Children's Liking Research Articles

Hands-On Gardening in Childcare Centers to Advance Preschool-Age Children's Fruit and Vegetable Liking in Semi-Arid Climate Zone.

Hands-on gardening is linked with healthy eating behaviors, increased outdoor activities, and overall well-being, all contributing factors to preventing obesity. Although these positive associations are widely established for adults and school-aged children, little evidence can be found on how such relationships may extend to early childhood, especially in the preschool years (3-5 years). One recent study conducted in North Carolina (NC) showed that participating in hands-on gardening significantly increased preschoolers' accurate identification of fruits and vegetables (FV) and FV consumption compared to children who did not participate in hands-on gardening, but no association was found between participation in hands-on gardening and the children's liking (eating preferences) of FV. FV identification and liking during the early years may lead to lifelong healthy eating behaviors and preferences, making hands-on gardening a critical health intervention in early childhood environments, especially in childcare centers where a majority of the 13 million children in the United States between the ages of 0 and 5 spend most of their waking hours. This research aimed to investigate how hands-on gardening in childcare centers may impact preschoolers' (3-5 years old) FV knowledge (identification) and liking in a semi-arid climate zone with a high concentration of Hispanic families by conducting experimental research with eight childcare centers and one hundred forty-nine children (n = 149) in Lubbock County, located in West Texas. The findings showed changes in average liking scores are generally positive in the experimental group of children who participated in hands-on gardening (compared to the control non-gardening group), implying an improved liking. The findings indicate that the benefits of hands-on gardening in childcare centers for enhancing healthy eating preferences are evident even in a semi-arid climate zone, where high temperatures and limited rainfall present significant gardening challenges. This research underscores the importance of integrating hands-on gardening into childcare programs, highlighting its potential as an effective obesity prevention strategy not only within the US but also in other regions with similar environmental constraints.

Children's liking for vegetarian and non-vegetarian school meals at the scale of a French city

In Western countries, a behavioural shift towards more plant-based diets is helpful in protecting population and planet health. School canteens are an important public policy target to achieve this transition. Increasing the frequency of vegetarian meals in school canteens has been proposed as a solution to decrease greenhouse gas emissions while maintaining a good nutritional quality. However, vegetarian meals acceptance by children is key to limit unintended consequences such as increased food waste or increased nutritional inequalities. We aimed to examine children's liking for vegetarian and non-vegetarian main dishes at school canteens; and whether it varied across socioeconomic level. Connected scoring devices displaying a five-point smiley scale were installed in all the 38 primary school canteens of a French city, located in socially diverse neighbourhoods. Every day after their school lunch, children were asked to rate the main dish they had just eaten. During one school year, from September 2021 to June 2022, we collected 208,985 votes for 125 main dishes, including 32 vegetarian (i.e., no meat or fish) and 93 non-vegetarian dishes, for an average of 1672 (SD 440) votes per day across the 38 school canteens. We showed no difference in children's liking for vegetarian and non-vegetarian dishes. Additionally, the socioeconomic level of the schools was found to interact negatively with children's liking for vegetarian main dishes whereby vegetarian main dishes tended to be more liked in schools of lower socioeconomic level. In this French city, children's acceptance would not be a barrier to increase the frequency of vegetarian school meals and would not increase social dietary inequalities.

Forensic interviewers' difficulty with the birthday narrative

BackgroundNarrative practice increases children's productivity in forensic interviews, and one recommended topic is the child's last birthday, though interviewers have raised concerns about its productivity. Study 1 ObjectiveStudy 1 surveyed forensic interviewers' use of and attitudes about the birthday narrative. Participants and settingParticipants included 170 forensic interviewers who subscribed to a webinar promoting use of the birthday narrative (Mage = 43 years, SD = 10.2, 94 % female). ResultsOver half (55 %) of interviewers reported that they rarely/never asked about children's birthdays, and non-users were especially likely to view the birthday narrative as never/rarely productive. Although interviewers viewed memory difficulties as more likely to occur with the birthday narrative than other practice topics (the child's likes, the child's day), non-users did not view memory difficulties, reluctance, generic reports, or religious objections as especially problematic. Open-ended responses identified negative experiences with the birthday as an additional concern, and interviewers' recommended wording of the prompts suggested suboptimal questioning strategies. Study 2 ObjectiveStudy 2 assessed the use of the birthday narrative in forensic interviews. Participants and settingThe sample included 350 forensic interviews with 4- to 12-year-old children (Mage = 8.85, SD = 2.59). ResultsOnly 4 % of children failed to recall substantive information if interviewers persisted, though another 11 % failed when interviewers stopped persisting. Invitations were more effective than other question types, especially among older children. 21 % of children mentioned a negative detail during their narrative. ConclusionsInterviewers' skepticism about the birthday narrative may be due to suboptimal questioning and sensitivity to occasional failures and negative information.

Investigation of the Relationship between Liking of Children Levels and Attitudes Toward Teaching Profession of Physical Education Teachers

This study examines the relationship between liking of children levels and attitudes toward teaching profession of permanent and contracted physical education teachers working in public schools within the Malatya Directorate of National Education, Turkey, in the 2021-2022 education period. In our study, age, gender, marital status, years of professional seniority, educational status, having children, and workplace locality were also examined in terms of subscales. 103 physical education teachers voluntarily participated in the study. The “Attitudes Toward Teaching Profession” scale developed by Demirel and Ünişen in 2015, the “Barnett Liking of Children” scale developed by Barnett and Sinsini in 1990 and adapted into Turkish by Duyan and Gelbal in 2008, and a personal information form were applied to the teachers who participated in the study based on volunteerism. Quantitative research methods and techniques were used in this study. The correlational survey model, one of the general surveying models, was used. Prior to analysis, data underwent a normality test confirming a normal distribution. Pairwise comparisons were assessed using Independent Samples t-test, and three-or-more-sample comparisons utilized One-Way Analysis of Variance (ANOVA). The Tukey test identified specific group differences in significant outcomes. The study revealed no significant difference in liking of children concerning the variables examined. Nonetheless, significant disparities were noted in attitudes toward teaching based on gender, marital status, parental status, age, and professional experience. Ultimately, a weak, positive linear correlation was identified between physical education teachers’ liking of children and their attitudes toward teaching.Keywords: Child, Love, Physical Education Teacher, Professional Attitude, Teacher Attitude

The Effect of Nursing Students’ Liking of Children and Attitudes Toward Clinical Practice on Their Comfort and Worry Levels in the Pediatric Clinic

ABSTRACT This research was conducted as a descriptive and cross-sectional study to determine the effects of nursing students’ liking of children and attitudes toward clinical practice on their comfort and worry levels in the pediatric clinic. The research was carried out with 270 nursing students who had already taken or were taking the child health and diseases nursing course. Data were collected using a Nursing Student Information Form, the Barnett Liking of Children Scale, the Nursing Students’ Attitudes toward Clinical Practices Scale, and the Pediatric Nursing Student Clinical Comfort and Worry Assessment Tool. Mean values, percentage calculations, and linear regression analysis were used for the analysis of the research data. Participants’ mean scores were 52.30 ± 6.16 on the Barnett Liking of Children Scale, 103.72 ± 19.35 on the Nursing Students’ Attitudes toward Clinical Practices Scale, 15.61 ± 3.74 on the comfort sub-dimension, and 11.63 ± 4.32 on the worry sub-dimension of the Pediatric Nursing Student Clinical Comfort and Worry Assessment Tool. It was determined that the liking of children and attitudes toward clinical practice explained 43.6% of the clinical comfort level of pediatric nursing students in Model 1 and 45.2% of their clinical worry level in Model 2. It was determined that the liking of children and attitudes toward clinical practice significantly affected the comfort and worry levels of nursing students in the pediatric clinic.

Working together to increase Australian children's liking of vegetables: a position statement by the Vegetable Intake Strategic Alliance (VISA).

Children need to be repeatedly and consistently exposed to a variety of vegetables from an early age to achieve an increase in vegetable intake. A focus on enjoyment and learning to like eating vegetables at an early age is critical to forming favourable lifelong eating habits. Coordinated work is needed to ensure vegetables are available and promoted in a range of settings, using evidence-based initiatives, to create an environment that will support children’s acceptance of vegetables. This will help to facilitate increased intake and ultimately realise the associated health benefits. The challenges and evidence base for a new approach are described.

Implementation of Loose Part Media to Increase Creativity in Early Childhood

In the learning process, children's liking and knowledge are the main factors in learning that can improve development in children, dislike and ignorance are also inhibiting factors in the learning process and aspects of development in children. Through games with loose part media that have been arranged according to their age group to develop early childhood creativity. However, there are some preschools and level schools that still use LKA or magazine books, so children don't like it and seem monotonous. The author uses a qualitative type of research type of descriptive-qualitative research, with the subject of the study being early childhood. The results of loose part media game research can increase children's liking and curiosity in learning, so as to increase the idea of imagination, creativity, ease of children to understand, and freedom. So that learning that was previously monotonous and boring becomes more fun for children.

The developmental trajectories of racial and gender intergroup bias in 5- to 10-year-old children: The impact of general psychological tendencies, contextual factors, and individual propensities

Racism and intergroup discrimination are pervasive problems in human societies. Whereas several studies have shown that children show bias in the context of many kinds of groups, much less is known about how and when general psychological tendencies and contextual factors contribute to the manifestation of intergroup bias across development, and whether individual differences play a role. In the present study, we pursue these questions by investigating and comparing the developmental trajectories of intergroup bias in 5- to 10-year-old (mostly) White children (n = 100). We assessed children's liking and preferences towards 4 racial groups (White, East Asian, Black, and Middle Eastern) and towards 2 gender groups (male and female) in a within-subject design. We found that the young children in our sample showed a significant racial and gender ingroup bias, speaking to an early and strong manifestation of intergroup bias on the basic ingroup-outgroup distinction. This bias decreased with age. At the same time, we found considerable differences between the different types of outgroups from early on. Furthermore, there were remarkable differences between the developmental trajectories of gender and racial intergroup bias, highlighting the role of both social and contextual influences. Finally, our results did not reveal consistent evidence for the influence of individual differences on children's intergroup bias.

An Exploration of the Relationship between Liking of Children and Determining Abuse and Neglect among Students Studying Child Development at a Vocational School

People working with children have important roles in diagnosing the symptoms and risks of child abuse and neglect. The purpose of this study was to explore the relationship between liking of children and determining a diagnosis of child abuse and neglect among a group of students studying child development at a Vocational School (N = 193). The data were collected using the Introductory Information Form, The scale for the Identification of the Symptoms and Risks of Child Abuse and Neglect and Barnett Liking of Children Scale. It was found that the mean score of the scale for diagnosing the symptoms and risks of child abuse and neglect was 3.58 ± 0.45 and the mean score of the liking of children scale was 86.64 ± 14.0. The results of the regression analysis indicated that the liking of children did not significantly predict the scores of the sub-dimensions of determination of symptoms and risks of CAN, and there was no relationship between them (p > 0.05). Moreover, the results indicated that the level of diagnosis of child abuse and neglect should be improved.

School lunch acceptance in pre-schoolers. Liking of meals, individual meal components and quantification of leftovers for vegetable and fish dishes in a real eating situation in Italy

This study explored pre-schoolers’ liking (n = 127; age range 3-5) of meals and of individual dishes (34 meals; 55 dishes) served in a meal by tasting actual foods in the natural setting of the school canteen. The leftovers of each children and of vegetable and fish items were recorded and the relation between the uneaten amount, liking of and familiarity to these items was studied. Liking varied (p < 0.001) across meals and individual dishes. The most appreciated meals included: a) solid starch-based dishes with meat sauce and cheese, lean poultry meat, roast potatoes and fruit yogurt, fresh seasonal fruit, or fruit ice-cream. Least liked meals included vegetable soup (with pasta or rice) or pasta with zucchini or legumes, seafood, or cheese. Overall, fish and cheese were moderately liked, and vegetables were liked the least. First and second courses contributed the largest portion to overall meal acceptability. Liking of side dishes was uncorrelated to individual meal liking in most children. Children liking and reported familiarity by parents successfully predicted the amount of food eaten. Girls were more familiar to vegetable dishes and more likely to like and consume these dishes than boys. Children sex had no effect on fish consumption.

Children's perceptions of fluid milk with varying levels of milkfat

Schools participating in federal meal programs are limited to serving skim or low-fat (≤1%) flavored and unflavored milk. Few studies have directly addressed child perceptions and preferences for milk containing different amounts of milkfat. The objective of this study was to determine whether children can differentiate between flavored and unflavored fluid milk containing varying levels of milkfat and whether preferences for certain levels of milkfat exist. Flavored and unflavored milks containing 4 different percentages of milkfat (≤0.5, 1, 2, and 3.25%) were high-temperature, short-time processed, filled into half-gallon light-shielded milk jugs, and stored at 4°C in the dark. Milks were evaluated by children (ages 8-13 yr) following 7 d at 4°C. Acceptance testing and tetrad difference testing were conducted on flavored and unflavored milks with and without visual cues to determine if differences were driven by visual or flavor or mouthfeel cues. Child acceptance testing (n = 138 unflavored; n = 123 flavored) was conducted to evaluate liking and perception of selected attributes. Tetrad testing (n = 127 unflavored; n = 129 flavored) was conducted to determine if children could differentiate between different fat levels even in the absence of a difference in acceptance. The experiment was replicated twice. When visual cues were present, children had higher overall liking for 1% and 2% milks than skim for unflavored milk and higher liking for chocolate milks containing at least 1% milk fat than for skim. Differences in liking were driven by appearance, viscosity, and flavor. In the absence of visual cues, no differences were observed in liking or flavor or mouthfeel attributes for unflavored milk but higher liking for at least 1% milk fat in chocolate milk compared with skim was consistent with the presence of visual cues. From tetrad testing, children could visually tell a difference between all unflavored pairs except 2% versus whole milk and could not detect consistent differences between milkfat pairs in the absence of visual cues. For chocolate milk, children could tell a difference between all milk fat pairs with visual cues and could tell a difference between skim versus 2% and skim versus whole milk without visual cues. These results demonstrate that in the absence of package-related flavors, school-age children like unflavored skim milk as well as milk with higher fat content in the absence of visual cues. In contrast, appearance as well as flavor and mouthfeel attributes play a role in children's liking as well as their ability to discriminate between chocolate milks containing different amounts of fat, with chocolate milk containing at least 1% fat preferred. The sensory quality of school lunch milk is vital to child preference, and processing efforts are needed to maximize school milk sensory quality.

Do children really eat what they like? Relationships between liking and intake across laboratory test-meals

Liking plays a primary role in determining what and how much children eat. Despite this, the relationship between liking and intake of foods and beverages served as part of a meal is not often reported, even though pediatric feeding studies frequently collect such data. In addition, few studies have reported on the test-retest reliability of both hedonic ratings and laboratory intake among children. To address these gaps, this study was designed to assess the relationship between children's liking of items at a meal and subsequent intake. 61, 4-6 year-olds were recruited to participate in two identical laboratory sessions where liking of 7 foods (i.e., chicken nuggets, ketchup, potato chips, grapes, broccoli, cherry tomatoes, cookie) and 2 beverages (i.e., fruit punch, milk) was assessed (5-point hedonic scale) prior to ad libitum consumption of the same items at a meal. Spearman's correlations tested the relationship between liking and intake and intra-class correlations assessed inter-session reliability of both measures. Liking for potato chips (p < 0.01), grapes (p < 0.05), cherry tomatoes (p < 0.001), and fruit punch (p < 0.001) was positively associated with amount consumed, but no associations were found between liking and intake of other meal items. For the majority of meal items, test-retest reliability of liking and intake were significant (ranging from 0.34 for cookies to 0.93 for tomatoes). At a multi-component meal, children's hedonic ratings were both reliable and modestly predictive of subsequent intake, and the relationships were stronger for lower energy, less well-liked foods. Rather than eating what they like, these data are more consistent with the notion that children do not eat what they dislike.

Children's acceptability profiles for biscuits with different fiber content.

Due to the widespread rejection by children of products with high-fiber content, new approaches to meet the dietary recommendations on fiber intake are necessary. To understand which sensory properties influence this rejection, children's acceptability was examined in high-fiber biscuits and drivers of liking were identified. One hundred and ten Spanish children (6-12 years old) evaluated the overall liking of eight commercial biscuits with variable fiber content and stated their preference. To study the drivers of liking, the samples were characterized through a quantitative descriptive analysis, the determination of the moisture and water activity as well as the instrumental evaluation of texture with a texture analyzer. It was suggested that the addition of fiber in biscuits reduced children's liking ratings. High-fiber samples were sensory and instrumentally described as harder, crispier, and more chewing than the samples with medium and low fiber content. The main sensory driver of liking identified in this study was the soft texture. Despite their hard texture, high- and medium-fiber samples were chosen as the preferred ones for 14% of the children that participated when they included chocolate taste. Drivers of disliking identified in this study were related to the addition of fruit as a filling or as dehydrated pieces. This knowledge about children's acceptability of high-fiber products might be of interest for the food industry with the aim of developing well-accepted products that supply nutritional deficiencies associated with the fiber intake.

Relationship Between Liking of Children and Emotional Labor Behaviors, Clinical Performances in Pediatric Nursing Students

Araştırma, pediatri hemşirelik öğrencilerin çocuk sevme düzeyleri ile duygusal emek davranışları, uygulama performansları arasındaki ilişkinin belirlenmesi amacıyla yapıldı. Araştırma tanımlayıcı tipte, ilişkisel tarama modelli olarak yapıldı. Örneklemi pediatri dersi alan hemşirelik bölümü öğrencileri (n=127) oluşturdu. Veriler; Bireysel Tanıtım Formu, Çocuk Sevme Ölçeği ve Duygusal Emek Davranış Ölçeği ile toplandı. Araştırmada öğrenci-eğitici etkileşimini önlemek amacı ile veriler bir anketör tarafından toplanarak bilgisayar ortamına aktarıldı. Çalışma grubu yaş ortalaması 21,50±1,23 olup, %84,7’sinin hemşirelik mesleğini sevdiği, %91,1’inin çocuk oyunlarını bildiği, %59,7’sinin çocuk kitapları okuduğu %38,7’sinin çalışma hayatında çocuk servisinde çalışmayı istediği tespit edildi. Barnett’s Çocuk Sevme Ölçeği puan ortalaması 80,27±13,40, Duygusal Emek Davranışı Ölçeği puan ortalaması 2,98±0,44’dır. Çocuk Sevme Ölçeği puan ortalamaları incelendiğinde cinsiyetin, lise tipinin, çocuk kitapları okumak, çocuk servisinde çalışmak isteme durumunun etkili olduğu belirlendi. Öğrencilerin klinik uygulama puanlarıyla; Çocuk Sevme Ölçeği puanları arasında pozitif yönde orta düzeyde, ‘Samimi davranış’ alt boyut puanı ile arasında pozitif yönde yüksek düzeyde anlamlı bir ilişki olduğu saptandı. Çalışmada öğrenci hemşirelerin çocukları sevme durumunun yüksek olduğu sonucuna varıldı. Çocuk sevme düzeyinin klinik uygulama puanı ve duygusal emek davranışını etkilediği saptandı. Öğrenci hemşirelerinin çocuk sevme düzeyine katkı sağlayacak faaliyetler ile pediatri klinik performansları güçlendirilebilir.

Factors associated with liking of milk among preschool children

Abstract Background Adequate calcium intake in childhood is essential for bone health, and dairy products are an important dietary source. However, children's milk consumption has reduced over the past decade in developing countries. Food preferences are a key determinant of consumption, and those developed in early life can persist into adulthood. Therefore, promoting a liking for milk before school age may be effective in improving milk consumption further into childhood. The aim of this analysis is to explore the factors associated with liking of milk among preschool children. Methods Questionnaires were completed by parents of 2-5 year-old children as part of a pilot intervention aiming to increase milk consumption in 12 preschools. Chi-squares and hierarchial logistic regression were used to examine the association between children's liking of milk, as reported by parents, and child-related factors (infant feeding; demographics; diet) and parent-related factors (attitudes; milk consumption and liking; education). Results Responses from 319 parents of 2-5 year-old children (50.5% male, 49.5% female) were analysed. Ninety-two percent of respondents were mothers and 85% of parents reported that their children liked the taste of milk. In a logistic regression model (N = 281) parents' belief that it is difficult to encourage their child to drink milk was associated with a lower likelihood of children liking the taste of milk (OR = 0.028; CI = 0.011, 0.075; P &amp;lt; 0.001). Liking of milk was not significantly associated with other factors examined (P &amp;lt; 0.05). Conclusions The present analysis suggests that parents' self-efficacy in encouraging their child to drink milk may be important in influencing their child's liking of its taste, and should be considered in interventions aiming to improve milk consumption. The taste of milk was well-liked in this cohort of preschool children and therefore, further research is necessary in a cohort with varying levels of milk consumption and liking of milk. Key messages Parental beliefs should be included as intervention targets when aiming to improve a liking for milk among preschool children. Further research on the determinants of milk consumption and liking of milk is necessary in diverse cohorts of preschool children.

Infant and Toddler Responses to Bitter-Tasting Novel Vegetables: Findings from the Good Tastes Study

BackgroundInfants are born with the biological predisposition to reject bitterness. Dark green vegetables contain essential nutrients but also bitter compounds, making them more difficult to like. ObjectiveThe Good Tastes Study was designed to determine whether reducing bitterness by adding small amounts of sugar or salt would alter infant acceptance of kale purées. MethodsCaregivers (n = 106, 94% mothers, 82% Non-Hispanic White) and children (53% male, aged 6–24 mo) participated in a videorecorded laboratory visit during which infants were offered 4 versions of puréed kale: plain, 1.2% or 1.8% added sugar, or 0.2% added salt. Caregivers rated their children's liking for each kale version. Videos were coded for the number of tastes accepted and for children's behaviors and acceptance of each kale version. A multilevel ordered logistic model was fit for the number of accepted tastes and caregiver ratings of child liking of kale versions with age, breastfeeding history, order effects, and kale version as predictors. ResultsInfants 6 to <12 mo accepted more tastes (b = 2.911, P < 0.001) and were rated by caregivers as liking the kale more than older toddlers (≥18 mo; b = 1.874, P = 0.014). The plain kale was more likely to be accepted (P < 0.001); also, the first version offered was more likely to be rejected (b = −0.586, P < 0.007). Older infants (≥18 mo) exhibited more avoidant behaviors (b = 1.279, P < 0.001), more playing (b = 2.918, P < 0.001), and more self-feeding (b = 1.786, P = 0.005) than younger infants (6 to <12 mo). Children who were reported to have been breastfed more in the last 7 d were more likely to self-feed (b = 0.246, P < 0.001) and play with food (b = 0.207, P < 0.005). ConclusionsOur findings support that there may be a sensitive period, during the early phase of complementary feeding, to improve success of introducing a novel, bitter, more difficult-to-like food. When low levels of sugar or salt were added, no advantage of bitterness reduction was observed. This study has been registered with ClinicalTrials.gov as NCT04549233.

Determination of Relation Between Liking of Children with Empathic Tendency Levels in Nursing Students

Amaç: Bu araştırma hemşirelik öğrencilerinin çocuk sevme ve empatik eğilim durumlarının ve aralarındaki ilişkinin belirlenmesi amacıyla yapılmıştır. &#x0D; Yöntem: Kesitsel-tanımlayıcı desende yapılan bu çalışmaya, 2017-2018 eğitim öğretim yılı, Güz döneminde İstanbul’da özel bir vakıf üniversitesinin Sağlık Bilimleri Fakültesi Hemşirelik bölümü öğrencileri alınmıştır. Toplam 508 öğrenciden, çalışmaya katılmayı kabul eden 425 öğrenci ile çalışma tamamlanmıştır. Veriler; Tanıtıcı Anket Formu, Barnett Çocuk Sevme Ölçeği ve Empatik Eğilim Ölçeği kullanılarak toplanmıştır. Veriler, SPSS 22.0 paket programında, Independent t, Mann-Whitney U, Kruskal Wallis testleri kullanılarak değerlendirilmiştir. Ölçekler arasındaki ilişkinin belirlenmesinde ise Pearson korelasyon analizi kullanılmıştır. İstatistiksel anlamlılık düzeyi p

Infant and Toddler Consumption of Sweetened and Unsweetened Lipid Nutrient Supplements After 2-Week Home Repeated Exposures

BackgroundSmall-quantity lipid-based nutrient supplements (SQ-LNS) are designed to address undernutrition during the complementary feeding period. SQ-LNS contains added sugars, but limited research has assessed whether infants’ acceptance varies between versions with and without sugars. ObjectivesOur objective was to examine the effects of repeated exposure on children's acceptance of sweetened and unsweetened SQ-LNS. We aimed to understand caregivers’ perceptions of children's liking of the 2 SQ-LNS versions and their influences on infant acceptance of SQ-LNS. MethodsCaregivers (86% non-Hispanic White) and children (7–24 mo), participated in a randomized, 2-week home-exposure study and baseline and post–home exposure assessments. Children were randomized to receive sweetened or unsweetened SQ-LNS versions, mixed with infant oatmeal. At in-person visits, caregivers fed both SQ-LNS versions to children and rated their child's liking for each. Caregivers fed the SQ-LNS version to which their child was randomized until the child refused to eat more. Acceptance was measured as total grams consumed. Mixed-effects linear models tested the change in SQ-LNS consumed between baseline and postexposure by the SQ-LNS version and number of home exposures. Covariates included the amount of SQ-LNS consumed at baseline, child BMI z-score, child age, and breastfeeding experience. ResultsChildren's acceptance of both SQ-LNS versions increased from baseline to postexposure (β, 0.71 g; 95% CI: 0.54–0.89 g; P = 0.04), regardless of SQ-LNS version (P = 0.88) or number of home exposures (P = 0.55). Caregivers rated children's liking of unsweetened SQ-LNS higher at baseline (P = 0.02). Children with lower liking ratings at baseline showed the greatest increases in acceptance between baseline and postexposure (P = 0.01). ConclusionsChildren's acceptance of SQ-LNS increased with repeated exposure, whether offered the sweetened or unsweetened version, providing preliminary support that adding sugar to SQ-LNS may not improve acceptance in young children. Children who initially like the supplement less may need repeated experience to learn to accept SQ-LNS. This trial was registered at clinicaltrials.gov as NCT04544332.

Supporting strategies for enhancing vegetable liking in the early years of life: an umbrella review of systematic reviews

Many children worldwide do not eat recommended amounts of vegetables. Disliking vegetables is a key factor associated with low intake. This umbrella review synthesized systematic reviews to determine the effectiveness of sensory and behavioral strategies to facilitate liking of vegetables (primary outcome) in young children up to 5 y of age, as key predictors of vegetable intake (secondary outcome). Nine databases were searched up to May 2019 (updated in September 2020). Two reviewers independently conducted study screening and selection, data extraction, and assessment of methodological quality using AMSTAR 2 (AMeaSurement Tool to Assess systematic Reviews). Eleven reviews (n=1 rated strong quality, n=4 moderate quality, n=6 low/critically low quality) examining 85 primary studies met the review criteria: systematic reviews and meta-analyses of primary studies (any quantitative design) that examined sensory or behavioral strategies on vegetable liking or intake (outcomes reported separately for children ≤5 y). Strategy effectiveness was synthesized into 3 categories based on evidence strength: 1) promising (large and consistent body of moderate quality evidence), 2) emerging (small to moderate body of mixed consistency and quality evidence), and 3) limited (small body of limited consistency and quality evidence). Promising evidence was identified for repeated exposure to a single or a variety of vegetables. Emerging evidence was identified for several strategies that increase familiarity with vegetable flavors (e.g., via exposure in utero and through breast milk, and a "vegetable first" approach to complementary feeding) and/or willingness to try vegetables (e.g., via parental role modeling, nonfood rewards, and vegetable-based story books). Current evidence supports incorporation of tailored advice into guideline documents for parents and carers to repeatedly expose their children to a variety of vegetables to increase vegetable intake. Ongoing robust research on strategies to facilitate children's liking of vegetables is warranted to strengthen the evidence base underpinning advice for parents and health professionals.

Child preferences and perceptions of fluid milk in school meal programs

School meal programs in the United States feed approximately 30 million children each day and account for the majority of child milk intake. Dairy consumption during childhood and adolescence has lasting effects on lifelong health status, so it is important for schools to ensure adequate consumption in this life stage by offering an appealing product. This study identified the intrinsic and extrinsic attributes that influence children's perceptions, attitudes, and consumption of fluid milk at school, especially as they relate to fluid milk packaging. An online choice-based conjoint survey (n = 211) and four 1-h focus groups (n = 31) were conducted with child milk consumers ages 8 to 13 yr to evaluate extrinsic attributes. The survey evaluated milk package attributes including packaging type, front-of-package graphics, package color, and labeled milk fat content. Focus group topics included preferences, usability, health, taste of fluid milk, and milk consumption habits. To evaluate intrinsic properties related to packaging, 3 varieties of milk (unflavored fat-free, unflavored low-fat, and chocolate-flavored fat-free) were produced and packaged in polyethylene-coated paperboard cartons, polyethylene terephthalate (PET) bottles, and high-density polyethylene (HDPE) bottles (all 250 mL). After 10 to 13 d of storage at 4°C under dark conditions, milks were evaluated by descriptive analysis and child acceptance testing (ages 8-13 yr; n = 126, 122, and 126 for each variety, respectively). Extrinsically, package type was the most important attribute to children, but graphics, nutritional labeling, branding, package size, and overall familiarity also drove preferences. The ideal milk packaging build from the conjoint survey was an HDPE bottle with blue-colored packaging and a cow graphic, labeled as low-fat milk. Intrinsically, all varieties of milks packaged in paperboard cartons developed package-specific flavors, including refrigerator/stale and paperboard, after 10 d of storage. These off-flavors were not detected in HDPE- or PET-packaged milks. For unflavored milks, child consumers preferred the flavor of PET- or HDPE-packaged milks over cartons, regardless of milk fat content, but preferences were not distinct for chocolate-flavored milk. The results of this study demonstrate that children's liking and preference for milk are driven by both intrinsic and extrinsic factors and suggest that improvements are needed to increase acceptance of milk currently served in school meal programs.