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Maternal feeding practices associated with food neophobia
Appetite 59 (2012) 483–487
Contents lists available at SciVerse ScienceDirect
Appetite journal homepage: www.elsevier.com/locate/appet
Research report
Maternal feeding practices associated with food neophobia Cin Cin Tan ⇑, Shayla C. Holub The University of Texas at Dallas, United States
a r t i c l e
i n f o
Article history: Received 28 July 2011 Received in revised form 15 June 2012 Accepted 18 June 2012 Available online 23 June 2012 Keywords: Food neophobia Feeding practices Eating behaviors Children Parents
a b s t r a c t The current study examined the associations between children’s and mother’s food neophobia and parental feeding practices. Eighty-five mothers of 3- to 12-year old children (M = 5.7 years; 52% girls) completed a questionnaire online about food neophobia and feeding practices. Mothers with children high in food neophobia used more restriction for health and less monitoring. Mothers with food neophobic children and mothers who were themselves food neophobic also reported that they do not make healthy foods readily available for their children. Mothers high in food neophobia also used more restriction for weight. This study is a starting point for understanding the link between neophobia and feeding practices, but future longitudinal work is needed in order to determine direction of effects. However, interventions could be created to help parents understand the importance of feeding practices for promoting children’s food acceptance. Published by Elsevier Ltd.
Introduction Many children show fear of new foods, rejecting foods that are unfamiliar to them (Addessi, Galloway, Visalberghi, & Birch, 2005; Cashdan, 1994; Dovey, Staples, Gibson, & Halford, 2008). Known as food neophobia, this behavior is thought to be adaptive as it prevents children from consuming foods that are poisonous (Benton, 2004; Pliner & Hobden, 1992; Rozin, 1976; Rozin & Vollmecke, 1986). Nevertheless, food neophobia may also hinder children from consuming a variety of healthy foods. Children with food neophobia consume fewer vegetables and fruits, but not fewer starchy and sweet foods, than children without food neophobia (Cooke, Carnell, & Wardle, 2006; Cooke, Wardle, & Gibson, 2003; Galloway, Lee, & Birch, 2003). Thus, food neophobia puts children at risk for obesity and developing lifelong unhealthy eating habits. Costanzo and Woody (1984) theorize that parents’ domain-specific parenting practices, including their feeding practices, are related to their perceptions about and concerns for their children. Little is known about the relation between children’s food neophobia and parents’ feeding practices. However, experimental research shows that neophobia can be altered by encouraging children to try a novel food several times (Birch, McPhee, Shoba, Pirok, & Steinberg, 1987), suggesting that parental feeding behaviors might be related to children’s food neophobia. Furthermore, parents’ own weight and eating behaviors relate to their use of specific feeding practices (Wardle, Sanderson, Guthrie, Rapoport, & Plomin, 2002). This suggests that parents’ own food neophobic tendencies might
⇑ Corresponding author. E-mail address: [email protected] (C.C. Tan). 0195-6663/$ - see front matter Published by Elsevier Ltd. http://dx.doi.org/10.1016/j.appet.2012.06.012
be associated with the way they feed their children, but research has yet to examine this association.
Parents’ feeding practices and child food neophobia Only a handful of studies have examined the association between parental feeding practices and child food neophobia (i.e., Koivisto & Sjoden, 1996; Wardle, Carnell, & Cooke, 2005). However, researchers speculate that children’s food neophobic responses lead to stressful feeding situations, which elicit negative feeding behaviors from parents (Dovey et al., 2008). For example, parents likely show negative emotions in these feeding situations, which children might associate with the presentation of the novel food (Dovey et al., 2008). Furthermore, in support of Costanzo and Woody’s (1984) model, parents report that they use different feeding practices in response to child characteristics, such as temperament and responsiveness to foods (Carnell, Cooke, Cheng, Robbins, & Wardle, 2011). Thus, it is likely that parents use different feeding practices with children high in food neophobia. Parents who use controlling feeding practices attempt to dictate the amount or type of foods their children eat by encouraging the child to eat more foods (pressure), limiting foods that are perceived as unhealthy to maintain health (restriction for health), or limiting foods for weight loss or maintenance (restriction for weight; Musher-Eizenman & Holub, 2007). Wardle et al. (2005) found that children’s food neophobia was related to parents’ use of controlling feeding practices. However, they did not distinguish between pressure and restriction. Since parents use restriction and pressure differently depending on whether children are showing food avoidance or acceptance (Webber, Cooke, Hill, & Wardle, 2010),
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the relationship between specific controlling feeding practices and children’s and parents’ food neophobia should be examined. Parents also use feeding practices that are autonomy promoting, which encourage children to develop the skills to eat healthily in the future (Musher-Eizenman & Holub, 2007). Encouraging children to eat by presenting novel food, sometimes multiple times, is an effective feeding practice that results in children being more likely to accept the food (Birch et al., 1987; Wardle, Herrera, Cooke, & Gibson, 2003). Having healthy foods, such as fruits and vegetables, available in the home is also related to children’s consumption of those healthy foods (Blanchette & Brug, 2005; Cooke et al., 2004; Cullen et al., 2001). Koivisto & Sjoden (1996) found that mothers high in food neophobia reported they thought less about serving some foods than mothers who were not high in food neophobia. Furthermore, children’s food neophobia was positively associated with parents allowing children to decide portion sizes. However, beyond this feeding practice, research has not examined the association between autonomy promoting feeding practices and children’s food neophobia. Other parents engage in feeding practices which use food for non-nutritive purposes. Some parents use food to regulate their child’s emotions or use food as a reward or punishment (Musher-Eizenman & Holub, 2007). Parents with children high in food neophobia might engage in these strategies, especially using food as a reward, to try to encourage their children to eat new food, but research has yet to examine whether these parents are more likely to employ these strategies. The current study The purpose of the current study is to examine the associations between mothers’ and children’s food neophobia and mothers’ feeding practices. It is expected that children’s food neophobia will be positively correlated with controlling feeding practices, but negatively correlated with autonomy promoting feeding practices. It is also expected that mothers’ own food neophobia might be related to their feeding practices. Although speculative, it is expected that mothers high in neophobia would be less likely to use some autonomy promoting feeding practices, such as providing healthy foods at home. Since no previous research has been conducted, no hypotheses were made about whether child or mother neophobia will be related to the use of food for non-nutritive purposes. Method Participants Parents in the United States were recruited to complete an online survey about 3- to 12-year old children’s eating behaviors through convenience and snowball sampling. Parents who were acquaintances of undergraduate and graduate students in the department and parents who were participants in other non-food related studies at the university were contacted through e-mail or were given a flyer about the study. These parents were asked to participate and to forward the information about the study to other parents they know. If parents had more than one child in this age range, they were asked to choose the child whose name came first alphabetically. Three fathers participated, but were excluded from the current study because of their small number. A total of 85 mothers completed the survey. This sample size was deemed acceptable based on power analysis assuming a medium effect size with an alpha of .05 (Cohen, 1992). The mean age of children in this sample was 5.7 years old (SD = 1.96; Range: 3.0–12.6); 48% were boys and 52% were girls. Most parents reported that their children were Caucasian (85%),
but 5% were Hispanic, 5% were African American, 3% were Asian, and 2% were Middle Eastern. Parents’ reports of their children’s height and weight were converted into BMI z-scores, which are standardized based on child gender and age (NutStat Program; Dean et al., 2007). There were two scores that were obvious outliers: children’s calculated scores were greater than 9 standard deviations above and below the mean. These values were coded as missing. The mean BMI z-score, not including these values, was .13 (SD = 1.35; Range: 2.92 to 4.36). The mean age of the mothers in this sample was 37.7 years old (SD = 6.3; Range: 24.5–52.6). Mothers’ reports of their own heights and weights were converted into body mass index scores (BMI; kg/ m2). The mean BMI was 25.4 (SD = 6.36; Range: 17.0–43.9). Measures Children’s food neophobia Mothers completed the 10 item Children’s Food Neophobia scale (CFNS; Pliner, 1994). Mothers rated their children’s eating behaviors on a scale from 1 (Disagree Strongly) to 7 (Agree Strongly). Higher scores represent greater food neophobia. The Cronbach’s coefficient alpha for this scale was .95. This measure has demonstrated concurrent validity in that children’s food neophobia is positively associated with behavioral measures of food neophobia (Pliner, 1994). Mothers’ food neophobia Mothers’ food neophobia was measured using the Food Neophobia Scale (FNS; Pliner & Hobden, 1992). Mothers completed a 10 item questionnaire, and rated items on a scale from 1 (Disagree Strongly) to 7 (Agree Strongly). Higher scores represent greater food neophobia. The Cronbach’s coefficient alpha for this scale was .88. This measure has demonstrated concurrent validity; food neophobia was positively associated with behavioral measures of food neophobia and related personality characteristics (Pliner & Hobden, 1992). Maternal feeding practices The Comprehensive Feeding Practices Questionnaire was used to measure parents’ feeding practices (CFPQ; Musher-Eizenman & Holub, 2007). Three controlling subscales were used (pressure, restriction for health, and restriction for weight). Seven autonomy promoting subscales were used (environment, encourage balance and variety, teaching about nutrition, monitoring, modeling, involvement and child control). Two using food for non-nutritive purposes subscales were used (emotion regulation and food as a reward). Mothers rated items on a scale from 1(Never) to 5 (Always) for child control, emotion regulation, and monitoring subscales. The remaining subscales were rated on a scale from 1 (Disagree) to 5 (Agree). Higher scores represent using more of those feeding practices. The Cronbach’s coefficient alphas for these subscales ranged from .60 to .84 (see Table 1). Data analysis plan Normality of the variables was assessed using skewness and kurtosis statistics, as well as visual inspection of histograms. All food neophobia and feeding measures were found to be acceptable, with the exception of the teaching for nutrition subscale, which was corrected by using a logarithmic transformation. Several preliminary analyses will be conducted to further understand food neophobia in this sample and to decide which demographic variables should be controlled for in the primary analyses. First, to examine whether children are more food neophobic than their mothers, a paired samples t-test will be conducted. Second, correlational analyses will also be conducted to
C.C. Tan, S.C. Holub / Appetite 59 (2012) 483–487 Table 1 Correlations between demographic variables, food neophobia and feeding practices. Cronbach coefficient alpha Child food neophobia Mother food neophobia Restriction for health Restriction for weight Pressure Environment Encourage balance and variety Teaching about nutrition Monitoring Modeling Involvement Child control Emotion regulation Food as reward
Maternal age
Maternal BMI
Child age
Child BMI z-score
.95
.16
.18
.14
.09
.88
.05
.17
.01
.05
.84
.10
.05
.13
.05
.80
.04
.08
.03
.07
.75 .81 .70
.11 .09 .16
.16 .20 .15
.01 .03 .05
.04 .01 .07
.68
.04
.19
.29**
.05
**
*
.84 .81 .76 .64 .60
.29 .14 .11 .14 .15
.23 .27* .16 .00 .06
.01 .05 .27* .26* .001
.07 .04 .02 .13 .14
.79
.02
.16
.05
.20
485
Results Preliminary analyses Mothers rated their children as more neophobic than they rated themselves, t(84) = 8.92, p < .001. The mean score for children’s food neophobia was 3.9 (SD = 1.5). The range (1.6–7.0) suggested that some children showed high food neophobia, while others did not. The mean score for mothers’ neophobia was 2.3 (SD = 1.0, Range: 1.0–5.8). Reports of child and maternal food neophobia were not significantly correlated, r(83) = .19, p = .08. Mothers’ and children’s neophobia were not related to maternal or child age or maternal or child weight status (Table 1). However, feeding practices were related to some demographic variables (Table 1). In addition, mothers of girls used more emotion regulation and involvement than mothers of boys, t(83) = 2.99, p = .004 and t(83) = 2.06, p = .04, respectively. No child gender differences were found for children’s food neophobia, mothers’ food neophobia, or for other feeding practices, p’s > .05. Significant demographic variables were controlled for using partial correlations in subsequent analyses (see Table 2 note for details). Primary analyses
*
p < .05. ** p < .01.
examine whether there is a relationship between neophobia in mothers and their offspring. Third, correlational analyses will be conducted to examine whether demographic variables (maternal age, maternal BMI, child age and child BMI z-scores) are associated with food neophobia, and feeding practices. Fourth, independent sample t-tests will be conducted to examine whether there are gender differences on key study variables. Primary analyses will be conducted to examine associations between neophobia and feeding practices using Pearson Correlations. When demographic variables are related to one of these variables, partial correlations will be conducted. All tests will be two-tailed.
The main purpose of this study was to examine the associations between child and maternal neophobia and maternal feeding practices. Child neophobia was positively related to higher use of restriction for health, but was not related to pressure or restriction for weight (Table 2). Children’s food neophobia was also related to some autonomy promoting feeding practices. As children’s food neophobia increased, parents reported lower scores for providing a healthy food environment and monitoring their children’s food intake. Children’s food neophobia was not associated with feeding for non-nutritive purposes. Maternal neophobia was related to restriction for weight: mothers who themselves had higher food neophobia used more restriction for weight. Marginal findings suggested that maternal neophobia was inversely related to providing a healthy feeding environment for children. Discussion
Table 2 Correlations between child and maternal food neophobia and feeding practices. Mean (SD) Restriction for health Restriction for weight Pressure Environment Encourage balance and variety Teaching about nutrition Monitoring Modeling Involvement Child control Emotion regulation Food as reward
Child food neophobia
Maternal food neophobia
3.2 (1.2) 1.7 (.60) 2.3 (1.0) 4.3 (.77) 4.3 (.54)
.36** .05 .14 .48** .18
.11 .24* .09 .20 .10
4.6 (.61)
.12
.07
4.3 (.64) 4.3 (.78) 4.0 (.94) 2.8 (.70) 1.6 (.49) 2.0 (1.1)
.27 .05 .11 .08 .06 .05
*
.09 .03 .12 .03 .05 .13
Note: The mean and standard deviation for teaching about nutrition was before logarithm transformation. Partial correlations were conducted for monitoring (controlling for maternal age and BMI), teaching about nutrition (controlling for child age), modeling (controlling for maternal BMI), involvement (controlling for child age and gender), child control (controlling for child age), and emotion regulation (controlling for child gender). * p < .05. ** p < .01. p < .10.
The current study was the first to examine children’s and mothers’ food neophobia in relation to maternal feeding practices. Some parental feeding behaviors were related to food neophobia, supporting Costanzo and Woody’s (1984) domain-specific parenting model. However, it should be noted that the direction of effects for these relations are unclear. It could be that mothers use specific feeding practices reactively: the feeding practice is in response to child behavior. For example, mothers with food neophobic children might not keep a variety of healthy foods in their home because they know that their children will not eat them. However, it could also be that not keeping healthy foods at home promotes food neophobic tendencies because of children’s lack of exposure to a variety of foods. Longitudinal research is needed to determine directionality and to better understand how parental behaviors contribute to the development of food neophobia in children. Children’s food neophobia was related to mothers’ use of the controlling feeding practice of restriction for health, but not pressure or restriction for weight. Children who are high in food neophobia consume foods with preferred flavors, like sweets or high fat foods (Cooke et al., 2003). This might lead to parental concerns about adequate nutrition and dietary variety, which could be manifested through restriction of these undesired foods. Surprisingly, parents with food neophobic children did not report using more pressure to eat. However, pressure includes parents’ attempts to
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get children to eat more food at mealtimes, not necessarily their attempts to get them to eat novel foods. Past research suggests that children’s food neophobia is associated with parents serving fewer uncommon foods and with less exposure to dietary variety (Koivisto & Sjoden, 1996; Pelchat & Pliner, 1986). Therefore, it is likely that the foods served during mealtimes are foods that parents know that their neophobic children will accept and consume, making pressure obsolete. Children’s food neophobia was not associated with restriction for weight in the current study, which is not surprising given children’s food neophobia was not related to child weight status. Parents with children high in food neophobia reported less monitoring of their children’s food intake. Future research should determine why these parents spend less time monitoring. Perhaps these parents are exasperated by their child’s unwillingness to try new foods that they choose not to monitor their intake of unhealthy foods. However, this seems unlikely given that these parents reported using more restriction for health. Future research should examine whether low monitoring is related to parents’ self-efficacy in feeding (Shumow & Lornax, 2002), as parents with food neophobic children might have low self-efficacy for feeding their children healthy foods. Parents whose children were high in food neophobia also reported that they are less likely to make healthy foods readily available and easily accessible to their children. This is not overly surprising considering that parents report making new foods available to their children only 3 to 5 times after they have been rejected (Carruth, Ziegler, Gordon, & Barr, 2004), while research suggests that 8 to 5 exposures are necessary (Birch et al., 1987). It is troublesome that these parents scored low on environment because it suggests that neophobic children might not be getting exposure to a wide variety of healthy foods. Exposure has been shown to work better than teaching or using food as a reward to get children to eat new or disliked foods in experimental studies (Wardle, Cooke, et al., 2003; Wardle, Herrera, et al., 2003). The current study suggests that in real-world contexts mothers are not participating in the feeding practice that could do the most good. There was a trend in the data that suggested that mothers who were themselves high in food neophobia also reported that they did not make healthy foods readily available for their children. These parents might be letting their own food preferences dictate what foods they make available to their children, which in the long-term might undermine children’s nutrition and dietary variety. Mothers high in food neophobia were also more likely to use restriction for weight. Since food neophobia limits dietary variety, these mothers may themselves prefer high fat or sugary foods. Future research should examine whether food neophobic mothers’ use of restriction for weight is a reflection of their weight concerns for themselves or for their children. No developmental differences in food neophobia were found in this study. Past research is mixed regarding age-related differences (Addessi et al., 2005; Dovey et al., 2008, 2011; Pliner, 1994), which could be due to differences in measurement across studies. Parentreport measures, like the one used in the current study, might not be sensitive to age differences in expression of food neophobia and appear to be related to more stable individual differences in food neophobia (Pliner & Loewen, 1997). Furthermore, the current study included a wide age range so age-related differences might have been difficult to detect. However, when this data was examined using smaller age ranges (i.e., 3- to 5-year olds and 3- to 8-year olds), the results did not change regarding the relations between child neophobia and feeding practices, suggesting child age might not matter to these relations. There were some limitations to the current study. First, only maternal reports were used, which could lead to mono-method bias. Second, fathers were not included in the current study.
Fathers report higher food neophobia than mothers (Hursti & Sjoden, 1997), so it would be worthwhile to look at the associations between child and paternal food neophobia in future research. Third, the current study examined food neophobia in relation to a previously validated measure of parental feeding practices, which is an important contribution to the literature. However, the use of this measure might have limited our understanding of how parents respond to food neophobia directly. Future research should examine the specific practices that parents use in response to food neophobia. This is especially important because past experimental research suggests that children high in food neophobia may not respond well to some feeding practices, such as receiving messages about the health benefits of novel foods (Dovey et al., 2011). Fourth, this study focused on food neophobia, not picky (fussy) eating. Although some researchers speculate that parental responses to food neophobia and picky eating are likely similar (Dovey et al., 2008), these are two distinct constructs. Future research should examine the association between picky eating and feeding practices. Last, it should be noted that snowball and convenience sampling was used, so future research should sample in ways to ensure the generalizability of these findings. The current study was an important first step in examining maternal feeding practices associated with food neophobia. Children’s food neophobia discourages dietary variety, which is necessary for good health. Thus, future research is needed to understand how to best create interventions that will provide parents with insights into how to best respond to children’s food neophobia in order to lessen its problematic effects. In addition, because mothers’ own food neophobia was associated with their feeding practices, research could also be conducted to create interventions that help parents to overcome their own food neophobia in order to promote child health.
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C.C. Tan, S.C. Holub / Appetite 59 (2012) 483–487 professionals [Computer Software]. Atlanta, Georgia: Centers for Disease Control and Prevention. Dovey, T. M., Aldridge, V. K., Dignan, W., Staples, P. A., Gibson, L. E., & Halford, J. C. G. (2011). Developmental differences in sensory decision making involved in deciding to try a novel fruit. British Journal of Health Psychology. http:// dx.doi.org/10.1111/j.2044-8287.2011.02036.x. Dovey, T. M., Staples, P. A., Gibson, E. L., & Halford, J. C. G. (2008). Food neophobia and ‘picky/fussy’ eating in children. A review. Appetite, 50, 181–193. Galloway, A. T., Lee, Y., & Birch, L. L. (2003). Predictors and consequences of food neophobia and pickiness in young girls. American Dietetic Association, 103, 692–698. Hursti, U. K., & Sjoden, P. (1997). Food and general neophobia and their relationship with self-reported food choices. Familial resemblance in Swedish families with children of ages 7–17 years. Appetite, 29, 89–103. Koivisto, U. K., & Sjoden, P. O. (1996). Reasons for rejection of food items in Swedish families with children aged 2–17. Appetite, 26, 89–103. Musher-Eizenman, D. R., & Holub, S. C. (2007). Comprehensive Feeding Practices Questionnaire. Validation of a new measure of parental feeding practices. Journal of Pediatric Psychology, 32, 960–972. Pelchat, M. L., & Pliner, P. (1986). Antecedents and correlates of feeding problems in young children. Journal of Nutrition Education, 18, 23–29. Pliner, P. (1994). Development of measures of food neophobia in children. Appetite, 23, 147–163. Pliner, P., & Hobden, K. (1992). Development of a scale to measure the trait of food neophobia in humans. Appetite, 19, 105–120.
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Contents lists available at SciVerse ScienceDirect
Appetite journal homepage: www.elsevier.com/locate/appet
Research report
Maternal feeding practices associated with food neophobia Cin Cin Tan ⇑, Shayla C. Holub The University of Texas at Dallas, United States
a r t i c l e
i n f o
Article history: Received 28 July 2011 Received in revised form 15 June 2012 Accepted 18 June 2012 Available online 23 June 2012 Keywords: Food neophobia Feeding practices Eating behaviors Children Parents
a b s t r a c t The current study examined the associations between children’s and mother’s food neophobia and parental feeding practices. Eighty-five mothers of 3- to 12-year old children (M = 5.7 years; 52% girls) completed a questionnaire online about food neophobia and feeding practices. Mothers with children high in food neophobia used more restriction for health and less monitoring. Mothers with food neophobic children and mothers who were themselves food neophobic also reported that they do not make healthy foods readily available for their children. Mothers high in food neophobia also used more restriction for weight. This study is a starting point for understanding the link between neophobia and feeding practices, but future longitudinal work is needed in order to determine direction of effects. However, interventions could be created to help parents understand the importance of feeding practices for promoting children’s food acceptance. Published by Elsevier Ltd.
Introduction Many children show fear of new foods, rejecting foods that are unfamiliar to them (Addessi, Galloway, Visalberghi, & Birch, 2005; Cashdan, 1994; Dovey, Staples, Gibson, & Halford, 2008). Known as food neophobia, this behavior is thought to be adaptive as it prevents children from consuming foods that are poisonous (Benton, 2004; Pliner & Hobden, 1992; Rozin, 1976; Rozin & Vollmecke, 1986). Nevertheless, food neophobia may also hinder children from consuming a variety of healthy foods. Children with food neophobia consume fewer vegetables and fruits, but not fewer starchy and sweet foods, than children without food neophobia (Cooke, Carnell, & Wardle, 2006; Cooke, Wardle, & Gibson, 2003; Galloway, Lee, & Birch, 2003). Thus, food neophobia puts children at risk for obesity and developing lifelong unhealthy eating habits. Costanzo and Woody (1984) theorize that parents’ domain-specific parenting practices, including their feeding practices, are related to their perceptions about and concerns for their children. Little is known about the relation between children’s food neophobia and parents’ feeding practices. However, experimental research shows that neophobia can be altered by encouraging children to try a novel food several times (Birch, McPhee, Shoba, Pirok, & Steinberg, 1987), suggesting that parental feeding behaviors might be related to children’s food neophobia. Furthermore, parents’ own weight and eating behaviors relate to their use of specific feeding practices (Wardle, Sanderson, Guthrie, Rapoport, & Plomin, 2002). This suggests that parents’ own food neophobic tendencies might
⇑ Corresponding author. E-mail address: [email protected] (C.C. Tan). 0195-6663/$ - see front matter Published by Elsevier Ltd. http://dx.doi.org/10.1016/j.appet.2012.06.012
be associated with the way they feed their children, but research has yet to examine this association.
Parents’ feeding practices and child food neophobia Only a handful of studies have examined the association between parental feeding practices and child food neophobia (i.e., Koivisto & Sjoden, 1996; Wardle, Carnell, & Cooke, 2005). However, researchers speculate that children’s food neophobic responses lead to stressful feeding situations, which elicit negative feeding behaviors from parents (Dovey et al., 2008). For example, parents likely show negative emotions in these feeding situations, which children might associate with the presentation of the novel food (Dovey et al., 2008). Furthermore, in support of Costanzo and Woody’s (1984) model, parents report that they use different feeding practices in response to child characteristics, such as temperament and responsiveness to foods (Carnell, Cooke, Cheng, Robbins, & Wardle, 2011). Thus, it is likely that parents use different feeding practices with children high in food neophobia. Parents who use controlling feeding practices attempt to dictate the amount or type of foods their children eat by encouraging the child to eat more foods (pressure), limiting foods that are perceived as unhealthy to maintain health (restriction for health), or limiting foods for weight loss or maintenance (restriction for weight; Musher-Eizenman & Holub, 2007). Wardle et al. (2005) found that children’s food neophobia was related to parents’ use of controlling feeding practices. However, they did not distinguish between pressure and restriction. Since parents use restriction and pressure differently depending on whether children are showing food avoidance or acceptance (Webber, Cooke, Hill, & Wardle, 2010),
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the relationship between specific controlling feeding practices and children’s and parents’ food neophobia should be examined. Parents also use feeding practices that are autonomy promoting, which encourage children to develop the skills to eat healthily in the future (Musher-Eizenman & Holub, 2007). Encouraging children to eat by presenting novel food, sometimes multiple times, is an effective feeding practice that results in children being more likely to accept the food (Birch et al., 1987; Wardle, Herrera, Cooke, & Gibson, 2003). Having healthy foods, such as fruits and vegetables, available in the home is also related to children’s consumption of those healthy foods (Blanchette & Brug, 2005; Cooke et al., 2004; Cullen et al., 2001). Koivisto & Sjoden (1996) found that mothers high in food neophobia reported they thought less about serving some foods than mothers who were not high in food neophobia. Furthermore, children’s food neophobia was positively associated with parents allowing children to decide portion sizes. However, beyond this feeding practice, research has not examined the association between autonomy promoting feeding practices and children’s food neophobia. Other parents engage in feeding practices which use food for non-nutritive purposes. Some parents use food to regulate their child’s emotions or use food as a reward or punishment (Musher-Eizenman & Holub, 2007). Parents with children high in food neophobia might engage in these strategies, especially using food as a reward, to try to encourage their children to eat new food, but research has yet to examine whether these parents are more likely to employ these strategies. The current study The purpose of the current study is to examine the associations between mothers’ and children’s food neophobia and mothers’ feeding practices. It is expected that children’s food neophobia will be positively correlated with controlling feeding practices, but negatively correlated with autonomy promoting feeding practices. It is also expected that mothers’ own food neophobia might be related to their feeding practices. Although speculative, it is expected that mothers high in neophobia would be less likely to use some autonomy promoting feeding practices, such as providing healthy foods at home. Since no previous research has been conducted, no hypotheses were made about whether child or mother neophobia will be related to the use of food for non-nutritive purposes. Method Participants Parents in the United States were recruited to complete an online survey about 3- to 12-year old children’s eating behaviors through convenience and snowball sampling. Parents who were acquaintances of undergraduate and graduate students in the department and parents who were participants in other non-food related studies at the university were contacted through e-mail or were given a flyer about the study. These parents were asked to participate and to forward the information about the study to other parents they know. If parents had more than one child in this age range, they were asked to choose the child whose name came first alphabetically. Three fathers participated, but were excluded from the current study because of their small number. A total of 85 mothers completed the survey. This sample size was deemed acceptable based on power analysis assuming a medium effect size with an alpha of .05 (Cohen, 1992). The mean age of children in this sample was 5.7 years old (SD = 1.96; Range: 3.0–12.6); 48% were boys and 52% were girls. Most parents reported that their children were Caucasian (85%),
but 5% were Hispanic, 5% were African American, 3% were Asian, and 2% were Middle Eastern. Parents’ reports of their children’s height and weight were converted into BMI z-scores, which are standardized based on child gender and age (NutStat Program; Dean et al., 2007). There were two scores that were obvious outliers: children’s calculated scores were greater than 9 standard deviations above and below the mean. These values were coded as missing. The mean BMI z-score, not including these values, was .13 (SD = 1.35; Range: 2.92 to 4.36). The mean age of the mothers in this sample was 37.7 years old (SD = 6.3; Range: 24.5–52.6). Mothers’ reports of their own heights and weights were converted into body mass index scores (BMI; kg/ m2). The mean BMI was 25.4 (SD = 6.36; Range: 17.0–43.9). Measures Children’s food neophobia Mothers completed the 10 item Children’s Food Neophobia scale (CFNS; Pliner, 1994). Mothers rated their children’s eating behaviors on a scale from 1 (Disagree Strongly) to 7 (Agree Strongly). Higher scores represent greater food neophobia. The Cronbach’s coefficient alpha for this scale was .95. This measure has demonstrated concurrent validity in that children’s food neophobia is positively associated with behavioral measures of food neophobia (Pliner, 1994). Mothers’ food neophobia Mothers’ food neophobia was measured using the Food Neophobia Scale (FNS; Pliner & Hobden, 1992). Mothers completed a 10 item questionnaire, and rated items on a scale from 1 (Disagree Strongly) to 7 (Agree Strongly). Higher scores represent greater food neophobia. The Cronbach’s coefficient alpha for this scale was .88. This measure has demonstrated concurrent validity; food neophobia was positively associated with behavioral measures of food neophobia and related personality characteristics (Pliner & Hobden, 1992). Maternal feeding practices The Comprehensive Feeding Practices Questionnaire was used to measure parents’ feeding practices (CFPQ; Musher-Eizenman & Holub, 2007). Three controlling subscales were used (pressure, restriction for health, and restriction for weight). Seven autonomy promoting subscales were used (environment, encourage balance and variety, teaching about nutrition, monitoring, modeling, involvement and child control). Two using food for non-nutritive purposes subscales were used (emotion regulation and food as a reward). Mothers rated items on a scale from 1(Never) to 5 (Always) for child control, emotion regulation, and monitoring subscales. The remaining subscales were rated on a scale from 1 (Disagree) to 5 (Agree). Higher scores represent using more of those feeding practices. The Cronbach’s coefficient alphas for these subscales ranged from .60 to .84 (see Table 1). Data analysis plan Normality of the variables was assessed using skewness and kurtosis statistics, as well as visual inspection of histograms. All food neophobia and feeding measures were found to be acceptable, with the exception of the teaching for nutrition subscale, which was corrected by using a logarithmic transformation. Several preliminary analyses will be conducted to further understand food neophobia in this sample and to decide which demographic variables should be controlled for in the primary analyses. First, to examine whether children are more food neophobic than their mothers, a paired samples t-test will be conducted. Second, correlational analyses will also be conducted to
C.C. Tan, S.C. Holub / Appetite 59 (2012) 483–487 Table 1 Correlations between demographic variables, food neophobia and feeding practices. Cronbach coefficient alpha Child food neophobia Mother food neophobia Restriction for health Restriction for weight Pressure Environment Encourage balance and variety Teaching about nutrition Monitoring Modeling Involvement Child control Emotion regulation Food as reward
Maternal age
Maternal BMI
Child age
Child BMI z-score
.95
.16
.18
.14
.09
.88
.05
.17
.01
.05
.84
.10
.05
.13
.05
.80
.04
.08
.03
.07
.75 .81 .70
.11 .09 .16
.16 .20 .15
.01 .03 .05
.04 .01 .07
.68
.04
.19
.29**
.05
**
*
.84 .81 .76 .64 .60
.29 .14 .11 .14 .15
.23 .27* .16 .00 .06
.01 .05 .27* .26* .001
.07 .04 .02 .13 .14
.79
.02
.16
.05
.20
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Results Preliminary analyses Mothers rated their children as more neophobic than they rated themselves, t(84) = 8.92, p < .001. The mean score for children’s food neophobia was 3.9 (SD = 1.5). The range (1.6–7.0) suggested that some children showed high food neophobia, while others did not. The mean score for mothers’ neophobia was 2.3 (SD = 1.0, Range: 1.0–5.8). Reports of child and maternal food neophobia were not significantly correlated, r(83) = .19, p = .08. Mothers’ and children’s neophobia were not related to maternal or child age or maternal or child weight status (Table 1). However, feeding practices were related to some demographic variables (Table 1). In addition, mothers of girls used more emotion regulation and involvement than mothers of boys, t(83) = 2.99, p = .004 and t(83) = 2.06, p = .04, respectively. No child gender differences were found for children’s food neophobia, mothers’ food neophobia, or for other feeding practices, p’s > .05. Significant demographic variables were controlled for using partial correlations in subsequent analyses (see Table 2 note for details). Primary analyses
*
p < .05. ** p < .01.
examine whether there is a relationship between neophobia in mothers and their offspring. Third, correlational analyses will be conducted to examine whether demographic variables (maternal age, maternal BMI, child age and child BMI z-scores) are associated with food neophobia, and feeding practices. Fourth, independent sample t-tests will be conducted to examine whether there are gender differences on key study variables. Primary analyses will be conducted to examine associations between neophobia and feeding practices using Pearson Correlations. When demographic variables are related to one of these variables, partial correlations will be conducted. All tests will be two-tailed.
The main purpose of this study was to examine the associations between child and maternal neophobia and maternal feeding practices. Child neophobia was positively related to higher use of restriction for health, but was not related to pressure or restriction for weight (Table 2). Children’s food neophobia was also related to some autonomy promoting feeding practices. As children’s food neophobia increased, parents reported lower scores for providing a healthy food environment and monitoring their children’s food intake. Children’s food neophobia was not associated with feeding for non-nutritive purposes. Maternal neophobia was related to restriction for weight: mothers who themselves had higher food neophobia used more restriction for weight. Marginal findings suggested that maternal neophobia was inversely related to providing a healthy feeding environment for children. Discussion
Table 2 Correlations between child and maternal food neophobia and feeding practices. Mean (SD) Restriction for health Restriction for weight Pressure Environment Encourage balance and variety Teaching about nutrition Monitoring Modeling Involvement Child control Emotion regulation Food as reward
Child food neophobia
Maternal food neophobia
3.2 (1.2) 1.7 (.60) 2.3 (1.0) 4.3 (.77) 4.3 (.54)
.36** .05 .14 .48** .18
.11 .24* .09 .20 .10
4.6 (.61)
.12
.07
4.3 (.64) 4.3 (.78) 4.0 (.94) 2.8 (.70) 1.6 (.49) 2.0 (1.1)
.27 .05 .11 .08 .06 .05
*
.09 .03 .12 .03 .05 .13
Note: The mean and standard deviation for teaching about nutrition was before logarithm transformation. Partial correlations were conducted for monitoring (controlling for maternal age and BMI), teaching about nutrition (controlling for child age), modeling (controlling for maternal BMI), involvement (controlling for child age and gender), child control (controlling for child age), and emotion regulation (controlling for child gender). * p < .05. ** p < .01. p < .10.
The current study was the first to examine children’s and mothers’ food neophobia in relation to maternal feeding practices. Some parental feeding behaviors were related to food neophobia, supporting Costanzo and Woody’s (1984) domain-specific parenting model. However, it should be noted that the direction of effects for these relations are unclear. It could be that mothers use specific feeding practices reactively: the feeding practice is in response to child behavior. For example, mothers with food neophobic children might not keep a variety of healthy foods in their home because they know that their children will not eat them. However, it could also be that not keeping healthy foods at home promotes food neophobic tendencies because of children’s lack of exposure to a variety of foods. Longitudinal research is needed to determine directionality and to better understand how parental behaviors contribute to the development of food neophobia in children. Children’s food neophobia was related to mothers’ use of the controlling feeding practice of restriction for health, but not pressure or restriction for weight. Children who are high in food neophobia consume foods with preferred flavors, like sweets or high fat foods (Cooke et al., 2003). This might lead to parental concerns about adequate nutrition and dietary variety, which could be manifested through restriction of these undesired foods. Surprisingly, parents with food neophobic children did not report using more pressure to eat. However, pressure includes parents’ attempts to
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get children to eat more food at mealtimes, not necessarily their attempts to get them to eat novel foods. Past research suggests that children’s food neophobia is associated with parents serving fewer uncommon foods and with less exposure to dietary variety (Koivisto & Sjoden, 1996; Pelchat & Pliner, 1986). Therefore, it is likely that the foods served during mealtimes are foods that parents know that their neophobic children will accept and consume, making pressure obsolete. Children’s food neophobia was not associated with restriction for weight in the current study, which is not surprising given children’s food neophobia was not related to child weight status. Parents with children high in food neophobia reported less monitoring of their children’s food intake. Future research should determine why these parents spend less time monitoring. Perhaps these parents are exasperated by their child’s unwillingness to try new foods that they choose not to monitor their intake of unhealthy foods. However, this seems unlikely given that these parents reported using more restriction for health. Future research should examine whether low monitoring is related to parents’ self-efficacy in feeding (Shumow & Lornax, 2002), as parents with food neophobic children might have low self-efficacy for feeding their children healthy foods. Parents whose children were high in food neophobia also reported that they are less likely to make healthy foods readily available and easily accessible to their children. This is not overly surprising considering that parents report making new foods available to their children only 3 to 5 times after they have been rejected (Carruth, Ziegler, Gordon, & Barr, 2004), while research suggests that 8 to 5 exposures are necessary (Birch et al., 1987). It is troublesome that these parents scored low on environment because it suggests that neophobic children might not be getting exposure to a wide variety of healthy foods. Exposure has been shown to work better than teaching or using food as a reward to get children to eat new or disliked foods in experimental studies (Wardle, Cooke, et al., 2003; Wardle, Herrera, et al., 2003). The current study suggests that in real-world contexts mothers are not participating in the feeding practice that could do the most good. There was a trend in the data that suggested that mothers who were themselves high in food neophobia also reported that they did not make healthy foods readily available for their children. These parents might be letting their own food preferences dictate what foods they make available to their children, which in the long-term might undermine children’s nutrition and dietary variety. Mothers high in food neophobia were also more likely to use restriction for weight. Since food neophobia limits dietary variety, these mothers may themselves prefer high fat or sugary foods. Future research should examine whether food neophobic mothers’ use of restriction for weight is a reflection of their weight concerns for themselves or for their children. No developmental differences in food neophobia were found in this study. Past research is mixed regarding age-related differences (Addessi et al., 2005; Dovey et al., 2008, 2011; Pliner, 1994), which could be due to differences in measurement across studies. Parentreport measures, like the one used in the current study, might not be sensitive to age differences in expression of food neophobia and appear to be related to more stable individual differences in food neophobia (Pliner & Loewen, 1997). Furthermore, the current study included a wide age range so age-related differences might have been difficult to detect. However, when this data was examined using smaller age ranges (i.e., 3- to 5-year olds and 3- to 8-year olds), the results did not change regarding the relations between child neophobia and feeding practices, suggesting child age might not matter to these relations. There were some limitations to the current study. First, only maternal reports were used, which could lead to mono-method bias. Second, fathers were not included in the current study.
Fathers report higher food neophobia than mothers (Hursti & Sjoden, 1997), so it would be worthwhile to look at the associations between child and paternal food neophobia in future research. Third, the current study examined food neophobia in relation to a previously validated measure of parental feeding practices, which is an important contribution to the literature. However, the use of this measure might have limited our understanding of how parents respond to food neophobia directly. Future research should examine the specific practices that parents use in response to food neophobia. This is especially important because past experimental research suggests that children high in food neophobia may not respond well to some feeding practices, such as receiving messages about the health benefits of novel foods (Dovey et al., 2011). Fourth, this study focused on food neophobia, not picky (fussy) eating. Although some researchers speculate that parental responses to food neophobia and picky eating are likely similar (Dovey et al., 2008), these are two distinct constructs. Future research should examine the association between picky eating and feeding practices. Last, it should be noted that snowball and convenience sampling was used, so future research should sample in ways to ensure the generalizability of these findings. The current study was an important first step in examining maternal feeding practices associated with food neophobia. Children’s food neophobia discourages dietary variety, which is necessary for good health. Thus, future research is needed to understand how to best create interventions that will provide parents with insights into how to best respond to children’s food neophobia in order to lessen its problematic effects. In addition, because mothers’ own food neophobia was associated with their feeding practices, research could also be conducted to create interventions that help parents to overcome their own food neophobia in order to promote child health.
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