Development of novel tools to measure food neophobia in children

Food Neophobia in Brazilian Children: A Nationwide Cross-Sectional Study Comparing Neurodivergent and Neurotypical Children with and Without Dietary Restrictions

Objective: This study aims to compare food neophobia (FN) in groups of neurodivergent and neurotypical children with and without food restrictions. Methods: This cross-sectional study used a convenience sample of participants from all Brazilian Federative Units through the snowball method. Participants were separated into four groups for comparison: neurodivergent children without dietary restrictions; neurodivergent children with dietary restrictions; neurotypical children with dietary restrictions; and neurotypical children without dietary restrictions. The Brazilian Children's Food Neophobia Questionnaire (BCFNeo) was selected and administered to caregivers of Brazilian children between four and eleven years old. The categorization of FN scores followed a previously validated protocol. Results: The sample was composed of the caregivers of 2387 children. Considering the sample as a whole (neurodiversity), the prevalence of high FN was 44.2%. Boys are significantly more neophobic (p < 0.001) than girls. FN does not decrease with age. Older children (eight to eleven years) are equally neophobic as younger children (four to seven years). The prevalence of high FN was greater in neurodivergent children (without dietary restrictions-62.8% and with dietary restrictions-62.4%) than in neurotypical children (with dietary restrictions-29.4% and without dietary restrictions-33.4%). Conclusions: FN is more prevalent in boys and neurodivergent children, regardless of food restrictions and age. More longitudinal and experimental studies are necessary to evaluate the factors influencing FN in these groups and to develop intervention strategies.

Parent-Reported Feeding Practices Associated With Children's Observed Willingness-to-Try-New-Foods in Childcare

Feeding behaviours are established early in life, with lifelong influences on children's appetite, growth and health, emphasizing the importance of understanding how parent-child feeding interactions relate to children's eating and growth patterns. The objective was to examine reciprocity between parent-reported feeding practices and children's observed willingness-to-try-new-foods in childcare settings without parental presence, thereby assessing independence from context and parental influence. The sample included parent-child dyads (n = 436) recruited from 51 childcare centres across 10 counties. Parent-reported feeding practices, children's observed willingness-to-try-new-foods and children's height and weight were measured using the Comprehensive Feeding Practices Questionnaire (CFPQ), a food tasting activity and standardized anthropometric protocols, respectively. Logistic and linear regression models assessed associations between parent-reported feeding practices and children's observed willingness-to-try-new-foods, as well as body mass index z-score (BMIz), respectively. All models adjusted for potential confounders, including clustering within childcare centres. Children's observed willingness-to-try-new-foods was positively associated with parent-reported restriction for weight control, suggesting independence from context. A child-driven interpretation suggests parental perceptions of children's high food responsivity or concerns about excess weight gain and a parent-driven interpretation suggests that children exhibit higher willingness-to-try-new-foods in response to parental weight-related restriction. Children's observed willingness-to-try-new-foods was not related to other parent-reported feeding practices. Child BMIz was positively associated with parent-reported restriction for weight and health and negatively associated with pressuring and giving children control over food intake. Future research is needed to determine factors associated with child and parent-driven interpretations of feeding practices and effective strategies to promote responsive parent feeding practices.

Childcare staff feeding practices associated with Children's willingness-to-try-new-foods

Parental feeding practices are associated with children's eating, but little is known about how childcare staff feeding practices relate to children's eating. The study examined the associations between childcare staff feeding practices and children's willingness-to-try-new-foods. Participants included children (n = 460), ages 3-5 years, and childcare staff (n = 91) recruited from 51 childcare centers in 10 Maryland counties. Feeding practices were measured using the Comprehensive Feeding Practices Questionnaire (CFPQ) adapted to the childcare setting. Children's willingness-to-try-new-foods was assessed using a food tasting activity administered in the childcare centers. Confirmatory and exploratory factor analyses were used to evaluate the factor structure of the CFPQ applied to childcare staff, and to identify modified factor structures. Logistic regressions assessed the association between childcare staff feeding practices and children's willingness-to-try-new-foods (categorized as high vs. low). Among this sample, a revised 7-factor, 32-item model, including encourage balance and variety, environment, healthy eating guidance, indulgent, monitoring, pressure, and restriction for health was identified. Children exposed to more indulgent feeding practices in the classroom had 2.13 (95% CI: 1.04, 4.37) times the odds of demonstrating high willingness-to-try-new-foods compared to children exposed to less frequent use of this feeding practice, with no associations among other feeding practices. Understanding mechanisms driving childcare staff feeding practices and their relation to children's eating behavior can inform interventions that promote healthy eating behaviors among young children.

Risk Factors and Consequences of Food Neophobia and Pickiness in Children and Adolescents: A Systematic Review

Food neophobia and pickiness are the resistance or refusal to eat and/or avoid trying new foods due to a strong reaction of fear towards the food or an entire group of foods. This systematic review aims to assess evidence on the risk factors and effects of food neophobia and picky eating in children and adolescents, giving elements to avoid the lack of some foods that can cause nutritional deficiencies, leading to future pathologies when they are adults. A systematic literature search was performed in Medlars Online International Literature (MEDLINE) via Pubmed and EBSCOhost, LILACS and IBECS via Virtual Health Library (VHL), Scopus, and Google Scholar. MeSH terms used were: ((food neophobia [Title/Abstract]) OR (picky eating [Title/Abstract]) OR (food selectivity [Title/Abstract])) NOT ((anorexia nervosa [MeSH Terms]) OR (bariatric surgery [MeSH Terms]) OR (avoidant restrictive food intake disorder [MeSH Terms]) OR (autism spectrum disorder [MeSH Terms])). One hundred and forty-two (n = 142) articles were selected for children and adolescents (0-18 years old). They were structured according to contents: prevalence, risk factors, consequences, strategies and treatment. The studies showed a prevalence of the need for intervention on modifiable risk factors. Food neophobia and pickiness developed in childhood are conditioned by risk factors related to biological, social, and environmental characteristics, as well as family education and skills. Strategies to minimize or avoid these disorders should be aimed at implementing healthy habits at these levels.

Introducing menus of three weekly insect- or plant-based dinner meals slightly reduced meat consumption in Danish families: Results of a randomized intervention study

The environmental concerns associated with excess meat consumption have emphasized the need for sustainable alternatives. Edible insects offer a promising alternative due to their environmental efficiency and nutritious profile, but their widespread adoption in Western diets remains a challenge. The objective of the study was to investigate the impact of exposing families (parents and children) to insect-based or plant-based dinner menus on dietary pattern, meat intake, and protein intake over a six-week intervention period. The study was a two-arm randomized equivalence trial comparing an insect-based menu to a plant-based control. Families received either an insect or plant-based menu to replace meat in dinner meals three times a week for six weeks, aiming to replace 20% of their meat protein intake. Dietary changes were assessed through dietary registrations and daily questionnaires. Both adults and children maintained their estimated daily total protein intake, while reducing daily meat protein intake. Neither group met the 20% weekly meat replacement goal. In the insect-based menu group, adults and children reached an average 5.5% and 2.3% weekly meat replacement, respectively. In the plant-based menu group, adults and children replaced 9.0% and 4.3%, respectively. Meat attachment had an effect on meat protein intake. The menus slightly reduced meat protein intake. The weekly frequency of meat meals slightly declined, but portions remained the same. By enhancing insect and plant-based food quality and understanding consumer behavior, insect- and plant-based products have the potential to be a complementary alternative in a sustainable dietary transition without sacrificing nutrition. CLINICAL TRIAL REGISTRY: ClinicalTrials.gov: NCT05156853; clinicaltrials. gov/study/NCT05156853.

Food neophobia scores at 8 Years and associations with nutrition-related behaviors at home in early life: Findings from a New Zealand contemporary birth cohort

Food neophobia (FN) reduces nutritional adequacy and variety which poses a significant concern for children's health and well-being We described the FN scores among 8-year-olds and examined its associations with nutrition-related behaviors at 45 months within the Growing Up in New Zealand cohort (n = 4621). FN was estimated using the Food Neophobia Scale (FNS). Mean FNS scores between variable categories were compared using t-tests for independent samples and ANOVA. Associations between FNS scores at 8 years and nutrition-related behaviors at 45-months were examined using multivariate linear regression. The mean (standard deviation) FN score was 46.2 (15.2) with statistically significant differences by sex (boys = 47.6 (15.7), girls = 43.8 (14.2), p=<0.001). For all children, in models adjusted by breastfeeding duration and sociodemographic characteristics: children who sometimes and never/almost never ate the same foods as their parents, scored, on average, 5.8 and 11 points higher in the FNS (versus those who did always/almost always); children who occasionally/never found mealtimes enjoyable scored on average 3.6 points lower in the FNS (versus mostly/quite often); children who always/almost always had the television on during mealtimes scored on average 2.7 higher in the FNS (versus never/almost never). In comparison to children who mostly/quite often had time to talk to others during mealtimes, those who never/occasionally did it scored on average higher points in the FNS overall (1.46 points higher) and within girls (1.73 points higher). These findings support the eating behavior statements in the National Children's Food and Nutrition Guidelines, which emphasize early exposure to food variety, limiting mealtime distractions, and acknowledge that parental role modeling shapes children's nutrition-related behaviors. Early adoption of preventative interventions for reducing FN in early and middle childhood are needed.

Food Neophobia in Children: A Case Study in Federal District/Brazil

A reluctance to eat and/or avoidance of novel foods is characterized as food neophobia (FN). FN restricts the diet to familiar foods when, in fact, it should be much more varied. FN can be a barrier to healthy foods, affecting the quality of diet, and impairing children's growth and development. Therefore, according to their caregivers' perceptions, this study aimed to evaluate FN in children from Federal District/Brazil. The Brazilian Children's Food Neophobia Questionnaire (BCFNeo), a specific instrument developed and validated in Brazil, was answered by caregivers of children aged 4 to 11 y/o. Sampling occurred through snowball recruitment, being convenient and non-probabilistic. The Health Sciences Ethics Committee approved the study. The analysis evaluated FN in total (BCFNeoTot) and in the following domains: general (FNgen), for fruits (FNfru), and for vegetables (FNveg). FN scores were compared between sex and child's age and categorized according to three ordinal levels. FN levels were compared using the Mann-Whitney U test. The Friedman test, followed by the Wilcoxon test with Bonferroni correction, was performed to analyze differences in FN according to the environment. Of the caregivers' answers for their children, 595 answers were included, because 19 were out of age. The prevalence of high FN was 42.9%. The domain with the highest prevalence of high FN was vegetables (48.6%). Children aged 8 to 11 y/o had a higher mean FN in two domains (FNgen p = 0.047 and FNveg p = 0.038) when compared to children aged 4 to 7 y/o. Boys were more neophobic in all domains (FNgen p = 0.017; FNfru p = 0.010; FNveg p = 0.013; BCFNeoTot p = 0.008), and FN tends not to decrease with age. The results showed that the children of the FD are more neophobic than Brazilian children in general, highlighting the importance of additional studies in FN determinants in this population and nutritional education interventions to reduce FN among FD children.

Neophobia, sensory experience and child's schemata contribute to food choices

PURPOSE

The aim of the present review is to analyze dynamic interactions between nutrigenomics, environmental cues, and parental influence, which can all lead to children's neophobic reactions and its persistence in time.

METHODS

We reviewed studies available on electronic databases, conducted on children aged from birth to 18 years. We also considered official websites of Italian Institutions, providing advice on healthy eating during infancy.

RESULTS

Modern day societies are faced with an eating paradox, which has severe and ever-growing implications for health. In face of a wider availability of healthy foods, individuals instead often choose processed foods high in fat, salt and sugar content. Economic reasons surely influence consumers' access to foods. However, there is mounting evidence that food choices depend on the interplay between social learning and genetic predispositions (e.g., individual eating traits and food schemata). Neophobia, the behavioral avoidance of new foods, represents an interesting trait, which can significantly influence children's food refusal. Early sensory experiences and negative cognitive schemata, in the context of primary caregiver-child interactions, importantly contribute to the priming of children's food rejection.

CONCLUSIONS

As neophobia strongly affects consumption of healthy foods, it will be relevant to rule definitively out its role in the genesis of maladaptive food choices and weight status in longitudinal studies tracking to adulthood and, in meanwhile, implement early in life effective social learning strategies, to reduce long-term effects of neophobia on dietary patterns and weight status.

LEVEL OF EVIDENCE

Level II, controlled trials without randomization.

Choice-induced tasting. Evaluating the effect of choice on children's acceptance of an unfamiliar vegetable

Children's vegetable intake is in general below recommendations. It is known that self-selection of vegetables out of multiple options can increase intake in children. However, it is not clear if this effect is driven by a pre-existing preference for the selected food, or purely by having a choice. Allowing children to choose could create a positive bias and endorse feelings of autonomy, which could increase acceptance of the food and promote intake. The aim of the present pre-registered study was to investigate the effect of choice in promoting the acceptance of an unfamiliar vegetable during a blind-choice task. Children aged 4-5 years old (n = 161) were randomly assigned to the choice or no-choice condition. Each child was presented with three closed cups, containing a vegetable. The children were unaware that the cups contained the same vegetable, a piece of raw celeriac. In the choice condition, the children were able to choose a cup themselves whereas in the no-choice condition, the experimenter made the decision. We hypothesized that children in the choice condition would show more acceptance of the vegetable compared to children in the no-choice condition and that higher levels of picky eating would lead to less vegetable acceptance. The results demonstrated that choice indeed significantly increased vegetable acceptance (4.7 ± 1.7 versus 4.0 ± 1.9 on a 6-point scale), irrespective of pickiness in eating. In addition, picky children showed less acceptance of the vegetable compared to non-picky children. The results of this study imply that choice is an important factor in promoting unfamiliar vegetable intake in young children. Including children in the decision process may be a practical strategy for educators and caregivers to increase children's vegetable intake.

Instruments to Evaluate Food Neophobia in Children: An Integrative Review with a Systematic Approach

Food neophobia (FN), a frequent disorder in childhood, profoundly impacts the quality of a diet, restricting the intake of nutrients to maintain proper nutrition. Therefore, using the appropriate tools to assess FN in children to promote healthy eating habits is essential. The study aimed to develop an integrative review with a systematic approach to identify the instruments to measure FN in children and analyze their differences. The included studies (n = 17) were more concentrated in Europe, demonstrating the possible lack of dissemination of the topic at a global level. Among the 18 tools, 6 were represented by adaptations of the Food Neophobia Scale (FNS) and the Children's Food Neophobia Scale (CFNS), and one was the CFNS itself, demonstrating the relevance of these pioneering tools. The need to meet mainly cultural and cognitive criteria led to the creation of other instruments (n = 11). A diversity of approaches concerning the respondents, age range, items, scales, and validation methods was revealed. Modifications to the tools in some nations highlighted their adaptability and effectiveness in addressing regional variations. The instruments can contribute to additional research to help us better understand the prevalence of FN in children, resulting in their health and well-being.

Measurement is the foundation of research and theory on children's eating behaviours: Current issues and directions for progress

Eating behaviours affect food intakes and are involved in the aetiology of obesity. There has been impetus to translate findings about children's eating behaviour into intervention and policy programs. However, measurement limitations have hindered our capacity to understand and influence children's eating behaviours. In the present paper we provide an overview of some of the key methodological and measurement issues facing the field of children's eating behaviours and highlight implications for research and health promotion. Drawing on insight from parallel issues that occur in the measurement of early social and emotional development, we examine two overlapping themes in children's (aged 0-∼12 years) eating behaviours (Somaraki et al., 2021) measurement issues related to validity and reliability, and (Steinsbekk & Wichstrøm, 2015) associated methodological challenges, such as contextual influences and the importance of designing studies that use multiple informants and multiple methods. We then suggest insights and strategies aimed at advancing approaches to measurement of children's eating behaviours. To progress our understanding of children's eating behaviours, we conclude that a range of psychometrically sound, fit-for-purpose measurement instruments and procedures are needed for use in multi-trait, multi-method, multi-informant studies in a range of populations and contexts.

Introducing insect- or plant-based dinner meals to families in Denmark: study protocol for a randomized intervention trial

BACKGROUND

Plant- and insect-based foods are promising alternative protein sources. Previous studies have shown that introducing plant-based foods to the diet can reduce meat intake, but no such intervention has explored the effects of insect-based foods.

METHODS

This study aims to integrate alternative proteins to main meals of 80 Danish families through a 6-week two-arm randomized intervention trial to investigate acceptance, consumption, and potential for meat replacement. The primary outcome is the replacement of dietary meat protein with plant- or insect-based protein from the intervention foods assessed through change in daily meat protein intake, proportion of meat protein to total protein intake, and counts of dinner meals with meat and intervention products.

CONCLUSION

The results of this study will contribute to research in alternative proteins and explore the effects of long-term exposure of meat replacement.

TRIAL REGISTRATION

ClinicalTrials.gov: NCT05156853 . Registered 24 December 2021.

Effectiveness of a teaching unit on the willingness to consume insect-based food - An intervention study with adolescents from Germany

This study investigated the effect of a four-lesson teaching unit titled "Entomophagy and Sustainability" on the willingness of adolescents in Germany to consume insect-based food (N = 114; M Age = 15.77 years; SD Age = 1.12 years; female = 58.8%). The main aim of the study was to test whether the teaching unit can induce long-term changes in selected nutritional-psychological factors (food disgust, food neophobia, food technology neophobia), attitudes, knowledge, and the willingness to consume insect-based food. For this purpose, a paper-pencil questionnaire was conducted immediately before (pre-test), immediately after (post-test), and approximately six weeks after (follow-up test) the teaching unit. Although significant changes in food disgust, food neophobia, food technology neophobia, attitudes, and knowledge were recorded, adolescents' willingness to consume insect-based food was not significantly increased. Attitudes were identified as the strongest predictor of adolescents' willingness to consume, while knowledge was not a significant predictor. Conclusions and recommendations that can be applied to other educational interventions are provided to increase the effectiveness of the teaching unit.

Screen Time and Its Association with Vegetables, Fruits, Snacks and Sugary Sweetened Beverages Intake among Chinese Preschool Children in Changsha, Hunan Province: A Cross-Sectional Study

(1) Introduction: Screen time may influence preschoolers’ food consumption. However, there is limited evidence regarding preschoolers, especially in China. The aim of this cross-sectional study was to investigate the association between screen time and the consumption of vegetables, fruits, snacks, and sugar sweetened beverages (SSBs). (2) Methods: Participants (1567 caregivers) were recruited from six kindergartens in Hunan, China. Caregivers completed the questionnaire, which included the food frequency questionnaire (FFQ) and questions regarding their children’s daily screen time. (3) Results: The mean screen time of preschoolers was 1.36 ± 1.26 h, and the proportion of children who spent more than one hour on screens was 54.3% in the overall sample. Children with longer screen time consumed vegetables and fruits less frequently, while having a higher consumption of snacks and SSBs. After adjustment of sociodemographic confounders, children’s eating behaviors and parental feeding practices, the association of screen time with vegetables and SSBs still remained significant. (4) Conclusions: Screen time exposure needs to be monitored in preschool children, which was negatively associated with their consumption of vegetables and fruits, whereas it was positively associated with snacks and SSBs. Future research should focus more on the impact of screen time on children’s unhealthy behaviors and dietary patterns.

Understanding Blood versus Blond Orange Consumption: A Cross-Cultural Study in Four Countries

Understanding consumer perceptions and attitudes to specific fruit is key information for not only increasing fruit consumption, but also for marketing reasons. It may also give clues to breeders to set quality objectives. This study explores different aspects that help to explain blood vs. blond orange consumption: availability and consumption habit, satisfaction attributes, facilitators and consumption barriers, consumption contexts, expectations and purchase intention. The study was conducted in China, Mexico, Spain and Italy, where citrus fruit consumers were invited to respond an online questionnaire. Our results revealed Italy as the country with the highest availability and consumption of blood oranges, followed by China, Mexico and Spain. "Liking" and "healthy properties" were the most important reasons for consumption irrespectively of orange type, but certain differences among countries were detected in secondary reasons. In all the countries, "juicy" was the most relevant attribute for consumer satisfaction, followed by flavour/taste attributes. "Aromatic" and "unfibrous" were substantial requirements for Italians and Chinese, while Spaniards attached importance to the blood oranges colour. Regarding consumption contexts, "eat with salt or chilly powder" was specific for Mexico, while "to improve health", "as a gift" or "at a restaurant" were contexts mainly cited in China. Despite taste preferences for other fruit being the main consumption barrier in all the countries for both orange types, the relevance of other barriers depended on culture and orange type. Mexican participants seemed to take a more neophobic attitude to blood oranges, while "inconvenient" was reported as a barrier for consuming blond ones in Spain and China. We conclude that blond and blood oranges can co-exist on markets at a high consumption rate, as in Italy. Specific interventions are needed in other countries because consumer attitudes to oranges, mainly blood ones, depend on culture.

Neophobia—A Natural Developmental Stage or Feeding Difficulties for Children?

Food neophobia is the tendency to reject or be reluctant to try new and unfamiliar foods. Due to the period of its occurrence, which falls in the years of early childhood, it can significantly affect the child’s food choices, shape taste preferences, and significantly influence the quality of the child’s diet. The neophobic attitude has an important evolutionary significance because it protects the individual from ingesting potentially dangerous substances. On the other hand, it fosters avoidance behaviors that can also relate to the beneficial aspects of obtaining and consuming food. Currently, the strong emphasis placed on food safety means that neophobia may be less adaptive; nevertheless, a conservative attitude toward new foods still prevails. There is a strong association between food neophobia and the diversity of a person’s diet and previous exposure to different foods. This review describes behaviors associated with food neophobia and analyzes other feeding and eating difficulties in children that should be differentiated from food neophobia. Management approaches affecting the reduction in food neophobia in children through various dietary and psychological interventions are also proposed.

Food Neophobia among Brazilian Children: Prevalence and Questionnaire Score Development

This study aims to create and validate a score to classify food neophobia among Brazilian children (from the ages of 4 to 11 years) and investigate the prevalence of food neophobia. This descriptive cross-sectional population-based study is conducted following three steps: (i) the application of an instrument to identify food neophobia in Brazilian children by their caregivers; (ii) the instrument’s score definition; and (iii) the evaluation and characterization of the national prevalence of food neophobia among Brazilian children. The scores were categorized into three levels, based on the tertial approximation: low, moderate, and high. The study had 1112 participants, and the prevalence of high food neophobia was observed in 33.4% of Brazilian children. The prevalence of food neophobia allowed us to identify this behavior in Brazilian children and better understand the population. Boys were significantly more neophobic than girls. The general neophobia score and domains did not significantly differ between Brazilian regions and age groups. It is worrying that food neophobia did not decrease with advancing age. The score for the complete instrument with 25 items, or the 3 domains, makes its use practical. It can be used to assess neophobia with more caution, evaluate the most neophobic children, and enable more targeted professional interventions to promote healthier and sustainable eating habits.

Food preferences, food neophobia and chemosensation among adolescents with ADHD

AIM

It has been suggested that adolescents diagnosed with ADHD have an unhealthier diet compared to their peers without ADHD. The association between chemosensation (smell and taste) and dietary patterns remains unknown. The aim is to investigate unhealthy food preferences and food neophobic behaviour among adolescents diagnosed with ADHD. Additionally, it is to investigate the relationship between dietary patterns and chemosensory function.

METHODS

We enrolled 36 adolescents with and without ADHD to complete a food item and a food neophobia questionnaire and to undergo chemosensory testing.

RESULTS

Adolescents with ADHD performed significantly worse on both chemosensory tests compared to the non-ADHD group. No difference in food preferences nor food neophobia was found between the two groups.

CONCLUSION

Adolescents with ADHD have a lower score on chemosensory tests compared to their peers, suggesting impaired chemosensory function. No differences in dietary preferences nor food neophobia were seen between the two groups.

Instrument to Identify Food Neophobia in Brazilian Children by Their Caregivers

This study aimed to develop a specific instrument to evaluate food neophobia focused on Brazilian children and to perform the content validation and internal semantic consistency and reproducibility evaluation of the instrument. Three steps were necessary to conduct the study: (i) development of the instrument, (ii) internal validation (content validation and semantic evaluation) of the food neophobia instrument using 22 experts in the first round and 20 of them in the second round, (iii) evaluation of the internal consistency and reproducibility of the instrument with the children’s caregivers, using the test–retest (where the same caregiver—n = 22—answered twice, with 24 h interval) and comparing responses between two caregivers (n = 44) of the same children (n = 22). We developed an instrument in Brazilian–Portuguese to evaluate children’s food neophobia based on the caregivers’ perceptions with 25 items divided into three domains (neophobia in general, neophobia for fruits and neophobia for vegetables). Our results indicated that the instrument has excellent internal consistency (>0.9) and reproducibility (>0.9) when answered by the caregiver who knows the child’s eating habits, indicating reliability to be applied in Brazil. In addition, when the two caregivers answered the instrument, we found a good reproducibility (>0.6), confirming the possibility to be answered by one of the caregivers. Further studies are necessary to complete external validation with a representative sample of the target group in Brazil, showing nationwide the profile of the population. The potential of a neophobia study would contribute to the implementation of effective strategies and guidelines to support parents and health professionals, especially those involved in health and nutrition, to identify traces of food neophobia or neophobic behavior. By accurately measuring food neophobia in children, families can prevent nutritional deficiencies throughout adolescence and adulthood, improving eating habits. Children usually have neophobias similar to the ones presented by their parents—and when early detected, these neophobias can be addressed.

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.

Children's Self-Reported Reasons for Accepting and Rejecting Foods

Children's eating behavior does not necessarily align with dietary recommendations, and there is a need for better understanding the factors underlying their food choices. The aim of this study was to investigate children's self-reported reasons for accepting and rejecting foods. A questionnaire was developed with reasons based on prior research and in-depth interviews. A set of various food stimuli covering different types was evaluated by 106 girls and 99 boys aged 10-13 years by checking all reasons that apply (CATA) for either accepting or rejecting them. Results showed gender differences among reasons for both food acceptance and rejection, but also in liking and willingness to re-taste the stimuli. The most common reason for food acceptance was good taste in boys and curiosity in girls; for food rejection they were bad taste, bad smell and dislike of appearance in boys and bad taste, bad smell, dislike of appearance and texture in girls. Overall, boys liked the food stimuli more than girls and were more willing to re-taste them. Future research should focus more on the role of sensory properties in both acceptance and rejection, and the potential of children's curiosity as a driver in tasting foods should be further explored.

Cross-cultural adaption and validation of the Chinese version of the Child Food Neophobia Scale

OBJECTIVE

To adapt the Child Food Neophobia Scale (CFNS) cross-culturally for use among 12-36-month-old Chinese toddlers and to perform a preliminary assessment of its construct validity and reliability.

BACKGROUND

Food neophobia is the fear of eating new or unfamiliar foods, which affects the type and quality of individual dietary intake, especially during early childhood. However, measurements of child food neophobia have rarely been reported in China due to a lack of reliable and valid measurements.

METHODS

The CFNS was translated and adapted into a Chinese version (CFNS-CN) through a forward translation, reconciliation, a back translation, expert review and pretesting. The construct validity and reliability of the CFNS-CN were tested in 390 caregivers of 12-36 months old Chinese toddlers through convenience sampling in Changsha Maternal and Child Health Care Hospital, Hunan Province, China. The internal consistency, confirmatory factor analysis (CFA) and reliability were estimated.

RESULTS

The kappa coefficients indicated moderate to perfect agreement between the test and retest, and Cronbach's α coefficient was 0.91. A normal χ²/df, CMIN/DF=3.302, Comparative Fit Index, CFI=0.993, Tucker-Lewis Index, TLI=0.986 and root mean square error of approximation, RMSEA=0.077 were found. The CFA results showed that the model indicators were acceptable. High food neophobia was observed in 25.1% of individuals.

CONCLUSION

The CFNS-CN showed good internal consistency reliability and construct validity. The CFNS-CN may become an effective tool for assessing food neophobia in Chinese toddlers.

TRIAL REGISTRATION

This trial was pre-registered at the China Clinical Trial Registration Center under registration number ChiCTR1800015890.

Influence of Food Neophobia Level on Fruit and Vegetable Intake and Its Association with Urban Area of Residence and Physical Activity in a Nationwide Case-Control Study of Polish Adolescents

Among the factors that may influence fruit and vegetable intake, there is a food neophobia level, but the other elements, including physical activity and place of residence, must also be taken into account as interfering ones. The aim of the study was to analyze the association between food neophobia level and the intake of fruits and vegetables in a nationwide case-control study of Polish adolescents (12–13 years), including the influence of gender, the physical activity program participation and the place of residence. The #goathletics Study was conducted among a group of 1014 adolescents, 507 individuals representative for a nationwide physical activity program “Athletics for All” participants (characterized by an active lifestyle) and 507 pair-matched individuals (characterized by sedentary behavior), while 502 were representative for urban and 512 for suburban area. The assessment of food neophobia level was based on the Food Neophobia Scale questionnaire and the assessment of fruit and vegetable intake was based on the validated food frequency questionnaire. It was observed that higher food neophobia level is associated with a lower fruit and vegetable intake, that was stated both for girls and boys, as well as both for individuals characterized by an active lifestyle and those characterized by sedentary behavior, both from urban and suburban area. Food neophobic individuals characterized by an active lifestyle and those from urban areas were characterized by a higher fruit intake than individuals characterized by sedentary behavior and those from suburban areas, from the same food neophobia category. It was found that food neophobia may reduce fruit and vegetable intake, but the physical activity education with peers may reduce the observed influence and should be applied especially in the case of neophobic individuals from suburban areas.