Repeated Exposure to Low-Sodium Cereal Affects Acceptance but Does not Shift Taste Preferences or Detection Thresholds of Children in a Randomized Clinical Trial.

BACKGROUND: Although salt taste preference is malleable in adults, no research to date has focused on children, whose dietary sodium intake exceeds recommended intake and whose salt taste preferences are elevated. OBJECTIVE: This proof-of-principle trial determined whether 8-wk exposure to low-sodium cereal (LSC) increased children's acceptance of its taste and changed their salty and sweet taste preferences. METHODS: Children (n = 39; ages 6-14 y; 67% female) were randomly assigned to ingest LSC or regular-sodium cereal (RSC) 4 times/wk for 8 wk. The cereals, similar in sugar (3 g/cup compared with 2 g/cup) and energy content (100 kcal/cup) yet different in sodium content (200 mg sodium/cup compared with 64 mg sodium/cup), were chosen based on taste evaluation by a panel of children. Mothers completed daily logs on children's cereal intake. At baseline and after the exposure period, taste tests determined which cereal children preferred and measured children's most preferred amount of salt (primary outcomes), and most preferred amount of sucrose and salt taste detection thresholds (secondary outcomes). Repeated measures ANOVAs were conducted on primary and secondary outcomes, and generalized estimating equations were conducted on amount of cereal ingested at home over time. RESULTS: Both treatment groups accepted and ate the assigned cereal throughout the 8-wk exposure. There were no group × time interactions in salt detection thresholds (P = 0.32) or amount of salt (P = 0.30) and sucrose (P = 0.77) most preferred, which were positively correlated (P = 0.001). At baseline and after the exposure, the majority in both groups preferred the taste of the RSC relative to LSC (P > 0.40). CONCLUSIONS: Children showed no change in salt preference but readily ate the LSC for 8 consecutive weeks. Findings highlight the potential for reducing children's dietary salt intake by incorporating low-sodium foods in the home environment without more preferred higher-salt versions of these foods. This trial was registered at clinicaltrials.gov as NCT02909764.

Farm to Sensory Lab: Taste of Blueberry Fruit by Children and Adults.

The average American child eats fewer fruits than recommended. Although taste is the primary motivator for food intake among children, little research has systematically measured children's liking of fruit and determined whether their preferences differ from adults. We phenotyped 49 children and their mothers to determine: (1) their liking of the taste of 3 blueberry cultivars ("Arcadia," "Keecrisp," and "Kestrel") from 2 harvests for which total soluble solids were determined using a handheld Brix refractometer; (2) the association between liking and blueberry sugar content; and (3) the most preferred level of fructose, one of the primary sugars in blueberry fruit. Multiple methods, identical for all participants, assessed which cultivar they liked best. Dietary intake, determined via 24-h dietary recall, revealed most children (73%) and adults (92%) did not meet dietary guidelines for fruit intake. We found that during the 1st harvest, Keecrisp was sweeter by 4° Brix than either Arcadia or Kestrel and was the cultivar most preferred by both children and adults. For the 2nd harvest, mothers liked each of the cultivars equally, but children preferred Arcadia, which was 2° Brix sweeter than the other 2 cultivars. Like other sugars, children's most preferred concentration of fructose was significantly higher than that of adults. In sum, children appear to be more sensitive to smaller variations in sweetness than are adults. Identifying drivers of fruit preference and assessing children's liking for whole fruits are important steps in developing strategies to increase fruit consumption among children.

Personal Variation in Preference for Sweetness: Effects of Age and Obesity.

BACKGROUND: Use of nonnutritive sweeteners (NNSs), which provide sweet taste with few to no calories, has increased, but data on whether children's hedonic responses to NNSs differ from nutritive sugars or from adults' hedonic responses are limited. METHODS: Most preferred levels of sucrose and the NNS sucralose were determined via a forced-choice tracking procedure in 48 children, 7-14 years (mean = 10 years), and 34 adults. Each participant also rated the liking of these taste stimuli, as well as varying concentrations of aspartame on 3- and 5-point facial hedonic scales. Anthropometric measures were obtained, and motives for palatable food intake were assessed with the Palatable Eating Motives Scale (PEMS, adults) and Kids PEMS. RESULTS: While use of the 3-point scale showed no age-related differences in liking of sweeteners, the 5-point scale showed that more children than adults liked higher concentrations of sucrose, sucralose, and aspartame, and the tracking procedure showed that children most preferred higher concentrations of sucrose and sucralose than adults. Regardless of age, sweet preference did not differ between obese and nonobese participants and showed no association with motives for eating palatable foods. Children's body mass index z-scores were positively associated with social and conformity motive scores for eating palatable foods. CONCLUSION: Research should move beyond measures of variation in sweet taste hedonics to include identifying motives, and the physiological and psychological consequences of eating sweets, to shed light on what children are more vulnerable to develop unfavorable eating habits, increasing risk for obesity, and other diseases.

Variation in the TAS2R31 bitter taste receptor gene relates to liking for the nonnutritive sweetener Acesulfame-K among children and adults.

The nonnutritive sweetener (NNS) acesulfame potassium (Ace-K) elicits a bitter off-taste that varies among adults due to polymorphisms in a bitter taste receptor gene. Whether polymorphisms affect liking for Ace-K by children, who live in different sensory worlds, is unknown. We examined hedonic response to Ace-K among children compared to adults, and whether response was related to common variants of the TAS2R31 bitter taste receptor gene and to NNS intake. Children (N = 48) and their mothers (N = 34) rated liking of Ace-K, and mothers reported whether they or their children ever consume NNSs via questionnaire. Participants were genotyped for TAS2R31 variant sites associated with adult perception of Ace-K (R35W, L162M, A227V, and V240I). Regardless of age, more participants with 1 or no copies than with 2 copies of the TAS2R31 WMVI haplotype liked Ace-K (p = 0.01). NNS-sweetened products were consumed by 50% and 15% of mothers and children, respectively, with no association between intake and TAS2R31. The TAS2R31 WMVI haplotype was partly responsible for children's hedonic response to Ace-K, highlighting a potential role for inborn differences in vulnerability to overconsumption of Ace-K-containing products. Currently available methods to measure NNS intake yield crude estimates at best, suggesting self-reports are not reflective of actual intake.

Psychophysical Tracking Method to Measure Taste Preferences in Children and Adults.

The Monell two-series, forced-choice, paired-comparison tracking method provides a reliable measure of sweet taste preferences from childhood to adulthood. The method, which is identical for children, adolescents, and adults, is of short duration (< 15 min), does not rely on sustained attention or place demands on memory (which would yield spurious age differences), and minimizes the impact of language development, making this method amenable to the cognitive limitations of pediatric populations. In this whole-mouth tasting method, subjects are asked to taste (without swallowing) pairs of solutions of different sucrose concentrations and to point to the solution they prefer. Each subsequent pair contains the participant's preceding preferred concentration and an adjacent stimulus concentration. The procedure continues until the subject chooses either a given concentration of sucrose when paired with both a higher and a lower concentration, or the highest or lowest concentration two consecutive times. Subjects are prevented from reaching response criteria on the basis of first or second position bias by the two-series design of the method, which counterbalances the order of solution presentation within each pair between the series (the weaker concentration is presented first in Series 1, second in Series 2). The geometric mean of the two sucrose concentrations chosen in Series 1 and 2 is an estimate of the participant's most preferred level of sucrose. Sucrose preference as determined with this laboratory-based measure has been shown to be associated with preference for sugars in foods and beverages and with taste receptor genotype, family history of alcoholism, and race/ethnicity, as well as depressive symptomatology among pediatric populations. The method has real-world relevance and has been applied to determine most preferred level of other tastes (e.g., salt), making it a valuable psychophysical tool.

The development of sweet taste: From biology to hedonics.

From the age of 2 years, an American child is more likely to consume a sugar-sweetened product than a fruit or vegetable on any given day-a troubling statistic, given that food preferences are established early in childhood, as well as the strong association between this dietary pattern and increased risk of developing a number of chronic diseases. Here, we review the ontogeny and biopsychology of sweet taste, highlighting how a biological drive to prefer sweetness at high concentrations during childhood, which would have conferred an advantage in environments of scarcity, now predisposes children to overconsume all that is sweet in a modern food system replete with added sugars. We review the power of sweet taste to blunt expressions of pain and mask bad tastes in foods as well as factors that predispose some to consume high-sugar diets, including experiential learning and taste preferences driven in part by genetics. Understanding children's unique vulnerability to our current food environment, rich in both nutritive and nonnutritive sweeteners, is highlighted as a priority for future research to develop evidence-based strategies to help establish healthy dietary behaviors early in life.

Shifting human salty taste preference: Potential opportunities and challenges in reducing dietary salt intake of Americans.

Dietary salt reduction of Americans has been a focus of public health initiatives for more than 40 years primarily due to the association between high salt intake and development of hypertension. Despite past efforts, salt intake of Americans has remained at levels well above dietary recommendations, likely due in part to the hedonic appeal of salty taste. As such, in 2010 the Institute of Medicine suggested a strategy of gradual salt reduction of processed foods, the primary source of Americans' dietary salt intake, via an approach intended to minimize impact on consumer acceptability of lower-sodium foods. This brief review discusses the ontogeny and development of human salt taste preference, the role of experience in shifting salt preference, and sources of dietary salt. Our current understanding of shifting human salt taste preference is discussed within the context of potential opportunities for success in reducing dietary salt, and gaps in the research that both limit our ability to predict effectiveness of gradual salt reduction and that need be addressed before a strategy to shift salt preference can realistically be implemented.

The sweetness and bitterness of childhood: Insights from basic research on taste preferences.

In this article, we review findings from basic, experimental research on children that suggest that the liking of sweet and the dislike of bitter tastes reflect children's basic biology. Children are born preferring sweet tastes, which attract them to mother's milk and even act as an analgesic. They prefer higher levels of sweet than do adults, with preferences declining to adult levels during middle to late adolescence, which coincides with the cessation of physical growth. The level of sweetness most preferred by children has remained heightened relative to adults for nearly a decade, despite reductions in sugar, both consumed and in the food environment. In spite of these reductions, however, children's intake of sugar remains higher than that recommended by health organizations worldwide. In contrast to sweet taste, children dislike and reject bitter taste, which protects them from ingesting poisons. Although variation in bitter taste receptor genes such as TAS2R38 accounts for people's marked differences in perceptions of the same bitter-tasting compounds, basic research revealed that these genotype-phenotype relationships are modified with age, with children of the same genotype being more bitter sensitive than adults and the changeover occurring during mid-adolescence. This heightened bitter sensitivity is also evident in the taste of the foods (green vegetables) or medicines (liquid formulations of drugs) they dislike and reject. While bitter taste can be masked or blocked to varying degrees by sugars and salts, their efficacy in modulating bitterness is not only based on the type of bitter ligand but on the person's age. Children's heightened preference for sweet and dislike of bitter, though often detrimental in the modern food environment, reflects their basic biology. Increasing knowledge of individual variation in taste due to both age and genetics will shed light on potential strategies to promote healthier eating since chronic diseases derive in large part from poor food choice dictated by taste preferences, and will contribute to a new era of drug formulations designed especially for the taste palate of children.

Disruption in the Relationship between Blood Pressure and Salty Taste Thresholds among Overweight and Obese Children.

BACKGROUND: Prevalence of high blood pressure among American children has increased over the past 2 decades, due in part to increasing rates of obesity and excessive dietary salt intake. OBJECTIVE: We tested the hypothesis that the relationships among blood pressure, salty taste sensitivity, and salt intake differ between normal-weight and overweight/obese children. DESIGN: In an observational study, sodium chloride (NaCl) and monosodium glutamate (MSG) taste detection thresholds were measured using the Monell two-alternative, forced-choice, paired-comparison tracking method. Weight and blood pressure were measured, and salt intake was determined by 24-hour dietary recall. PARTICIPANTS/SETTING: Children aged 8 to 14 years (N=97; 52% overweight or obese) from the Philadelphia, PA, area completed anthropometric and blood pressure measurements; 97% completed one or both thresholds. Seventy-six percent provided valid dietary recall data. Testing was completed between December 2011 and August 2012. MAIN OUTCOME MEASURES: NaCl and MSG detection thresholds, blood pressure, and dietary salt intake. STATISTICAL ANALYSES: Outcome measures were compared between normal-weight and overweight/obese children with t tests. Relationships among outcome measures within groups were examined with Pearson correlations, and multiple regression analysis was used to examine the relationship between blood pressure and thresholds, controlling for age, body mass index z score, and dietary salt intake. RESULTS: NaCl and MSG thresholds were positively correlated (r[71]=0.30; P=0.01) and did not differ between body weight groups (P>0.20). Controlling for age, body mass index z score, and salt intake, systolic blood pressure was associated with NaCl thresholds among normal-weight children (P=0.01), but not among overweight/obese children. All children consumed excess salt (>8 g/day). Grain and meat products were the primary source of dietary sodium. CONCLUSIONS: The apparent disruption in the relationship between salty taste response and blood pressure among overweight/obese children suggests the relationship may be influenced by body weight. Further research is warranted to explore this relationship as a potential measure to prevent development of hypertension.