Abstract

Food preferences are a primary determinant of dietary intake and behaviors, and they persist from early childhood into later life. As such, establishing preferences for healthy foods from a young age is a promising approach to improving diet quality, a leading contributor to cardiometabolic health. This narrative review first describes the critical period for food preference development starting in utero and continuing through early childhood. Infants’ innate aversion to sour and bitter tastes can lead them to initially reject some healthy foods such as vegetables. Infants can learn to like these foods through exposures to their flavors in utero and through breastmilk. As solid foods are introduced through toddlerhood, children’s food preferences are shaped by parent feeding practices and environmental factors such as food advertising. Next, we discuss two key focus areas to improve diet quality highlighted by the current understanding of food preferences: (1) promoting healthy food preferences through breastfeeding and early exposures to healthy foods and (2) limiting the extent to which innate preferences for sweet and salty tastes lead to poor diet quality. We use an ecological framework to summarize potential points of intervention and provide recommendations for these focus areas, such as worksite benefits that promote breastfeeding, and changes in food retail and service environments. Individuals’ choices around breastfeeding and diet may ultimately be influenced by policy and community-level factors. It is thus crucial to take a multilevel approach to establish healthy food preferences from a young age, which have the potential to translate into lifelong healthy diet.

Highlights

  • Food preferences begin taking shape during fetal development and continue changing throughout life, influenced by biological, social, and environmental factors [1, 2]

  • Childhood is a critical period to establish food preferences [1], making it an ideal age for efforts to improve diet quality. Investments made during this period will be compounded over time, as food preferences established in early childhood persist into later life [1, 5]

  • A recent study among low-income participants not enrolled in Supplemental Nutrition Assistance Program (SNAP) showed that dietary improvements were greatest for those randomized to receive food assistance with a financial incentive for fruits and vegetables and a restriction on purchasing unhealthy foods such as sugar-sweetened beverages and candy, compared with not having incentives or restrictions

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Summary

Introduction

Food preferences begin taking shape during fetal development and continue changing throughout life, influenced by biological, social, and environmental factors [1, 2]. The strength of causal inference is limited by the observational nature of these studies, this finding has been repeated across diverse cohorts with different food cultures, supporting breastfeeding as a plausible mechanism in flavor learning and increased fruit and vegetable consumption in children.

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