A child’s first years of life are crucial for cognitive development and future health. Studies show that a varied diet with a high intake of vegetables is positive for both weight and cognitive development. The present low intake of vegetables in children’s diets is therefore a concern. Food neophobia can be a barrier for vegetable intake in children. Our hypothesis is that interventions that can increase children’s intake of vegetables should be introduced early in life to overcome children’s neophobia. This study aims to develop, measure and compare the effect of two different interventions among one-year-old children in kindergartens to reduce food neophobia and promote healthy diets.
The kindergartens are randomized to one of three groups: two different intervention groups and one control group. We aimed to include a total of 210 children in the study. The first intervention group will be served a warm lunch meal with a variety of vegetables, 3 days a week during the intervention period of 3 months. The second intervention group will be served the same meals and, in addition, kindergarten staff will be asked to implement pedagogical tools including sensory lessons, adapted from the Sapere method, and advices on meal practice and feeding practices. The control group continues their usual meal practices. Parents and kindergarten staff will complete questionnaires regarding food neophobia, food habits and cognitive development at baseline and post intervention. A similar intervention among 2-year-old children in kindergarten has been implemented and evaluated earlier. We will investigate whether a digital version of this intervention has an effect, because digital interventions can be easily implemented nationwide. We will also investigate whether there are benefits of conducting such interventions in younger children, before the onset of food neophobia. Questionnaires, information videos and recipes will be digitally distributed.
Results of this study will provide new knowledge about whether a sensory education and a healthy meal intervention targeting children, kindergarten staff and parents will reduce levels of food neophobia in children, improve parental and kindergarten feeding practices, improve children’s dietary variety, improve children’s cognitive development and reduce childhood overweight.
Lim SS, Vos T, Flaxman AD, Danaei G, Shibuya K, Adair-Rohani H, AlMazroa MA, Amann M, Anderson HR, Andrews KG, et al. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the global burden of disease study 2010. Lancet. 2012;380(9859):2224–60. https://doi.org/10.1016/S0140-6736(12)61766-8. CrossRefPubMedPubMedCentral
Knudsen AK, Tollånes MC, Haaland ØA, Kinge JM, Skirbekk V, Vollset SE. Disease Burden in Norway 2015. Results from the Global Burden of Diseases, Injuries, and Risk Factors Study 2015 (GBD 2015). Oslo: Public Health Institute Norway; 2017. https://www.fhi.no/en/publ/2017/sykdomsbyrde-i-norge-2015/#results. Accessed 15.01.2018
Schwingshackl L, Schwedhelm C, Hoffmann G, Lampousi AM, Knuppel S, Iqbal K, Bechthold A, Schlesinger S, Boeing H. Food groups and risk of all-cause mortality: a systematic review and meta-analysis of prospective studies. Am J Clin Nutr. 2017;105(6):1462–73. https://doi.org/10.3945/ajcn.117.153148. PubMedCrossRef
WHO. Increasing fruit and vegetable consumption to reduce the risk of noncommunicable diseases. Geneva: World Health Organization; 2014. http://www.who.int/elena/titles/bbc/fruit_vegetables_ncds/en/. Accessed 15.01.2018
Ng M, Fleming T, Robinson M, Thomson B, Graetz N, Margono C, Mullany EC, Biryukov S, Abbafati C, Abera SF, et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the global burden of disease study 2013. Lancet. 2014;384(9945):766–81. https://doi.org/10.1016/s0140-6736(14)60460-8. CrossRefPubMedPubMedCentral
Ledoux TA, Hingle MD, Baranowski T. Relationship of fruit and vegetable intake with adiposity: a systematic review. Obes Rev. 2011;12(5):e143–50. https://doi.org/10.1111/j.1467-789X.2010.00786.x. CrossRefPubMed
The Thousand Days. In: thethousanddaysorg. 2010 https://thousanddays.org/. Accessed 15.01.2018.
Øverby NC, Lene KA, Frost AL. Spedkost 12 måneder. Landsomfattende kostholdsundersøkelse blant 12 måneder gamle barn. Spedkost 2006-2007. Oslo: The Norwegian Directorate of Health; 2009.
Lafraire J, Rioux C, Giboreau A, Picard D. Food rejections in children: cognitive and social/environmental factors involved in food neophobia and picky/fussy eating behavior. Appetite. 2016;96:347–57. https://doi.org/10.1016/j.appet.2015.09.008. CrossRefPubMed
Russell CG, Worsley A. A population-based study of preschoolers’ food neophobia and its associations with food preferences. J Nutr Educ Behav. 2008;40:11–9. https://doi.org/10.1016/j.jneb.2007.03.007. CrossRefPubMed
Helland SH, Bere E, Bjørnarå HB, Øverby NC. Food neophobia and its association with intake of fish and other selected foods in a Norwegian sample of toddlers: a cross-sectional study. Appetite. 2017;114:110–7. https://doi.org/10.1016/j.appet.2017.03.025. CrossRefPubMed
Moding KJ, Stifter CA. Stability of food neophobia from infancy through early childhood. Appetite. 2016;97:72–8. https://doi.org/10.1016/j.appet.2015.11.016. CrossRefPubMed
Anzman-Frasca S, Savage JS, Marini ME, Fisher JO, Birch LL. Repeated exposure and associative conditioning promote preschool children’s liking of vegetables. Appetite. 2012;58(2):543–53. https://doi.org/10.1016/j.appet.2011.11.012. CrossRefPubMed
Hausner H, Olsen A, Møller P. Mere exposure and flavour–flavour learning increase 2–3 year-old children’s acceptance of a novel vegetable. Appetite. 2012;58(3):1152–9. https://doi.org/10.1016/j.appet.2012.03.009. CrossRefPubMed
Caton SJ, Ahern SM, Remy E, Nicklaus S, Blundell P, Hetherington MM. Repetition counts: repeated exposure increases intake of a novel vegetable in UK pre-school children compared to flavour–flavour and flavour–nutrient learning. Br J Nutr. 2012;109(11):2089–97. https://doi.org/10.1017/S0007114512004126. CrossRefPubMed
de Wild VWT, de Graaf C, Jager G. Use of different vegetable products to increase preschool-aged Children's preference for and intake of a target vegetable: a randomized controlled trial. J Acad Nutr Diet. 2017;117(6):859–66. https://doi.org/10.1016/j.jand.2016.11.006. CrossRefPubMed
Holley CE, Haycraft E, Farrow C. ‘Why don’t you try it again?’ A comparison of parent led, home based interventions aimed at increasing children’s consumption of a disliked vegetable. Appetite. 2015;87:215–22. https://doi.org/10.1016/j.appet.2014.12.216. CrossRefPubMed
Blissett J, Fogel A. Intrinsic and extrinsic influences on children's acceptance of new foods. Physiol Behav. 2013;121:89–95. https://doi.org/10.1016/j.physbeh.2013.02.013. CrossRefPubMed
Stok FM, Hoffmann S, Volkert D, Boeing H, Ensenauer R, Stelmach-Mardas M, Kiesswetter E, Weber A, Rohm H, Lien N, et al. The DONE framework: creation, evaluation, and updating of an interdisciplinary, dynamic framework 2.0 of determinants of nutrition and eating. PLoS One. 2017;12(2):e0171077. https://doi.org/10.1371/journal.pone.0171077. CrossRefPubMedPubMedCentral
Bandura A. Self-efficacy: the excercise of control. New York: W H Freeman/Times Books/Henry Holt & Co.; 1997.
Dazeley P, Houston-Price C. Exposure to foods’ non-taste sensory properties. A nursery intervention to increase children's willingness to try fruit and vegetables. Appetite. 2015;84:1–6. https://doi.org/10.1016/j.appet.2014.08.040. CrossRefPubMed
Coulthard H, Sealy A. Play with your food! Sensory play is associated with tasting of fruits and vegetables in preschool children. Appetite. 2017;113:84–90. https://doi.org/10.1016/j.appet.2017.02.003. CrossRefPubMed
Park BK, Cho MS. Taste education reduces food neophobia and increases willingness to try novel foods in school children. Nutr Res Pract. 2016;10(2):221–8. https://doi.org/10.4162/nrp.2016.10.2.221. CrossRefPubMed
Association Sapere. Les classes du goût - Jacques Puisais. Bruxelles: Association Sapere. http://sapere-asso.fr/en/. Accessed 16.01.2018
Hagman U, Algotson S. Mat för alla sinnen - sensorisk träning enligt Sapere-metoden (Food for the senses): Sensory Training According to the Sapere Method. 1st ed. Uppsala: Livsmedelsverket & Grythättan Stiftelsen för måltidsforskning; 1999.
Taste education in sweden. In: Association Sapere. http://sapere-asso.fr/en/suede/. Accessed 16.01.2018.
SSB. Kindergartens. Oslo: Statistics Norway; 2017. https://www.ssb.no/utdanning/statistikker/barnehager Accessed 16.01.2018
UDIR. Framework Plan for Kindergartens. Oslo: Norwegian Directorate for Education and Training; 2017. https://www.udir.no/globalassets/filer/barnehage/rammeplan/framework-plan-for-kindergartens2-2017.pdf. Accessed 16.01.2018
Elford L, Brown A. Exploring child-feeding style in childcare settings: how might nursery practitioners affect child eating style and weight? Eat Behav. 2014;15(2):314–7. https://doi.org/10.1016/j.eatbeh.2014.04.001. CrossRefPubMed
Cooke L, Wardle J, Gibson EL. Relationship between parental report of food neophobia and everyday food consumption in 2-6-year-old children. Appetite. 2003;41 https://doi.org/10.1016/s0195-6663(03)00048-5.
Cassells EL, Magarey AM, Daniels LA, Mallan KM. The influence of maternal infant feeding practices and beliefs on the expression of food neophobia in toddlers. Appetite. 2014;82:36–42. https://doi.org/10.1016/j.appet.2014.07.001. CrossRefPubMed
Fangupo LJ, Heath AL, Williams SM, Somerville MR, Lawrence JA, Gray AR, Taylor BJ, Mills VC, Watson EO, Galland BC, et al. Impact of an early-life intervention on the nutrition behaviors of 2-y-old children: a randomized controlled trial. Am J Clin Nutr. 2015;102(3):704–12. https://doi.org/10.3945/ajcn.115.111823. CrossRefPubMed
Daniels LA, Magarey A, Battistutta D, Nicholson JM, Farrell A, Davidson G, Cleghorn G. The NOURISH randomised control trial: positive feeding practices and food preferences in early childhood - a primary prevention program for childhood obesity. BMC Public Health. 2009;9(1):387. https://doi.org/10.1186/1471-2458-9-387. CrossRefPubMedPubMedCentral
Kerstjens JM, Bos AF, ten Vergert EM, de Meer G, Butcher PR, Reijneveld SA. Support for the global feasibility of the ages and stages questionnaire as developmental screener. Early Hum Dev. 2009;85(7):443–7. https://doi.org/10.1016/j.earlhumdev.2009.03.001. CrossRefPubMed
Richter J, Janson H. A validation study of the Norwegian version of the ages and stages questionnaires. Acta Paediatr. 2007;96(5):748–52. https://doi.org/10.1111/j.1651-2227.2007.00246.x. CrossRefPubMed
Barratt H, Kirwan M. Clustered data - effects on sample size and approaches to analysis. Bucks: Public Health Textbook; 2009. https://www.healthknowledge.org.uk/public-health-textbook/research-methods/1a-epidemiology/clustered-data. Accessed 17.01.2018
- A cluster randomized web-based intervention trial to reduce food neophobia and promote healthy diets among one-year-old children in kindergarten: study protocol
Eli Anne Myrvoll Blomkvist
Sissel Heidi Helland
Elisabet Rudjord Hillesund
Nina Cecilie Øverby
- BioMed Central
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