Sensory evaluation of a novel vegetable in school age children

Neophobia, sensory experience and child's schemata contribute to food choices

PURPOSE

The aim of the present review is to analyze dynamic interactions between nutrigenomics, environmental cues, and parental influence, which can all lead to children's neophobic reactions and its persistence in time.

METHODS

We reviewed studies available on electronic databases, conducted on children aged from birth to 18 years. We also considered official websites of Italian Institutions, providing advice on healthy eating during infancy.

RESULTS

Modern day societies are faced with an eating paradox, which has severe and ever-growing implications for health. In face of a wider availability of healthy foods, individuals instead often choose processed foods high in fat, salt and sugar content. Economic reasons surely influence consumers' access to foods. However, there is mounting evidence that food choices depend on the interplay between social learning and genetic predispositions (e.g., individual eating traits and food schemata). Neophobia, the behavioral avoidance of new foods, represents an interesting trait, which can significantly influence children's food refusal. Early sensory experiences and negative cognitive schemata, in the context of primary caregiver-child interactions, importantly contribute to the priming of children's food rejection.

CONCLUSIONS

As neophobia strongly affects consumption of healthy foods, it will be relevant to rule definitively out its role in the genesis of maladaptive food choices and weight status in longitudinal studies tracking to adulthood and, in meanwhile, implement early in life effective social learning strategies, to reduce long-term effects of neophobia on dietary patterns and weight status.

LEVEL OF EVIDENCE

Level II, controlled trials without randomization.

Nutrition education strategies to promote vegetable consumption in preschool children: the Veggies4myHeart project

OBJECTIVE

To test the efficacy of three nutrition education strategies on the intake of different vegetables in preschool children.

DESIGN

This is an experimental study conducted in four Portuguese preschools. The intervention consisted of 20-min educational sessions, once a week, for 5 weeks, with one of the following randomised educational strategies: Portuguese Food Wheel Guide (control), digital game, storybook, storybook and reward (stickers). All groups had repeated exposure to vegetables in all sessions. A pre- and post-test were conducted to determine vegetable intake, and a 6-month follow-up was realised.

SETTING

Preschools of Leiria district, Portugal.

PARTICIPANTS

A sample of 162 children aged 3 to 6 years. All eligible children attending the preschools were invited to participate.

RESULTS

All interventions tested were effective in increasing vegetable consumption both in the short and medium term, without statistically significant differences, compared to the control group. Stickers were more effective in the short term than in the medium term.

CONCLUSIONS

The nutritional education strategies associated with repeated exposure tested in this study were effective in promoting vegetable consumption in preschool children. The use of stickers may be a valid strategy to promote the consumption of vegetables less recognised by children.

VeggieSense: A non-taste multisensory exposure technique for increasing vegetable acceptance in young children

Vegetable consumption falls well below recommended levels for children in the UK. Previous research has found that repeated non-taste sensory exposure over the course of several days increases young children's willingness to touch and taste vegetables. The current study examined the impact of a one-off multisensory non-taste exposure intervention that took place on a single day on children's willingness to taste and intake of the exposed vegetables. Children (N = 110) aged 3- to 4-years-old were assigned to one of three intervention groups or to a control group. Children in all groups participated individually in a single activity session delivered in their nursery. Children in the intervention conditions took part in fun activities that provided either (a) visual exposure, (b) smell and visual exposure, or (c) smell, touch and visual exposure to six raw and prepared vegetables. Children in the control group engaged in a visual exposure activity with non-food items. After the exposure activities, all children were offered the prepared vegetables to eat; their willingness to taste and intake of the vegetables were measured. Results confirmed previous findings of sensory exposure activities increasing children's willingness to taste and intake of vegetables and revealed linear trends in both measures of acceptance with the number of senses engaged; children who took part in smell, touch and visual activities showed the highest level of acceptance. Findings suggest that multisensory exposures are effective in increasing consumption of vegetables in young children and that the effect of sensory exposure to healthy foods may be cumulative, with the more senses engaged prior to offering a food, the better.

Food neophobia and the evaluation of novel foods in adults; the sensory, emotional, association (SEA) model of the decision to taste a novel food

Reluctance to eat new foods, known as food neophobia, is well researched in children but not adults. Two studies were carried out to understand the emotional, sensory, and cognitive factors associated with food neophobia in an adult sample, and to propose a preliminary explanation of the decision to taste a novel food named the SEA model (Sensory, Emotional, cognitive Association model). Participants were recruited through opportunity sampling of a university population in the Leicester region of the UK. Study one (n = 534) was a cross sectional study examining associations between self-report measures of food neophobia, emotional variables and sensory variables. In study two (n = 160), participants completed an online cognitive evaluation of 7 images of novel fruits and vegetables, rating perceived familiarity, categorisation as fruit or vegetable, cognitive associations based on appearance (what does the food look like), liking of any associated foods, and expected liking of the novel food. In study 1 it was found that tactile sensitivity and disgust sensitivity were the main sensory and emotional variables associated with food neophobia. In study 2, it was found that food neophobia and lower expected liking of novel foods were associated with disgust sensitivity, associating the novel foods with disliked foods, and lower perceived familiarity. The SEA model further proposes that underlying tendencies and automatic reactions to foods, combine with cognitive associations based on negative memories and negative beliefs about tasting new foods, to create expected disliking of a food and a decreased likelihood that it will be tried. Further work is needed to fully test the SEA model of the decision to taste a novel food, in particular to further examine how associations are formed.

Relationship between Anthropometric Parameters and Sensory Processing in Typically Developing Brazilian Children with a Pediatric Feeding Disorder

In this study, we aimed to relate anthropometric parameters and sensory processing in typically developing Brazilian children diagnosed with a pediatric feeding disorder (PFD). This was a retrospective study of typically developing children with a PFD. Anthropometric data were collected and indices of weight-for-age, length/height-for-age, and body mass index-for-age (BMI-for-age) were analyzed as z-scores. Sensory profile data were collected for auditory, visual, tactile, vestibular, and oral sensory processing. We included 79 medical records of children with a PFD. There were no statistically significant (p > 0.05) relationships between the anthropometric variables (weight-, length/height-, or BMI-for-age) and the sensory variables (auditory, visual, tactile, vestibular, or oral sensory processing). In conclusion, we found no relationship between anthropometric parameters and sensory processing in the sample of typically developing Brazilian children diagnosed with a PFD under study.

Optimising Repeated Exposure: Determining Optimal Stimulus Shape for Introducing a Novel Vegetable among Children

Although it is well evident that a healthy diet rich in fruit and vegetables could prevent a number of major chronic diseases, national and international guidelines concerning their intake are not being reached by a large percentage of the population, including children. Thus, it is of interest to investigate how the consumption of this food group by children could be increased. The aim of this study was to examine the impact of serving style on the consumption of a raw snack vegetable (daikon) and the influence of its exposure on liking and intake of the vegetable. A group of 185 children 3–5 years old participated in the study. Two kindergartens served as intervention groups, while the third was assigned to be the control group of the study (n = 50). The intervention groups were repeatedly exposed to one of three different serving styles of daikon: sticks (n = 42), triangles (n = 46) or grated (n = 47), and they were all visited 7 times during the exposure period, on the same frequency (twice per week). Familiarity and liking of the target vegetable, daikon, and six other vegetables (cucumber, celery, celeriac, broccoli, cauliflower and beetroot) were measured at baseline, post-intervention and two follow up sessions (3- and 6-month) to investigate the likelihood of generalisation effects. Intake of daikon was measured at all control sessions and exposures. Moreover, children were asked to rank their favourite serving style of daikon and beetroot, among triangle, stick and grated, towards understanding the influence of shape on the efficacy of the exposure. The results revealed significant changes between liking and intake of daikon for the groups of triangles and sticks and the control group (p < 0.05). The group that received grated daikon did not show significant differences in liking and at intake levels during the exposures but performed well in the long-term. Throughout the exposure period, intake levels followed an overall increasing pattern, with all the groups to demonstrate a decrease of their intake at the last session, which was not found significant for the triangle group. Mere exposure was efficient towards increasing liking and intake of the novel vegetable with all the shapes to deliver positive results, but based on this study no particular serving style can be recommended.

Inactivation of the ventral hippocampus facilitates the attenuation of odor neophobia in rats

Food neophobia is a behavior observed in rodents involving reduced consumption of a novel food or drink. In the absence of negative post-ingestive consequences, consumption increases with exposure (attenuation of neophobia), which is seen as an associative safe memory. Olfaction and gustation are sensory modalities essential for the development of a food preference. However, little is known about the neural mechanisms underlying neophobia to a food-related odor stimulus. In the present study, we examined the effect of pharmacological inactivation of the ventral hippocampus (vHPC) on neophobia to orally consumed solutions in rats using muscimol, a gamma aminobutyric acid type A receptor agonist. Two different types of solutions, almond odor (benzaldehyde) and sweet taste (saccharin), were prepared. In the results, microinjections of muscimol into the bilateral vHPC before the first odor and taste exposures did not alter the neophobic reactions of the rats to each stimulus. However, in the second odor, but not taste, exposure, the muscimol-injected rats showed higher consumption in comparison to that observed in the control rats, suggesting that the vHPC inactivation facilitates the attenuation of odor neophobia. On the other hand, intra-vHPC muscimol microinjections after the first odor and taste exposures did not facilitate consumption at the second exposures. These results indicate that neural activations within vHPC during orally consuming a novel odor, but not taste, solution play an inhibitory role in the subsequent attenuation of neophobia.

Association between Body Mass Index and Sensory Processing in Childhood: InProS Study

We assessed the association between body mass index (BMI) and sensory processing in 445 Spanish children aged 3-7 from the InProS project. Child sensory processing was measured using the short sensory profile (SSP); an atypical sensory performance was defined as an SSP total score <155 and scores of tactile sensitivity <30; taste/smell sensitivity <15; movement sensitivity <13; under-responsive/seeks sensation <27; auditory filtering <23; low energy/weak <26; and visual/auditory sensitivity <19. The BMI was calculated according to the cutoffs by the World Health Organization for children aged 0-5 and 5-19 years. We used multiple Poisson regression models with robust variance to obtain prevalence ratios (PR). No associations between children's overweight and obesity and the prevalence of atypical sensory outcomes were observed. A one-point increase in BMI was significantly associated with a higher prevalence of atypical tactile sensitivity (PR = 1.07, 95% CI: 1.02; 1.12). A statistically marginal association was also observed for atypical total SSP (PR = 1.03, 95% CI: 1.00; 1.07) and atypical movement sensitivity (PR = 1.05, 95% CI: 1.00; 1.10). To our knowledge, this is the first time the association between children's BMI and sensory processing has been reported. Our findings suggest that sensory processing issues may play a part in the complex context of childhood obesity. Further research is required to confirm these findings.

A longitudinal examination of the role of sensory exploratory behaviors in young children's acceptance of new foods

OBJECTIVE

Prompted engagement with a new food's sensory properties (smell, texture) has been associated with young children's acceptance of new foods. However, little is known about the prevalence and stability of children's sensory exploratory behaviors exhibited spontaneously when trying new foods. The aim of this analysis was to examine developmental trajectories of sensory exploratory behaviors (i.e., smelling, licking, spitting) in response to new foods.

METHOD

This 3-year longitudinal study included observational data collected from 244 preschoolers. At age 4 years, children were asked to taste four novel foods. An experimenter recorded the child's displays of smelling, licking, spitting, refusals, and acceptance. Assessments were repeated at 4.5, 5.5, and 6.5 years of age. Summary scores were created for each child by totaling the number of foods smelled, licked, spit out, refused, and accepted at each time point. A series of growth models were fit to the summary scores to examine individual sensory behavior trajectories and associations between trajectories of sensory behaviors and acceptance.

RESULTS

Linear growth model parameters indicated that spitting and refusals decreased over time (p-values < 0.01), whereas acceptances increased (p < 0.01). Licking and smelling showed non-significant change (p-values > 0.01) Furthermore, decreases in licking, spitting, and refusals were associated with increases in acceptance across the study period (p-values < 0.01).

DISCUSSION

The decline in young children's sensory exploratory behaviors in response to new foods was associated with increases in food acceptance. Our findings suggest that sensory exploratory behaviors may promote familiarity and help children learn that new foods are acceptable and safe to consume.

Association between Adherence to the Antioxidant-Rich Mediterranean Diet and Sensory Processing Profile in School-Aged Children: The Spanish Cross-Sectional InProS Project

We assessed the association between adherence to the Mediterranean diet (MD) and sensory processing in 583 Spanish children aged 3–7 years from the InProS project in Alicante, Spain. Child sensory processing was measured using the short sensory profile (SSP); atypical sensory performance was defined as SSP total score <155; tactile sensitivity <30; taste/smell sensitivity <15; movement sensitivity <13; under-responsive/seeks sensation <27; auditory filtering <23; low energy/weak <26; and visual/auditory sensitivity <19 scores. Adherence to the MD was measured using the Mediterranean diet quality index KIDMED. Multiple Poisson regression models with robust variance, based on the Huber sandwich estimate, were used to obtain prevalence ratios (PR). Our findings suggested that a lower prevalence of atypical tactile and taste/smell sensitivity were associated with having medium (PR = 0.50, 95% CI: 0.25; 0.99; PR = 0.57, 95% CI: 0.33; 0.99, respectively) and high adherence to the MD (PR = 0.58, 95% CI: 0.34; 0.99; PR = 0.33, 95% CI: 0.19; 0.60, respectively), and of atypical low energy/weak with having medium adherence to the MD (PR = 0.37, 95% CI: 0.16; 0.83). A two-point increase in adherence to the MD showed a general positive effect against atypical sensory performance, although it was statistically significant on taste/smell sensitivity (PR = 0.71, 95% CI: 0.59; 0.85) and low energy/weak (PR = 0.80, 95% CI: 0.64; 0.99) subscales. To our knowledge, this is the first study that shows a protective effect of adherence to the MD against prevalence of atypical sensory processing in school-aged children. Further research from longitudinal studies is required to confirm these findings.

Developing Healthy Food Preferences in Preschool Children Through Taste Exposure, Sensory Learning, and Nutrition Education

PURPOSE OF REVIEW

The present review was undertaken in order to summarize and evaluate recent research investigating taste exposure, sensory learning, and nutrition education interventions for promoting vegetable intake in preschool children.

RECENT FINDINGS

Overall, taste exposure interventions yielded the best outcomes for increasing vegetable intake in early childhood. Evidence from sensory learning strategies such as visual exposure and experiential learning also show some success. While nutrition education remains the most common approach used in preschool settings, additional elements are needed to strengthen the educational program for increasing vegetable intake. There is a substantial gap in the evidence base to promote vegetable intake in food fussy children. The present review reveals the relative importance of different intervention strategies for promoting vegetable intake. To strengthen intervention effects for improving vegetable intake in preschool children, future research could consider integrating taste exposure and sensory learning strategies with nutrition education within the preschool curriculum.

A Polish Study on the Influence of Food Neophobia in Children (10-12 Years Old) on the Intake of Vegetables and Fruits

Adhering to the recommended intake of fruits and vegetables is an important habit that should be inculcated in children, whereas food neophobia is indicated as one of the most important factors creating food preferences that may interfere. The aim of the presented study was to analyze the association between the food neophobia level and the intake of fruits and vegetables in children aged 10-12 years. The study was conducted among a group of 163 children (78 girls and 85 boys). The assessment of the food neophobia level was based on the Food Neophobia Scale (FNS) questionnaire and the assessment of the fruit and vegetable intake was based on the food frequency questionnaire. A negative correlation between the food neophobia level and the vegetable intake was observed both for girls (p = 0.032; R = -0.2432) and for boys (p = 0.004; R = -0.3071), whereas for girls differences in vegetable intake were observed also between various food neophobia categories (p = 0.0144). It may be concluded that children with higher food neophobia level are characterized by lower vegetable intake than children with lower food neophobia level. For fruits and juices of fruits and vegetables, associations with food neophobia level were not observed.