour towards odorized and control bottles was measured in terms of mouthing defined as direct contact with perioral and/or perinasal areas. For each odorized bottle, duration proportions of mouthing were calculated relative to the control bottles.ResultsFor the three ages, shorter duration of mouthing was found for unpleasantly scented bottles compared to pleasantly scented bottles. This contrast between pleasant and unpleasant odours was similar for girls and boys. Correlations of responses between ages were modest in number and level, and concerned mostly unpleasant odours.ConclusionDuring the first two years of life, infants discriminate the hedonic valence of odours. They avoid most of the food odours considered as unpleasant by adults, but their attraction towards food-odours judged pleasant by adults does not appear to be fully shaped at this early age. Taken as a whole, the present results highlight both the plasticity of hedonic responses to food odours, and relatively stable avoidance behaviours towards some unpleasant odours.

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.

Food neophobia in children and its relationships with parental feeding practices/style

Abstract This chapter aims at examining the question of food neophobia in healthy children up to the end of school age, excluding adolescents. Firstly, the definition of food neophobia in children is clarified, as well as its partial overlap with the notion of fussiness/pickiness; then the association between food neophobia and children’s diet quality and weight status is described. The second part describes the internal influence on food neophobia, more precisely by depicting the development of neophobia in children as a function of individual forces such as the affective and cognitive development, as well as temperament. The third part examines the psychosocial influences on food neophobia, focusing on how they may alter the typical development of neophobia, looking at the influence of parents and peers. The fourth part describes strategies that can be useful to overcome neophobic reactions in children, based on food properties modifications and modifications of the psychosocial context. Finally, directions for future studies are indicated.

Non-Conscious Effect of Food Odors on Children’s Food Choices Varies by Weight Status

Objective Food cues are omnipresent in the daily environment and may influence eating behavior even non-consciously. An increased reactivity to food cues, such as food odors, has been shown to be correlated with obesity in children. The objective of this study is to investigate whether the non-conscious influence of food odors on children’s food choices varies by their weight status. Methods Seventy-four children, of whom 29 were obese, took part in this study. The children performed a food choice intention task presented as a computer game in which 30 pairs of food images (a fatty-sweet food picture vs. a fruit picture) successively appeared on the screen. The children had to choose the item “they most wanted to eat at the present moment” for each pair. While performing this task, the children wore a headset in which the microphone foam was odorized with a fruity odor, a fatty-sweet odor or no odor. They performed the intention task three times, one time for each olfactory condition. The odors were non-attentively perceived, i.e., none of the children were aware of the odorization of the microphone foams. The modeled probability is the probability to choose a fruit. Results In children with obesity, the fruity odor increased the likelihood of a fruit to be chosen compared to the no-odor condition [OR (95% CL) = 1.42 (1.13–1.78), P = 0.0028], while the fatty-sweet odor had no effect on food choice [OR (95% CL) = 1.07 (0.85–1.36), P = 0.55]. In children without obesity, both the fruity and the fatty-sweet odors decreased the likelihood to choose a fruit compared to the no-odor condition [OR (95% CL) = 0.76 (0.64–0.90), P = 0.0015, for the fruity odor and OR (95% CL) = 0.79 (0.66–0.93), P = 0.0062, for the fatty-sweet odor]. Conclusion The different patterns of results obtained in both groups of children suggest differences in the mental representations activated by non-attentively perceived olfactory cues based on weight status.