Child Involvement in Choosing a Recipe, Purchasing Ingredients, and Cooking at School Increases Willingness to Try New Foods and Reduces Food Neophobia.

OBJECTIVE: To investigate the effect of involving children in their feeding process (choosing a recipe, purchasing the ingredients, and cooking) on their lunch food choice in a school environment. DESIGN: Quasi-experimental. SETTING: Two schools in Bilbao, Spain. PARTICIPANTS: A total of 202 children (aged 8-9 years) participated in the study (43% girls), with 99 in the nutrition education (NE) group and 103 in the hands-on (HO) group. INTERVENTION: Three 1-hour workshops (1 workshop/wk), different for each group: HO, cooking-related activities, and NE, healthy habits promotion through nutrition education activities. MAIN OUTCOME MEASURES: Food neophobia, diet quality, cooking self-efficacy and attitudes toward cooking, and food intake and selection of the experimental lunches. ANALYSIS: Chi-square test of independence, ANCOVA, and t tests were performed. RESULTS: Students from the HO group selected and ate more spinach/broccoli (P < 0.001 and P = 0.02, respectively) for the first lunch; and selected more spinach/broccoli (P = 0.04) for the second lunch. After the intervention, improvements were observed for spinach liking and neophobia for the HO group and cooking self-efficacy and KidMed score for both groups. CONCLUSIONS AND IMPLICATIONS: Both interventions succeeded in improving children's diet quality, but only the HO group reduced food neophobia levels. Therefore, involving children in choosing a recipe, purchasing ingredients, and cooking may promote changing eating behaviors toward healthy habits such as increasing vegetable consumption.

Art on a Plate: A Pilot Evaluation of an International Initiative Designed to Promote Consumption of Fruits and Vegetables by Children.

OBJECTIVE: To evaluate the 2016 International Chefs Day cooking workshops Art on a Plate. DESIGN: Nonexperimental pretest-posttest design SETTING: Art on a Plate workshops with children from 14 countries in Asia, America, and Europe. PARTICIPANTS: A total of 433 workshop participants aged 4-14 years (mean age, 8.6 years). INTERVENTION: Instructed by a chef, children in the workshops created a self-chosen design on their plate with a spinach-fruit salad. MAIN OUTCOME MEASURES: Before and after the workshop, a questionnaire assessing liking and willingness to eat or taste; hunger was assessed using the Teddy the Bear method and emotions were assessed using the Self-assessment Manikin. The event coordinator evaluated salad intake. ANALYSIS: Linear and generalized linear (logit) mixed models were used to test statistical differences before and after the workshop. RESULTS: The workshop resulted in a small increase in liking (n = 409; P = .02) and person control (n = 375; P < .001) and a decrease in hunger (n = 379; P < .001). A total of 30% of children increased their liking scores, 18% decreased them, and 52% did not change them. Significant associations of liking and change in liking with salad intake were in the expected direction. CONCLUSION AND IMPLICATIONS: This study showed the positive effect of a cooking workshop on children's salad liking across a selection of countries worldwide. Further research and novel methods are needed to evaluate the long-term effectiveness of cooking activities in real-life settings across countries.

Direct Experience While Eating in a Sample With Eating Disorders and Obesity.

Background: Individuals with eating disorders might be characterized by lower levels of direct engagement with the eating experience. This study aims to explore similarities and differences in direct experience while eating in four different weight conditions and healthy controls (HCs): anorexia nervosa (AN), bulimia nervosa (BN), eating disorders not otherwise specified (EDNOS), and obesity (OB). Methods: A total sample of 143 women were recruited. Participants were asked to eat an orange slice and write down 10 things about the experience of eating, classifying the focus of these thoughts as either experiential ("direct experience") or analytical ("thinking about"). A direct experience index (DEI) was calculated by dividing the number of times a participant classified an experience as a "direct experience" (the numerator) by the total number of observations. Participants completed the Five Facet Mindfulness Questionnaire (FFMQ) and rated their level of anxiety after the task. Results: Between-groups significant differences were found on the DEI, with individuals in the OB group scoring higher than AN and BN, and similar to HC. After the task, the AN group reported significantly higher anxiety levels than HC, and EDNOS reported more anxiety than HC and OB. Between-group significant differences were also found for all the FFMQ facets. Conclusion: AN and BN presented lower access to direct experience while eating. Individuals with OB did not respond in the same way as the other clinical groups, showing a similar performance to HC.

La importancia de involucrar a niños y niñas en la preparación de las comidas / The importance of involving boys and girls in food preparation

La neofobia alimentaria infantil se asocia normalmente a un menor consumo de frutas y verduras, y esto último se relaciona con una dieta menos saludable. Se han llevado a cabo diferentes tipos de programas con el objetivo de reducir la neofobia alimentaria y aumentar así la ingesta de frutas y verduras en la infancia. Entre ellos, los de educación sensorial han mostrado su eficacia. Por otro lado, los diversos programas nutricionales que incluyen actividades de huerto y preparación de alimentos se utilizan con el mismo fin. No obstante, la heterogeneidad de los programas y de sus evaluaciones dificultan llegar a conclusiones sólidas sobre su efectividad. Se han llevado a cabo diversos estudios experimentales para determinar el efecto de cada una de las etapas de la preparación de alimentos por separado: la elección de la receta, la compra de los alimentos, su cocinado y su emplatado. Si bien los resultados son prometedores, es necesario realizar estudios en entornos reales para validar dichos experimentos. Un ejemplo es el proyecto EgizuSUK, llevado a cabo en el ámbito escolar y que engloba diferentes sesiones que trabajan las etapas del proceso de alimentación y cuyos resultados, comparados con un grupo control, parecen estar en línea con los estudios experimentales. Finalmente, y con el objetivo de promover una alimentación saludable en la población infantil, se considera necesario que los programas incluyan elementos de educación nutricional y educación sensorial, así como de habilidades culinarias. Además, tener en cuenta el entorno escolar y el contexto familiar es clave para el adecuado desarrollo de dichos programas

Child food neophobia is usually associated with a lower consumption of fruits and vegetables, and the latter, is related to a less healthy diet. Different types of programs have been conducted in order to reduce food neophobia and thus increase the intake of fruits and vegetables in childhood. Among them, sensory education programs have shown their effectiveness. On the other hand, various nutritional programs that include garden and food preparation activities are used for the same purpose. However, the heterogeneity of programs and their evaluations, make it difficult to reach firm conclusions about its effectiveness. Several experimental studies have been conducted to determine the effect of each of the stages of preparing food separately: the selection of the recipe, the purchase of food, cooking and the presentation of the plate. While the results are promising, it is necessary to realize studies in real environments to validate such experiments. An example is the EgizuSUK project, carried out at schools and that encompasses different sessions that involve children in the different stages of the preparation of new foodstuffs, and whose results, compared with a control group, seem to be in line with the experimental studies. Finally, in order to promote healthy eating in children, it is considered that programs should include elements of nutrition education, sensory education, as well as culinary skills. In addition, school setting as well as the family context should be taken into consideration as key elements in the development of such programs

[The importance of involving boys and girls in food preparation]. / La importancia de involucrar a niños y niñas en la preparación de las comidas.

Child food neophobia is usually associated with a lower consumption of fruits and vegetables, and the latter, is related to a less healthy diet. Different types of programs have been conducted in order to reduce food neophobia and thus increase the intake of fruits and vegetables in childhood. Among them, sensory education programs have shown their effectiveness. On the other hand, various nutritional programs that include garden and food preparation activities are used for the same purpose. However, the heterogeneity of programs and their evaluations, make it difficult to reach firm conclusions about its effectiveness. Several experimental studies have been conducted to determine the effect of each of the stages of preparing food separately: the selection of the recipe, the purchase of food, cooking and the presentation of the plate. While the results are promising, it is necessary to realize studies in real environments to validate such experiments. An example is the EgizuSUK project, carried out at schools and that encompasses different sessions that involve children in the different stages of the preparation of new foodstuffs, and whose results, compared with a control group, seem to be in line with the experimental studies. Finally, in order to promote healthy eating in children, it is considered that programs should include elements of nutrition education, sensory education, as well as culinary skills. In addition, school setting as well as the family context should be taken into consideration as key elements in the development of such programs.

La neofobia alimentaria infantil se asocia normalmente a un menor consumo de frutas y verduras, y esto último se relaciona con una dieta menos saludable. Se han llevado a cabo diferentes tipos de programas con el objetivo de reducir la neofobia alimentaria y aumentar así la ingesta de frutas y verduras en la infancia. Entre ellos, los de educación sensorial han mostrado su eficacia. Por otro lado, los diversos programas nutricionales que incluyen actividades de huerto y preparación de alimentos se utilizan con el mismo fin. No obstante, la heterogeneidad de los programas y de sus evaluaciones dificultan llegar a conclusiones sólidas sobre su efectividad.Se han llevado a cabo diversos estudios experimentales para determinar el efecto de cada una de las etapas de la preparación de alimentos por separado: la elección de la receta, la compra de los alimentos, su cocinado y su emplatado. Si bien los resultados son prometedores, es necesario realizar estudios en entornos reales para validar dichos experimentos. Un ejemplo es el proyecto EgizuSUK, llevado a cabo en el ámbito escolar y que engloba diferentes sesiones que trabajan las etapas del proceso de alimentación y cuyos resultados, comparados con un grupo control, parecen estar en línea con los estudios experimentales.Finalmente, y con el objetivo de promover una alimentación saludable en la población infantil, se considera necesario que los programas incluyan elementos de educación nutricional y educación sensorial, así como de habilidades culinarias. Además, tener en cuenta el entorno escolar y el contexto familiar es clave para el adecuado desarrollo de dichos programas.

Shopping for food with children: A strategy for directing their choices toward novel foods containing vegetables.

Involving children in the different steps of meal preparation has been suggested as a strategy for enhancing dietary habits in childhood. It has previously been shown that involving children in cooking can increase their willingness to taste novel foods and direct their food choices towards foods containing vegetables. The objective of the present study was to assess the effect of involving children in food purchasing on food choices, intake, liking and appetite. A between-subject experiment was conducted with 86 children (from 8 to 10 years old). Forty-three children (PURCHASE group) participated in a workshop dedicated to purchasing the necessary ingredients online for the preparation of three unfamiliar foods containing vegetables: apple and beetroot juice, zucchini tortilla sandwich and spinach cookies. Forty-three children (CONTROL group) participated instead in a creativity workshop. Afterwards, all the children were invited to choose, for an afternoon snack, between three familiar vs. unfamiliar foods: orange vs. apple and beetroot juice, potatoes vs. zucchini tortilla sandwich and chocolate vs. spinach cookie. The mean number of unfamiliar foods chosen per child was higher in the PURCHASE (0.70 ± 0.14) vs. CONTROL (0.19 ± 0.07) group (P = 0.003). The liking for 1 of the 3 unfamiliar foods was higher in the PURCHASE group (P < 0.05). We did not find any difference between the two groups in food intake estimation and in the levels of subjective appetite. This study demonstrates that involving children in purchasing food can help in directing their food choices towards unfamiliar foods containing vegetables. It highlights the importance of involving children in the different steps of meal preparation for decreasing food neophobia.

Involving children in cooking activities: A potential strategy for directing food choices toward novel foods containing vegetables.

Involving children in cooking has been suggested as a strategy to improve dietary habits in childhood. Interventions in schools including cooking, gardening and tasting activities have showed promising results. Several cross-sectional surveys demonstrated associations between frequency of involvement in food preparation and better diet quality. However, experimental studies confirming the beneficial effect of cooking on food choices in children are missing from the literature. The objective of the present study was to assess the effect of involving children in cooking on their willingness to taste novel foods, food intake, liking and hunger. A between-subject experiment was conducted with 137 children between 7 and 11 years old. 69 children (COOK group) participated in the preparation of three unfamiliar foods containing vegetables: apple/beetroot juice, zucchini tortilla sandwich and spinach cookies. 68 children (CONTROL group) participated, instead, in a creative workshop. Afterwards, the children were invited to choose, for an afternoon snack, between three familiar vs. unfamiliar foods: orange vs. apple/beetroot juice, potato vs. zucchini tortilla sandwich and chocolate vs. spinach cookie. The mean number of unfamiliar foods chosen per child was higher in the COOK vs. CONTROL group (P = 0.037). The overall willingness to taste the unfamiliar foods was also higher in the COOK group (P = 0.011). The liking for the whole afternoon snack (P = 0.034), for 2 of 3 unfamiliar foods and for 1 of 3 familiar foods was higher in the COOK group (P < 0.05). We did not demonstrate any difference between the two groups in overall food intake and hunger/satiety scores. This study demonstrated that involving children in cooking can increase their willingness to taste novel foods and direct food choices towards foods containing vegetables.

Effects of a breakfast spread out over time on the food intake at lunch and the hormonal responses in obese men.

The effects of frequent eating on health and particularly on appetite and metabolism are unclear. We have previously shown that frequent eating decreased appetite and energy intake at the subsequent meal in lean men. In the present study, we tested the same pattern in obese subjects. Seventeen obese men participated in: (i) two sessions consisting of a breakfast consumed in one eating episode at T0 (F1), or in four isocaloric eating episodes at T0, T60, T120, and T180min (F4), followed by an ad libitum buffet (T240) in an experimental restaurant. Subjects rated their appetite throughout the sessions. (ii) two sessions consisting of the same breakfasts F1 and F4 in a Clinical Centre, followed by a standardized meal. Blood sampling was performed to study ghrelin, glucagon-like peptide-1 (GLP-1), and metabolic kinetics. Indirect calorimetry measurements were performed. After F4, at T240min, ghrelin concentration (P=0.03) and hunger ratings (P<0.001) were lower while GLP-1 concentration (P=0.006) and satiety ratings (P=0.02) were higher. In F4, subjects consumed at the buffet, less food in grams (P=0.04) and less energy from low energy dense foods (P=0.01), but total energy intakes were not different between conditions. In F4, the area under the curve was lower for insulin (P=0.02) and non-esterified fatty acids (NEFA) (P=0.03). Diet induced thermogenesis was reduced in F4 (P=0.03) between T0 and T240. Even if subjective and physiological data suggest a beneficial effect of frequent eating on appetite in obese men, no effect was demonstrated on energy intake. Moreover, the decrease in diet induced thermogenesis and lipolysis, reflected by NEFA profiles, could be deleterious on energy balance in the long run.

An isocaloric increase of eating episodes in the morning contributes to decrease energy intake at lunch in lean men.

The effects of increasing eating frequency on human health are unclear. This study used an integrated approach to assess the short-term consequences on appetite and metabolism. Twenty normal-weight men participated in: (i) two sessions consisting of a breakfast consumed in one eating episode at T0 (F1), or in four isocaloric eating episodes at T0, T60, T120, and T180 min (F4), and followed by an ecological ad libitum buffet meal (T240) designed in an experimental restaurant. Intakes were assessed for the whole buffet meal and for each temporal quarter of the meal. (ii) two sessions consisting of the same two breakfasts F1 and F4 in a Clinical Investigation Centre. Blood sampling was performed to study the kinetics of ghrelin, glucagon-like peptide-1 (GLP-1), glucose, insulin, triglycerides and non-esterified fatty acids (NEFA). Substrate oxidation was measured by indirect calorimetry. During each of the 4 sessions, participants rated their appetite throughout the experiment. After F4, at T240 min, GLP-1 concentration was higher (P=0.006) while ghrelin concentration and hunger ratings were lower (P<0.001). We showed a trend for subjects to consume less energy (-88±61 kcal, P=0.08) at the buffet after F4, explained by a decrease in lipid intake (P=0.04). Marked differences in consumption were observed during the last temporal quarter of the meal for total energy and lipid intake (P=0.03). Mixed models highlighted differences between F1 and F4 for the kinetics of glucose, insulin and NEFA (P<0.001). The area under the curve was lower for insulin (P<0.001) and NEFA in F4 (P=0.03). Diet induced thermogenesis was reduced in F4 (P<0.05). This study demonstrated the beneficial short-term effect of increasing eating frequency on appetite in lean men considering subjective, physiological and behavioral data. However, the loss of the inter-prandial fast was associated with an inhibition of lipolysis, reflected by NEFA profiles, and a decrease in energy expenditure.

Validation of a buffet meal design in an experimental restaurant.

We assessed the reproducibility of intakes and meal mechanics parameters (cumulative energy intake (CEI), number of bites, bite rate, mean energy content per bite) during a buffet meal designed in a natural setting, and their sensitivity to food deprivation. Fourteen men were invited to three lunch sessions in an experimental restaurant. Subjects ate their regular breakfast before sessions A and B. They skipped breakfast before session FAST. The same ad libitum buffet was offered each time. Energy intakes and meal mechanics were assessed by foods weighing and video recording. Intrasubject reproducibility was evaluated by determining intraclass correlation coefficients (ICC). Mixed-models were used to assess the effects of the sessions on CEI. We found a good reproducibility between A and B for total energy (ICC=0.82), carbohydrate (ICC=0.83), lipid (ICC=0.81) and protein intake (ICC=0.79) and for meal mechanics parameters. Total energy, lipid and carbohydrate intake were higher in FAST than in A and B. CEI were found sensitive to differences in hunger level while the other meal mechanics parameters were stable between sessions. In conclusion, a buffet meal in a normal eating environment is a valid tool for assessing the effects of interventions on intakes.

Determinants of overweight associated with stunting in preschool children of Yaounde, Cameroon.

BACKGROUND: Nutrition transition in developing countries has been associated with higher prevalence of overweight. AIM: The study aimed to identify the factors associated with concurrent stunting and overweight in urban preschool children of Yaounde, Cameroon. SUBJECTS AND METHODS: 169 preschool children of both sexes were recruited according to their nutritional status: Stunted, overweight, stunted-overweight, and non-stunted-non-overweight. Factors associated with concurrent stunting and overweight were investigated through interviewer-administered questionnaires. A binary logistic regression model was used to determine the relation between nutritional statuses and associated factors. RESULTS: A low-income family and a low maternal educational level are independent risk factors for a child to be stunted-overweight [odds ratios (95% CI): 3.81 (13.32-1.08), 2.90 (7.82-1.07), respectively]. Mother under-evaluation of child's weight is a factor associated with stunting-overweight and overweight in children [odds ratios (95% CI): 3.42 (8.72-1.33), 6.52 (18.09-2.34), respectively]. Being overweight is also related to higher birth weight. Unlike stunted children, stunted-overweight children live with both their parents and have an older mother. Short maternal stature and mother's over-evaluation of her child's height are independent factors associated with stunting. CONCLUSION: Poor preschool children of Yaounde are facing concomitant stunting and overweight. More studies are needed to better assess the impact of maternal factors.