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Johnson SL, Moding KJ, Flesher A, Boenig R, Campain J. I'll Never Give Up: A Qualitative Study of Caregivers' Perceptions and Decisional Processes When Feeding Infants and Toddlers Novel and Disliked Foods. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2024:S1499-4046(24)00008-3. [PMID: 38493374 DOI: 10.1016/j.jneb.2024.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 01/16/2024] [Accepted: 01/18/2024] [Indexed: 03/18/2024]
Abstract
OBJECTIVE To better understand caregivers' decisional processes related to offering novel and disliked foods to their infants and toddlers. DESIGN As part of a parent study on young children's food acceptance that took place in Denver, CO, this secondary analysis used a basic qualitative approach to explore caregivers' decisional processes related to repeated exposure and children's food rejection. PARTICIPANTS English-speaking caregivers of infants and toddlers (aged 6-24 months; n = 106) were recruited via flyers and social media and interviewed (from July, 2017 to January, 2018) during a laboratory visit focused on introducing a novel food. PHENOMENON OF INTEREST Factors influencing caregiver decisions to (dis)continue offering novel or disliked foods. ANALYSIS Using a combined deductive and inductive coding approach, trained researchers coded transcripts and codes, which were reviewed and discussed by all investigators to identify themes. RESULTS Three major themes (and 2 subthemes) were generated regarding caregivers' decisions about re-offering rejected foods: 1) Caregivers understand that multiple experiences with new foods are needed because children's reactions can be unpredictable and depend upon time, developmental stage, and child traits; 2) Caregivers vary in their persistence and decisions to keep offering foods depending on responsiveness to child cues (sub-theme) and adult-centered beliefs, needs, and decisions (sub-theme); 3) Child food acceptance will change with time, circumstances, and development if you keep trying. CONCLUSIONS AND IMPLICATIONS Although caregivers are aware of repeated exposure, additional implementation research focused on translating theory into effective home practices could assist caregivers to persist in offering novel or disliked foods.
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Affiliation(s)
- Susan L Johnson
- Department of Pediatrics, Section of Nutrition, University of Colorado Anschutz Medical Campus, Aurora, CO.
| | - Kameron J Moding
- Department of Human Development and Family Science, Purdue University, West Lafayette, IN
| | - Abigail Flesher
- Department of Pediatrics, Section of Nutrition, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Rebecca Boenig
- Department of Pediatrics, Section of Nutrition, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Joseph Campain
- Department of Pediatrics, Section of Nutrition, University of Colorado Anschutz Medical Campus, Aurora, CO
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2
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Ranmal SR, Nhouchi Z, Keeley A, Adler L, Lavarde M, Pensé-Lhéritier AM, Tuleu C. Taste assessment for paediatric drug Development: A comparison of bitterness taste aversion in children versus Naïve and expert young adult assessors. Int J Pharm 2023; 647:123494. [PMID: 37806503 DOI: 10.1016/j.ijpharm.2023.123494] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 10/01/2023] [Accepted: 10/05/2023] [Indexed: 10/10/2023]
Abstract
Medicines for children often taste bitter, presenting a significant challenge to treatment compliance. However, most studies on paediatric drug development rely on adult volunteers for sensory research, and the level of expertise required from these assessors is unclear. This study aimed to address this gap by investigating perceived bitterness aversion to taste strips impregnated with different concentrations of quinine hydrochloride in 439 school-aged children. Expert (n = 26) and naïve (n = 65) young adult assessors evaluated quinine solutions as well as taste strips, for methodological bridging purposes. All assessors differentiated the aversiveness of the taste strips in a dose dependent manner. Younger children aged 4-8 years had difficulty discriminating higher bitter concentrations, whereas pre-adolescents 9-11 years and naive adults showed better discrimination at the top of the scale. Naive assessors showed similar bitter perception as children. However, the results were slightly different between strips and solution in adults. These findings highlight the key role that adult panels can play in paediatric formulation development. Taste strips show promise as a safe and pragmatic tool for sensory pharmaceutical evaluations, though further studies are warranted to establish the relationship between age and hedonic taste perception using compounds with diverse physicochemical and sensory qualities.
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Affiliation(s)
- Sejal R Ranmal
- UCL School of Pharmacy, University College London, 29-39, Brunswick Square, London WC1N 1AX, UK.
| | - Zeineb Nhouchi
- Ecole de Biologie Industrielle - EBI, UPR EBInnov®, 49, Avenue des Genottes CS90009 95895, Cergy-Pontoise, France.
| | - Alexander Keeley
- UCL School of Pharmacy, University College London, 29-39, Brunswick Square, London WC1N 1AX, UK.
| | - Lisa Adler
- Ecole de Biologie Industrielle - EBI, UPR EBInnov®, 49, Avenue des Genottes CS90009 95895, Cergy-Pontoise, France.
| | - Marc Lavarde
- Ecole de Biologie Industrielle - EBI, UPR EBInnov®, 49, Avenue des Genottes CS90009 95895, Cergy-Pontoise, France.
| | - Anne-Marie Pensé-Lhéritier
- Ecole de Biologie Industrielle - EBI, UPR EBInnov®, 49, Avenue des Genottes CS90009 95895, Cergy-Pontoise, France.
| | - Catherine Tuleu
- UCL School of Pharmacy, University College London, 29-39, Brunswick Square, London WC1N 1AX, UK.
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Moding KJ, Kielb EI. Conceptual Considerations and Methodological Challenges to Measuring Food Acceptance During Infancy. Curr Nutr Rep 2023; 12:407-415. [PMID: 37460785 DOI: 10.1007/s13668-023-00480-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/10/2023] [Indexed: 08/23/2023]
Abstract
PURPOSE OF REVIEW The purpose of this review is to (1) present a conceptual definition of infant food acceptance, (2) explore methodological challenges to measuring different components of food acceptance, and (3) provide recommendations for future research on food acceptance during infancy. RECENT FINDINGS Infant food acceptance includes separate but overlapping components: wanting, liking, and consumption. Recent evidence suggests that although these components are often correlated, there is variability in the sensitivity of these measures to detect differences in infants' responses to target foods. To date, consumption and caregiver perceptions of liking have been the primary outcome measures of interest in studies of infant food acceptance. More diverse and precise measures across the three components of infant food acceptance are needed to address a wider scope of research questions, which would in turn strengthen the interpretability and translational potential of research in this area.
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Affiliation(s)
- Kameron J Moding
- Department of Human Development & Family Science, Purdue University, 1200 Mitch Daniels Blvd, West Lafayette, IN, 47907, USA.
| | - Elizabeth I Kielb
- Department of Human Development & Family Science, Purdue University, 1200 Mitch Daniels Blvd, West Lafayette, IN, 47907, USA
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Barrett KJ, Moding KJ, Flesher A, Johnson SL. "The Kale Is Green" and Other Things Caregivers Say when Feeding Infants and Toddlers Are Associated with Child Rate of Acceptance. J Nutr 2023; 153:1297-1304. [PMID: 36803576 DOI: 10.1016/j.tjnut.2023.01.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 01/18/2023] [Accepted: 01/30/2023] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Responsive feeding is important for helping children to develop healthy eating behaviors. Verbal feeding interactions between caregivers and children may reflect caregiver's responsiveness and contribute to children's developing lexical networks related to food and eating. OBJECTIVES This project aimed to: 1) characterize what caregivers say to infants and toddlers during a single feeding session and 2) test the associations between caregiver's verbal prompts and food acceptance by children. METHODS Filmed interactions of caregivers and their infants (N = 46 infants aged 6-11 mo) and toddlers (N = 60 toddlers aged 12-24 mo) were coded and analyzed to explore the following: 1) what caregivers said during a single feeding session and 2) whether caregiver's verbalizations were associated with child food acceptance. Caregiver verbal prompts were coded during each food offer and summed across the feeding session; prompts were categorized as supportive, engaging, and unsupportive. Outcomes included accepted tastes, rejected tastes, and rate of acceptance. Mann-Whitney's U tests and Spearman's correlations tested bivariate associations. Multilevel ordered logistic regression tested associations between verbal prompt categories and the rate of acceptance across offers. RESULTS Verbal prompts were largely supportive (41%) and engaging (46%), and caregivers of toddlers used significantly more verbal prompts than caregivers of infants (mean ± SD: 34.5 ± 16.9 compared with 25.2 ± 11.6; P = 0.006). Among toddlers, more engaging and unsupportive prompts were associated with a lower rate of acceptance (ρ = -0.30, P = 0.02; ρ = -0.37, P = 0.004). For all children, multilevel analyses revealed that more unsupportive verbal prompts were associated with a lower rate of acceptance (b = -1.52; SE = 0.62; P = 0.01) and individual caregiver use of more engaging and unsupportive prompts than usual was associated with a lower rate of acceptance (b = -0.33; SE = 0.08; P < 0.001: b = -0.58; SE = 0.11; P < 0.001). CONCLUSIONS These findings suggest that caregivers may strive for a supportive and engaging emotional setting during feeding, although verbalization category may change as children exhibit more rejection. Furthermore, what caregivers say may change as children develop more advanced language capabilities.
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Affiliation(s)
- Katherine J Barrett
- University of Colorado Anschutz Medical Campus, Department of Pediatrics, Section of Nutrition, Aurora, CO, United States.
| | - Kameron J Moding
- Purdue University, Department of Human Development and Family Studies, West Lafayette, IN, United States
| | - Abigail Flesher
- University of Colorado Anschutz Medical Campus, Department of Pediatrics, Section of Nutrition, Aurora, CO, United States
| | - Susan L Johnson
- University of Colorado Anschutz Medical Campus, Department of Pediatrics, Section of Nutrition, Aurora, CO, United States
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Fazzino TL, Kong KL. A new paradigm for investigating the etiology of obesity in early childhood: Exposure to added sugars and hyper-palatable foods in infancy and dysregulation of food reinforcement processes. Obes Rev 2023; 24:e13526. [PMID: 36358033 DOI: 10.1111/obr.13526] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 08/17/2022] [Accepted: 10/27/2022] [Indexed: 11/13/2022]
Affiliation(s)
- Tera L Fazzino
- Department of Psychology, University of Kansas, Lawrence, Kansas, USA.,Cofrin Logan Center for Addiction Research and Treatment, University of Kansas, Lawrence, Kansas, USA
| | - Kai Ling Kong
- Baby Health Behavior Lab, Division of Health Services and Outcomes Research, Children's Mercy Research Institute, Children's Mercy Hospital, Kansas City, Missouri, USA.,Department of Pediatrics, University of Missouri-Kansas City, Kansas City, Missouri, USA.,Department of Pediatrics, University of Kansas Medical Center, Kansas City, Kansas, USA
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Ustun B, Reissland N, Covey J, Schaal B, Blissett J. Flavor Sensing in Utero and Emerging Discriminative Behaviors in the Human Fetus. Psychol Sci 2022; 33:1651-1663. [PMID: 36130610 DOI: 10.1177/09567976221105460] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The diet of pregnant women exposes fetuses to a variety of flavors consisting of compound sensations involving smell, taste, and chemesthesis. The effects of such prenatal flavor exposure on chemosensory development have so far been measured only postnatally in human infants. Here, we report the first direct evidence of human fetal responsiveness to flavors transferred via maternal consumption of a single-dose capsule by measuring frame-by-frame fetal facial movements. Pregnant women and their fetuses based in the northeast of England were involved in this study from 32 to 36 weeks' gestation. Fetuses exposed to carrot flavor (n = 35) showed "lip-corner puller" and "laughter-face gestalt" more frequently, whereas fetuses exposed to kale flavor (n = 34) showed more "upper-lip raiser," "lower-lip depressor," "lip stretch," "lip presser," and "cry-face gestalt" in comparison with the carrot group and a control group not exposed to any flavors (n = 30). The complexity of facial gestalts increased from 32 to 36 weeks in the kale condition, but not in the carrot condition. Findings of this study have important implications for understanding the earliest evidence for fetal abilities to sense and discriminate different flavors.
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Affiliation(s)
| | | | | | - Benoist Schaal
- Developmental Ethology and Cognitive Psychology Laboratory, Centre for Taste, Smell and Feeding Behaviour Science, Centre National de la Recherche Scientifique (CNRS), UMR 6265, Université de Bourgogne
| | - Jacqueline Blissett
- School of Psychology, Institute of Health and Neurodevelopment, College of Health and Life Sciences, Aston University
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Hetherington MM, Chawner LR. From food preference development to responsive feeding - Selective studies to commemorate the life and work of Dr Leann Birch. Appetite 2022; 175:106051. [PMID: 35436532 DOI: 10.1016/j.appet.2022.106051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 03/29/2022] [Accepted: 04/12/2022] [Indexed: 11/02/2022]
Abstract
Dr Leann Birch was a pioneer in conducting research on infant and child eating behaviour. At the beginning of her research career, Leann recognised a significant gap in the developmental psychology literature, namely that few studies had been conducted to understand infant eating and feeding behaviours. This seems an unusual omission given that food intake is essential and that developmental milestones from milk to solids, and from being fed to becoming an autonomous eater, are obvious to most caregivers. Leann paved the way for interdisciplinary research from psychology, paediatrics and public health to explore and apply this knowledge to infant and child appetite, eating behaviour, dietary patterns, food preferences, and obesity risk. Early studies in her laboratory demonstrated that children form food preferences through experience and socialisation. Experiments published in 1979 tested the role of familiarisation through repeat exposure, and the impact of instrumental and social learning on the acquisition of food preferences. In 1984, a presentation given to the British Feeding and Drinking Group (BFDG) in Brighton set out three organising principles for understanding how children acquire food preferences: genetically pre-programmed behavioural propensities; social constraints on experience with food; and social transmission resulting from direct social interaction. Building on these three organising principles, research on child eating behaviour has flourished, including the intersection between individual differences, food experience and environmental influences on children's food preferences, energy regulation, and weight outcomes. In this review, the initial groundwork set out by Leann Birch on food preference development in children is considered followed by a discussion of how this has since inspired an interdisciplinary, international and expanding field of research on children's food intake, appetite and body weight regulation.
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Affiliation(s)
| | - Liam R Chawner
- School of Psychology, University of Leeds, Leeds, LS2 9JT, England, UK
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Shapiro ALB, Lawless MC, Flesher A, Lattanzi K, Charlifue-Smith R, Johnson SL. Acceptance of a Novel Food is Related to Caregiver Perceptions of Infant and Toddler Food-related Receptive Language. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2022; 54:684-690. [PMID: 35643749 PMCID: PMC9682559 DOI: 10.1016/j.jneb.2022.04.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 03/17/2022] [Accepted: 04/06/2022] [Indexed: 06/09/2023]
Abstract
OBJECTIVE Language development, both what is understood (receptive language) and spoken (expressive language), is considered critical to a child's ability to understand and interact with their environment. However, little research has investigated the role children's early language skills might play in their food acceptance. The objective of this study was to explore the relationships between young children's food-related receptive language (FRL) and food-related expressive language (FEL) and acceptance of novel food. METHODS Caregivers (n = 54) reported their perceptions of children's (aged 7-24 months) FRL and FEL using the MacArthur-Bates Communicative Development Inventory. Novel food acceptance was observed (grams consumed) during a laboratory visit. Multivariable linear regression tested associations between FRL, FEL, and novel food acceptance, by child age (infants [aged from 7 to < 12 months], toddlers [aged 12-24 months]), and at a significance level of P < 0.1 for hypothesis-generating research. RESULTS Children's FRL and food acceptance differed by age (F = 8.08, P = 0.01). Among toddlers, greater FRL was associated with greater novel food acceptance (0.22 g [95% confidence interval, -0.04 to 0.49]), P = 0.09). In infants, greater FRL was associated with lower novel food acceptance (-0.80 g [95% confidence interval, -1.53 to -0.07], P = 0.03). No association between FEL and novel food acceptance was noted in either group. CONCLUSIONS AND IMPLICATIONS Toddlers' understanding of food-related vocabulary may facilitate food acceptance; however, young infants may not yet have sufficient FRL to facilitate novel food acceptance.
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Affiliation(s)
- Allison L B Shapiro
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Megan C Lawless
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Abigail Flesher
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Kendal Lattanzi
- JFK Partners, University of Colorado Anschutz Medical Campus, Aurora, CO
| | | | - Susan L Johnson
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO.
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Anzman‐Frasca S, Moding KJ, Forestell CA, Francis LA. Applying developmental science concepts to improve the applicability of children’s food preference learning research. CHILD DEVELOPMENT PERSPECTIVES 2022. [DOI: 10.1111/cdep.12452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Stephanie Anzman‐Frasca
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences University at Buffalo Buffalo New York USA
- Center for Ingestive Behavior Research University at Buffalo Buffalo New York USA
| | - Kameron J. Moding
- Department of Human Development & Family Studies Purdue University West Lafayette Indiana USA
| | | | - Lori A. Francis
- Department of Biobehavioral Health The Pennsylvania State University University Park Pennsylvania USA
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Gajari D, Rumbak I, Ranilović J, Tomić-Obrdalj H. Application of a salt substitute in bitter taste suppression and toward better acceptance of cruciferous vegetables in diet. Appetite 2022; 173:105996. [PMID: 35276254 DOI: 10.1016/j.appet.2022.105996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 02/20/2022] [Accepted: 03/02/2022] [Indexed: 11/30/2022]
Abstract
The addition of table salt has been reported to enable better acceptance when consuming the least preferred vegetables belonging to the Cruciferae family. Considering the adverse effect of excessive table salt intake on incidence of hypertension and cardiovascular diseases, it is essential to explore an alternative healthier option for better acceptance and to encourage consumption of these vegetables. In this study, 261 adult participants were evaluated for their preferences toward basic tastes and food as well as sensory evaluation of a meal prepared from cruciferous vegetables with the addition of two different salts, sodium chloride and salt substitute containing a blend of potassium and sodium salts. A general questionnaire was used to assess taste and food preferences, while the Cruciferous Vegetable Food Frequency Questionnaire (CVFFQ) was used for vegetable intake assessment. The Labeled Magnitude Scale (LMS), Just About Right (JAR) scale, and several hedonic scales were used to determine taster status and sensory evaluation. The results show that a low concentration of the salt substitute did not impact bitterness suppression but did result in higher preference of the cruciferous vegetable meal. Although, subjects self-reported to have salty taste preferences were more sensitive to bitter taste, they did not perceive samples as less salty and less acceptable than subjects with lower sensitivity. The results show the necessity for further examination of the effectiveness of different concentrations of the assessed salt substitute in suppressing perceived bitterness of cruciferous vegetables and regarding their overall acceptance for inclusion in diets.
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Affiliation(s)
- Davorka Gajari
- Research and Development, Podravka Inc, Ante Starčevića 31, 48000, Koprivnica, Croatia.
| | - Ivana Rumbak
- Laboratory for Nutrition Science, Faculty of Food Technology and Biotechnology, University of Zagreb, Pierottijeva 6, 10000, Zagreb, Croatia
| | - Jasmina Ranilović
- Research and Development, Podravka Inc, Ante Starčevića 31, 48000, Koprivnica, Croatia
| | - Helena Tomić-Obrdalj
- Research and Development, Podravka Inc, Ante Starčevića 31, 48000, Koprivnica, Croatia
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