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Association for Professional Development in Early Years

OCCASIONAL PAPER 11 - ‘Big,strongandhealthy’?Children,foodandeatingintheearlyyears,and

therolepreschoolscanplayMimiTatlow-Golden,OpenUniversity

IntroductionFoodandeatingmaybeviewedasadomainoflearningthatbelongstotherealmoffamily–intimatelyboundupwithchildren’sbodies,familyrelationships,identitiesandcultures.Yetpreschooleducatorscanbekeyfiguresinformalandinformalpedagogiesoffood.Inthispaper,Idrawoninterdisciplinaryresearchtoilluminatewho’sresponsibleforchildren’searlyeatingpreferences:children,parents,educatorsorothers?Arepreferencesinnateordotheyoriginateintheworldsaroundchildren?Thepicture,asitturnsout,isquitecomplex.Ithendrawonmystudiesofchildren’searlylearningaboutfoodandfoodbrands.Throughout,Irecommendhowearlyyearseducatorscansupportchildren’sandfamilies’learning,healthandwell-beinginthisimportantareaoflearning–andpleasure.Childrenhaveclearfoodpreferencesfrominfancy,whichcanbequitepronounced.Still,childrenremainopentolearningaboutflavourandeatingthroughouttheearlyyears,andevidenceshowsthatearlyyearseducatorscanbepartofthisprocess.Givencurrentconcernsaboutweightandlong-termhealth,understandingearlyinteractionswithfood,tasteandeatingiscritical,asthesestronglypredictdietlaterinlife.Children’searlyfoodpreferencesInfantsandyoungchildreninnatelyprefersweetandsaltiertastesandgenerallyfirstdislikebitterflavourssuchasvegetables.Theyalsohavegeneticallyinfluenced,individualsensitivitiestotaste,smell,colour,tactilepropertiessuchascrunch,andawarenessofhunger.Theveryearliesttasteexperiences,includingflavoursexperiencedinthewomb,breastorformulamilkandfoodsonwhichtheywereweaned,alsoinfluencetheirtastepreferences.Sochildrenwhosemothersatelessvarieddietsinpregnancy,orwhowerebottlefed,oftenpreferfewerflavoursandmayneedmoretasteexposurestolearntoacceptnewflavours(Blissett&Fogel,2013;Fiese&Bost,2016;Larsenetal.,2015;Ventura&Worobey,2013).Children’sgreaterautonomyinthetoddleryearsisoftenexpressedinfoodinteractions–yetparentsandcaregiversaretypicallyconcernedaboutfoodrefusals,seekingadultcontrol(Larsenetal.,2015;Waltonetal.,2017).Theymayevenclaimtoknowchildren’sfoodlikesbetter(Wiggins,2014)andtodeterminehowmuchtheyshouldeat(Johnsonetal.,2015)–possiblyreflectingconcernforchildren’sthriving.Ifcarersencourage‘eatingup’oflargeportions,childrenmayeattoomuch,asgrowthslowsduringthepreschoolyears,–fromaboutone-yeartheylosetheabilitytoadjustfoodintakeguidedbytheirhungeralone.

Pickyandfussyeating,and‘neophobia’Anotherdevelopmentalcausefordifficulteatinginteractionsisearlyyearstasteandsmell‘neophobia’and/orpickyeating,whenmostchildrenrejectsomefoods,evenpreviouslyacceptedones.Peakingatapproximatelythree-years,butoftenextendingtoeight-yearsorbeyond,pickyeatingisverycommon:parentsrateupto74%oftwo-to-five-yearoldsas‘verychoosy’(Taylor,etal.,2015)andchildrenagedfour-to-five-yearsdislikedoveronein10commonfoods(morevegetablesandproteinsthanstarchesandsweetfoods;Wardle&Cooke,2008).Educatorscanbearinmindthatchildrenarenottoblameforfussinessandneophobia,whichareduetobiological/developmentalfactors:(i)slowergrowthcausinglesseating;(ii)protectivecautionregardingnewtastesatatimeoffirstindependentexploration;and(iii)increasingpsychologicalautonomy.However,thesebehaviourscanalsobeinfluencedbythosearoundchildren,includingtheircarers.Interestingly,professionalsoftenbelievethatparentscreatechildren'sfoodpreferences,whereasparentsbelievetheseareinnate.Infact,researchsuggeststhatcarersandchildrenbothaffectchildren’seatingbehaviours.TheUKGeminitwinstudy(Fildesetal.,2014)foundthateatingvegetables,fruitandproteinwasindeedlinkedtogeneticeffectsamongthree-year-olds-suggestingcarefulstrategiesareneededwhenchildrendonotreadilytaketosuchfoods,astheyhaveinnatetastesensitivities.Incontrast,eatingdairy,starches,andsnacks,foodsmostlinkedtolesshealthyeating,waslinkedtofoodenvironments.Soitisvitalthatparentsandcarersattendtofoodenvironmentstosupportlearningabouthealthiereatingpatterns.Furthermore,longitudinalresearchfoundthatpre-schoolers’foodavoidanceledtoparentalpressurising–intwinstudies,whenonewasfussier,mothersusedmorepressuretoeatandmorerewardswiththatchild(Waltonetal.,2017)–butthatpressurethencreatesfurtherchildfussiness.Socontrollingstylesoffoodparentingarenothelpful;fussyeatingneedsdifferentstrategies(Jansenetal.,2017).It’slikelythatthisappliestocarersaswell.What’simportanttonoteisthatcarerscananddointroducechildrentonewfoodsandchangewhattheyeat–thoughsomeverycommonpracticeshavetheoppositeeffectofthoseintended.I’llreturntotheseshortly.Children’slearningaboutfoodLearningtoeatinvolvesrecognisingandcategorisingfood,oneoftheearliestdomainschildrenlearnabout.Byone-year

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oldchildrencangroupitemsvisuallyandcanpointtoexpressdesire,aswellasindicaterefusal.Fromtwo-yearstheycangroupfoodintomultipleconceptualcategories,e.g.,‘vegetables’,‘breakfast’or‘healthy’andlearnaboutsocialculturalandhealthfoodexpectations.Soactivelearningaboutfoodconceptscanbeginearly–considerablyearlierthanisoftenthecase.Whenweaskedchildrenagedthree-tofive-yearswhichfoodstheyshouldeat,withthehelpofashortpicturebookaboutalittlemousewhowantedtogrowuptobe‘big,strongandhealthy’likeolderchildren,aninterestingpatternoffindingsemerged(Tatlow-Goldenetal.,2013).Fromthree-years,mostchildrenwereabletoidentifyfruitandvegetables(apples,oranges,broccoli,etc.)asitemsthatshouldbeeatentogrowupandbehealthy.Yettheirabilitytoidentifyfoodsthatwouldnothelpwithhealthygrowthsuchassweets,cakes,andfastfooditems,wassignificantlylower.Thismaybeduetoparentsandcarersbeingreluctanttospeaknegativelyaboutsomefoods,yetitsuggeststhatteachingchildrenaboutwhatisnothealthymaybeusefulfromanearlyage.Thisislikelytobechallengingintheyearswhenchildrenalsorefusesomefoods,socarefulconsiderationofapproachesisneeded.Inadditiontoinstruction,childrenlearnmuchaboutfoodfromimitatingtheeatingofothers,whethersignificantadults,friendsorthemedia.Fromone-year,theyimitateadultbehaviours,andolderandsimilar-agedpeers’eatingfromtwo-to-three-years(Hendy,2002).Theyalsoimitateeatingfromscreenviewing(Shuttsetal.,2013).EffectsoffoodmarketingandadvertisingMarketingeffectsonchildren’sfoodpreferencesandeatingarewell-established.Notonlydoesithaveimmediateeffectsoneating–childrensnackmoreafterviewingadvertsforunhealthyfoods,takinginenoughextracaloriestogainweightovertime–butmarketingalsocreatesnormativebeliefsinsocietyaboutfoodanditspleasures,andwaysthatparentsandcarerscanmakechildrenhappy.Pre-schoolersenjoyandengageactivelywithfoodadverts,andtheyacquirefoodknowledgefromthem(Tatlow-Goldenetal.,inpreparation).Instudieswithimagesoffoodbrandlogos,wefoundthatyoungchildrencancorrectlyidentifyfoodswhichthelogosrepresent,whenselectingfromimagesofarangeoffoods.Theycanidentifyhalformoreatthree-yearsandbyfive-yearscandothiswithnearcompleteaccuracy(Tatlow-Goldenetal.,2014).Notably,atallagestheycanidentifyunhealthyfoodsattwicetherateofhealthierfoods.Thissuggeststhatthemarketingsurroundinwhichchildrenlive–acombinationoftheirexposurethroughthemedia,inshopsandathomeandothersettings–teachesthemaboutunhealthyfoodbrandsbeforetheylearnabouthealthierfoods–orindeedbeforetheylearntheirABCs.Theimpactoffoodmarketingisalsooftenseeninchildren’sfoodrequests,or‘pestering’.Childrenagedtwo-to-eight-years(Huangetal.,2016),askingforfoodseenontelevisionwasthegreatestpredictorofweight.Notably,wehavefoundthatparentsandgrandparentsintheUKandIrelandroutinely

givefoodtreats(mostlysweetitemsandsavourysnacks),primarilyasareward,andalsobecausechildrenaskforthem(Shanetal.,2018),andthatallcarers,includingpreschooleducators,thinkoffoodtreatsassomethingspecial,yetagreethattheyhavebecomeroutinisedincontemporarylifecomparedtotheirownchildhoods(McCaffertyetal.,inpress).Althoughparentstypicallyholdstrongnegativeattitudesaboutfoodadvertiserstargetingpre-schoolers,mostnevertalkwiththeirchildaboutadvertisingandalmostallneverencouragetheirchildtoswitchoffadvertswhenwatchingtelevision(Tatlow-Goldenetal.,2015).Indigitalmedia,parentaladvertrestrictionisharder,ifnotimpossibletocarryout–andthusmorerestrictionoffoodmarketingiscrucial.FoodcaringpracticesChildren’scaregivers,includingpreschoolstaff,canhelpthemtolearnaboutfoodandeating,increaselikesandreducedislikes,bymodellingeatingofnewandhealthierfoods;creatinghealthyfoodenvironments;andengaginginparticularfoodcaringpractices.OnerecentUKstudyoffood,powerandcontrolwithcasestudiesofchildrenandparentsin47families(O’Connell&Brannen,2014)identifiedfourtypesofparent–childfood/controlrelationships.Withchildrenunderfive-years,parentsexercisedcontrol,includingpunishments,rewardsandbribes,hidingcrispsand‘sneaking’vegetablesintosauces.Theextenttowhichsuchfoodcaringpracticesareresponsibleforlesshealthyeatinglaterinlife–assuggestedbytheaboveexperimentalstudiescited–isn’tknown,andnoristheextenttowhichthesefoodcaringpracticesarefoundinpreschools.It’smostimportanttonotethatmanycommonstrategiessuchaspressuretoeatcertainfoodsortoeatlargerportions;offering‘bribes’offoodornon-fooditems,orissuingthreatsiffoodsarenottastedoreaten;restrictingchildren’sdiets;andmonitoringeating,areallcounterproductive.Indeed,manyareassociatedwithweightgain.Asummaryofpracticesthathelptofosterenjoymentandpositiveeatingpractices,andthosethatdon’t,isgivenintheinsetonthenextpage.Whoseresponsibility?Thesocialsurroundandfood’ssymbolicmeaningsNoconsiderationofchildren’slearningaboutfoodandeatingshouldfailtoaddresstheimpactoftheenvironmentinwhichchildrengrowup.Above,I’vementionedthatchildren’simmediatefoodenvironmentsaffecttheirlikingforsweetandstarchythings.Someconcludefromthisthatparentsareprimarilyresponsibleforcreatinghealthyfoodenvironments.YetitiscriticalalsotoconsiderthemarkedeconomicdeprivationinsomeareasofcountriessuchastheUK,wherequestionsofhealthyeatingtakeonadifferenthue.Lesshealthyfoodsareoftencheaperthanfruits,vegetablesandprotein-baseditems,andaremoreeasilyavailableincommunitieswhere‘fooddeserts’arecommon.Creatinghealthiermealsonlowbudgetsrequirescookingfacilitiesandskills.Wherepovertyisintergenerational,gapsinfamily

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practicescanbefurtherembedded.Recommendationsthatyoungchildrenbeexposedtofoodsmanytimesinordertosensitisethemtoitcanbeverychallenging,ifnotimpossibleforparentstoimplementwhenmoneyandfoodarescarce.Whenparentscannotriskachildrejectingameal,offeringfoodsthataresuretobeacceptedissafer(Harden&Dickson,2015),suchasstarchesandsweeterfoods.Moralitiesof‘healthychoices’,andtheroleofloveDespiteinnatepreferencesforsweet,salty,energy-densefoods,healthpolicytypicallyexpectschildrenandfamiliestosimplymake‘healthychoices’.Withoutignoringindividuals’agency,thecontextmustbeconsidered:simplisticattributionofblameonindividualparentsdoesn’treflecttherealityofcomplexsystemsthatpromoteobesityfrommoleculargeneticstomarketingeffects(Ralstonetal.,2018).Extensive,cheaper,powerfullyappealingoffersoflesshealthyfoodswhichchildreninnatelyprefer,aremadeconstantlyinretail,mediaandelsewhere.Notably,thesefoodsalsorepresentaffordableways–sometimestheonlyaffordableways–thatparentscanshowloveandcarethroughfood(Fielding-Singh,2017).Itisnecessarytorecognisesuchchild-rearingchallengesandtoconsiderwhatpreschoolsettingscanofferinpartnershipwithparentswho,forvariousreasons,facechallengeswiththeirchildren’seating.Whatcanpreschoolsdo?Preschooleducatorscanengageinsensitivefoodpedagogiesandpartnershipwithchildrenandparents.Itisimportanttorecognisethemanyindividual,family,environmentalandsocio-economicfactorsinfluencechildren’spreferencesandeating.Itisalsoimportanttoacknowledgethatrelyingonpreschoolsalonetoaddresslesshealthyeatingisunlikelytosucceed.Fewpreschoolinterventionshaveachievedweightreductions,thoughsomehaveincreasedfruitandvegetableeatingandnutritionrelatedknowledge.Still,somepracticesareeffectiveinpreschoolsettingsandcanplayanimportantroleinintroducingparentstonewpracticesandapproaches.Asummaryoffindingsfromrecentresearchisintheinsert.Twofurtherjust-publishedexamplesworthexploringinpreschoolsettingsare:• Picturebooksandtasteexposure:Parentsandchildren

aged21-24-monthslookedatpicturebookswithfruit,vegetables,ornofoodbook,fortwo-weeks,beforeallchildrenwereofferedthefruitandvegetabledailyfor14days.Inallgroups,tasteexposurealoneincreasedlikingofbothfoodsuptothree-monthslater.Notably,childrenwhoviewedvegetablebookslikedthevegetableandatemoreafterthree-months,alsoshowinglowerincreasesinfoodfussinessandneophobiathancontrols(Owen,Kennedy,Hill&Houston-Price,2018).

• • Sensory-basedfoodeducation:Inearlychildhoodsettings

(three-to-five-years)inFinland,thiswasassociatedwithincreasedwillingnesstochooseandeatvegetables,berriesandotherfruit;theassociationwasstrongeramongchildrenwhosemothershadalowlevelofeducation(Kähkönen,Rönkä,,Hujo,Lyytikäinen,&Nuutinen,2018).

Foodcaringpractices:Whathelps–andwhatdoesn’tAdultstendtofocusonrestrictions,pressuretoeat,rewardsandencouragementwhentheywantchildrentolearntoeatwell.Butchildrenlearnbywhattheysee–foodavailabilityandmodellingofeatingaremoreimportant• Pressuretoeataparticularfoodreducesliking

ofit.Maternalpressuretoeatfruitorvegetablesatone-yearpredictedlesseatingattwo-years.

• Overtrestrictionoffoodsincreasesfocusonthem,preferenceforthem,andlatereating(andisassociatedwithchildweightgainandoverweight).

• Food-basedrewardsforeatingdecreasepreferenceandenhancepreferenceforrewards.

• Smallnon-foodrewards(e.g.,stickers)mayhelpwithinitialneophobiabutshouldbeusedwithcaution.

‘Socialfacilitation’–Modellingofeating• Ifchildrenseesomeonetryandovertlyenjoy

anunfamiliarfood,theyaremorelikelytotryit.Thisalsoappliestounhealthyfoods!

• Modellingdislikeofspecificfoodscanalsoaffectchildren’spreferencesandwillingnesstotry

• Parentsandothercarersarestrongmodelsparticularlyintheearlieryears;

• Adultsmayexertastrongerinfluenceonyoungchildren;peersmayinfluenceolderchildrenmore

Availability,accessibility,preparationandserving• Freelyaccessiblefruitsandvegetablesmayhave

long-termpositiveeffectsoneating(thoughindicatedbyfewstudies);

• Preparationandservingstyleinfluencechildren'sintakeandliking.

Carerscanencouragehealthyeatingby• neverusingunhealthyfoodsasrewardsorfor

emotionalregulation;• providinglargerportionsofhealthyfoodsand

smallerportionswithlessvarietyofunhealthyfoods;

• providingclearandhealthyrulesaboutwhenandwhatcanbeeaten;

• avoidingconsumptionof‘junkfood’,butnotdoingsoovertly;

• activelymodellingeatingofhealthyfood,eatinghealthyfoodthemselvesandshowingenjoymentwhendoingso;

• facilitatingchildren’srepeatedexposuretonewflavours–upto15mayberequired.

(Blissett&Fogel,2013;DeCostaetal.,2017;Fiese&Bost,2016;Fildesetal.,2014;Larsenetal.,2015)

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Recommendations1.UnderstandfoodpreferencesanddevelopmentEatinginvolvesstrongpersonalpreferencesthatareinnate,andlearningfromthefoodenvironmentsandpeoplearoundus.Mostchildrencananddolearntolikemostfoodsintheseearlyyearsorlater,andcarersshouldexpectthattheywill.Thefollowingbehavioursaretobeexpectedfromyoungchildren:pronouncedfoodpreferencesanddislikes;tasteandtexturesensitivities;reducedappetiteoncegrowthslows;periodsofrejectingfoods;andassertingautonomyabouteating.Thesedonotnecessarilyreflectonchildrenorparents,thoughallcarerscanavoidescalationsthroughcarefulfoodpracticesandbyagreeinghowfoodisprovidedinthehomeandeducationenvironments.2.Offer,share,enjoyhealthierfoodsSomefoodcaringpracticesarecounterproductiveandcanthemselvescausefussyeating.Workinginpartnershipwithparentstocareforchildrendifferentlyinvolvesapplyingtheknowledgethatchildrenbestlearntoeatnewfoods:• whentheseareeasilyandfrequentlyavailable;• whenadultsshowchildrentheyeatthesefoodsandenjoy

them(modelling);• whenadultsoffermanyopportunitiestoencountersuch

foodsintheirenvironmentsandinbooks;and• whenadultsoffermanyopportunitiestotastethem(upto

15times)inanon-stressfulsetting.

3.Contributetochildren’shealthyenvironmentsTonormalisehealthiereating,a‘wraparound’approachisrequired,ensuringwidespreadavailability,opportunitiestotaste,andaffordabilityofhealthierfoods.Theextensivepromotionofunhealthyfoodsinourenvironmentsmustbeaddressed.It’salsocrucialthatanypublichealtheducationaddressestheroleofthewiderenvironmentinfoodandeatingpractices,andthatitalsounderstandstherolethatfoodplaysinloveandcaring.Muchofwhatneedschangingrequireslocal,cityandnationalgovernmentintervention.Butpreschoolscansupportchildrenandtheirfamiliestogrownot-too-big,verystrong,anddefinitelyhealthy,byengagingintheevidence-basedstrategiesoutlinedabove,soparentscanthentrythesestrategiestoo:• modellingeatingandenjoyment;• ensuringavailabilityofhealthierfoods;• educatingchildrenaboutfoods;and• offeringyoungchildrenmanyopportunitiestotaste.

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