The Good Tastes Study: Young Children's Food Acceptance Patterns

The Good Tastes Study: Young Children's Response to Vegetables and Caregiver Perceptions Regarding Their Children's Food Acceptance Patterns

Children begin developing food acceptance and preferences during the first years of life, especially through repeated exposure and increased familiarity. Caregivers pay attention to the amounts of food that their children consume, and they also are sensitive to when their refuses to eat what is offered. This study will examine the interactions between caregivers and their infants when bitter vegetables are introduced to infants and toddlers. The goals for this study are to:

1. understand if masking bitterness with very low levels of sugar or salt may facilitate whether infants accept new vegetables;
2. understand if masking bitterness impacts caregivers' perceptions of infants' acceptance of new vegetables; and
3. understand the stress levels experienced by infants and caregivers throughout this process.

Study Overview

• Status: Completed
• Conditions: Parenting; Food Neophobia

Detailed Description

During a single visit, four versions of a kale puree will be made with 1) no added sugar or sodium; 2) 1.2% added sugar; 3) 1.8% added sugar; and 4) 0.2% added sodium to mask bitterness. First, a familiar food will be offered to provide baseline data. Then each of the four versions of the novel kale puree will be offered to the infant by their caregiver, and the order the kale versions are presented will be randomized. The salt version will always be offered last to control for the effects of a very different taste exposure (salt vs. sweet) and to try to avoid any significant carryover effects of salt taste on sweet perception. Feeding interactions will be video recorded for behavioral coding of infant responses to each bite. Additionally, infant and caregiver heart rate and skin conductance will be monitored to assess physiological responses in each participant throughout the feeding interaction.

Several measures will be observed in order to test predictors of infant food acceptance, caregiver perceptions of infants' responses, and physiological responses in infants and caregivers. These include:

• Demographic measures
• Observed caregiver height and weight
• Observed infant length and weight
• Child developmental stage using Ages and Stages screening tool
• Caregiver neophobia
• Caregiver preferences for and intake of fruits and vegetables
• Infant feeding history and food experience
• Eating behaviors using the Child Eating Behavior Questionnaire for Toddlers
• Infant behavior using the Infant Behavior Questionnaire-Revised (Garstein & Rothbart 2003 Infant Behav Dev)
• Caregiver feeding persistence

• Study Type: Observational
• Enrollment (Actual): 110

Contacts and Locations

Study Locations

• United States
  • Colorado
    • Aurora, Colorado, United States, 80045
      • University of Colorado Denver

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 6 months to 2 years (Child)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

Infants and caregivers who live in the Denver area will be recruited using advertising flyers, emails sent through a university listserv and parent email distribution, and word of mouth.

Description

Inclusion Criteria:

• Term birth (gestational age > 37 weeks);
• Experience with at least 1 complementary food (e.g., infant cereal);
• Caregivers who are > 18 y and < 51 y of age;
• Caregivers who live within 75 miles of the University of Colorado-Denver campus.

Exclusion Criteria:

• Has genetic disorders or developmental disabilities as these conditions often result in feeding difficulties;
• Has a reported illness or metabolic disorder that would affect food intake (e.g., significant history of allergies);
• Born prematurely (< 37 weeks gestation);
• Caregivers who are younger than 18 y of age or > 51 y;
• Caregivers who live more than 75 miles from the University of Colorado-Denver campus;
• Caregivers who do not read and speak English.

Study Plan

How is the study designed?

Design Details

• Observational Models: Case-Only
• Time Perspectives: Cross-Sectional

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Infant rate of acceptance of kale puree	Acceptance is measured using an adaptation of the Feeding Infants: Behavior and Facial Expression Coding System (FIBFECS) on a 4-point scale from 0-3 where 0 = refusal and 3 = early acceptance of food. (Hetherington et al. 2016 Food Qual Prefer)	Baseline
Infant responses to kale puree	Responses are measured using an adaptation of the Feeding Infants: Behavior and Facial Expression Coding System (FIBFECS). Positive behaviors include leaning forward, and negative behaviors include turning head away, getting fussy, and pushing the spoon away. (Hetherington et al. 2016 Food Qual Prefer)	Baseline

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Caregivers' perceived ratings of infant liking of kale	After feeding each vegetable version, the caregiver will be instructed to rate how much he/she thought his/her infant liked the vegetable using a 9-point scale ranging from 1 = "dislikes extremely", 5 = "neither likes nor dislikes", to 9 = "likes extremely"(19).	Baseline
Caregivers' intentions to offer kale again	After feeding each vegetable version, the caregiver will be instructed to rate how likely he/she is to offer his/her infant kale in the future. Caregivers will be asked to respond using a 5-point scale ranging from 1 = "note at all likely" to 5 = "very likely".	Baseline
Infant mean heart rate reactivity to kale exposure	Infant heart rate will be collected through disposable leads placed on the infant's torso. The mean heart rate for each of the four vegetable versions will be compared to the mean heart rate when given a familiar food.	Baseline
Infant amplitude of skin conductance in response to kale exposure	Infant skin conductance will be collected by placing a lead on the infant's foot. The amplitude of voltage across a resistor is measured to calculate the amplitude of skin conductance. (Lykken and Venables 1971 Psychophysiology)	Baseline
Caregiver mean heart rate reactivity to infant exposure to kale	Caregiver heart rate will be collected by placing disposable leads on the caregiver's torso. The mean heart rate recorded during the offering of each of the four vegetable versions will be compared to the mean heart rate during the offering of a familiar food.	Baseline
Caregiver amplitude of skin conductance in response to infant exposure to kale	Caregiver skin conductance will be collected by placing a lead on the caregiver's finger. The amplitude of voltage across a resistor is measured to calculate the amplitude of skin conductance. (Lykken and Venables 1971 Psychophysiology)	Baseline
Infant respiratory sinus arrhythmia (RSA) in response to kale exposure	Infant heart rate will be collected through disposable leads placed on the infant's torso. Respiratory sinus arrhythmia, the heart rate response to breathing, will be calculated using a proprietary algorithm through CardioBatch Plus (Brain-Body Center, University of North Carolina, Chapel Hill). The mean RSA observed during the offering of each vegetable version will be compared to the mean RSA observed during the offering a familiar food.	Baseline
Caregiver respiratory sinus arrhythmia (RSA) in response to infant exposure to kale	Caregiver heart rate will be collected by placing disposable leads on the caregiver's torso. Respiratory sinus arrhythmia, the heart rate response to breathing, will be calculated using a proprietary algorithm through CardioBatch Plus (Brain-Body Center, University of North Carolina, Chapel Hill). The mean RSA observed during the offering of each vegetable version will be compared to the mean RSA observed during the offering a familiar food.	Baseline

Collaborators and Investigators

• Sponsor: University of Colorado, Denver
• Collaborators: Purdue University; The Sugar Association
• Investigators: Principal Investigator: Susan L Johnson, PhD, UC Denver

Publications and helpful links

General Publications

• Wardle J, Guthrie CA, Sanderson S, Rapoport L. Development of the Children's Eating Behaviour Questionnaire. J Child Psychol Psychiatry. 2001 Oct;42(7):963-70. doi: 10.1111/1469-7610.00792.
• Squires J, Bricker D, Potter L. Revision of a parent-completed development screening tool: Ages and Stages Questionnaires. J Pediatr Psychol. 1997 Jun;22(3):313-28. doi: 10.1093/jpepsy/22.3.313.
• Ham J, Tronick E. Infant resilience to the stress of the still-face: infant and maternal psychophysiology are related. Ann N Y Acad Sci. 2006 Dec;1094:297-302. doi: 10.1196/annals.1376.038.
• Johnson SL, Moding KJ, Grimm KJ, Flesher AE, Bakke AJ, Hayes JE. Infant and Toddler Responses to Bitter-Tasting Novel Vegetables: Findings from the Good Tastes Study. J Nutr. 2021 Oct 1;151(10):3240-3252. doi: 10.1093/jn/nxab198.

Study record dates

Study Major Dates

• Study Start (Actual): July 6, 2017
• Primary Completion (Actual): January 7, 2018
• Study Completion (Actual): January 7, 2018

Study Registration Dates

• First Submitted: August 18, 2020
• First Submitted That Met QC Criteria: September 8, 2020
• First Posted (Actual): September 16, 2020

Study Record Updates

• Last Update Posted (Actual): September 16, 2020
• Last Update Submitted That Met QC Criteria: September 8, 2020
• Last Verified: September 1, 2020

More Information

Terms related to this study

• Keywords: Parenting; Infant Feeding; Complementary Feeding; Toddler Feeding; Food Acceptance
• Additional Relevant MeSH Terms: Mental Disorders; Feeding and Eating Disorders; Avoidant Restrictive Food Intake Disorder
• Other Study ID Numbers: 15-2437

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: Undecided
• IPD Plan Description: Data may be available upon request to the Principal Investigator

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No