Study: Sooner Infants and Children Learn to Eat Healthy, the Better

Published January 23, 2018

Stephanie Anzman-Frasca, PhD

A new review paper led by Stephanie Anzman-Frasca, PhD, assistant professor of pediatrics, suggests varied diets and persistence in exposing infants and children to healthy foods is key to promoting healthy eating behaviors.

Anzman-Frasca, a researcher in the Division of Behavioral Medicine, is lead author on the paper published Dec. 20 in Obesity Reviews.

“The goal was to review the literature in order to make recommendations to parents and caregivers on how they can best encourage children’s healthy eating starting as early as possible,” she says.

Actions During Pregnancy, Breast-Feeding Influential

The researchers based their recommendations on data gathered from more than 40 peer-reviewed studies on how infants and young children develop preferences for healthy foods, especially vegetables and fruits.

Healthy eating during pregnancy starts the ball rolling, the authors point out.

“Flavors of mom’s diet reach the child in utero,” Anzman-Frasca explains, “so if she’s eating a healthy diet, the fetus does get exposed to those flavors, getting the child used to them.”

After birth, if the mother breast-feeds, the baby also benefits from exposure to flavors from her healthy diet through the breast milk.

These early exposures familiarize the baby with specific flavors as well as the experience of variety and set the stage for later acceptance of healthy flavors in solid foods.

Repeated Exposure to Healthy Foods Beneficial

Even after infancy, repeatedly exposing children to foods that they previously rejected can help them to accept and like the food.

“This method of simply repeating the child’s exposure to healthy foods has a robust evidence base behind it,” Anzman-Frasca says. “There are many studies with preschoolers who start out not liking red peppers or squash, for example, but after five to six sessions where these foods are repeatedly offered, they end up liking them.”

However, the review pointed out, one study has found that in low-income homes, parents often do not serve previously rejected foods because of the desire not to waste food.

The authors call for interventions to promote repeated exposure to healthy foods in these environments, while addressing challenges parents face.

Varied Diets Most Important During Early Development

Other conclusions from the study are:

  • vary foods during the prenatal period, early milk feeding and toddlerhood, taking advantage of periods when neophobia — the rejection of novel things — is lower
  • start with simple approaches like repeated exposure — or caregivers and siblings modeling the consumption and enjoyment of healthy foods — reserving other strategies for cases where they are needed to motivate initial tasting
  • larger-scale changes to make healthy choices easy in children’s everyday environments can help caregivers to use recommended strategies to increase acceptance of healthier foods successfully; for example, making healthy side dishes and beverages the default accompaniments in kids’ meals in restaurants can increase children’s exposure to these items

Parents and Caregivers Urged to Remain Persistent

“Overall, based on all the studies we reviewed, our strongest recommendation to parents and caregivers is ‘don’t give up!’” Anzman-Frasca says.

Sarah Ehrenberg, an undergraduate Honors student majoring in biomedical sciences at UB, was also an author on the study that was funded by the Robert Wood Johnson Foundation through its Healthy Eating Research program.

Other authors on the study were from California Polytechnic State University and Bucknell University.