Assessing the effect of food exposure on children's identification and acceptance of fruit and vegetables

Abstract

Currently, fewer than 15% of children between the ages of 4–8 years consume the recommended levels of fruit and vegetables. In order to address this serious public health issue, a variety of nutrition programs have been implemented across the United States which have varied in their success. The present research analyzed the effectiveness of providing fruit and vegetable exposure as part of a school nutrition program. Kindergarten students at two schools (N = 59) were exposed to interactive activities about healthy eating and physical activity. In addition, those at one school (n = 29) were exposed to a variety of fruits and vegetables as part of this program. Assessment of children's ability to identify and their willingness to try fruit and vegetables before and after the program indicated that while all children were better able to identify a range of fruit, only those who received exposure to healthful foods were more willing to try fruit after the program. There were no changes in their identification or willingness to eat vegetables. These results suggest that schools should provide exposure to a variety of healthy foods as part of their nutrition programs. Such programs should focus specifically on exposing children to vegetables because increasing children's willingness to try foods that are typically considered unpalatable may be especially challenging.

Introduction

Nutrients from a diet that is rich in fruit and vegetables can contribute to the prevention of cancer and cardiovascular disease and may displace other less healthy foods, thereby reducing fat consumption (Hu et al., 2000, Liu et al., 2000). However, fewer than 15% of children between the ages of 4–8 years consume the recommended levels of fruit and vegetables (Guenther, Dodd, Reedy, & Krebs-Smith, 2006). This is a serious public health concern given that eating habits established in childhood track into adulthood (Mikkila, Rasanen, Raitakari, Pietinen, & Viikari, 2004).

Barriers exist that make it especially difficult for young children to improve their eating habits. From a biological perspective, children tend to prefer energy-dense foods, which are often sweet and salty, as opposed to healthier foods, such as fruit and vegetables, which may be sour- or bitter- tasting (Desor, Mallor, & Greene, 1977). In addition, children are often unwilling to try unfamiliar foods. This fear of new food experiences, referred to as neophobia, has been identified as a factor in children's low consumption of fruit and vegetables (Cooke et al., 2004, Wardle et al., 2005).

In an effort to counteract these barriers to healthy eating in children, government agencies and community groups have begun to develop strategies that encourage healthy eating in children (CDC, 2007). Because children spend a large amount of time in educational environments, schools are key venues for nutrition intervention programs (Mullen & Shield, 2004). While 70% of all states require nutrition and dietary education (Kann, Telljohann, & Wooley, 2007), the median number of hours devoted to this topic is limited (i.e., < 5 h per year; Story, Nanney, & Schwartz, 2009). Moreover, while some programs are effective at increasing attitudes towards healthy eating, many programs do not successfully change children's eating behaviors (Jan et al., 2009, McCullough et al., 2004, Seaman and Kirk, 1995). Such findings suggest that more work is needed to understand mechanisms underlying the development of food preferences in order to create effective evidence-based nutrition programs for children.

Recently, Reverdy, Chesnel, Schlich, Koster, and Lange (2008) found that nutrition education that focused on the sensory experiences of tasting unfamiliar foods decreased neophobia and enhanced 8–10 year old children's willingness to try healthful foods compared to those not exposed to this program. This approach is consistent with experimental findings that have shown that repeated exposures to foods increases children's preferences for these foods (e.g., Birch et al., 1987, Forestell and Mennella, 2007, Gerrish and Mennella, 2001, Sullivan and Birch, 1990). The research proposed herein aimed to expand upon these findings to determine whether food exposures presented as part of a nutrition education program increased children's ability to identify fruit and vegetables and their willingness to try them relative to those who did not receive such exposure.

The children examined in the current study participated in a School Health Initiative Program (hereafter referred to as SHIP), which uses multiple programmatic strategies to create and maintain healthy physical and social environments for children in all schools throughout the school district. For kindergarten students, this includes activities provided by the OrganWise Guys® Program, 2010 (OWG, Duluth, GA), such as music, books, games, and activities that encourage healthy eating, and physical activity through daily stretches, and activity enhanced lessons. Over the course of the 2009–10 academic year children in one school additionally received exposure to a variety of fruit and vegetables provided by the USDA Fresh Fruit and Vegetable Program. This program is provided to select low-income elementary schools throughout the United States. Although $3 million is allocated to this program annually, there has been relatively little evaluation of its impact on children's food preferences (Story et al., 2009). In the school that received this program, 57 different fruits and 23 vegetables were presented in the afternoon three times a week.

We hypothesized that kindergarten children who received fruit and vegetable exposures in addition to regular SHIP activities would be better at identifying and more willing to try a fruit and vegetables compared to those at another school who were exposed to SHIP only.