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The Journal of Nutrition Vol. 128 No. 2 February 1998,
pp. 407S-410S
Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA 16802
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ABSTRACT |
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Abstract
Introduction
References
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Psychological influences on the childhood diet are addressed. The focus is on factors that influence the formation of children's food preferences. Evidence for links among food preferences, dietary intake and children's adiposity is presented, with an emphasis on dietary fat. Few food and flavor preferences are innate; most are learned via experience with food and eating and involve associative conditioning of food cues to aspects of the child's eating environment, especially the social contexts and physiological consequences of eating. Parents' child-feeding practices are central in this early feeding environment and affect children's food preferences and their regulation of energy intake. An understanding of how children's food preferences are acquired is essential in developing strategies to improve the quality of children's dietary intake.
KEY WORDS: children · food preferences · dietary fat intake · adiposity
To enhance the nutritional quality of children's diets, an understanding of the factors that influence children's food preferences is essential. Children eat what they like and leave the rest, and they are blissfully ignorant of considerations that influence many adult eaters: the fat and cholesterol content, nutrient density of a food, and its cost and ease of preparation. Children's food preferences are major determinants of food consumption patterns, and current evidence has begun to reveal that preferences are linked to dietary patterns, which in turn influence current and subsequent risk for obesity and chronic disease. However, there are no data to support or refute the idea that preferences and dietary patterns formed in childhood persist into adulthood.
What do we know about factors influencing the etiology of children's food likes and dislikes? The preference for the sweet taste, probably the preference for salty tastes, and the rejection of sour and bitter tastes are innate and unlearned (Beauchamp et al. 1994 As omnivores, children must consume a variety of foods to obtain an adequate diet and to maintain growth and health. Omnivores can adapt to consuming a diet consisting of whatever set of edibles happens to be available in their environment. As mammals, we all begin life consuming only milk, and this exclusive milk diet provides a dramatic contrast to the variety that defines the omnivore's diet. The transition from milk to an omnivorous diet begins during the latter part of the first year of life, when milk is no longer an adequate diet. However, probably because ingesting new substances is a risky business, most new foods are not immediately accepted.
It is well known that there are familial patterns of obesity and that there are genetic effects on obesity; a child with two obese parents is more likely to become obese than is a child with two thin parents. What is not clear is how genetics and environment interact to produce obesity in the developing child and whether obese parents might also provide "obesigenic" environments. For example, an environment that provides many opportunities to learn to like high fat, energy-dense foods and few opportunities to learn to like complex carbohydrates and fruits and vegetables could be obesigenic.
The social environment of children's eating is important in shaping children's preferences and intake. A series of early experiments revealed that children learned to dislike foods eaten to obtain rewards, "eat your vegetables and you can watch TV" (Birch et al. 1984 Children's food preferences and intake patterns are shaped via early experience with food and eating, and parents' child-feeding practices are central features of the child's early feeding experience. Infants and young children can be responsive to the energy content of food in regulating their food intake, but this responsiveness can be modified by child-feeding practices that attempt to control the child's intake, thereby limiting opportunities for the child to exert self control. During infancy, eating is initially depletion driven, but the evidence indicates that even during the first few years of life, the controls of food intake become more complex, as we learn to eat in response to the presence of palatable food, the social setting, our emotional states, and our attitudes, knowledge and beliefs about nutrition, food and eating.
INTRODUCTION
Abstract
Introduction
References
), but nearly all food preferences are learned via children's early experience with food and eating. Children's preferences are shaped by the quantity and quality of children's experience with food, and as a result of many eating occasions in which foods are associated with the social contexts of eating and with the physiological consequences of ingestion, children come to accept some foods and reject others, shaping their dietary intake.
EARLY EXPERIENCE, "NEOPHOBIA,"
AND FOOD ACCEPTANCE
, Pliner et al. 1993), as well as with adults and other omnivores, confirms that repeated opportunities to sample a new food can reduce the neophobic response and can alter the response from rejection to acceptance (Birch and Marlin 1982, Sullivan and Birch 1994). Figure 1 also indicates that the effects of dietary experience are moderated by prior feeding method; breast-fed infants seem to more readily accept new foods than do formula-fed infants (Sullivan and Birch 1994).
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Fig 1.
Mean intake of exposed version of vegetables for breast-fed (n = 19) and formula-fed infants (n = 17). Infant intake was assessed at pre-exposure, post-exposure and delayed post-exposure trials.
, Drewnowski and Rock 1995). The question of how genetic factors and environment may interact to produce food preferences and in turn dietary intake is a complex one, because parents supply both the child's genes and the environment.
PHYSIOLOGICAL CONSEQUENCES OF EATING: EFFECTS ON FOOD ACCEPTANCE
). If, as is usually the case, eating a food is followed by positive feelings of satiety, a learned preference for that food can result. Learning to associate foods' flavors with the physiological consequences of eating can provide a mechanism for learned preferences for energy-dense foods (Sclafani 1991).
, Kern et al. 1993). On both days, the same fixed amount of a food was eaten, such as yogurt or soup, where the energy density was varied by varying the either the carbohydrate or fat content. The foods also contained different and distinct flavors. Before and after repeated opportunities to eat these foods, we obtained preference data to test for learned food preferences. Representative results from one experiment are shown in Figure 2 (Kern et al. 1993). The upper panel shows the results relating to learned, "conditioned" preferences for energy-dense foods. Prior to repeated opportunities to consume the high fat and fat-free versions (pre-treatment), preferences for the two foods did not differ. However, following repeated opportunities to consume these foods (post-treatment), preference was significantly enhanced only for the high fat version, especially when the children were hungry. The bottom panel presents contrast data from a "mere exposure" control and indicates that preference for both versions of the initially unfamiliar foods increased in the "mere exposure" condition, in which foods were tasted but not eaten. These findings indicate that children can learn to prefer high energy versions of foods over similar, lower energy foods. Learning to prefer foods that are the best energy sources could be adaptive in contexts where food is scarce. For middle-class Americans, where the food context is one of excess, learning to prefer energy-dense foods can be a liability.
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Fig 2.
Effects of conditioning (n = 12) or mere exposure (n = 15) treatment on 3- and 4-yr-olds' preferences for fat-free ( 
) and high fat paired (
) flavors. After treatment, children's preferences were assessed when they were both hungry and full. Preferences were assessed prior to conditioning trials, immediately after conditioning and after 8 wk (delayed assessment).
, Nguyen et al. 1996). We examined the links among children's preferences for high fat foods, their consumption patterns, and children's and parents' adiposity. When 3- to 5-yr-olds were offered menus containing 32% of energy from fat over 6 d, their diets varied from 25% to 42% of energy from fat, and their preferences for high fat foods predicted these intakes (Fisher and Birch 1995). With respect to links among fat preferences, fat intake, and adiposity, fatter children preferred high fat foods, consumed higher fat diets, and had parents with the highest body mass indices. These data suggest that the food environments of fatter children were systematically different from those of thinner children.
CHILD FEEDING PRACTICES: EFFECT ON FOOD PREFERENCES, INTAKE AND ADIPOSITY
), and learned to prefer foods eaten in positive social contexts as rewards, "clean up your toys and you can have some cookies" or paired with positive interactions with a friendly adult (Birch et al. 1980).
). Results revealed that children consistently ate more in the second course following the low energy first course. Children adjusted their energy intake in the second course to compensate for the energy in the first course. Subsequent research indicates that children can regulate energy intake over 24-h periods. Over several-day periods, the CV for single meals are about 40%; CV for energy intake summed over 24-h periods are about 10%. Analysis revealed that meal-to-meal compensation in energy intake produced these patterns (Birch et al. 1991 and 1993). However, there were large individual differences in children's ability to regulate intake, and we have been exploring the antecedents and consequences of these individual differences.
). Findings indicated that children with the highest body fat showed the poorest energy regulation. We also noted a difference between sexes here, with boys regulating energy intake more accurately than girls, and this early sexual difference may be an early precursor of later sexual differences in the prevalence of dieting and problems of energy balance. Children whose parents exerted the most control over what, when, and how much children could eat showed the weakest evidence for regulating energy intake. Parental control of children's eating can include both 1) restriction of certain "forbidden" foods, sweets and high fat foods, as well as 2) "encouraging" consumption of "healthy" foods.
). We also explored predictors of parental control in child feeding, including maternal and child adiposity, and mothers' own dieting history. We obtained information on mothers' dieting, body mass index, and maternal control and restriction of children's eating. After a normal lunch, each child's preferences for a set of 10 snack foods (sweet and savory, differing in fat content) were assessed, and the child was then left alone in a playroom with the snack foods and a number of toys, so that the child could choose to eat or play. We hypothesized that when mothers' restrictive control was low, children would be more responsive to internal cues signaling hunger and satiety, and following a meal, consumption of snack foods should be minimal. However, for children whose mothers were restricting their intake, we predicted that eating would be elicited by the presence of "forbidden" palatable food, even when they were not hungry.
), indicating that their own eating was "out of control," used more food restriction with their daughters, and their daughters ate more when not hungry. This was the case even when controlling for girls' adiposity (Fisher and Birch 1996). These findings reveal parallels between the mothers' and daughters' eating style and suggest that restrictive child-feeding practices may mediate the transmission of a "disinhibited" eating style from mothers to daughters. In addition, results indicate that restricting children's food intake can actually promote their intake of the restricted foods.
SUMMARY
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FOOTNOTES |
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LITERATURE CITED |
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Abstract
Introduction
References
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