Determinants of Preference and Consumption of Healthy Food in Children

Understanding and Exploring the Food Preferences of Filipino School-Aged Children Through Free Drawing as a Projective Technique

BACKGROUND AND OBJECTIVES

Numerous traditional and innovative approaches have been employed to understand and evaluate children's food preferences and food and nutrition knowledge, recognizing their essential role in shaping good nutrition. Drawing as a projective technique allows children to express their unconscious thoughts and preferences through visual representation, distinguishing it from other methods by providing an insight into their inner feelings and perceptions that may not be easily articulated through verbal techniques. The main goals of the study are to use drawing as a projective technique to gain insights into children's food preferences, and to examine the children's current nutrition knowledge and dietary perceptions.

METHODS

This study involved school-aged children from four public schools in San Jose City, Nueva Ecija, Philippines, who met the inclusion criteria and provided parental consent and the children's permission. Data collection included (a) questionnaires to measure food group and food frequency knowledge, the children's opinions on food healthiness and likability, and (b) a drawing activity as a projective technique. The questionnaire scores and the specific foods on the children's drawings were entered into an electronic worksheet and analyzed quantitatively.

RESULTS

The majority of Filipino school-aged children have a low (50%) to average (43%) level of food group knowledge and an average (62%) to low (32%) level of food frequency knowledge. The children can identify the healthiness of the food, but they express a liking for both healthy and unhealthy options. The children's drawings showed a low preference for Glow food groups, including fruits and vegetables (47%), as compared to Grow foods (94%), Beverages (89%), and Go foods (85%) groups. "Rice and Egg", the most paired items, indicated a preference among Filipino children. Gender-based analysis showed girls favored "Ice Cream", "Bread", "Apple", and "Oranges" more than boys, but there were no significant gender differences found in Grow food group preferences.

CONCLUSIONS

Children's drawings are an effective, valuable complementary tool for understanding children's food preferences, displaying the value of creative methods in gaining unique insights. The results highlight specific gaps in knowledge, such as the need for a better understanding of food groups and the importance of fruits and vegetables among children. Addressing these gaps in educational programs could enhance children's food knowledge and encourage healthier dietary choices. Nutrition education programs might use interactive activities focused on food groups and emphasize the benefits of fruits and vegetables to promote better dietary habits for the improvement of children's long-term health outcomes.

Barriers to healthy eating practices among school-aged children in Armenia: A qualitative study

The aim of this study was to use diverse perspectives of stakeholders to explore barriers to healthy eating, and attitudes, norms, and practices contributing to unhealthy food choices among school-aged children in Armenia. A qualitative study was carried out through focus group discussions and in-depth interviews, using the Theory of Planned Behavior. The study was conducted in 21 public schools located in three provinces (marzes) of Armenia: Shirak, Lori, and Tavush, and the capital city Yerevan. These study areas were chosen purposefully to target more vulnerable regions and have a geographically diverse sample. Purposive sampling techniques were used to choose the study participants. Five groups were targeted: high school students, school principals, teachers, school cafeteria staff members, and mothers of school children. Overall, 10 focus group discussions, and 51 in-depth interviews were conducted with a total of 94 participants. The study explored two main themes underlying unhealthy eating behaviors among school-aged children in Armenia - suboptimal preferences and restricted opportunities. Three subthemes were identified within the theme of suboptimal preferences: preferences/tastes, attitudes, and role models/normative referent, and another three subthemes within the theme of restricted opportunities: choice restrictions, time constraints, and financial barriers. The study found that most of the constructs of theory of planned behavior, such as general attitudes, preferences, perceived norms and perceived behavioral control, impacted unhealthy eating behaviors of school-aged children in Armenia. The recommendations for practice included enhancing the appeal of healthy foods, highlighting the significance of breakfast and healthy eating in educational activities utilizing role models, expanding and empowering school canteens, including higher grade students in school feeding programs, and extending school breaks to provide sufficient time for healthy eating.

Naturalistic food categories are driven by subjective estimates rather than objective measures of food qualities

Food-related studies often categorize foods using criteria such as fat and sugar content (e.g., high-fat, high-sugar foods; low-fat, low-sugar foods), and use these categorizations for further analyses. While these criteria are relevant to nutritional health, it is unclear whether they agree with the ways in which we typically group foods. Do these objective categories correspond to our subjective sense? To address this question, we recruited a group of 487 online participants to perform a triplet comparison task involving implicit object similarity judgements on images of 36 foods, which varied in their levels of fat and sugar. We also acquired subjective ratings of other food properties from another set of 369 online participants. Data from the online triplet task was used to generate a similarity matrix of these 36 foods. Principal Components Analysis (PCA) of this matrix identified that the strongest determinant of food similarity (the first PC) was most highly related to participants' judgements of how processed the foods were, while the second component was most related to estimates of sugar and fat content. K-means clustering analysis revealed five emergent food groupings along these PC axes: sweets, fats, starches, fruits, and vegetables. Our results suggest that naturalistic categorizations of food are driven primarily by knowledge of the origin of foods (i.e., grown or manufactured), rather than by their sensory or macronutrient properties. These differences should be considered and explored when developing methods for scientific food studies.

Food Behaviour and Metabolic Characteristics of Children and Adolescents with Type 1 Diabetes: Relationship to Glycaemic Control

Diet is an essential element of treating and managing type 1 diabetes (T1D). However, limited research has examined food behaviour in children and adolescents with T1D and their relationship to glycaemic control. This study evaluated food behaviour, metabolic characteristics and their impact on the glycaemic control of children and adolescents with T1D. Two hundred and fifty-eight participants with T1D (6-15 years, duration of diabetes >1 year) were recruited. Demographic, anthropometric and clinical data were collected. Questionnaires on food neophobia and food preferences were administered. The Child Food Questionnaire (CFQ) also assessed parental feeding practices. An analysis of food behaviour showed that food neophobia was inversely associated with the liking of vegetables, fruits, fish, sweets and carbohydrates. Moreover, by analysing parental feeding practices, an inverse association of "Pressure to eat", "Monitoring" and "Restriction" with liking for vegetables and carbohydrates emerged. Considering glycaemic control, increased food neophobia and the parent practices "Restriction", "Pressure to eat" and "Concern about weight" were found in participants with glycated haemoglobin (HbA1c) values >8.5%. Finally, higher body mass index (BMI) and total cholesterol values were observed in subjects with HbA1c values >8.5%. These findings contribute to a better understanding of eating behaviour, metabolic status and their complex relationship with glycaemic control.

Change in preference for vegetables and their perceptual attributes as a function of age and pickiness

Preference for vegetables is influenced by various factors, including demographic, psychological, socio-environmental, and genetic factors. This study confirmed that age, pickiness, and perceptual attributes were predictors of preference for vegetables and examined how preference for vegetables and their perceptual attributes varies with age and pickiness. Children (8-14 years, n = 420), youth (15-34 years, n = 569), middle-aged adults (35-64 years, n = 726), and older adults (65-85 years, n = 270) were asked which vegetables they liked (or disliked) and which perceptual attributes of each vegetable they liked (or disliked). On the basis of their responses, an overall preference score and a preference sub-score for each perceptual attribute were calculated. Participants in each age group were classified into four statuses (non-, mild, moderate, and severe) according to their pickiness scores. Multiple regression analysis revealed that age and preference sub-scores for eight perceptual attributes (sweetness, sourness, bitterness, umami, pungency, orthonasal aroma, texture, and appearance) were positive predictors of overall preference score and that pickiness score and four perceptual attributes (saltiness, astringency, retronasal aroma, and aftertaste) were negative predictors. In addition, overall preference score and preference sub-scores for perceptual attributes other than saltiness increased with increasing age group and decreasing picker status; however, preference sub-scores for at least one of the six perceptual attributes (bitterness, astringency, pungency, orthonasal aroma, retronasal aroma, and aftertaste) exhibited negative values in children, youth, and pickers (mild, moderate, and severe). The increase in preference for these perceptual attributes might be an indicator of the adultization of food perception and the expansion of food acceptance.

Contribution of home garden vegetables on reducing stunting among 6- to 23-month-old children in South Tigray, northern Ethiopia

The study was conducted to analyze the contribution of home garden vegetables in reducing stunting among 6- to 23-month-old children from South Tigray, Northern Ethiopia. The quasi-experimental study design was used. Multistage sampling technique was used to select the districts and study communities. A total of 94 purposively selected vegetable producer (intervention) households and 260 randomly selected non-producer (control) households were included in the study (1:3 ratio). The recumbent length of children was measured using horizontal wooden board to the nearest 0.1 cm. The length-for-age Z-scores were computed using WHO-Anthro 2006 software. Propensity score-matching and difference-in-difference (DID) estimates were used to analyze data using STATA software version 12. Prevalence of child stunting was 19.8 (12.7-29.4) and 21.1 (16.4-26.7)% (baseline) and 43.5 (33.5-54.1) and 46.5 (45.7-47.2)% (end line) among intervention and control groups, respectively. Child stunting was higher for boys and older children from both intervention and control households. DID estimation revealed that there was no significant difference in child stunting between intervention and control households (DID = 1.7, p = .604). However, there was an intervention effect of -0.5, 2.5, and 1.7% in the prevalence of child stunting among females, males, and both sexes, respectively. Vegetable production as an intervention strategy reduced the prevalence of stunting in children aged 6-23 months. However, vegetable production needs to be well integrated with other nutrition-sensitive interventions to realize the objective of reducing child stunting.

Do Peers Matter? Unhealthy Food and Beverages Preferences among Children in a Selected Rural Province in China

With the growing problem of childhood obesity, unhealthy dietary preferences among children have become an issue of worldwide concern. This article examines the class-peer effect of these preferences using random class assignment data from a field survey. The results show significant positive peer effects for both unhealthy food and beverages preference. These results remained robust after controlling for endogeneity issues using instrumental variables. Further analysis of the mechanism of peer effect shows that the better the relationship between classmates, the greater the influence peers have on unhealthy diet preferences among rural children. The same peer effect is found in situations where it is easy for children to obtain unhealthy food and beverages. The analysis of heterogeneity finds that the peer effects of unhealthy dietary preferences are stronger for girls, older students, and obese students. This paper also discusses the role of parents and schools in mitigating the peer effect. This paper proposes policy recommendations for rural areas in China to improve dietary preferences in children. These results may also provide useful guidelines for policy in other developing countries.

Study on the Influencing Factors and Willingness to Pay of Consumers Purchasing Ecological Agricultural Products

With the steady rise of China's agricultural production and management level, the market of ecological agricultural products has developed rapidly, and consumers are increasingly concerned about ecological agricultural products. Consumers' cognition and purchase intention are the keys to determine their future development. This research is aimed at ensuring that consumers have access to high-quality ecological agricultural products, thereby promoting the supply and production of ecological agricultural products, minimizing agricultural carbon emissions, and providing information on sustainable food pricing. Based on the research status at home and abroad, this study combines the questionnaire survey method to study the influencing factors and willingness to pay of consumers purchasing ecological agricultural products. A total of 601 online questionnaires from consumers in Harbin, a city in northeastern China, were collected, and statistical factor analysis, principal component analysis, and regression analysis were used to study the influencing factors of consumers' purchase of ecological agricultural products from both positive and negative aspects, and in-depth analysis of the reasons why consumers refuse to pay, get the most real willingness to pay and related influencing factors, and quantify the influence of various variables on consumers' purchasing behavior was done. On this basis, a logit model of survival analysis is constructed to study the premium payment level of consumers for ecological agricultural products, and the payment premium is 24.95%. The research results show that married, who have purchased ecological agricultural products, the higher the understanding of ecological agricultural products, the consumers who buy ecological agricultural products in farmers' markets, Meituan and community group purchases, and the households with higher monthly consumption of agricultural products have a significant positive correlation with consumers' purchase of ecological agricultural products. The higher the education level, the older the age, and the larger the family size were significantly negatively correlated with consumers' purchase of ecological agricultural products.