Eating behaviours evolve during the first years of life; children learn what, when, and how much to eat through direct experiences with food and by observing the eating behaviours of others. In light of the increasing prevalence of overweight and obesity in North America among all age groups, including very young children, an understanding of the factors that influence eating behaviours during childhood is needed to improve the dietary patterns and health status of this age group. In this review, we will describe behavioural factors that shape the development of food acceptance, including food selection and food preferences, as well as the regulation of food intake in young children. Although a range of environmental factors may directly influence the development of child eating behaviours, the primary focus of this review will be on ways in which caregivers influence children’s eating environments and eating behaviours.
The Current State of Children’s Diets
Across human history, undernutrition and food scarcity have been major threats to children’s survival, and parental feeding practices have evolved in response to these threats. These feeding practices, which include behaviours such as providing large portions of palatable foods and encouraging children to eat, are still pervasive in most cultures, despite the fact that in many regions the balance has shifted from food scarcity to food excess and over-consumption has become a new threat. The impact of these ongoing practices on children’s dietary intake can be seen in several recent dietary surveys.
The Feeding Infants and Toddlers Study (FITS), which provided data on the dietary patterns of 3022 infants and toddlers, revealed that 4 to 24 month old children typically consumed significant amounts of developmentally inappropriate, energy-dense, nutrient poor foods. Of particular concern was the finding that 18% to 33% of infants and toddlers consumed no distinct servings of vegetables on a typical day and when vegetables were consumed the most common choice was french fries. Additionally, reported energy intakes exceeded requirements by 10 to 30%. Unfortunately, there is also evidence that these patterns tend to persist throughout childhood and into adolescence, and that diet quality tracks and declines from early childhood through adolescence.
The Canadian Community Health Survey (CCHS) suggests that seven out of ten children aged 4 to 8 years fail to meet the minimum number of servings for vegetables and fruit in Canada’s Food Guide to Healthy Eating. These children also fall short of reaching the recommended servings for grains and milk products, thereby suggesting that poor eating habits among children are endemic.
The transition into late childhood and adolescence can also be characterized by undesirable changes in eating behaviours such as increased consumption of sugar sweetened beverages (e.g., soda), calorie-dense, nutrient poor snacks and food away from home (e.g., fast food) and a decline in the consumption of milk and other nutrient-dense foods.Meal patterns also tend to change, as teenagers are more likely to skip breakfast and less likely to participate in family dinners All of these trends are associated with decreased diet quality and may partially explain the fact that most adolescents are failing to meet the majority of dietary recommendations.
Influences during Infancy and the Toddler Years
The first year of life is a period of rapid physical, social and emotional growth, during which eating patterns also develop. During this first year, infants transition from consuming a single food (i.e., breast milk or formula) to consuming a variety of foods more characteristic of an adult diet. This transition allows infants to learn about food through direct experience, as well as through observation of others’ eating behaviours.
Data indicate that breastfeeding and parental modeling in the toddler years play significant roles in establishing longer-term eating behaviours. As reviewed below, children who are not breastfed still derive a significant benefit from the behaviours that their parents impart as they grow and develop. Breastfeeding is recommended as the optimal feeding method for the first 6 months of life15, in part because of the mounting evidence that breastfeeding has a positive impact on the development of a child’s later eating behaviours.16-18
Breastfeeding plays a role in the development of a child’s response to internal hunger and satiety cues19, and may foster the development of self-regulatory abilities during feeding.20 Variations in the composition of breast milk during a single feed, as well as differences in composition across the first months of life, foster this heightened sensitivity to energy intake. Emerging scientific evidence also supports the role of breastfeeding in early metabolic imprinting, which partially accounts for later differences in eating behaviours.
Breastfeeding also has a positive impact on later eating behaviour because it may promote acceptance of flavours in the maternal diet that are passed through breast milk.
As a result, breastfed infants are exposed to a more varied flavour experience, depending on the variety of the mother’s diet and this exposure may affect food acceptance during the transition to solid foods and later in life.
Infants are born with a preference for sweet and salty taste,27 thus sweet and salty foods have a greater likelihood of being accepted by infants when compared to foods with bitter flavours, such as certain vegetables. Both infants and young children can learn to accept a greater variety of foods and flavours through repeated exposure.28 Thus, in a sense, breastfeeding gives the infant early, repeated exposure to the flavours of the mother’s diet, providing a flavour bridge that promotes the infant’s acceptance of familiar flavours when they appear in solid foods.25 As a result, breastfed infants may be more accepting of new foods and likely to consume a more varied diet later in life, depending on the variety of the mother’s diet during breastfeeding
Leann Birch, Jennifer S. Savage, and Alison Ventura. Can J Diet Pract Res. 2007; 68(1): s1–s56. Influences on the Development of Children’s Eating Behaviours: From Infancy to Adolescence
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