Neophobia

In the United Kingdom, as in many other developed countries, children are not eating the five or more daily servings of fruit and vegetables recommended for optimal health and prevention of chronic diseases. Instead, many children's diets are high in sugar, fat, and refined carbohydrates. Such a diet is implicated in the growing prevalence of obesity and also may be a contributing factor in many chronic diseases. As a result, there is increased interest in identifying the causes of poor diet in children, and particularly in understanding environmental factors that may be potential targets for early intervention. Because parents are both elements and determinants of the environment for young children, parental behavior has been an obvious area for attention. Food-related parenting style, and specifically the degree to which parents attempt to exert control over their children's eating, has been highlighted recently as an important influence on children's food choice. The impact of parental control on children's fruit and vegetable consumption is an important area for investigation because children's intake is consistently low and parents need to be informed about which feeding strategies are effective and which are counterproductive. The aim of the present study was to investigate the relationship between parental control, food neophobia, and fruit and vegetable consumption in preschool children.

Twenty-two nursery schools in London, UK, with a total of 896 pupils in the age range 2 to 6 years, were invited to participate in a study of children's food preferences. Frequency of fruit and vegetable consumption by both parent and child was measured using single items based on those in the Dietary Instrument for Nutrition, which was originally designed to measure fat and fiber intake and has been validated against 4-day diet records. Respondents were asked: "How often do [you] [your child] eat the following items?" This was followed by a list of six food types, including fruit (fresh or canned) and vegetables (including salad but not potatoes). Possible answers were: never, less than once a week, once a week, twice a week up to six times a week, every day, or more than once a day, yielding a 10-item response scale.

Control was measured using the Parental Control Index, which has been used to measure control in parents of younger and older children. The following six items assess the extent to which parents use restriction and pressure to eat to control their child's eating: "When my child does not finish dinner, s/he should not get dessert," "My child should always eat all of the food on his/her plate," "Generally, my child should only be allowed to eat at set meal times," "My child has to be strongly encouraged to eat things that are good for him or her," "My child should be told off for playing or fiddling with food," and"I have to be especially careful to make sure my child eats enough." Possible responses ranged from disagree to agree on a 5-point scale. Higher scores indicate greater control.

The Child Food Neophobia Scale is a 10-item scale to measure children's willingness to sample novel foods, scores of which correlate highly with behavioral measures of neophobia. For the purposes of this study, four items were excluded because they seemed inappropriate for the age range of this sample, with no resulting reduction in the consistency of the scale. The six remaining items were: "My child does not trust new foods," "If my child doesn't know what's in a food, he or she won't try it," "My child is afraid to eat things s/he has never had before," "My child will eat almost anything" (reverse scored), "My child is very particular about the foods he or she will eat," and "My child is constantly sampling new and different foods" (reverse scored). Responses are on a 4-point scale from strongly disagree to strongly agree. The higher the score, the higher the level of neophobia.

The researchers found that parental control was correlated with children's fruit and vegetable consumption and found no significant sex differences. Parental fruit and vegetable consumption and children's food neophobia were also strong predictors of children's fruit and vegetable consumption, and both were associated with parental control, suggesting that they might explain the association between control and intake. Controlling for children's food neophobia and parental intake reduced the association of parental control with children's fruit and vegetable intake to nonsignificance.

In this data set, as previous studies have found, the strongest predictor of children's fruit and vegetable consumption was parental fruit and vegetable consumption, which explained 21.5% of variance in this large sample of British families. The level of the child's food neophobia was the next strongest predictor, explaining an additional 5.5% of the variance. Including parental control in this model showed no additional effect. The mechanism by which parental consumption of fruits and vegetables influences that of children remains unclear.

The strong influence of parents' consumption of fruit and vegetables is confirmed in the data. Although excessive parental control may exacerbate the problem of poor or limited diets in children, it seems from this data that neophobia is a stronger predictor of low consumption of fruits and vegetables. The emergence of neophobia as an important predictor of low fruit and vegetable intake in children may reduce some of the blame typically apportioned to parents. Nevertheless, the strong parent-child similarities in fruit and vegetable consumption observed here and elsewhere emphasize the importance of parents' own intake in overcoming this natural predisposition. Future interventions aimed at increasing children's intake of fruits and vegetables would be well advised to target parents' eating habits and feeding practices. Parents will always attempt to control the types and quantities of foods that their children have access to and in what quantities, but it may be more productive to advise parents to lead by example--the "do as I do" rather than "do as I say" approach.

Jane Wardle, Susan Carnell, Lucy Cooke. Parental control over feeding and children's fruit and vegetable intake: How are they related? JADA 105(2):227-232 (February2005) [Correspondence to: Jane Wardle, PhD, Director, Cancer Research UK Health Behaviour Unit, Department of Epidemiology and Public Health, University College London, 2-16 Torrington Place, London WC1E 6BT, England. Email: j.wardle@ucl.ac.uk]

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