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Kielb EI, Moding KJ, Kimiecik C, Klenosky DB. Parents' food choice for their preschool-aged children: A means-end investigation. Child Care Health Dev 2024; 50:e13172. [PMID: 37699702 DOI: 10.1111/cch.13172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 07/26/2023] [Accepted: 08/22/2023] [Indexed: 09/14/2023]
Abstract
BACKGROUND Despite the growing literature on the importance of parental feeding practices, the factors that influence how parents make decisions regarding the foods they offer to their young children are not fully understood. Means-end theory and its associated methodology known as laddering provide a useful framework for characterizing the relationships between the attributes of a choice option (e.g., a food item), the consequences (i.e., the benefits or costs/risks) associated with those attributes and the personal values (i.e., enduring beliefs) those consequences help reinforce. The present research uses this means-end perspective to enrich our understanding of how parents make food choices for their preschool-aged children. METHODS Interviews were conducted with parents (N = 33) of 3- to 5-year-old children to explore the factors underlying parents' decisions regarding the foods they recently offered, prefer to offer and avoid offering to their preschooler. The resulting data were transcribed, content analysed and summarized in a series of summary diagrams known as hierarchical value maps (HVMs). RESULTS Study results indicate that although most parents reported trying to make food decisions because they want their child to be healthy, factors such as avoiding fights/battles and low perceived likelihood their child would eat a food may be barriers to offering certain foods. CONCLUSIONS Taken together, these study findings enhance our understanding of the range of meanings underlying parents' food choice decisions and suggest opportunities for interventions to improve the quality of foods that parents offer to their children at home.
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Vázquez-Frias R, Ladino L, Bagés-Mesa MC, Hernández-Rosiles V, Ochoa-Ortiz E, Alomía M, Bejarano R, Boggio-Marzet C, Bojórquez-Ramos MC, Colindres-Campos E, Fernández G, García-Bacallao E, González-Cerda I, Guisande A, Guzmán C, Moraga-Mardones F, Palacios-Rosales J, Ramírez-Rodríguez NE, Roda J, Sanabria MC, Sánchez-Valverde F, Santiago RJ, Sepúlveda-Valbuena N, Spolidoro J, Valdivieso-Falcón P, Villalobos-Palencia N, Koletzko B. Consensus on complementary feeding from the Latin American Society for Pediatric Gastroenterology, Hepatology and Nutrition: COCO 2023. REVISTA DE GASTROENTEROLOGIA DE MEXICO (ENGLISH) 2023; 88:57-70. [PMID: 36737343 DOI: 10.1016/j.rgmxen.2023.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 11/17/2022] [Indexed: 02/04/2023]
Abstract
Complementary feeding (CF) is defined as the feeding of infants that complements breastfeeding, or alternatively, feeding with a breast milk substitute, and is a process that is more than simply a guide as to what and how to introduce foods. The information provided by healthcare professionals must be up-to-date and evidence-based. Most of the recommendations that appear in the different international guidelines and position papers are widely applicable, but some must be regionalized or adapted to fit the conditions and reality of each geographic zone. The Nutrition Working Group of the Latin American Society for Pediatric Gastroenterology, Hepatology and Nutrition (LASPGHAN) summoned a group of experts from each of the society's member countries, to develop a consensus on CF, incorporating, whenever possible, local information adapted to the reality of the region. The aim of the present document is to show the results of that endeavor. Utilizing the Delphi method, a total of 34 statements on relevant aspects of CF were evaluated, discussed, and voted upon.
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Affiliation(s)
- R Vázquez-Frias
- Departamento de Gastroenterología y Nutrición, Instituto Nacional de Salud Hospital Infantil de México Federico Gómez, Mexico City, Mexico; Grupo de Nutrición, Sociedad Latinoamericana de Gastroenterología, Hepatología y Nutrición Pediátrica, SLAGHNP/LASPGHAN.
| | - L Ladino
- Grupo de Nutrición, Sociedad Latinoamericana de Gastroenterología, Hepatología y Nutrición Pediátrica, SLAGHNP/LASPGHAN; Facultad de Medicina, Grupo de Nutrición, Genética y Metabolismo, Universidad El Bosque, Bogotá, Colombia
| | - M C Bagés-Mesa
- Grupo de Nutrición, Sociedad Latinoamericana de Gastroenterología, Hepatología y Nutrición Pediátrica, SLAGHNP/LASPGHAN; Facultad de Medicina, Grupo de Nutrición, Genética y Metabolismo, Universidad El Bosque, Bogotá, Colombia
| | - V Hernández-Rosiles
- Departamento de Gastroenterología y Nutrición, Instituto Nacional de Salud Hospital Infantil de México Federico Gómez, Mexico City, Mexico; Grupo de Nutrición, Sociedad Latinoamericana de Gastroenterología, Hepatología y Nutrición Pediátrica, SLAGHNP/LASPGHAN
| | - E Ochoa-Ortiz
- Grupo de Nutrición, Sociedad Latinoamericana de Gastroenterología, Hepatología y Nutrición Pediátrica, SLAGHNP/LASPGHAN; Tecnológico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Departamento de Nutrición, Mexico City, Mexico
| | - M Alomía
- Posgrado de Pediatría, Facultad de Medicina, Pontificia Universidad Católica del Ecuador, Quito, Ecuador
| | - R Bejarano
- Servicio de Gastroenterología y Nutrición, Hospital de Especialidades Pediátricas, Ciudad de Panamá, Panama
| | - C Boggio-Marzet
- Grupo de Trabajo en Gastroenterología y Nutrición Pediátrica, Hospital General de Agudos "Dr. I. Pirovano", Buenos Aires, Argentina
| | | | - E Colindres-Campos
- Departamento de Pediatría, Facultad de Ciencias Médicas, Universidad Nacional Autónoma de Honduras, Tegucigalpa, Honduras
| | - G Fernández
- Departamento de Gastroenterología, Hospital Infantil Dr. Robert Reid Cabral, Santo Domingo, Dominican Republic
| | - E García-Bacallao
- Sección de Pediatría, Instituto de Gastroenterología, Universidad de Ciencias Médicas, La Habana, Cuba
| | - I González-Cerda
- Servicio de Pediatría, Hospital Militar Escuela "Dr. Alejandro Dávila Bolaños", Managua, Nicaragua
| | - A Guisande
- Centro Hospitalario Pereira Rossell, Montevideo, Uruguay
| | - C Guzmán
- Hospital La Católica, San José, Costa Rica
| | - F Moraga-Mardones
- Unidad de Nutrición, Servicio de Pediatría, Hospital Clínico San Borja Arriarán, Santiago, Chile
| | - J Palacios-Rosales
- Facultad de Medicina, Universidad de San Carlos de Guatemala, Guatemala, Guatemala
| | - N E Ramírez-Rodríguez
- Facultad de Medicina, Departamento de Medicina y Salud Mental, Universidad Mayor de San Andrés, La Paz, Bolivia
| | - J Roda
- Gastroenterología e Nutrição Pediátrica, Hospital Pediátrico - Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - M C Sanabria
- Cátedra y Servicio de Pediatría, Hospital de Clínicas, Facultad de Ciencias Médicas, Universidad Nacional de Asunción, Asunción, Paraguay
| | - F Sánchez-Valverde
- Sección de Gastroenterología y Nutrición Pediátrica, Hospital Universitario de Navarra, NAVARRA BIOMED, Pamplona, Navarra, Spain
| | - R J Santiago
- Departamento de Pediatría y Unidad de Gastroenterología, Hepatología y Nutrición, Hospital Universitario de Valera "Dr. Pedro Emilio Carrillo", Universidad de Los Andes, Valera, Venezuela
| | - N Sepúlveda-Valbuena
- Departamento de Nutrición y Bioquímica, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - J Spolidoro
- Escuela de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - P Valdivieso-Falcón
- Departamento de Pediatría, Servicio subespecialidades pediátricas, Hospital Nacional Docente Madre Niño San Bartolomé, Lima, Peru
| | | | - B Koletzko
- Departamento de Pediatría, Medical Centre of LMU Munich, Ludwig Maximilian University of Munich, Dr. von Hauner Children's Hospital, München, Germany
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Vázquez-Frias R, Ladino L, Bagés-Mesa M, Hernández-Rosiles V, Ochoa-Ortiz E, Alomía M, Bejarano R, Boggio-Marzet C, Bojórquez-Ramos M, Colindres-Campos E, Fernández G, García-Bacallao E, González-Cerda I, Guisande A, Guzmán C, Moraga-Mardones F, Palacios-Rosales J, Ramírez-Rodríguez N, Roda J, Sanabria M, Sánchez-Valverde F, Santiago R, Sepúlveda-Valbuena N, Spolidoro J, Valdivieso-Falcón P, Villalobos-Palencia N, Koletzko B. Consenso de alimentación complementaria de la Sociedad Latinoamericana de Gastroenterología, Hepatología y Nutrición Pediátrica: COCO 2023. REVISTA DE GASTROENTEROLOGÍA DE MÉXICO 2023. [DOI: 10.1016/j.rgmx.2022.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Johnson SL, Moding KJ, Grimm KJ, Flesher AE, Bakke AJ, Hayes JE. Infant and Toddler Responses to Bitter-Tasting Novel Vegetables: Findings from the Good Tastes Study. J Nutr 2021; 151:3240-3252. [PMID: 34191021 PMCID: PMC8485907 DOI: 10.1093/jn/nxab198] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 04/29/2021] [Accepted: 05/25/2021] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Infants are born with the biological predisposition to reject bitterness. Dark green vegetables contain essential nutrients but also bitter compounds, making them more difficult to like. OBJECTIVE The Good Tastes Study was designed to determine whether reducing bitterness by adding small amounts of sugar or salt would alter infant acceptance of kale purées. METHODS Caregivers (n = 106, 94% mothers, 82% Non-Hispanic White) and children (53% male, aged 6-24 mo) participated in a videorecorded laboratory visit during which infants were offered 4 versions of puréed kale: plain, 1.2% or 1.8% added sugar, or 0.2% added salt. Caregivers rated their children's liking for each kale version. Videos were coded for the number of tastes accepted and for children's behaviors and acceptance of each kale version. A multilevel ordered logistic model was fit for the number of accepted tastes and caregiver ratings of child liking of kale versions with age, breastfeeding history, order effects, and kale version as predictors. RESULTS Infants 6 to <12 mo accepted more tastes (b = 2.911, P < 0.001) and were rated by caregivers as liking the kale more than older toddlers (≥18 mo; b = 1.874, P = 0.014). The plain kale was more likely to be accepted (P < 0.001); also, the first version offered was more likely to be rejected (b = -0.586, P < 0.007). Older infants (≥18 mo) exhibited more avoidant behaviors (b = 1.279, P < 0.001), more playing (b = 2.918, P < 0.001), and more self-feeding (b = 1.786, P = 0.005) than younger infants (6 to <12 mo). Children who were reported to have been breastfed more in the last 7 d were more likely to self-feed (b = 0.246, P < 0.001) and play with food (b = 0.207, P < 0.005). CONCLUSIONS Our findings support that there may be a sensitive period, during the early phase of complementary feeding, to improve success of introducing a novel, bitter, more difficult-to-like food. When low levels of sugar or salt were added, no advantage of bitterness reduction was observed. This study has been registered with ClinicalTrials.gov as NCT04549233.
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Affiliation(s)
- Susan L Johnson
- Department of Pediatrics University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Kameron J Moding
- Department of Human Development & Family Studies, Purdue University, West Lafayette, IN, USA
| | - Kevin J Grimm
- Department of Psychology, Arizona State University, Tempe, AZ, USA
| | - Abigail E Flesher
- Department of Pediatrics University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Alyssa J Bakke
- Sensory Evaluation Center, The Pennsylvania State University, University Park, PA, USA
- Department of Food Science, The Pennsylvania State University, University Park, PA, USA
| | - John E Hayes
- Sensory Evaluation Center, The Pennsylvania State University, University Park, PA, USA
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Yanagisawa T, Misaka T. Characterization of the Human Bitter Taste Receptor Response to Sesquiterpene Lactones from Edible Asteraceae Species and Suppression of Bitterness through pH Control. ACS OMEGA 2021; 6:4401-4407. [PMID: 33644553 PMCID: PMC7906577 DOI: 10.1021/acsomega.0c05599] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 01/14/2021] [Indexed: 06/12/2023]
Abstract
Vegetables are important sources of nutrients and bioactive compounds; however, their consumption is often insufficient, partly because of unpleasant taste characteristics. This study aimed to investigate the mechanisms underlying bitter taste reception and to develop methods to suppress bitterness. We focused on sesquiterpene lactones found in edible Asteraceae species. HEK293T cells that heterologously expressed human bitter taste receptors (including TAS2R46) together with a chimeric G protein were analyzed using calcium imaging, and cellular responses to four sesquiterpene lactones contained in lettuce were examined. We found that TAS2R46-expressing cells responded most strongly to bitter compounds. The EC50 value of 11β,13-dihydrolactucopicrin was 2.0 ± 0.6 μM, in agreement with the previously reported bitterness threshold of the compound. Adjustment of pH from neutral to weak acidic conditions reduced the response of TAS2R46-expressing cells to sesquiterpene lactones. We demonstrate the possibility of regulating the bitterness of Asteraceae species by controlling the pH.
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Affiliation(s)
- Takuya Yanagisawa
- Institute
of Technology Solutions, R&D Division, Kewpie Corporation, 2-5-7, Sengawa-cho, Chofu-shi, Tokyo 182-0002, Japan
| | - Takumi Misaka
- Department
of Applied Biological Chemistry, Graduate School of Agricultural and
Life Sciences, The University of Tokyo, 1-1-1 Yayoi, Bunkyo-ku, Tokyo 113-8657, Japan
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Johnson SL, Ryan SM, Kroehl M, Moding KJ, Boles RE, Bellows LL. A longitudinal intervention to improve young children's liking and consumption of new foods: findings from the Colorado LEAP study. Int J Behav Nutr Phys Act 2019; 16:49. [PMID: 31159810 PMCID: PMC6547533 DOI: 10.1186/s12966-019-0808-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 05/08/2019] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Many interventions have been conducted to improve young children's liking and consumption of new foods however their impacts on children's consumption have been limited. Consistent evidence supports the use of repeated exposure to improve liking for new foods however longitudinal effects lasting greater than 6 months often have not been demonstrated. Here we report the eating-related findings of the Colorado Longitudinal Eating And Physical Activity (LEAP) Study, a multi-component intervention, delivered primarily in the school setting, which aimed to improve children's liking and consumption of a target food via repeated exposure and positive experiential learning. METHODS Four sites in rural Colorado, each housing Head Start preschool programs, matched on state vital statistics for childhood obesity rates, (2 intervention and 2 control sites) took part in a quasi-experimental study design which included 4 time points (baseline, post-intervention, one-year [Y1] and two- year [Y2] follow ups). A total of 250 children and families were enrolled (n = 143 intervention and n = 107 control; 41% Hispanic and 69% low-income). A 12-week intervention, Food Friends - Fun With New Foods®, delivered by trained preschool teachers and which focuses on positive and repeated experiences with new foods, and a 5-month (1 unit/month) social marketing "booster program" was delivered in kindergarten (one-year follow up) and 1st grade (two-year follow up). Main outcome measures included change in children's liking for new foods, analyzed by ordinal regression using generalized estimating equations, and change in weighed consumption of new foods over time, analyzed using a hierarchical mixed effects model. RESULTS The intervention was delivered with good fidelity (87%). Both intervention and control groups demonstrated an increase in liking for the target food over time (p = 0.0001). The pattern of consumption of the target food was different, over time, for intervention and control groups (p < 0.005). In particular the change in intake between baseline and post-intervention was significantly greater in the intervention compared to the control group (p < 0.0001) though this pattern of change did not hold between baseline and Y2 follow up (p = 0.1144). Children in the intervention group who liked the target food consumed nearly double their baseline consumption at post-intervention (p < 0.0001;) and maintained this increase at Y2 follow up (p < 0.0001). CONCLUSIONS The Food Friends intervention, which utilized positive, repeated experiences with new foods, and was delivered with good fidelity by trained preschool teachers, found that larger improvements were observed in children's eating behaviors than would be expected with developmentally-based changes in eating behaviors. TRIAL REGISTRATION NUMBER This trial is registered at ClinicalTrials.gov : NCT01937481. Date registered: 09/09/2013; Retrospectively registered. Date first participant registered: 09/15/2010.
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Affiliation(s)
- Susan L. Johnson
- Department of Pediatrics, Section of Nutrition, University of Colorado Anschutz Medical Campus, School of Medicine, Aurora, CO USA
| | - Sarah M. Ryan
- Department of Biostatistics and Informatics, University of Colorado Anschutz Medical Campus, Colorado School of Public Health, Aurora, CO USA
| | - Miranda Kroehl
- Department of Biostatistics and Informatics, University of Colorado Anschutz Medical Campus, Colorado School of Public Health, Aurora, CO USA
| | - Kameron J. Moding
- Department of Pediatrics, Section of Nutrition, University of Colorado Anschutz Medical Campus, School of Medicine, Aurora, CO USA
| | - Richard E. Boles
- Department of Pediatrics, Section of Nutrition, University of Colorado Anschutz Medical Campus, School of Medicine, Aurora, CO USA
| | - Laura L. Bellows
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO USA
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Bakke AJ, Stubbs CA, McDowell EH, Moding KJ, Johnson SL, Hayes JE. Mary Poppins was right: Adding small amounts of sugar or salt reduces the bitterness of vegetables. Appetite 2018; 126:90-101. [DOI: 10.1016/j.appet.2018.03.015] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 03/01/2018] [Accepted: 03/21/2018] [Indexed: 01/23/2023]
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Di Pizio A, Ben Shoshan-Galeczki Y, Hayes JE, Niv MY. Bitter and sweet tasting molecules: It's complicated. Neurosci Lett 2018; 700:56-63. [PMID: 29679682 DOI: 10.1016/j.neulet.2018.04.027] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2017] [Revised: 03/22/2018] [Accepted: 04/16/2018] [Indexed: 12/12/2022]
Abstract
"Bitter" and "sweet" are frequently framed in opposition, both functionally and metaphorically, in regard to affective responses, emotion, and nutrition. This oppositional relationship is complicated by the fact that some molecules are simultaneously bitter and sweet. In some cases, a small chemical modification, or a chirality switch, flips the taste from sweet to bitter. Molecules humans describe as bitter are recognized by a 25-member subfamily of class A G-protein coupled receptors (GPCRs) known as TAS2Rs. Molecules humans describe as sweet are recognized by a TAS1R2/TAS1R3 heterodimer of class C GPCRs. Here we characterize the chemical space of bitter and sweet molecules: the majority of bitter compounds show higher hydrophobicity compared to sweet compounds, while sweet molecules have a wider range of sizes. Importantly, recent evidence indicates that TAS1Rs and TAS2Rs are not limited to the oral cavity; moreover, some bitterants are pharmacologically promiscuous, with the hERG potassium channel, cytochrome P450 enzymes, and carbonic anhydrases as common off-targets. Further focus on polypharmacology may unravel new physiological roles for tastant molecules.
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Affiliation(s)
- Antonella Di Pizio
- The Institute of Biochemistry, Food and Nutrition, The Robert H Smith Faculty of Agriculture, Food and Environment, The Hebrew University, 76100, Rehovot, Israel; The Fritz Haber Center for Molecular Dynamics, The Hebrew University, Jerusalem, 91904, Israel
| | - Yaron Ben Shoshan-Galeczki
- The Institute of Biochemistry, Food and Nutrition, The Robert H Smith Faculty of Agriculture, Food and Environment, The Hebrew University, 76100, Rehovot, Israel; The Fritz Haber Center for Molecular Dynamics, The Hebrew University, Jerusalem, 91904, Israel
| | - John E Hayes
- Department of Food Science, College of Agricultural Sciences, The Pennsylvania State University, University Park PA, USA
| | - Masha Y Niv
- The Institute of Biochemistry, Food and Nutrition, The Robert H Smith Faculty of Agriculture, Food and Environment, The Hebrew University, 76100, Rehovot, Israel; The Fritz Haber Center for Molecular Dynamics, The Hebrew University, Jerusalem, 91904, Israel.
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Moding KJ, Ferrante MJ, Bellows LL, Bakke AJ, Hayes JE, Johnson SL. Variety and content of commercial infant and toddler vegetable products manufactured and sold in the United States. Am J Clin Nutr 2018; 107:576-583. [PMID: 29635494 PMCID: PMC6693381 DOI: 10.1093/ajcn/nqx079] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Accepted: 12/18/2017] [Indexed: 12/23/2022] Open
Abstract
Background Exposure to vegetable flavors during infancy and toddlerhood is hypothesized to enhance vegetable acceptance when children transition to table foods. Objective We sought to examine the vegetable types, ingredients, and nutrient contents of vegetable-containing infant and toddler foods (ITFs) manufactured and sold in the United States. Design A database of ITFs that contain vegetables (n = 548) was compiled from websites of companies based in the United States (n = 24). Product information was recorded, including intended age or stage, ingredient lists, and selected nutrients from the Nutrition Facts label. Ingredient lists were used to categorize vegetables using the USDA vegetable categories: dark green (e.g., spinach), red and orange (e.g., carrots), starchy (e.g., green peas, corn), beans and peas (e.g., black beans), and other (e.g., green beans, beets). Furthermore, products were categorized as single-vegetable, multi-vegetable, vegetable and fruit, vegetable and meat, or vegetable and other combinations (e.g., grains and and or dairy). Nutrients were examined, including energy (kilocalories), carbohydrates, fiber, and total sugars [per serving, per 100 g, per reference amount customarily consumed (RACC), and percentage of kilocalories from sugars]. Results Of the 548 vegetable products, only 52 single-vegetable products (9.5%) were identified, none of which contained dark green vegetables or beans and peas. Red and orange vegetables most often appeared as the first ingredient (23.7%) compared to other vegetable types, such as dark green vegetables, which were rarely listed first (1.1%). Fruits were listed as the first ingredient more commonly than all vegetables (37.8%). One-way ANOVA revealed that vegetable and fruit products contained more sugars on average than did vegetable products with other ingredients, such as dairy and/or grains (all P values < 0.001). Conclusions Current available products do not provide caregivers with a sufficient variety of single-vegetable products or products containing dark green vegetables to facilitate children's subsequent acceptance of these vegetables. Guidance should include making caregivers aware of the limitations of commercial ITFs manufactured and sold in the US market.
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Affiliation(s)
- Kameron J Moding
- Department of Pediatrics/Section of Nutrition, University of Colorado Anschutz Medical Campus, Aurora, CO,Address correspondence to KJM (e-mail: )
| | - Mackenzie J Ferrante
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO
| | - Laura L Bellows
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO
| | - Alyssa J Bakke
- Department of Food Science, The Pennsylvania State University, University Park, PA
| | - John E Hayes
- Department of Food Science, The Pennsylvania State University, University Park, PA
| | - Susan L Johnson
- Department of Pediatrics/Section of Nutrition, University of Colorado Anschutz Medical Campus, Aurora, CO
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