Elsevier

Food Quality and Preference

Volume 52, September 2016, Pages 172-178
Food Quality and Preference

Associations between appetitive traits and food preferences in preschool children

https://doi.org/10.1016/j.foodqual.2016.04.006Get rights and content

Highlights

  • Only some appetitive traits predicted children’s food preferences.

  • Fussiness predicted all measures of food preferences.

  • Enjoyment of Food predicted liking of vegetables, meats and variety.

  • Food Responsiveness predicted preferences for non-core foods and vegetables.

Abstract

Background

The ways in which children eat, their appetitive traits, are associated with their food intakes and weight status yet it is unclear whether they also relate to food preferences.

Methods

A cross-sectional self-report survey administered in two Australian cities. Food preferences were grouped according to the Australian Guide to Healthy Eating and a summary measure of healthiness, the Healthy Preference Index, was constructed. Bi-variate and multiple linear analyses examined relationships between each of the CEBQ dimensions and between the CEBQ dimensions and children’s food preferences (P < 0.05).

Results

In total, 371 parents of children aged 2–5 years (response rate 53.5%) participated. The models explained approximately 32% of the variance in children’s Healthy Preference Index scores and 42% of the variance in preferences for vegetables. CEBQ dimensions Fussiness, Enjoyment of Food and Food Responsiveness were significant predictors of several of the food preference measures in linear regression analyses. Fussiness predicted all of the measures of food preferences, explaining a large proportion of the variance in such measures (ranging from 23% to 59%). Enjoyment of Food predicted greater liking of Vegetables and Meats as well as a higher Variety Index score. Food Responsiveness was associated with greater preferences for non-core Extra Foods, and reduced preferences for Vegetables. None of the other CEBQ dimensions meaningfully associated with children’s food preferences.

Conclusions

Of the eight CEBQ subscales, children’s Fussiness, Enjoyment of Food and Food Responsiveness predicted food preferences. Some, but not all, of the CEBQ subscales appear to be meaningful predictors of children’s food preferences.

Introduction

Given the high prevalence of overweight and obesity (Australian Bureau of Statistics, 2014, de Onis et al., 2010, Ogden et al., 2012, Olds et al., 2010) and patterns of poor food intakes in young children (Commonwealth Scientific Industrial Research Organisation and University of South Australia, 2007, Cowin et al., 2000, Siega-Riz et al., 2010) investigation of the factors that affect children’s food intakes is a public health priority. To improve the efficacy of interventions targeting children’s eating, which have been only moderately successful to date, (Hung et al., 2015, Laws et al., 2014, Wake and Lycett, 2014) a comprehensive understanding of what affects children’s diets is required. One important behavioral characteristic affecting children’s eating and weight that has largely been overlooked in health interventions is appetitive traits: how a child eats.

Appetitive traits influence food intakes and weight by affecting when and where individuals eat, the initiation and termination of eating and the types and amounts of foods consumed. (Carnell and Wardle, 2009, French et al., 2012). Wardle and colleagues (Wardle, Guthrie, Sanderson, & Rapoport, 2001) developed the Children’s Eating Behavior Questionnaire (CEBQ) as a means of quantitatively studying children’s non-clinical appetitive traits. The CEBQ has eight dimensions representing food approach (i.e. Enjoyment of Food, Emotional Overeating, Food Responsiveness, Desire to Drink) and food avoidance (i.e. Satiety Responsiveness, Slowness in Eating, Emotional Undereating and Fussiness) styles.

Appetitive traits are associated with children’s dietary intakes (Cooke et al., 2004, Sweetman et al., 2008) and eating patterns (Syrad, Johnson, Wardle, & Llewellyn, 2016). For instance, in 2–6 year old British children the Enjoyment of Food CEBQ subscale positively associated with fruit and vegetables intakes (Cooke et al., 2004), whilst in a study of older British children (mean age 11 years), the Desire to Drink CEBQ subscale was positively associated with higher intakes of soft drinks (Sweetman et al., 2008). Some CEBQ subscales are also associated with children’s energy intakes and weight status (Carnell and Wardle, 2008, Parkinson et al., 2010, Spence et al., 2011, Viana et al., 2008, Webber et al., 2008) even when controlling for possible confounders such as parental BMI and socio-economic disadvantage (Jansen et al., 2012), although there are exceptions (Powers et al., 2006, Svensson et al., 2011). In one study, for instance lower Satiety Responsiveness and higher Food Responsiveness predicted children’s higher weight status (Carnell & Wardle, 2008). Given the growing body of work now attesting to the importance of appetitive traits as predictors of children’s weight and food intakes, it is relevant to understand further the mechanisms that may explain this.

Children’s food preferences (i.e. food likes and dislikes) are one of the most significant influences on children’s food intakes amongst available foods (Benton, 2004) and, importantly, they can be shifted to healthier patterns with public health intervention (Lowe, Horne, Tapper, Bowdery, & Egerton, 2004). The reasons why children’s appetitive traits may associate with food preferences are twofold. Firstly, both children’s appetitive traits and food preferences and may share a common genetic architecture {Fildes, van Jaarsveld, Cooke, Wardle, & Llewellyn, 2016 #1938; Dubois et al., 2013 #1672}. The second pathway is via children’s food experiences. In particular, one avenue through which children’s appetitive traits may affect their food experiences is via the influence they have on parents’ feeding strategies. Children with higher food approach tendencies have parents who use more restriction and parents of children with higher food avoidance tendencies have parents who use more pressure in feeding (Jani et al., 2015, Webber et al., 2010). This is important because the ways in which parents feed children has effects on their food preferences. For example, pressuring children to consume foods can reduce subsequent liking for the pressured food while restriction increases preference {Johnson, 2016 #1986}.

There is recent evidence that children’s appetitive traits are in fact related to particular patterns of food preferences: Fildes et al. (Fildes et al., 2015) examined links between CEBQ scores and children’s preferences for fruits, vegetables and non-core foods and showed that several associations between the CEBQ dimensions and children’s food preferences, although not always in expected directions. In that study, children’s vegetable preferences were associated with higher Enjoyment of Food and lower Satiety Responsiveness, Slowness in Eating and Food Fussiness. Preferences for non-core foods were associated with Food Responsiveness and Enjoyment of Food and not the other CEBQ dimensions.

While this research indicates that children’s appetitive traits can be associated with their food preferences, data on associations between the CEBQ dimensions and other aspects of children’s food preferences (e.g. variety), and in other samples are needed to further explore and understand relationships between children’s appetitive traits and patterns of food preferences. From a public health perspective, information on relationships between appetitive traits and food preferences would aid in the development of strategies to attempt to modify appetitive traits and/or how parents react to them. For example, it may be important to provide parents of children high in either food approach or food avoidance tendencies with tailored support and information on how to feed such children to promote the further development of healthy food preferences and intakes. The aim of the present study was therefore to provide evidence on associations between children’s appetitive traits as measured by the CEBQ and patterns of food preferences in a group of pre-school aged children.

Section snippets

Participants

Parents of children aged 2–5 years were approached at various locations (e.g. preschools, child care centres, swim centres) in Melbourne (44.20%) and Adelaide (55.80%), Australia, to participate in the study. Parents were provided with a consent form, plain language letter and reply-paid envelope. In order to recruit a diverse sample, centres were selected in low, middle and high socio-economic areas which was achieved by ranking all of the suburbs in the two cities by the 1998 Socio-Economic

Participants

A total of 371 usable questionnaires was returned after exclusion of those with greater than 10% of food preference data missing, representing a response rate of 53%. Ninety per cent of the respondents were mothers or female caregivers. The mean age of the respondents was 36.0 years (SD ± 5.00) and the children were aged between 2 and 5 years (mean 3.7 SD ± 0.88 years). Most (96%) usually spoke English at home and 83% were Australian-born. Just over half of respondents were tertiary-educated (56%), a

Discussion

The models explained approximately 32% of the variance in children’s Healthy Preference Index scores, 42% of the variance in preferences for vegetables and legumes and 20% of children’s preferences for the non-core food group. Fussiness was linked with children’s food preferences in several ways, mostly negative, but was also linked with children’s lower liking for non-core foods. Enjoyment of Food was linked with patterns of food preferences consistent with dietary recommendations whilst Food

Conclusions

The appetitive traits Fussiness, Food Responsiveness and Enjoyment of Food were associated with children’s food preferences in meaningful ways. Only some appetitive traits, then, appear to associate with children’s food preferences. The findings provide insights into the mechanisms linking appetitive traits with children’s weight status and food intakes and possibly new intervention targets to promote optimal diets in children. Further research is needed with appropriate tools to test when, how

Competing interests

The authors have no competing interests to declare.

Authors’ contributions

CG Russell and A Worsley conceptualized and designed the study, drafted the initial manuscript, and approved the final manuscript as submitted.

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    The research was conducted at Deakin University Centre for Physical Activity and Nutrition Research, Deakin University, 221 Burwood Hwy, Burwood 3125, Australia.

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