Examining preschoolers' nutrition knowledge using a meal creation and food group classification task: age and gender differences

Eating behaviours begin to develop during early childhood, but relatively little is known about preschoolers' nutrition knowledge. The current study examined age and gender differences in this knowledge using two tasks: food group classification and the creation of unhealthy, healthy and preferred meals. Sixty‐nine three‐ to six‐year‐old children were interviewed. Findings suggest that the healthy meals children created were lower in calories and fat than their preferred and unhealthy meals. Older children and girls had a larger discrepancy in the calorie/fat content of their healthy and unhealthy meals than younger children and boys, respectively. Children's created meals showed some dietary variety, but many children could not provide valid explanations for why they selected the foods they did. Children were better at classifying fruits and vegetables than foods from the grain and dairy group. This study highlights the utility of using ecologically valid measures to understand children's developing nutrition knowledge.     

Examining opportunities for promotion of healthy eating at children's sports clubs

Objective: Australian data indicate that 63% of children participated in sport in 2009, a 4% increase since 2000. Children's high participation in sport, and the association between sport and health, means that these settings provide an opportunity to promote other aspects of health, such as healthy eating, to children. This study aimed to determine healthy eating practices and policies at children's sports clubs. Methods: Sports clubs (n=108) for the nine most popular sports for children aged 5 to 14 were randomly sampled from three large geographical areas across one state and one territory in Australia. A purpose‐designed telephone questionnaire for sports club officials was developed to determine the food and beverages sold, provided and promoted at sports clubs and the availability of healthy‐eating policies. Results: The most frequently sold item at canteens was water, followed by sports drinks, chocolate/confectionery and soft drink. Only 20% of canteens promoted healthy food. Thirty‐nine per cent of clubs made recommendations on the food and beverages to be consumed during sport, mostly relating to water consumption. The majority (76%) engaged in fundraising; many in collaboration with chocolate/confectionery companies. Only three clubs had a written policy on healthy eating. Conclusion: Addressing the low uptake of healthy eating policies would be a useful strategy to improve the healthiness of sports clubs. Implications: Policies could seek to reduce the availability and promotion of unhealthy food and beverages through canteens, vending machines and fundraising.     

Children's eating behavior: the importance of nutrition standards for foods in schools

BACKGROUND: To enhance the impact of school nutrition programs on children's health, more information is needed on the associations between healthy and unhealthy food offerings during school lunch periods and children's eating behavior. The purpose of this study is to evaluate the contributions of food offerings and participation in school lunch programs on children's overall (both in‐ and out‐of‐school) eating behavior. METHODS: A cross‐sectional observational study was conducted in which 2039 students in 12 elementary and 10 middle schools reported their eating behavior and the frequencies with which they purchased meals and à la carte items in the school cafeteria. Food service managers from each school provided information on the availability of foods and beverages during school lunch periods. Multilevel regression analyses were conducted to identify school‐ and student‐level predictors of children's eating behavior. RESULTS: The availability of nutritious foods during school lunch periods was associated with healthier eating behavior among students. However, this effect was observed only among children who infrequently purchased à la carte food items, and not among those who were frequent purchasers. CONCLUSION: Increased availability of fruits, vegetables, whole grains, and low‐fat dairy products as components of school meals may be an effective strategy to promote healthy eating behaviors among children. Improving the nutrition standards for foods offered in competition with federally reimbursable school meals may enhance the positive effects of school meal programs on student eating behavior.     

Opening up Australian preschoolers' lunchboxes

Objective: Early childhood services have been identified as key settings for promoting healthy eating and obesity prevention. However, little is known about the obesity‐related behaviours of preschool‐aged children or food‐related policies in these settings. The purpose of this study was to describe the contents of preschoolers' lunchboxes to inform future interventions. Methods: Cross‐sectional survey of 259 children attending preschools in the Sydney West and Sydney South West regions of New South Wales in 2008. Lunchbox data were collected using a purpose‐designed audit tool. Food and beverages were classified as fruit, vegetables, dairy, breads and cereals, ‘extra’ (energy‐dense) foods, ‘extra’ drinks or water. Results: Sandwiches and home‐cooked meals were the most frequently identified food item, found in 92% of children's lunchboxes, followed by fresh fruit. However, 60% of lunchboxes contained more than one serve of extra food or drink. Conclusion: While nutrition guidelines allow one to two serves of extra foods per day for preschool‐aged children, the majority of children appear to consume most of this allocation during their school day, potentially contributing to over‐consumption of extra foods and excess kilojoule intake. Implications: Preschool food policies may help to guide the content of children's lunchboxes, however this study emphasises the need for better communication and enforcement of these policies, as well as broader public policy changes.     

The commercial food landscape: outdoor food advertising around primary schools in Australia

Objective: Food marketing is linked to childhood obesity through its influence on children's food preferences, purchase requests and food consumption. We aimed to describe the volume and nature of outdoor food advertisements and factors associated with outdoor food advertising in the area surrounding Australian primary schools. Methods: Forty primary schools in Sydney and Wollongong were selected using random sampling within population density and socio‐economic strata. The area within a 500m radius of each school was scanned and advertisements coded according to pre‐defined criteria, including: food or non‐food product advertisement, distance from the school, size and location. Food advertisements were further categorised as core foods, non‐core foods and miscellaneous drinks (tea and coffee). Results: The number of advertisements identified was 9,151, of which 2,286 (25%) were for food. The number of non‐core food advertisements was 1,834, this accounted for 80% of food advertisements. Soft drinks and alcoholic beverages were the food products most commonly advertised around primary schools (24% and 22% of food advertisements, respectively). Non‐core food products were twice as likely to be advertised close to a primary school (95 non‐core food advertisements per km 2 within 250 m vs. 46 advertisements per km 2 within 250–500 m). Conclusions: The density of non‐core food advertisements within 500 m of primary schools, and the potential for repeated exposure of children to soft drink and alcoholic beverage advertisements in particular, highlights the need for outdoor food marketing policy intervention. Implications: Outdoor advertising is an important food marketing tool that should be considered in future debates on regulation of food marketing to children.     

Nutrient intake of children consuming breakfast at school clubs in London

Introduction: Research into the effectiveness of breakfast clubs has most commonly focused on social benefits to the child and school, such as improved attendance at school, punctuality and improved concentration levels in the classroom ( UEA, 2002 ). Limited research has been undertaken to investigate the nutritional value of the breakfast foods on offer, or the nutritional content of foods consumed by the child. The aim of this study was to find out what children eat and drink at school breakfast clubs in London. Method: The sample population consisted of 98 children (39 boys and 59 girls) aged 5–11 years attending four primary schools in London. Data were collected about the food on offer and the pricing of different food items, demographic data about the children attending the school club, qualitative data on food preferences and a weighed food intake on two different occasions for each child. Statistical tests (anova and chi‐squared tests) and nutrient analysis using Comp‐Eat were carried out. Results: The average nutrient content of the breakfast meal consumed was 330 kcal, 12 g protein, 11 g fat and 49 g carbohydrate. Variation was seen between schools. Generally intakes of vitamin C, calcium and sodium were high and intakes of iron were average. anova between schools showed statistically significant results for a number of nutrients – protein, fat, saturated fat, carbohydrate, sugar, calcium and sodium. Boys were consuming statistically significantly more fat, saturated fat and calcium than girls. One in five children did not have a drink at breakfast. Menu options and pricing of food items varied between the schools and it was noted to influence children's food choice and consumption. Mean energy intakes equated to 18% of the estimated average requirement for boys and 20% for girls, with girls consuming more carbohydrate and sugar, and boys consumed more fat and protein. Discussion: The findings suggest that careful planning of menus should be undertaken with cereal‐based options being offered daily and cooked options only occasionally, and that healthier eating messages can be incorporated effectively into school clubs when supported by the whole school approach to healthy eating. Conclusion: Food offered at school breakfast clubs can contribute substantial nutrients to a child's daily intake and therefore a varied menu, and guided food choices, should be developed incorporating healthier nutrient rich options. This work was supported by Brooke Bond working in partnership with the BDA Community Nutrition Group.     

Chemical composition and keeping-quality of carrot (Daucus carota L.) varieties

This article studies the alimentary habits of children in relation to their body mass index (BMI) and food preferences, and to underline the influences of cultural and social aspects. The investigation tested 198 children (90 male and 108 female) from Cento (Ferrara), using food frequency questionnaires that were completed by the children. Subjects were subdivided into three groups based on their BMI—normal weight, overweight and underweight—taking into consideration their food frequency and preferences. The correlations between the BMI of children, mother's geographic origin and cultural level revealed differences between boys and girls. The variability of results does not allow precise correlations to be made between food frequency and children's weight, psychological and social aspects. Some incorrect dietary habits were revealed in the overweight and underweight groups. These could be controlled for and corrected by an alimentary education programme.     

School children's own views,roles and contribution to choices regarding diet and activity in Spain

Background Behaviours regarding food and activity are learned during childhood and continue throughout life. Children can be very important agents in making decisions concerning their own well‐being and care and their perspective is essential to understanding how they and/or others make choices for them to achieve a healthy lifestyle. However, their perspectives remain under‐researched. This study provides an insight into school children's own perspectives, behaviours and contribution to food and activity choices. Methods The paper reports on the findings from an ethnographic study with 38 Spanish children aged 5–7 years. Information was obtained through participant observations, diaries kept by children and group interviews. Data were analysed using techniques of analytical induction and constant comparison. Results The children who took part in this study described choices about activities with enthusiasm. Children saw activity as a way of learning new things, mastering skills and socializing. They were willing to try and experience new activities and games. However, the activities performed depended on parents' agendas and security issues. In contrast, children reported less interest in and active involvement in food choices. They contributed to family food choices indirectly through the expression of their preferences, not wanting to eat what they disliked or tasting new foods. Conclusion Children had strong preferences and motivations, particularly about activities which could be harnessed in interventions to prevent obesity and promote healthy diet and activity. Parental involvement and commitment is also important both to encourage exercise according to children's interests and active informed food choices, including introduction to unfamiliar foods.     

The development of childhood dietary preferences and their implications for later adult health

The food fed to infants and young children not only determines their health in childhood but also predicts the foods that they eat in later life. Because adult dietary preferences are partially formed in childhood, the childhood diet inevitably contributes to the long‐term health of the individual. We are all aware of preferences that have endured since childhood, and that our dietary habits only change if we have reason to adapt them, perhaps for a healthier lifestyle. Adopting a healthy diet in adulthood is likely to be considerably easier if we have developed healthy food preferences during our childhood. Current information shows that toddlers are fed diets high in fat, sugar and salt and that mothers are confused about what toddlers should be eating. A healthy diet for toddlers combines foods from all the five food groups. This combination involves mixing high‐calorie and low‐calorie foods. Healthy food options should be introduced from weaning, and offered repeatedly through the infant and toddler years. Furthermore, the whole family should model a healthy eating lifestyle in order to foster the acceptance of foods that constitute a well‐balanced diet.     

Policies influencing the provision of healthy food and drinks in local government‐owned sport and recreation facilities in Victoria,Australia

Objective : Sporting facilities owned or managed by local governments (LGs) can promote health by selling healthy food and drinks. This study assessed the policies, attitudes and practices of LGs in Victoria, Australia, relating to obesity prevention and the provision of healthy food in their sporting facilities. Methods : An online survey was e‐mailed to all Victorian LGs (n=79) in July 2018. Questions assessed LGs' healthy food policies relating to sport and recreation facilities and the priority LGs give to obesity prevention. Results : Forty‐nine LGs (62%) completed the survey from July to November 2018. Obesity prevention and promotion of healthy food and drink were a moderate to high priority for councils. The priority LGs give to healthy food promotion was reported to have increased over the previous year in 55% of LGs. Those LGs in areas of higher socioeconomic position and located in major cities had made more healthy changes at their facilities. Conclusion : Obesity prevention is a priority for LGs, and they are making changes to improve the food environments in their sporting facilities. Greater support may be required for smaller LGs and those in socioeconomically disadvantaged areas to create healthier food environments. Implications for public health : Monitoring changes to healthy eating policies within council facilities is essential to understand how local government actions are contributing to obesity prevention.     

Les expériences gustatives précoces persistent-elles à influencer les préférences alimentaires des enfants à l’âge scolaire ?

ObjectiveThe continuity of food preferences established during utero and postnatal phase is not well assessed. The aim of this study was to analyse the relation ship between early taste exposures and children's food preferences at school age.Materials and MethodsThe persistence of early food preferences was measured in 175 children aged between 7 and 11 years. Two questionnaires were used; the first aimed to measure early taste experiences during pregnancy, breastfeeding and diversification period, and the second assessed children's current food preferences in relation to six food categories. Children's early preferences were grouped into likes and dislikes for each period. The mean scores of the current preferences were compared with the early preferences for each child. Statistical analysis was performed using SPSS V25 software. The significance level was set at 0.05.ResultsThe type and duration of breastfeeding had no influence on the continuity of children's food preferences. Regarding the persistence of food preferences, vegetables and sweet foods were the first categories to change between the pregnancy and the diversification period, the other categories (fruit, dairy, meat and substitutes) remained stable between pregnancy and diversification and then changed between the diversification period and the current period. Cereals and starches remained stable from the gestation phase.ConclusionFood preferences established during utero and postnatal period changed gradually, and did not continue to influence the child's food choices at school age. Their impact was proportional and short term.     

A Portrait of Food and Drink in Commercial TV Series

This study examines the content and presentation of food and drink on fictional, commercial television. It provides the first comparison of food and drink consumption across different television program genres designated for different age groups. Data originated with a random sample of 50 taped episodes of children's shows, 50 episodes of “tween” programs (shows targeted for 9- to 14-year-olds), 40 episodes of afternoon soaps, and 50 episodes of prime time shows. The choice of TV series was based solely on the strength of Nielsen audience ratings. The study coded the foods for nutritional content and the drinks for alcoholic/nonalcoholic content, how they were used, and in what context. Findings indicate that foods were more commonly offered and consumed on children's shows, and that problematic foods (defined as oils, solid fats, and foods with added sugars) were significantly more prevalent in youth-oriented shows than in adult-oriented shows. Although there was only a negligible presence of alcohol on children's shows, the average hourly use of alcohol on the tween shows matched that of the adult programs; therefore, alcohol was as common in the shows directed at young audiences as in shows for adults. Negative outcomes were largely absent from food and drink behaviors on these TV series.     

Self‐perceptions of competence and social support in Korean children

This study assesses the effects of social support from parents, teachers, and peers on various dimensions of children's self‐perception. The Korean versions of the Self‐Perception Profile and Social Support Scale were administered to 189 Korean elementary school children in grades three through six. Children's perceived scholastic competence can best be explained by teachers’ unique contribution and joint effects of parents with peers and teachers. Teacher support is a strong contributing factor to children's perceived physical appearance and athletic competence, while peer support is important for children's perception of social acceptance and behavioral conduct.     

Australian print news media coverage of sweet, non-alcoholic drinks sends mixed health messages

Objective: This study aimed to analyse the contribution of Australian print news coverage to the public profile of sweet, non‐alcoholic beverages. News media portrayal of health contributes to individuals’ decision‐making. The focus on sugar‐sweetened beverages reflects their contribution to excessive energy intake. Methods: One year's coverage of sweet, non‐alcoholic beverages by major Australian newspapers was analysed using content and frame analysis. Research questions addressed which sweet drinks are most prominently covered, what makes sweet drinks newsworthy and how are the health aspects of sweet drinks framed? Results: Fruit juice was the most widely covered sweet drink, closely followed by carbonated, sugar‐sweetened soft drinks. Overall coverage was positively oriented towards sweet drinks, with fruit juice primarily portrayed as having health benefits. Some coverage mentioned risks of sweet drinks, such as obesity, tooth decay, metabolic syndrome and heart attack. Conclusions: Sweet drinks often enjoy positive coverage, with their health benefits and harms central to their ability to attract journalists’ attention. However, the mix of coverage may be contributing to consumer confusion about whether it is safe and/or healthy to consume sweet non‐alcoholic drinks. Implications: Framing of sweet drinks as healthy may undermine efforts to encourage individuals to avoid excess consumption of energy‐dense drinks which offer few or minimal health benefits.     

An experimental investigation of the influence of health information on children's taste preferences

Promotion of healthy diets often involves provision of information about which food types are most favourable for health. This is based on the assumption that the rational consumer will, other things being equal, choose the food that they know is healthier. However, health information may not always have a positive effect, since there is evidence that some people, particularly children, believe that healthiness and tastiness are mutually exclusive characteristics. To the extent that taste governs preferences and consumption, the characterization of a food as healthy could reduce its anticipated pleasantness. The present study tested the idea that a 'healthy' label would reduce liking for a novel drink. The results showed that the children rated a 'healthy labelled' drink as less pleasant and said they would be less likely to ask their parents to buy it than the same drink presented with control information. These results suggest that care may need to be exercised in promoting foods to children through an emphasis on health, unless the implications of healthiness can be rendered more positive.     

Trends in food advertising to children on free-to-air television in Australia

Objective: The issue of marketing unhealthy food to children and its contribution to childhood obesity has become a highly politicised debate in Australia. The aim of this study was to compare recent television food advertising patterns in 2008 to previously published Australian research on television advertising from 2006 and 2007, to examine any changes following policy debates. Methods: Television broadcasting was recorded for two weekdays and two weekend days between 6:00 and 22:00 in February 2008 for all three commercial television channels. Food advertisements were classified as core/healthy, non‐core/unhealthy or miscellaneous. Television audience data were obtained to determine broadcast periods corresponding to children's peak viewing times. Results: The overall rate of food advertising decreased over time: from seven food advertisements/hour/channel in 2006/07 to five in 2008. However, the relative contribution of non‐core food advertising to overall food advertising remained stable. In 2008, the proportion of food advertisements for non‐core foods was significantly higher during children's peak viewing times (p<0.01). Conclusions and implications: Australian children remain exposed to a disproportionate volume of television advertisements for unhealthy foods on commercial television, which are shown during time periods when the highest numbers of children are watching. Regulations to limit unhealthy food advertising during the time periods when a significant number of children are watching are required.     

‘It's very hard to find what to put in the kid's lunch’: What Perth parents think about food for school lunch boxes

Aim: To describe the factors affecting school food selection by parents of young children attending low socioeconomic schools in Perth and recommend the features of resources parents need to make healthier choices. Methods: Nine focus groups of parents of young children attending low socioeconomic status schools in Perth were conducted where parents were asked about the food their children ate at school and their opinions of school food resources. Results: Focus group discussion centred on the themes of the challenge of being a good parent by providing healthy lunch box food; making compromises in what their children eat at school and the barriers to healthy eating in the school environment. Parents were concerned about what their children were eating at school but the barriers of convenience, child preference, cost and food safety prevented them from including healthier food in the lunch box. The amount of time allowed for eating and lack of refrigeration were school‐based barriers that impacted on the type and amount of food selected. Parents liked colourful, practical school food resources with recipes and nutrition information aimed at children. Conclusions: Parents want help with selecting lunch box food/drinks that are nutritious, convenient, inexpensive and appealing for children to eat. Schools need to be supported to introduce healthy eating programs and should review the time given for young children to eat at school. Dietitians need to consider the home food environment and what motivates parents to make food choices for their children.     

Are children rational decision makers when they are asked to value their own health? A contingent valuation study conducted with children and their parents

Despite the importance of including children's preferences in the valuation of their own health benefits, no study has investigated the ability of children to understand willingness‐to‐pay (WTP) questions. Using a contingent valuation method, we elicit children's and parents' WTP to reduce children's risk of an asthma attack. Our results suggest that children are able to understand and value their own health risk reductions, and their ability to do so improves with age. Child age was found to be inversely related to parents' and children's WTP. The results also suggest that non‐paternalistic altruism is predictive of children's WTP. For parents, care for their own health was found to be inversely related with their WTP for children's risk reductions. Comparison of parents' and children's WTP suggests that parents are willing to sacrifice for their child's health risk reduction an amount that is approximately twice that of their children. The analysis of matched pairs of parents and children suggest that there are within‐household similarities as the child's WTP is positively related to parents' WTP.     

The association of maternal food intake and infants' and toddlers' food intake

Background Young children's first experiences with food may influence development of food preferences and lifelong eating habits. However, little is known about what factors are associated with the development of eating behaviours in infants and toddlers. Studies with older children and adolescents suggest that parental food intake is associated with children's food intake. The purpose of the present paper is to determine whether this association starts even earlier during infancy and toddlerhood. Methods A convenience sample of n= 98 primarily African American mothers of children 6–18 months old completed questionnaires, including questions on their own and their young child's food intake. Mothers completed questions while waiting to be seen by their child's primary care provider. Results Per maternal report, children consumed fruit 2.45 (1.79) times, vegetables 1.63 (1.51) times and snack foods 2.22 (2.49) times each day. Infants' and toddlers' fruit (r= 0.54, P < 0.001), vegetable (r= 0.42, P < 0.001) and snack food (r= 0.37, P < 0.001) intake were significantly associated with maternal intake of each of these foods, respectively. These significant associations remained even after controlling for additional study variables. Conclusion Even at very young ages, maternal food intake is an important correlate of children's food intake. Taken together with findings documenting significant snack food consumption in this age group, findings suggest that development of prevention and intervention programmes to enhance healthy eating behaviours need to start very early, perhaps just prior to children being introduced to complementary foods.