Food Texture Acceptance, Sensory Sensitivity, and Food Neophobia in Children and Their Parents

Older adults' acceptability of and preferences for food-based protein fortification in the UK, France and Norway

Research suggests that as we age, protein intake, recognised as vital for combating negative health outcomes, consistently falls below recommendations in older adults. Decreased food intake, combined with age-related eating complications is a major determinant of this protein undernutrition. If nutritional interventions are to be effective and sustainable, they must enable eating pleasure, cater for personal preferences and be adaptable to different eating patterns. As such, we aimed to identify successful strategies for at-home protein-fortification to empower older adults to take a personalised approach to their nutrition, without requiring a large behavioural change. To explore healthy older adults' (age 70+) acceptability and preferences for at-home protein fortification, European project Fortiphy led discussions with older adults (n = 37) and caregivers of older adults (n = 15) to develop high-protein recipes, which were then utilised in a home-use trial with healthy older adults (n = 158). Each fortified recipe was paired with a questionnaire to rate the ease of preparation and liking, and an end-of-study questionnaire was provided to capture overall opinions and preferences. The uniqueness of this study is that the protein fortified recipes were prepared and tested by older adults themselves, in their own homes. Findings showed that older adults were unaware of the importance of protein in ageing and did not have a desire to fortify their foods at present. Yet, they were positive regarding the concept and highlighted the importance of taste, familiar ingredients, and preferred preparation methods. Cultural preferences across countries were identified as having the most influence on the liking of fortified meals. This study also indicated a need for increased awareness of protein requirements to influence the motivation to use fortification.

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.

Effect of texture preference on food texture perception: Exploring the role of matching food texture and preference

This study aimed to investigate the influence of smooth texture preference on smoothness perception. An online questionnaire (Study 1, n = 464) and a sensory evaluation test (Study 2, n = 65) were administered to Japanese elderly participants (65-74 years), with common Japanese confectionery (Daifuku) as test foods. Through the online questionnaire, four distinct texture preference groups were formed based on the factors of preference for smoothness and firmness of the inner bean paste layer. Analysis of the food preference scale for imbalanced diet (FPSID) revealed that smooth-texture likers were more likely to be picky eaters than firm-texture likers. Furthermore, high (HiSm) and low smoothness preference groups (LoSm) were selected for the food sensory evaluation test to compare perceived textures (smoothness and firmness). Only the HiSm group exhibited a positive association between perceived smoothness and overall texture liking, perceiving smoothness significantly more intense than the LoSm group in situations where overall texture liking was high. This finding indicates that smooth texture preference does not act independently but rather interacts with food texture matching to affect perception. Our findings suggest that when food texture aligns with individuals' preferences, it elicits hedonic emotions and dynamically enhances food texture perception. This preference-involved perceptual process may contribute to the development of more explicit texture preferences.

The influence of food sensory properties on eating behaviours in children with Down syndrome

Developing new food products for children is challenging, particularly in vulnerable groups including children with Down syndrome (DS). Focusing on children with DS, the aim of this study was to study the influence of parent liking on acceptance of food products by children with DS and demonstrate the influence of food sensory properties on indicators of food acceptance, food rejection, and challenging eating behaviours. Children (ages 1158 months) with DS (n = 111) participated in a home use test evaluating snack products with varying sensory properties as profiled by a trained sensory panel. Parents recorded their children's reactions to each food product; trained coders coded videos for eating behaviours. To understand the influence of each sensory modality on eating behaviour, ordered probit regression models were run. Results found a significant correlation between the parent liking and overall child disposition to the food (p < 0.05). From the regression analysis, the inclusion of all food sensory properties, including texture, flavour, taste, product shape and size, improved the percentage of variance explained in child mealtime behaviours and overall disposition over the base model (containing no sensory modalities), with texture having the largest influence. Overstuffing the mouth, a challenging eating behaviour, was most influenced by product texture (children ≥ 30 months), and product texture and size (children < 30 months). In both age groups, coughing/choking/gagging was most influenced by food texture and was associated with a product that was grainy and angular (sharp corners). In both age groups, product acceptance was associated with a product that was dissolvable, crispy, and savoury while rejection was associated with a dense, gummy and fruity product. These results suggest that a dissolvable, crispy texture, with a cheesy or buttery flavour are the sensory properties important in a desirable flavoured commercial snack product for children with DS; however, overall disposition must be balanced against mouth overstuffing.

Eating and Sensory Features of Children With Autism Spectrum Disorder and Their Typically Developing Peers

IMPORTANCE

Impaired sensory processing is associated with eating problems. There seem to be no previous studies that compare those who have autism spectrum disorder (ASD) with eating problems (ASD-W) and those with ASD without eating problems (ASD-WO) with typically developing (TD) groups. Comparisons are expected to provide further knowledge to guide the intervention programs.

OBJECTIVE

To investigate differences among ASD-W, ASD-WO, and TD groups in eating and sensory features; to detect associations between sensory and eating behaviors and any most involved sensory dimensions; and to search for age-related differences in sensory and eating features in ASD.

DESIGN

Nonrandomized comparison study.

SETTING

Questionnaires administered as parent interviews.

PARTICIPANTS

A total of 165 children were recruited: 117 with ASD and 48 TD children.

OUTCOMES AND MEASURES

Standardized questionnaires: the Brief Autism Mealtime Behaviors Inventory for eating problems; the Short Sensory Profile and the Sensory Experience Questionnaire for sensory problems.

RESULTS

The ASD-W group showed generalized, impaired eating behaviors and turned out to be the most impaired with regard to sensory responsiveness. No differences in feeding behaviors were found between the ASD-WO and TD groups. All children with ASD showed sensory hyper- or hyporesponsiveness. Four main sensory dimensions were found to be associated with eating behaviors in ASD. No age differences were found in the eating and sensory behaviors of children with ASD.

CONCLUSIONS AND RELEVANCE

Differing eating and sensory profiles were found between the ASD and TD groups, especially in children with ASD-W. Early eating interventions using sensory stimulations are strongly recommended. What This Article Adds: This study reports novel information derived from the comparisons of children with ASD with eating problems and those with ASD without eating problems with typically developing groups of children.

Food oral processing and eating behavior from infancy to childhood: evidence on the role of food texture in the development of healthy eating behavior

Eating behaviors develop in early life and refine during childhood, shaping long-term food choice and dietary habits, which underpin optimum growth and health. The development of Food Oral Processing (FOP) is of major importance in the establishment of eating behaviors at two scale levels: for the initial acceptance of food texture and for the longer-term development of eating behaviors associated to food intake. To date, both processes have been studied as independent topics and the current review proposes a parallel vision on their development from the onset of complementary feeding to later childhood. Individual factors affecting these FOP-related behaviors as they relate to food texture acceptance are discussed, alongside examples of interventions aiming at modifying them. Opportunity to better consider food textures when designing foods for children is addressed. Altogether, the review demonstrates the critical role of food texture in the development of a child's FOP skills, eating habits, and dietary patterns. These scientific knowledges need to be considered for the development of healthier eating behavior. We identify research gaps that need to be addressed and highlight the need to design foods that can support the development of healthy oral processing and eating behaviors among infants and children.

Why have a bottle when you can have draught? Exploring bottle refusal by breastfed babies

Bottle refusal by breastfed babies is a scenario that has received surprisingly little attention in the literature, given the number of mothers who appear to be experiencing it globally and the subsequent negative impact it can have. In line with this, we undertook a study to explore mothers' views on why their breastfed baby refuses to bottle feed. A parallel, two-stage, exploratory qualitative design was employed using 30 semi-structured interviews and 597 online forum posts. Data were analysed using a thematic analysis, and a biopsychosocial model was applied resulting in four overarching themes being identified: 'Breastfeeding is the answer to everything….' 'Bottle feeding: an alien concept… 'Babies are individuals' and 'Find the right bottle and don't delay'. The psychological benefits of breastfeeding, not inherent in bottle feeding, appeared to underpin some mothers' views on their baby's refusal. Other mothers explained refusal as being down to a baby's biological expectation to be fed by the breast; therefore, bottle feeding was not a normal concept to them. A baby's individual personality and temperament were also suggested as contributing to the scenario and refusal was linked to babies disliking a certain brand of bottle and being introduced to it 'too late'. This study's findings point to a complex, multifactorial picture underpinning bottle refusal by breastfed babies, which transcends physical, psychological and biological concepts, and is influenced by socio-cultural norms surrounding infant feeding. Recognition of these contributing factors is needed to aid those supporting mothers experiencing the scenario and, importantly, to underpin mothers' decision-making around managing it.

A review on children's oral texture perception and preferences in foods

Texture properties of foods are particular drivers for food acceptance and rejection in children. The texture preferences follow the developmental progression of the child and these changes modulate the present and future food habits. This paper reviews the development and factors influencing texture preferences in children and the methods in food texture research with children. The child's acceptance of more complex food textures is age-dependent. The progression is indorsed by the development of oral processing skills at an early age and bolstered by repeated exposures to foods with varying textures. Children generally reject foods containing pieces or bits (i.e., geometrical textural properties); however, the impact of mechanical textural properties on food acceptance is less clear. Child characteristics such as food neophobia, picky eating, and tactile over-responsivity, negatively affect the acceptance of more diverse food textures. Depending on the child's age, the prevailing methods of characterizing food texture preferences in children include observational techniques and self-reported questionnaires. Despite knowledge of children's development of masticatory skills, learning, and cognitive abilities, the relationships of these changes to food texture acceptance and the recommended test methodology for evaluating product texture acceptance in this period of life are still limited.

Impact of the Gut-Brain Hormonal Axis and Enteric Peptides in the Development of Food Neophobia in Children with Genetically Determined Hypersensitivity to the Bitter Taste

Objective: The aim of this prospective study was to determine the role of the gut-brain hormonal axis and the effect of the enteric peptides, as well as the role of genetically determined sensitivity to the bitter taste, on the development of child food neophobia (CFN). Methods: 114 children were enrolled in the study: 43 in food neophobia group (FNG), 21 In the control group (CG) and 50 in prospective group (PG). All patients were assessed with the child food neophobia scale (CFNS), underwent an oral 6-propylthiouracil (6-PROP) test, buccal swab for bitter-taste genotyping, anthropometric measurements, and were tested for serum levels of leptin, adiponectin, insulin-like growth factor-1(IGF-1), ghrelin, and neuropeptide Y (NPY), and complete blood count (CBC); measurements were taken from a blood sample after 4 h fasting. Results: Subjects from FNG were more often hypersensitive to bitter taste (6-PROP) than CG (p = 0.001). There was no correlation between the result of genetic analysis and CFNS (p = 0.197), nor the body mass index (BMI) at the age of 18–36 months (p = 0.946) found. Correlation between 6-PRO perception and genotype have not been confirmed (p = 0.064). The score of CFNS was positively related to the serum level of NPY (p = 0.03). BMI percentile was negatively related to serum level of NPY (p = 0.03), but positively related to leptin serum level (p = 0.027). Conclusions: Bitter taste sensitivity to 6-PROP plays an important role in the development of the CFN, but correlation between 6-PROP perception and genotype have not been confirmed. Children with food neophobia due to elevated serum NPY level should be constantly monitored in order to control the nutritional status at a later age.

Neophobia—A Natural Developmental Stage or Feeding Difficulties for Children?

Food neophobia is the tendency to reject or be reluctant to try new and unfamiliar foods. Due to the period of its occurrence, which falls in the years of early childhood, it can significantly affect the child’s food choices, shape taste preferences, and significantly influence the quality of the child’s diet. The neophobic attitude has an important evolutionary significance because it protects the individual from ingesting potentially dangerous substances. On the other hand, it fosters avoidance behaviors that can also relate to the beneficial aspects of obtaining and consuming food. Currently, the strong emphasis placed on food safety means that neophobia may be less adaptive; nevertheless, a conservative attitude toward new foods still prevails. There is a strong association between food neophobia and the diversity of a person’s diet and previous exposure to different foods. This review describes behaviors associated with food neophobia and analyzes other feeding and eating difficulties in children that should be differentiated from food neophobia. Management approaches affecting the reduction in food neophobia in children through various dietary and psychological interventions are also proposed.