Effectiveness of a kindergarten-based intervention to increase vegetable intake and reduce food neophobia amongst 1-year-old children: a cluster randomised controlled trial.

BACKGROUND: Children's first years of life are crucial to their future health. Studies show that a varied diet with a high intake of vegetables is positive in several domains of health. The present low vegetable intake amongst children is, therefore, a concern. Food neophobia is a common barrier to vegetable intake in children. As most Norwegian children attend kindergarten from an early age, kindergartens could contribute to the prevention of food neophobia and the promotion of vegetable intake. OBJECTIVE: The aim of this study was to assess the effect of a cluster randomised trial amongst 1-year-old children in kindergarten to reduce food neophobia and promote healthy eating. METHODS: Kindergartens were randomly allocated to either a control group or one of two intervention groups. Both intervention groups (diet and diet + Sapere-method) were served a warm lunch meal including three alternating intervention vegetables, whilst the intervention group 2 (diet + Sapere) in addition received tools for weekly sensory lessons. The intervention was digitally administered via information and recipes on a study website. The control group did not receive any information. Parents completed digitally distributed questionnaires addressing food neophobia and food habits at baseline and post-intervention. RESULTS: The parents of 144 1-year-old children in 46 kindergartens completed the questionnaires, which were included in the main analysis. The results suggested a higher intake of the intervention vegetables in group 2 (diet + Sapere) compared to the control group. The effect on total vegetable intake was inconclusive. No effect was observed on the level of food neophobia in either of the intervention group. CONCLUSION: This digitally delivered dietary and sensory intervention promoted the intake of intervention-targeted vegetables with inconclusive effect on total vegetable intake due to large loss to follow-up. No effect on the level of food neophobia was detected.

Associations between breastfeeding mode and duration and food neophobia in toddlerhood: A cross-sectional study among Norwegian toddlers.

BACKGROUND: Research on the association between breastfeeding duration and food neophobia is inconclusive. Breastfeeding and measures to reduce food neophobia are highly recommended to ensure a healthy diet early in life. OBJECTIVE: The aim of this study was to evaluate the association between breastfeeding duration and food neophobia in young Norwegian children. DESIGN: Participants (n = 246) were recruited through kindergartens in four Norwegian counties in 2017. The parents of 1-year-olds filled in questionnaires, including standardized questions on breastfeeding and food neophobia. Cross-sectional results are presented. Comparisons of child neophobia score at 16 months of age according to breastfeeding status at various timepoints during infancy were explored in linear regression models adjusted for maternal education and parental food neophobia. RESULTS: Still being breastfed at 12 months and being exclusively breastfed at 5 months were independently associated with slightly higher food neophobia score at the mean age of 16 months compared to shorter duration of breastfeeding. We found no other associations between breastfeeding duration and child food neophobia. DISCUSSION: Our study adds to the somewhat scarce literature regarding associations between breastfeeding mode and duration and later food neophobia; some literature shows protective relations between breastfeeding and food fussiness, and others report opposite or null findings. CONCLUSION: We found that both being breastfed at 12 months and being exclusively breastfed at 5 months were independently associated with slightly higher food neophobia score at the mean age of 16 months compared to shorter duration of breastfeeding. As the data are derived from a cross-sectional study, these findings should be interpreted with caution.

Diet and Neurodevelopmental Score in a Sample of One-Year-Old Children-A Cross-Sectional Study.

Environmental factors in the first years of life are crucial for a child's neurodevelopment. Research on the association between breastfeeding and neurodevelopment is inconclusive, while research on the possible association between other dietary factors and neurodevelopment is inadequate in children as young as one year of age. The aim of the present study was to investigate associations between both breastfeeding and other dietary factors and the neurodevelopment of one-year-old children in Norway. METHODS: Participants were recruited from kindergartens in four Norwegian counties in 2017. A questionnaire including questions about dietary factors and breastfeeding, and a standardised age-related questionnaire on neurodevelopment (the Ages and Stages Questionnaire), were completed by parents of one-year-olds. Linear regressions adjusting for relevant covariates were conducted to explore the associations. RESULTS: In our sample of 212 one-year-old children, a longer duration of breastfeeding was associated with higher neurodevelopmental scores. Dietary intake of fish, fruits and vegetables was also strongly associated with higher neurodevelopmental scores, even after adjustment for breastfeeding and maternal education. CONCLUSION: Our results indicate that healthy dietary factors are important for neurodevelopment in young children, with measurable effects already at the age of one year.

A cluster randomized web-based intervention trial to reduce food neophobia and promote healthy diets among one-year-old children in kindergarten: study protocol.

BACKGROUND: A child's first years of life are crucial for cognitive development and future health. Studies show that a varied diet with a high intake of vegetables is positive for both weight and cognitive development. The present low intake of vegetables in children's diets is therefore a concern. Food neophobia can be a barrier for vegetable intake in children. Our hypothesis is that interventions that can increase children's intake of vegetables should be introduced early in life to overcome children's neophobia. This study aims to develop, measure and compare the effect of two different interventions among one-year-old children in kindergartens to reduce food neophobia and promote healthy diets. METHODS: The kindergartens are randomized to one of three groups: two different intervention groups and one control group. We aimed to include a total of 210 children in the study. The first intervention group will be served a warm lunch meal with a variety of vegetables, 3 days a week during the intervention period of 3 months. The second intervention group will be served the same meals and, in addition, kindergarten staff will be asked to implement pedagogical tools including sensory lessons, adapted from the Sapere method, and advices on meal practice and feeding practices. The control group continues their usual meal practices. Parents and kindergarten staff will complete questionnaires regarding food neophobia, food habits and cognitive development at baseline and post intervention. A similar intervention among 2-year-old children in kindergarten has been implemented and evaluated earlier. We will investigate whether a digital version of this intervention has an effect, because digital interventions can be easily implemented nationwide. We will also investigate whether there are benefits of conducting such interventions in younger children, before the onset of food neophobia. Questionnaires, information videos and recipes will be digitally distributed. DISCUSSION: Results of this study will provide new knowledge about whether a sensory education and a healthy meal intervention targeting children, kindergarten staff and parents will reduce levels of food neophobia in children, improve parental and kindergarten feeding practices, improve children's dietary variety, improve children's cognitive development and reduce childhood overweight. TRIAL REGISTRATION: ISRCTN98064772 .