Increasing food acceptance in the home setting: a randomized controlled trial of parent-administered taste exposure with incentives

Abstract

The use of rewards to encourage children to eat healthily is controversial. However, researcher-led interventions have shown that incentives combined with taste exposure can increase both intake and liking. To date, this has not been tested in the home setting. The objectives were to test the hypothesis that parent-administered repeated taste exposures to an initially disliked vegetable combined with reward will increase children's liking and intake and to compare the effects of tangible and social rewards. In this randomized controlled trial, families with children aged 3-4 y (n = 173) were randomly assigned to exposure + tangible reward (sticker), exposure + social reward (praise), or no-treatment control conditions after a pretest assessment in which a target vegetable was selected for each child. In the intervention groups, parents offered their children 12 daily tastes of the vegetable, giving either praise or a sticker for tasting. No specific advice was given to the control group. Assessments of intake and liking of the target vegetable were conducted by researchers immediately after the intervention period and 1 and 3 mo later. Children who received exposure + tangible rewards increased their intake (P = 0.001) and liking (P = 0.001) of their target vegetable significantly more than did children in the control group. Differences were maintained at the 3-mo follow-up (intake: P = 0.005; liking: P = 0.001). Increases in intake and liking in the exposure + social reward group were not significantly different from the control group. The findings of this home-based study support parental use of tangible rewards with repeated taste exposures to improve children's diets. This trial is registered as ISRCTN42922680.