Food neophobia associates with poorer dietary quality, metabolic risk factors, and increased disease outcome risk in population-based cohorts in a metabolomics study

Food neophobia and its relationship with dietary quality and diversity in Turkish young adults: a cross-sectional study

Food neophobia, the fear of trying new foods, may reduce dietary variety, posing risks for nutritional deficiencies. This study examined the links between food neophobia, dietary quality, and diversity among Turkish young adults. A cross-sectional study with 949 participants (470 males, 479 females) aged 18-35 years used the Food Neophobia Scale (FNS) and a 24-h dietary recall to assess food intake. Dietary diversity score (DDS), food variety score (FVS), mean adequacy ratio (MAR), and healthy eating index (HEI-2015) were calculated. The mean neophobia score was 37.07 ± 12.17, with 13.4% high, 67.9% average, and 18.8% low neophobia. The average neophobia group had higher diet quality scores (MAR, DDS, FVS) than the low and high neophobia groups (p < 0.01). Positive relationships with food neophobia were found for niacin, calcium, zinc, plant protein, and cholesterol (p < 0.05). These findings suggest that food neophobia may affect dietary quality variably, with certain micronutrients positively linked to it.

Food neophobia among university students in Saudi Arabia: a cross-sectional survey of prevalence and predictor analysis

Introduction

Due to the absence of scientific information on food neophobia (i.e., fear or reluctance to try new or unfamiliar foods) among young adults in Saudi Arabia, the aim of this study was to assess the prevalence and predictors of food neophobia in Saudi university students.

Methods

This cross-sectional study included 480 students from two public universities of Saudi Arabia. The data was collected via an internet-based structured questionnaire. Participants' sociodemographic, health and behavioral information were included as explanatory variables (15 variables). Participants' food neophobia was assessed using a10-item validated food neophobia scale. A logistic regression model was fitted to find out the predictors of food neophobia.

Results

Approximately half of the participants (49.6%) exhibited food neophobia. Participants who engaged in regular physical exercise had a lower risk of developing food neophobia than their counterparts (AOR: 0.43, 95%CI: 0.20-0.92). Participants with food allergies (AOR: 4.36, 95%CI: 2.73-6.94) and disordered eating attitudes (AOR: 2.52, 95%CI: 1.27-5.02) and who took dietary supplements (AOR: 6.76, 95%CI: 3.54-12.90) were more likely to be food neophobic. Moreover, participants' preferences for fish and sea food (rs = -0.150), milk and dairy products (rs = -0.309,), chocolate and candies (rs = -0.329) and snacks, chips, and nuts (rs = -0.166) were significantly correlated with food neophobia.

Conclusion

A higher level of food neophobia was observed among surveyed university students in Saudi Arabia. Several factors, such as regular physical exercise, food allergies, dietary supplement consumption, and disordered eating attitudes, were found to be associated with food neophobia. To provide empirical evidence on food neophobia, additional research with large and representative samples could be performed in other regions of Saudi Arabia.

Food intake and eating behaviour during a real-life Snack Scenario in childhood obesity-An experiment using a hidden camera

OBJECTIVE

To compare food intake and eating behaviour in children and adolescents with obesity (OBE) undergoing weight loss intervention and normal weight (NW) in a real-life Snack Scenario.

METHODS

Sixty OBE were examined before (T0) and after weight loss (T1) and compared to a single measurement comparison group of 27 NW. Participants watched a 20-min film and were encouraged to snack from a variety of foods ad libitum. Food intake was measured and eating behaviour assessed via a hidden camera and a validated questionnaire.

RESULTS

The food and energy intake did not differ between NW (155 ± 83 g, 1067 ± 732 kJ) and OBE at T0 (144 ± 106 g, 1088 ± 883 kJ) but increased in OBE at T1 (187 ± 91 g, 1544 ± 845 kJ). Latency of food intake was significantly shorter in NW (0 m:07 s ± 0 m:08 s) compared to OBE (T0: 1 m:11 s ± 2 m:57 s). After weight loss, latency decreased in OBE (0 m:26 s ± 1 m:00 s). NW touched food more often (49 ± 24) than OBE (T0: 29 ± 23), but takes from plate were similar. The questionnaire revealed differences between OBE and NW, not correlating with Snack Scenario observations.

CONCLUSION

Eating behaviours differed in NW versus OBE at T0 but food intake was similar. Therefore, behaviour while eating may be an underestimated factor in the considerations for childhood obesity.

CLINICAL TRIAL REGISTRATION

German Clinical Trials Register (DRKS) with the trial number DRKS00005122.

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.

Medical Comorbidities, Nutritional Markers, and Cardiovascular Risk Markers in Youth With ARFID

OBJECTIVE

Avoidant/restrictive food intake disorder (ARFID) is common among populations with nutrition-related medical conditions. Less is known about the medical comorbidity/complication frequencies in youth with ARFID. We evaluated the medical comorbidities and metabolic/nutritional markers among female and male youth with full/subthreshold ARFID across the weight spectrum compared with healthy controls (HC).

METHOD

In youth with full/subthreshold ARFID (n = 100; 49% female) and HC (n = 58; 78% female), we assessed self-reported medical comorbidities via clinician interview and explored abnormalities in metabolic (lipid panel and high-sensitive C-reactive protein [hs-CRP]) and nutritional (25[OH] vitamin D, vitamin B12, and folate) markers.

RESULTS

Youth with ARFID, compared with HC, were over 10 times as likely to have self-reported gastrointestinal conditions (37% vs. 3%; OR = 21.2; 95% CI = 6.2-112.1) and over two times as likely to have self-reported immune-mediated conditions (42% vs. 24%; OR = 2.3; 95% CI = 1.1-4.9). ARFID, compared with HC, had a four to five times higher frequency of elevated triglycerides (28% vs. 12%; OR = 4.0; 95% CI = 1.7-10.5) and hs-CRP (17% vs. 4%; OR = 5.0; 95% CI = 1.4-27.0) levels.

DISCUSSION

Self-reported gastrointestinal and certain immune comorbidities were common in ARFID, suggestive of possible bidirectional risk/maintenance factors. Elevated cardiovascular risk markers in ARFID may be a consequence of limited dietary variety marked by high carbohydrate and sugar intake.

Food Neophobia and Avoidant/Restrictive Food Intake among Adults and Related Factors

Avoidant/restrictive food intake disorder (ARFID) includes age-inappropriate feeding behaviors in eating patterns, including food neophobia, defined as refusal or reluctance to eat new or unknown foods. This study aimed to assess the prevalence of ARFID and food neophobia among adults and determine the related characteristics of these risks. The study used an anonymous survey questionnaire consisting of three parts as the research tool. The first part of the questionnaire was a metric and concerned socio-demographic data. The Food Neophobia Scale (FNS) and the Nine-Item Avoidance/Restrictive Food Disorder Screen Questionnaire (NIAS) were used to evaluate the eating disorders. The survey included 309 people (60.2% women, 39.8% men) aged 18-77 years. NIAS results indicated that 15.2% of the subjects showed food selectivity, and 11.0% had food anxiety. In the FNS assessment, 42.4% had a low risk of food neophobia, 38.2% a medium risk, and 19.4% a high risk. A higher risk of food neophobia correlated with higher NIAS scores, indicating a higher risk of ARFID (p = 0.00231). The NIAS score increased with the risk of food neophobia (p = 0.000). Respondents at low risk of neophobia were most likely to avoid several products (83.97%), while in the high-risk group, 56.67% did not want to eat a favorite food enriched with a new ingredient. A higher risk of neophobia was correlated with more food avoidance and adverse reactions to new foods (p = 0.000). A higher risk of food neophobia is strongly correlated with a higher risk of ARFID. Although demographics did not significantly impact NIAS results, some trends were noted, such as higher scores among older and underweight people. Those with a higher risk of food neophobia show more food avoidance and a greater reluctance to experiment with new ingredients. Public education should emphasize that eating disorders affect both sexes equally, with tailored interventions for high-risk groups such as the elderly, rural populations, and those with lower education. Health policies should promote access to nutrition education, psychological support, and diverse food options, while further research is needed to improve targeted interventions.

Arousal and the modulation of sensory experience: evidence from food-related emotions

Across sensory systems, several stimulus collative characteristics, including intensity, novelty, complexity and perceived dangerousness, are known to elicit high levels of physiological and psychological arousal. It has become apparent that food rejections by both children and adults are frequently linked to such arousal-inducing characteristics. This paper examines how arousal and arousability are important elements in responding to stimuli generally, but specifically to foods, ultimately influencing food preferences and choices. It is clear that responses to sensory properties are subject not just to variations in perceptual sensitivity due to genetics or experience-as in the case of widely rejected qualities such as bitterness or pungency-but also to the arousal potential of those stimuli. Moreover, this is linked to various enduring aspects of personality, suggesting that the impact of arousal on food choices is merely one aspect of a more general sensory sensitivity. The impact of diet on various health outcomes underlines the importance of understanding the relationship of arousal to food choices. This article is part of the theme issue 'Sensing and feeling: an integrative approach to sensory processing and emotional experience'.

Food Neophobias in Spanish Adults with Overweight or Obesity by Sex: Their Association with Sociodemographic Factors and the Most Prevalent Chronic Diseases

Food neophobia has been defined as the reluctance to try new foods. Food neophobia is common in children and older people, but until now, scarce research has been carried out on food neophobia in the adult population. The aim of this study was to assess the most usual food neophobias in Spanish adults with overweight and obesity by sex, and their association with sociodemographic factors and the most prevalent chronic diseases. A cross-sectional observational study was carried out on adults (mean age of 43.5 ± 13.7 years old; n = 590; 50% female) with overweight or obesity. Their anthropometrics, adherence to the Mediterranean diet, age, educational level, economic level, smoking and sleeping habits, physical activity, chronic diseases, and food neophobias were assessed. The highest food neophobias in Spanish adults with overweight or obesity were directed toward vegetables, meat, fish, pulses, game meat, and fruits, mostly among females, with differences between sexes. Phobias of the soft texture of foods were also observed, without differences between sexes. Age, educational level, sleeping habits, and physical activity were directly related, and economical level and smoking were inversely related to food neophobia, mainly to healthy foods, and more obvious in males than in females. There were associations between body mass index (BMI) and chronic diseases and food neophobia. Adherence to the adaption of healthy and sustainable diets is low within food neophobics, increasing the risk of diet-related chronic diseases.

The association between food neophobia, bi-dimensional aspects of orthorexia, and anxiety among vegetarians and omnivores

Vegetarianism is a growing trend, and food neophobia and orthorexia nervosa could act as barriers to achieving a healthy vegetarian diet. The aim of this study is to compare the levels of food neophobia, anxiety, and both healthy and pathological aspects of orthorexia among vegetarians and omnivores. Additionally, the study aims to identify the relationships between food neophobia, anxiety, and orthorexia. In this cross-sectional online survey, a total of 324 vegetarian and 455 omnivores adults participated. The questionnaire consisted of four sections: sociodemographic, lifestyle, and health-related characteristics, the Food Neophobia Scale (FNS), the Teruel Orthorexia Scale (TOS), and the Generalized Anxiety Disorders-7 Scale. Vegetarians exhibited lower FNS scores (p < 0.001) and had higher healthy orthorexic scores (p < 0.001) than omnivores. There were no differences between groups for anxiety scores (p > 0.05). Regression analysis indicated that higher food neophobia (OR: 0.953, 95% CI:0.937-0.968) and TOS-OrNe scores (OR: 0.946, 95% CI: 0.901-0.993) were associated with lower odds of following a vegetarian diet. Conversely, higher TOS-HeOr scores (OR: 1.135, 95% CI:1.096-1.176) were linked to an increased likelihood of adopting a vegetarian diet. Furthermore, both FNS and GAD-7 scores showed negative correlations with TOS-HeOR (r = -0.124, p < 0.001 and r = -0.129 p < 0.001, respectively), and positive correlations with TOS-OrNe (r = 0.106, p < 0.001 and r = 0.146, p < 0.001). In conclusion, vegetarians exhibit lower levels of food neophobia and a greater interest in healthy eating than omnivores. Additionally, the distinct correlation between two dimensions of orthorexia and food neophobia and anxiety provides support for the two-dimensional nature of orthorexia.

Exploring Adult Eating Behaviors and Food Neophobia: A National Study in Romania

Food neophobia involves avoiding new foods due to reluctance, aversion, or disgust. The Food Neophobia Scale (FNS) is the most reliable and common adult food neophobia test. It helps compare food neophobia across cultures by being translated into numerous languages. This study adapted, translated, and validated the FNS for Romania. This translated version was piloted in November 2023 on 59 students in the medical field from two distinct Romanian cities. Between December 2023 and February 2024, 375 adults were surveyed, representing Romania's population within a 90% confidence interval. The average age of responders was 38.07 years, with a standard deviation of 10.75 and a 4:1 female-to-male sex ratio. The Cronbach's alpha test was used to validate the questionnaire. Our study found that the mean FNS value was 31.86; most Romanian respondents (69.20%) were neutral towards trying new foods, with a significant portion being neophobes (18.21%) outnumbering neophiles (12.59%). When compared to international study results, Romanian adults, on average, exhibited a higher percentage of neophobes compared to those in Korea (13%), Hungary (16.8%), Italy (17%), and Brazil (17.5%), but a lower percentage than those in Lebanon (21.5%). The findings indicate that the translated scale can be utilized to assess neophobia among Romanian speakers.

Food Behaviour and Metabolic Characteristics of Children and Adolescents with Type 1 Diabetes: Relationship to Glycaemic Control

Diet is an essential element of treating and managing type 1 diabetes (T1D). However, limited research has examined food behaviour in children and adolescents with T1D and their relationship to glycaemic control. This study evaluated food behaviour, metabolic characteristics and their impact on the glycaemic control of children and adolescents with T1D. Two hundred and fifty-eight participants with T1D (6-15 years, duration of diabetes >1 year) were recruited. Demographic, anthropometric and clinical data were collected. Questionnaires on food neophobia and food preferences were administered. The Child Food Questionnaire (CFQ) also assessed parental feeding practices. An analysis of food behaviour showed that food neophobia was inversely associated with the liking of vegetables, fruits, fish, sweets and carbohydrates. Moreover, by analysing parental feeding practices, an inverse association of "Pressure to eat", "Monitoring" and "Restriction" with liking for vegetables and carbohydrates emerged. Considering glycaemic control, increased food neophobia and the parent practices "Restriction", "Pressure to eat" and "Concern about weight" were found in participants with glycated haemoglobin (HbA1c) values >8.5%. Finally, higher body mass index (BMI) and total cholesterol values were observed in subjects with HbA1c values >8.5%. These findings contribute to a better understanding of eating behaviour, metabolic status and their complex relationship with glycaemic control.

Adherence to Mediterranean Diet and Food Neophobia Occurrence in Children: A Study Carried out in Italy

Food Neophobia (FN), defined as the reluctance to eat new or unfamiliar foods, mainly concerns fruit, vegetables, and legumes, typical of the Mediterranean Diet (MD). Considering these premises, this study aimed to clarify the relationship between FN and AMD in a sample of Italian children and their association with some socio-demographic factors and children's nutritional status. A sample of 288 children aged 3-11 years participated in an assessment carried out with a questionnaire evaluating FN and AMD, respectively, with the Child Food Neophobia Scale (CFNS) and the KIDMED test. Most of the sample showed an intermediate (67.3%) or high level of FN (18.1%), with high rates among 6-11-year-old children (63.9%) and especially in those who were the only child (50%). The AMD was mostly low (29.5%) or medium (54.8%) and reached lower levels among higher neophobic children (51.9%; p value < 0.05). The present results confirm the study hypothesis that FN is a driver of MD abandonment and shows the positive effects on children's eating habits and siblings. Finally, this study proves the relevance of adopting effective feeding strategies against FN to avoid its maintenance in adulthood and the detrimental effects on future overall health and well-being.

Infant Complementary Feeding Methods and Subsequent Occurrence of Food Neophobia-A Cross-Sectional Study of Polish Children Aged 2-7 Years

Food neophobia is standard behaviour in child development. It is a complex process and occurs to varying degrees. The symptoms of neophobia can be variable depending on the individual. Food neophobia is a fear of new foods, whereby difficulties in eating and trying unfamiliar foods follow. It is one of the more vital determinants of the number of meals consumed at a young age. Such a process is not a disorder in itself but can lead to one. The highest severity of neophobia occurs between the ages of two and six, but in some children, it lasts beyond age 6. This study aimed to assess the prevalence of food neophobia among children aged 2-7 years, taking into account the method of complementary feeding, the length of breastfeeding, exclusive breastfeeding, the period of introduction of complementary foods, and the use of the BLW method during the period of dietary expansion.

MATERIALS AND METHODS

The study used an anonymous survey questionnaire consisting of five parts as the research tool. The first part of the questionnaire was a metric and concerned the socio-demographic data of the parent/guardian and their child. A standardised questionnaire assessing food neophobia among children was used to assess food neophobia: the Food Neophobia Scale-Children (FNSC).

RESULTS

In the study group, 171 children (29.23%) had a low risk of food neophobia according to the FNSC, 182 children (31.11%) had a medium risk of neophobia, and 232 children (39.66%) had a high risk of neophobia. A correlation was observed between the age and the risk of food neophobia (p = 0.0002). Statistically significant differences were found between children aged 2 and 4 (p = 0.003) and children aged 2 and 5 years (p = 0.049). We observed no correlation between gagging (p = 0.88557), choking (p = 0.17597), and needing medical intervention (p = 0.61427) and the risk of associated neophobia.

CONCLUSION

In the study group of children, the highest risk of food neophobia was characterized by children aged 4, 5, and 7 years. The length of breastfeeding and exclusive breastfeeding did not affect the risk of food neophobia. In the month in which complementary feeding (CF) was introduced, the children were fed using the baby-led weaning method (BLW method), and introducing puree and puree with lump food into the children's diet also did not affect the risk of food neophobia. It was shown, however, that children whose mothers observed difficulties during CF and whose children had a vomiting reflex and spat food out of their mouths during CF were more likely to develop food neophobia at the preschool age.

Environmental Planning and Non-Communicable Diseases: A Systematic Review on the Role of the Metabolomic Profile

Non-communicable diseases (NCDs) are the major cause of death worldwide and have economic, psychological, and social impacts. Air pollution is the second, contributing to NCDs-related deaths. Metabolomics are a useful diagnostic and prognostic tool for NCDs, as they allow the identification of biomarkers linked to emerging pathologic processes. The aim of the present study was to review the scientific literature on the application of metabolomics profiling in NCDs and to discuss environmental planning actions to assist healthcare systems and public managers based on early metabolic diagnosis. The search was conducted following PRISMA guidelines using Web of Science, Scopus, and PubMed databases with the following MeSH terms: "metabolomics" AND "noncommunicable diseases" AND "air pollution". Twenty-nine studies were eligible. Eleven involved NCDs prevention, eight addressed diabetes mellitus, insulin resistance, systemic arterial hypertension, or metabolic syndrome. Six studies focused on obesity, two evaluated nonalcoholic fatty liver disease, two studied cancer, and none addressed chronic respiratory diseases. The studies provided insights into the biological pathways associated with NCDs. Understanding the cost of delivering care where there will be a critical increase in NCDs prevalence is crucial to achieving universal health coverage and improving population health by allocating environmental planning and treatment resources.

Food neophobia and its association with dietary choices and willingness to eat insects

Growing populations, changing dietary preferences and limitations on natural resources have meant that finding an alternative to traditional animal-based protein sources is a priority. Insects have been proposed as a possible solution due to their many benefits including low resource inputs and rich nutritional profile. However, insects are not consumed on a large scale by Australians. Food neophobia (reluctance to try new foods) could be contributing to this delay and as such, this study aimed to explore the role of food neophobia on protein food source habits and willingness to eat insects as food. A total of 601 participants (76.2% female, 23.8% male) completed an online survey which included a questionnaire measuring food neophobia status, participants' self-reported usual protein dietary habits, their previous insect-eating experience, future willingness to eat insects, and potential motivations to include insects in their diet. Results indicated a strong association between food neophobia and participants' dietary choices such as following a vegan or vegetarian diet (p = 0.024). In addition, food neophobia was correlated with a reduced likelihood of previous insect-eating experience (p < 0.001), as well as a decreased willingness to eat insects in the future (p < 0.001). This study provides a greater understanding of the role of food neophobia status and dietary choices in consumers' willingness to eat insects and identifies possible motivating factors that may increase the likelihood of consumers' future insect eating.

High arousal as the source of food rejection in food neophobia

Food neophobia (FN) at moderate to high levels is very common among adult populations in all cultures and is usually defined in terms of rejection of unfamiliar foods. However, food rejection in FN is only partly related to food familiarity. Experimental and survey studies have suggested that unpleasantly high arousal may be induced by food novelty, but also be produced by foods with intense or complex flavours, that are perceived as dangerous or foreign, or that have unusual ingredients. Liking for foods with these characteristics have recently been shown to be strongly negatively associated with FN. Thus, induced high arousal may underlie food rejection in FN. Here, we collected familiarity, liking and arousal ratings, and scores on the standard Food Neophobia Scale from more than 7000 consumers in four countries - Australia, United Kingdom, Singapore, Malaysia - for a series of food names that were manipulated to produce standard and 'high arousal' (variant) versions of the same foods. Consistent across all four countries, arousal ratings increased, and liking decreased, with decreases in food familiarity. Variant food names were always associated with ratings of higher arousal than the standard names. The variant foods were generally less familiar than the standard foods, although this was not a necessary condition for their higher arousal ratings, suggesting that the other arousal-inducing factors (e.g., flavour intensity) also played a role. Across all foods, arousal ratings increased, and liking ratings decreased, as FN increased, but these effects were accentuated for the variant foods. The consistency of these effects across multiple countries supports a view that arousal is universally a strong determinant of liking for foods and that this underlies the rejection of foods, familiar and novel, in FN.

Parental food neophobia, feeding practices, and preschooler's food neophobia: A cross-sectional study in China

This study explores the relationship between parental food neophobia, feeding practices, and preschoolers' food neophobia in China.

METHODS

A cross-sectional study was conducted among 1616 pairs of preschoolers and their parents. Electronic questionnaires were conducted to collect information about social and demographic characteristics, scores of food neophobia among both children and their parents, parents' feeding patterns and children's dietary quality.

RESULTS

Children's average food neophobia score was 23.72 ± 4.45. There was a positive correlation between parental food neophobia score (β: 0.154; 95%CI: 0.113, 0.195), pressure to eat (β: 0.694; 95%CI: 0.423, 0.964), postpartum breastfeeding initiation (β: 0.010; 95%CI: 0.002, 0.018), and children's score of food neophobia. However, parental modeling (β: -0.470; 95%CI: -0.732, -0.207) and the frequency of children eating with their families at home (β: -0.407; 95%CI: -0.707, -0.108) were negatively associated with children's food neophobia scores. The consumption frequencies of vegetables(P < 0.001), fruits(P < 0.001), domestic animals and poultry(P < 0.01), aquatic products(P < 0.05), beans and their products(P < 0.01), eggs(P < 0.05) and nuts(P < 0.05) and children's dietary diversity score (P < 0.001) are negatively associated with children' food neophobia score. While the consumption frequencies of fast food(P < 0.001), sweets(P < 0.01) and puffed/fried food(P < 0.001) were positively associated with children's food neophobia.

CONCLUSION

Chinese preschoolers' food neophobia needs more attention because children with high food neophobia tend to have lower dietary quality. Children whose parents have high-level food neophobia should be the focus of early prevention. Earlier postpartum breastfeeding, more use of parental modelling, less pressure to eat and higher frequency of children eating with families are helpful to reduce the incidence of children's food neophobia.

Exploring the Longitudinal Stability of Food Neophilia and Dietary Quality and Their Prospective Relationship in Older Adults: A Cross-Lagged Panel Analysis

Poor dietary quality is a major cause of morbidity, making the promotion of healthy eating a societal priority. Older adults are a critical target group for promoting healthy eating to enable healthy aging. One factor suggested to promote healthy eating is the willingness to try unfamiliar foods, referred to as food neophilia. This two-wave longitudinal study explored the stability of food neophilia and dietary quality and their prospective relationship over three years, analyzing self-reported data from N = 960 older adults (M_T1 = 63.4, range = 50-84) participating in the NutriAct Family Study (NFS) in a cross-lagged panel design. Dietary quality was rated using the NutriAct diet score, based on the current evidence for chronic disease prevention. Food neophilia was measured using the Variety Seeking Tendency Scale. The analyses revealed high a longitudinal stability of both constructs and a small positive cross-sectional correlation between them. Food neophilia had no prospective effect on dietary quality, whereas a very small positive prospective effect of dietary quality on food neophilia was found. Our findings give initial insights into the positive relation of food neophilia and a health-promoting diet in aging and underscore the need for more in-depth research, e.g., on the constructs' developmental trajectories and potential critical windows of opportunity for promoting food neophilia.

The Chinese version of the child food neophobia scale and its reliability and validity in preschool children

OBJECTIVE

To translate the English version Child Food Neophobia Scale (CFNS) into the Chinese version and test its reliability and validity in preschool children.

METHODS

To create the Chinese version of the CFNS, it was translated, back-translated, and cross-culturally adapted. The use of the Chinese version of CFNS by 575 parents of preschool children in two kindergartens in Yangzhou City was investigated using cluster sampling to assess the reliability and validity of the scale.

RESULTS

The Chinese version of CFNS has nine items in total. The scale-level average content validity index (S-CVI/Ave) is 0.983. Exploratory factor analysis (EFA) extracted 2 common factors, and the cumulative variance contribution rate was 49.437%. Confirmatory factor analysis (CFA) showed that the 2-factor model was well fitted. The Cronbach'α coefficient of the scale was 0.759, the Cronbach'α coefficients of the two factors were 0.735 and 0.713, the split-half reliability was 0.788, and the test-retest reliability was 0.756.

CONCLUSION

The Chinese version of the Child Food Neophobia Scale has good reliability and validity in preschool children and can be used as an assessment tool for food neophobia in preschool children in China.

PRACTICE IMPLICATIONS

This study has gone through a rigorous translation process, and the CFNS may support future exploration of food neophobia in preschool children. Food allergy factors in the results may be the next step in the research, and several studies are still needed to understand the relationship between food allergy and food neophobia.

Body Dissatisfaction, Eating Styles, Weight-Related Behaviors, and Health among Young Women in the United States

Body dissatisfaction is a common condition that poses health behavior risks, such as the use of maladaptive eating styles instead of adaptive eating styles. Few studies have simultaneously examined both adaptive and maladaptive eating styles and their association with body dissatisfaction in a comprehensive manner. To address this gap, this study examined how body dissatisfaction is related to an array of adaptive and maladaptive eating styles, weight-related behaviors, and health status as well as the associations of health status, BMI, and weight-related behaviors with body dissatisfaction in 261 young adult women. Maladaptive eating styles, such as emotional eating, tended to rise in tandem with body dissatisfaction, differing significantly among body-dissatisfaction levels with medium to large effect sizes. For adaptive eating styles, as body dissatisfaction increased, compensatory restraint increased, intuitive eating declined, and mindful eating did not differ. Weight-related dietary, physical activity, and sleep behaviors did not differ by body dissatisfaction level. BMI increased and health status decreased as body dissatisfaction increased. Binary logistic regression revealed those who were body-dissatisfied had significantly lower health status, higher BMIs, and did not differ on weight-related behaviors. Study findings suggest strategies to improve health-promotion interventions aiming to increase body satisfaction.

Neurobiology of Avoidant/Restrictive Food Intake Disorder in Youth with Overweight/Obesity Versus Healthy Weight

OBJECTIVE

Avoidant/restrictive food intake disorder (ARFID) occurs across the weight spectrum, however research addressing the coexistesnce of ARFID with overweight/obesity (OV/OB) is lacking. We aimed to establish co-occurrence of OV/OB and ARFID and to characterize divergent neurobiological features of ARFID by weight.

METHOD

Youth with full/subthreshold ARFID (12 with healthy weight [HW], 11 with OV/OB) underwent fasting brain fMRI scan while viewing food/non-food images (M age = 16.92 years, 65% female, 87% white). We compared groups on BOLD response to high-calorie foods (HCF) (vs. objects) in food cue processing regions of interest. Following fMRI scanning, we evaluated subjective hunger pre- vs. post-meal. We used a mediation model to explore the association between BMI, brain activation, and hunger.

RESULTS

Participants with ARFID and OV/OB demonstrated significant hyperactivation in response to HCF (vs. objects) in the orbitofrontal cortex (OFC) and anterior insula compared with HW participants with ARFID. Mediation analysis yielded a significant indirect effect of group (HW vs. OV/OB) on hunger via OFC activation (effect = 18.39, SE = 11.27, 95% CI [-45.09, -3.00]), suggesting that OFC activation mediates differences in hunger between ARFID participants with HW and OV/OB.

CONCLUSIONS

Compared to youth with ARFID and HW, those with OV/OB demonstrate hyperactivation of brain areas critical for the reward value of food cues. Postprandial changes in subjective hunger depend on BMI and are mediated by OFC activation to food cues. Whether these neurobiological differences contribute to selective hyperphagia in ARFID presenting with OV/OB and represent potential treatment targets is an important area for future investigation.

Effects of food neophobia and oral health on the nutritional status of community-dwelling older adults

BACKGROUND

Food preferences and oral health of older adults greatly affect their nutritional intake, and old-age-related increase in food neophobia may consequently reduce food intake in older adults. This study aimed to determine the impact of food neophobia and oral health on nutritional risk in community-dwelling older adults.

METHODS

This cross-sectional study included 238 independent adults aged ≥ 65 years (mean, 76.3 ± 7.3 years). The survey items included a Food Neophobia Scale, frequency of protein intake, oral-health-related quality of life (QOL) assessment, and oral diadochokinesis (ODK; /pa/, /ta/, /ka/) as an index of oral function. Nutritional status was assessed using the Mini Nutritional Assessment®, and based on a cutoff value of 24 points, respondents were categorized as well-nourished (≥ 24 points, Group 1) or at risk of malnutrition (< 24 points, Group 2). A logistic regression model was used to calculate the adjusted odds ratio (adj-OR) with 95% confidence interval (CI) to identify risks factors for malnutrition associated with food neophobia and oral health.

RESULTS

Factors associated with the risk of malnutrition in the older population were higher food neophobia (adj-OR = 1.036, 95% CI: 1.007-1.067) and lower oral function (OR = 0.992, 95% CI: 0.985-0.999) and lower oral-health-related QOL (adj-OR = 0.963, 95% CI: 0.929-0.999).

CONCLUSIONS

Older adults at risk of developing malnutrition may have higher food neophobia and lower oral function and oral-health-related QOL. Factors contributing to preventing malnutrition include predicting the risk of malnutrition based on the oral health indicators that older people are aware of, signs appearing in the oral cavity, minor deterioration, and providing dietary guidance about food neophobia. Notably, these approaches represent novel strategies for nutrition support that can be implemented based on a multifaceted understanding of the eating habits of older adults.

Dining with liberals and conservatives: The social underpinnings of food neophobia

Although food and politics seem to be distant domains, socio-political ideology and food neophobia (i.e., reluctance to eat unfamiliar food) may be related. Conservatives’ high threat sensitivity and the inherently threatening nature of novel foods (the existential explanation), along with conservatives’ negative attitudes toward minority outgroups (e.g., foreigners) and the role of the latter in introducing novel foods to a culture (the social explanation), led us to expect that socio-political ideology would predict food neophobia over and above their common roots. Across two correlational and two experimental studies (N = 627), socio-political ideology emerged as a strong predictor of food neophobia. In addition, the findings did not support the existential explanation, while confirming the social explanation of the ideology–food neophobia link: Conservatives seem more neophobic than liberals not because of their higher threat sensitivity but rather because they hold more negative attitudes toward foreigners who are associated with those foods.

Characterizing patterns of dietary exposure using metabolomic profiles of human biospecimens: a systematic review

CONTEXT

Establishing diet-disease associations requires reliable assessment of dietary intake. With the rapid advancement of metabolomics, its use in identifying objective biomarkers of dietary exposure has substantially increased.

OBJECTIVE

The aim of our review was to systematically combine all observational studies linking dietary intake patterns with metabolomic profiles of human biospecimens.

DATA SOURCES

Five databases were searched - MEDLINE, Embase, Scopus, Web of Science, and Cochrane CENTRAL - to March 2020.

DATA EXTRACTION

Of the 14 328 studies initially screened, 35 observational studies that met the specified inclusion criteria were included.

DATA ANALYSIS

All reviewed studies indicated that metabolomic measures were significantly correlated with dietary patterns, demonstrating the potential for using objective metabolomic measures to characterize individuals' dietary intake. However, similar dietary patterns did not always result in similar metabolomic profiles across different study populations.

CONCLUSION

Metabolomic profiles reflect a multitude of factors, including diet, genetic, phenotypic, and environmental influences, thereby providing a more comprehensive picture of the impact of diet on metabolism and health outcomes. Further exploration of dietary patterns and metabolomic profiles across different population groups is warranted.

Food neophobia and its relationship with dietary variety and quality in Irish adults: Findings from a national cross-sectional study

Food neophobia is characterised by a reluctance to eat novel or unfamiliar foods and has been linked to reduced dietary variety and quality. However, this link has been primarily studied in children. Therefore, we aimed to explore the relationship between food neophobia and dietary variety and quality in adults using a sub-sample of the National Adults Nutrition Survey collected between 2008 and 2010 (n = 1088). Food and nutrient intakes were assessed using a 4-day semi-weighed food diary. Food neophobia was measured using the Food Neophobia Scale (FNS). Dietary variety was assessed in three ways; Total Dietary Variety (TDV), Food-Group Variety (FGV) and Fruit and Vegetable Variety (FVV). Diet quality was assessed using the Mean Adequacy Ratio (MAR) and Nutrient-Rich Food Index (NRF9.3). A multivariate general linear model was used to assess the linear relationships between FNS score and all dietary measures, controlling for age, sex, education level, social class, location and BMI. Food neophobia was found to be inversely associated with TDV, FGV and FVV. In addition, food neophobia was negatively associated with vitamin C, magnesium and fruit and vegetable intakes and positively associated with percentage energy from free sugars. However, food neophobia was not significantly associated with all other nutrients, MAR and NRF9.3. While these results suggest food neophobia may not be a particularly important risk factor for poor nutrient status, adherence to certain dietary recommendations remains low within the Irish population and food neophobia may further inhibit the adaption of healthy and sustainable diets. Future research should seek to understand the implications of food neophobia on dietary behaviour change.

Food neophobia in Lebanese children: scale validation and correlates

OBJECTIVE

To validate the Food Neophobia Scale (FNS) and determine factors associated with the presence of food neophobia (FN) in a sample of Lebanese children.

DESIGN

Cross-sectional study conducted between July and December 2019.

SETTING

All Lebanese governorates.

PARTICIPANTS

Parents of Lebanese children aged 2 to 10 years.

RESULTS

Out of 850 questionnaires, 194 were excluded. The mean age of children was 5·34 ± 2·20 years (50·8 % females); 238 (36·4 %) had low neophobia scores (≤37), whereas 219 (33·5 %) and 197 (30·1 %) had, respectively, moderate (between 38 and 41) and severe neophobia scores (≥42). All items of the FNS were extracted except item 8 and yielded a two-factor solution with Eigenvalues > 1 (variance explained = 51·64 %; Kaiser-Meyer-Olkin (KMO) test = 0·746; Bartlett's sphericity test P < 0·001; αCronbach = 0·739). Children who refused initially to eat vegetables (β = 5·51), fish (β = 4·57), fruits (β = 4·75) or eggs (β = 2·99) and higher parents' instrumental feeding scores (β = 0·3) were significantly associated with higher neophobia scores, whereas higher parents' encouragement scores (β = -0·21) were significantly associated with lower neophobia scores in children.

CONCLUSION

FN is common in children. Neophobic children tend to have lower variety in their diets. One of the ways to lower the levels of neophobia is the use of encouragement by the parents. In contrast, offering a reward to children for them to eat a certain food was associated with more signs of avoidance. More studies should be conducted to evaluate awareness levels concerning FN.

Estimated Prevalence and Care Pathway of Feeding and Eating Disorders in a French Pediatric Population

Feeding and Eating Disorders (FED) are mostly described in infants and adolescents but are less well-known in children. Information on the prevalence of FED in the general pediatric population is still limited. The aim of this study was to estimate the prevalence and the care pathway of FED in a population aged 0-18 years old, using the Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 classification. Two physicians interviewed 401 families using a questionnaire including demographics, BMI, dietary behavior data, and age-appropriate screening tools. Qualitative and quantitative variables were compared using the Chi² test and Student's t-test, respectively. After a headcount adjustment based on the French population by age group, the estimated prevalence rate was 3% [95%CI (1.7-5.1)] for Avoidant and Restrictive Food Intake Disorder (ARFID), and 9.7% [95%CI (7.2-13.0)] for Unspecified FED (UFED), which included other restrictive and compulsive FED. The median age for ARFID was 4.8 years (0.8-9 years), and 7.5 years (0.6-17 years) for UFED. The interviews did not identify cases of anorexia, bulimia, binge eating disorder, other specified FED, pica or rumination. Only 15.2% of children with an FED were receiving medical care. The development of validated pediatric screening tools, as well as the training of health professionals in children FED is necessary.

Childhood overeating is associated with adverse cardiometabolic and inflammatory profiles in adolescence

Childhood eating behaviour contributes to the rise of obesity and related noncommunicable disease worldwide. However, we lack a deep understanding of biochemical alterations that can arise from aberrant eating behaviour. In this study, we prospectively associate longitudinal trajectories of childhood overeating, undereating, and fussy eating with metabolic markers at age 16 years to explore adolescent metabolic alterations related to specific eating patterns in the first 10 years of life. Data are from the Avon Longitudinal Study of Parents and Children (n = 3104). We measure 158 metabolic markers with a high-throughput (1H) NMR metabolomics platform. Increasing childhood overeating is prospectively associated with an adverse cardiometabolic profile (i.e., hyperlipidemia, hypercholesterolemia, hyperlipoproteinemia) in adolescence; whereas undereating and fussy eating are associated with lower concentrations of the amino acids glutamine and valine, suggesting a potential lack of micronutrients. Here, we show associations between early behavioural indicators of eating and metabolic markers.

Food Neophobia among Adults: Differences in Dietary Patterns, Food Choice Motives, and Food Labels Reading in Poles

Food neophobia (FN) is associated with reduced quality of diet in adults; thus, the understanding of the relationship between FN and food consumption in more depth appears to be a key issue. The aim of the study was to assess the relationship between food neophobia, dietary patterns, food choice motives, and food label reading in the group of adults. Data were collected using the computer-assisted personal interviewing technique (CAPI). A cross-sectional quantitative survey was carried out in November-December 2017 in a sample of 1017 Polish adults. The questionnaire used in the study included the Food Neophobia Scale (FNS), the Beliefs and Eating Habits Questionnaire (KomPAN), and questions regarding food choice motives, reading food labels, and sociodemographic characteristics. The food neophobics were older, had a lower level of education, and had higher BMI compared to others. Compared to others, among the food neophobics, there were more people who often consumed vegetables, fruit, meat, and meat products and who rarely consumed functional and convenience food, sweets, and sweetened beverages. When choosing food, more food neophobics chose healthy and tasteless food products, while more food neophilics chose unhealthy and tasty products. More food neophobics declared not reading price and shelf-life information on food labels compared to the other two groups. Although food neophobia may make adaptation to dietary recommendations difficult, health-promoting features of the diet were observed within the food neophobics. Actions focusing on food choice motives may help even more to limit the effects of food neophobia in adults. Further research is recommended to confirm the observed relationships under different sociocultural conditions.

Optimising Repeated Exposure: Determining Optimal Stimulus Shape for Introducing a Novel Vegetable among Children

Although it is well evident that a healthy diet rich in fruit and vegetables could prevent a number of major chronic diseases, national and international guidelines concerning their intake are not being reached by a large percentage of the population, including children. Thus, it is of interest to investigate how the consumption of this food group by children could be increased. The aim of this study was to examine the impact of serving style on the consumption of a raw snack vegetable (daikon) and the influence of its exposure on liking and intake of the vegetable. A group of 185 children 3–5 years old participated in the study. Two kindergartens served as intervention groups, while the third was assigned to be the control group of the study (n = 50). The intervention groups were repeatedly exposed to one of three different serving styles of daikon: sticks (n = 42), triangles (n = 46) or grated (n = 47), and they were all visited 7 times during the exposure period, on the same frequency (twice per week). Familiarity and liking of the target vegetable, daikon, and six other vegetables (cucumber, celery, celeriac, broccoli, cauliflower and beetroot) were measured at baseline, post-intervention and two follow up sessions (3- and 6-month) to investigate the likelihood of generalisation effects. Intake of daikon was measured at all control sessions and exposures. Moreover, children were asked to rank their favourite serving style of daikon and beetroot, among triangle, stick and grated, towards understanding the influence of shape on the efficacy of the exposure. The results revealed significant changes between liking and intake of daikon for the groups of triangles and sticks and the control group (p < 0.05). The group that received grated daikon did not show significant differences in liking and at intake levels during the exposures but performed well in the long-term. Throughout the exposure period, intake levels followed an overall increasing pattern, with all the groups to demonstrate a decrease of their intake at the last session, which was not found significant for the triangle group. Mere exposure was efficient towards increasing liking and intake of the novel vegetable with all the shapes to deliver positive results, but based on this study no particular serving style can be recommended.

Food Neophobia and Consumer Choices within Vietnamese Menu in a Polish Cohort Study

One of the factors influencing consumer food choices is food neophobia (FN), described as a reluctance to try novel or unknown food products. The aim of the study was to determine the influence of FN on food choices in young Polish respondents through a web-based choice experiment with Vietnamese restaurant menu. The choice experiment was conducted using a Computer-Assisted Web Interview (CAWI) method in a sample of 601 young adults, while using a developed Vietnamese restaurant menu. For the dishes, neophobic potential for a Polish population was defined, based on content of ingredients not typical for Polish diet. The FN was assessed using the Food Neophobia Scale (FNS) by Pliner and Hobden. The neophobic potential was the determinant of choice of dishes (p < 0.05). The participants characterized by a high FN level less commonly than others chosen dishes characterized by neophobic potential as: starter (Nem quõn—non-fried spring rolls with shrimps) (p = 0.0003), soup (Mién gà—soup with cellophane noodles and nam huong mushrooms) (p < 0.0001), main course (Phở xào bò—rice noodles with soy sauce and fish sauce) (p < 0.0001) and dessert (Chè thập cãm—dessert of golden gram, black eye beans, Azuki beans and tapioca) than other options (p = 0.0007). It was stated that FN in young respondents may reduce the frequency of choosing dishes containing unfamiliar ingredients and, as a result, it may cause lower diversity of consumed dishes. Taking into account that not properly balanced diets resulting from rejecting some types of products are becoming a growing problem, the FN should be taken into account in the general public health policy.

Yuck, This Biscuit Looks Lumpy! Neophobic Levels and Cultural Differences Drive Children's Check-All-That-Apply (CATA) Descriptions and Preferences for High-Fibre Biscuits

Food neophobia influences food choice in school-aged children. However, little is known about how children with different degrees of food neophobia perceive food and to what extent different sensory attributes drive their liking. This paper explores liking and sensory perception of fibre-rich biscuits in school-aged children (n = 509, age 9–12 years) with different degrees of food neophobia and from five different European countries (Finland, Italy, Spain, Sweden and United Kingdom). Children tasted and rated their liking of eight commercial biscuits and performed a Check-All-That-Apply task to describe the samples and further completed a Food Neophobia Scale. Children with a higher degree of neophobia displayed a lower liking for all tasted biscuits (p < 0.001). Cross-cultural differences in liking also appeared (p < 0.001). A negative correlation was found between degree of neophobia and the number of CATA-terms used to describe the samples (r = −0.116, p = 0.009). Penalty analysis showed that degree of food neophobia also affected drivers of biscuit liking, where particularly appearance terms were drivers of disliking for neophobic children. Cross-cultural differences in drivers of liking and disliking were particularly salient for texture attributes. Further research should explore if optimizing appearance attributes could be a way to increase liking of fibre-rich foods in neophobic children.

Importance of food choice motives vary with degree of food neophobia

Food Neophobia (FN) is a stable trait that measures individuals' propensity to avoid novel/unfamiliar foods. In this research, focus was directed to covariation between FN and food choice factors as measured using two variants of the food choice questionnaire (FCQ). To our knowledge, there are no previous studies which investigates these associations in detail, and in this regard the present research advances understanding of individual differences in FN and FCQ. Existing survey data were used, collected in the USA and Australia with ~1500 and ~750 consumers, respectively. Data from New Zealand came from studies conducted at central location test (CLT) facilities (Ñ400, Ñ1100). There were many consistencies in results across the four studies, and this was noteworthy considering that the data were obtained in 3 different countries across more than 10 years and with participants in CLT and online studies. The FCQ factor Familiarity always gained in importance with increasing FN. The FCQ factor Convenience also always gained in importance with increasing FN, in particular importance of simplicity in preparation and cooking. Conversely, the factors Health and Natural Content decreased in importance, as did factors linked to Environmental and Social Justice concerns. Price and Sensory Appeal remained very important for daily food choices among "neophobic" and "neophilic" consumers alike, and this mirrors past studies from diverse consumer populations. The importance of Mood was low regardless of FN status. Additional research is needed to confirm that these findings generalise to consumers in other countries, and assuming they do, this work contributes to the mounting evidence of the pervasive effects of FN on consumers' food-related experiences and motivations. Determining why FN influences food choice motives is an important next step.

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.

Gender, Age, Geographical Area, Food Neophobia and Their Relationships with the Adherence to the Mediterranean Diet: New Insights from a Large Population Cross-Sectional Study

The Mediterranean diet (MD) is associated with many health benefits. The association between the MD and food neophobia (FN) is still unexplored in adults. The present cross-sectional study was aimed to explore the relationships between adherence to the MD, FN, and sociodemographic variables in a large Italian cohort. Familiarity and frequency use (FFI) of prototypical and non-prototypical Mediterranean foods were used to calculate a new adherence index: the Italian Taste Mediterranean Index (ITMI). The FFI of all Mediterranean foods increased with age, while butter, soft drinks, red/cured meat, and sweets were more common in younger people. Accordingly, ITMI increased with age (F_2,2384 = 54.11; p < 0.0001). Women recorded a higher ITMI (6.70) than men (6.10). Individuals with high FN showed higher FFI for soft drinks and sweets and lower ones for most typical MD foods, than individuals with low FNs. A decrease of ITMI was recorded with the increase of the FN(F_2,2384 = 22.84; p < 0.0001). With ageing, ITMI increased even in individuals with a high FN. The results suggest that FN may negatively affect adherence to the MD, lowering its potential health benefits, in the adult population. Monitoring of food habits, dietary education, and anxiety management, may be valuable tools to control FN and support the adherence to the MD.

Food Neophobia in Celiac Disease and Other Gluten-Free Diet Individuals

The only treatment currently available to combat celiac disease (CD) is strict adherence to a gluten-free diet (GFD), but there may be various determinants of its adherence, including food neophobia (FN), that is associated with sensory aversions, or fears of negative consequences of eating specific food products, that may be crucial for CD patients following a GFD. The aim of the present study was to analyze food neophobia levels and its determinants in CD patients in comparison with other individuals who follow a GFD based on their own decision. The study was conducted in two independent groups of individuals following a GFD: those diagnosed with CD (n = 101) and those following a GFD based on their own decision (n = 124). Each group was recruited with cooperation from the local CD and GFD societies located in Poland. The FN was assessed using the Food Neophobia Scale (FNS) and compared between groups, as well as the influence of gender, age, body mass index, educational level, place of residence and employment status was assessed. It was stated, that for the individuals following a GFD, CD was the major determinant of FN. The FNS score values were higher (indicating higher food neophobia) for CD individuals (39.4 ± 9.2), than for those following a GFD based on their own decision (33.6 ± 8.7; p < 0.0001) and it was observed both for general group and for sub-groups stratified by assessed variables. Moreover, the indicated variables did not influence the FNS in any of the analyzed groups. The influence of CD with no influence of other variables was confirmed in the regression analysis. It may be concluded that CD is a major contributor to FN, which can be attributed to fear of developing adverse reactions to gluten-contaminated food products, which is more pronounced in CD patients compared to non-CD patients following a GFD based on their own decision.