ZB

nutrition wk6

Topic overview

  • Readings for the unit: Wyse et al. 2011; Beauchamp et al. 2011. Topic focus: Encouraging Healthy Eating as part of the Lifespan Nutrition curriculum.
  • Key aim: Understand how dietary behaviours develop from prenatal through adolescence and how environments (family, school, media) shape healthy eating.

Learning objectives and unit outcomes

  • Learning objectives include understanding what is meant by healthy eating behaviours, the importance of a positive food environment, the role of family mealtimes, the impact of television and marketing, and evidence-based strategies to promote healthy eating.
  • Unit Learning Outcomes (ULO 3): explain physiological changes across growth, development and ageing and their influence on nutrition needs; justify nutritional recommendations at each life stage; identify common nutrition issues across life stages; apply practical, evidence-based solutions to nutritional problems for optimal nutrition through the lifespan.

Lecture outline by life stage

  • Encourage healthy eating in:
    • Early life
    • Infancy and preschool-aged children
    • Adolescence
    • Adulthood

Case study: The fussy eater (four-year-old)

  • Scenario: Parents report child refuses fruits and vegetables and does not eat the family dinner; child is active and thriving.
  • Questions:
    • What dietary behaviours to assess first?
    • What strategies to recommend to increase meals consumed by the child?

Core concepts: Healthy eating and responsibility

  • Healthy eating involves: eating healthy foods, maintaining a healthy attitude to eating, and recognizing that healthy eating is a shared responsibility among the individual, the family, and the wider environment (schools, policy, and marketing).
  • There is no concept of "good" or "bad" foods; all foods have a place in a healthy diet when considering proportion, timing, and frequency appropriate for growth, development, and function.

Parental influence and shaping food preferences

  • Parental diet composition tends to resemble the child’s due to availability, accessibility, and exposure.
  • Quotation attributed to Birch: parents provide genetic predisposition but also shape the environment where these predispositions are expressed.
  • Early experiences with food shape lifelong food preferences and intake patterns.

Targets and guiding principles for healthy intake (practice implications)

  • Aims include higher intakes of fruits, vegetables, whole grains, and low-fat dairy/alternatives; lower intakes of added sugars, high-fat, and salty foods (often labeled as “junk” foods).
  • Emphasis on increased intake of lower-energy-dense and nutritionally dense foods; note that in the US, fat and sugar are principal ingredients in many familiar and preferred foods.

Prenatal food preferences and early flavour learning

  • Taste function begins in utero; flavour perception and preference are influenced by what the mother consumes.
  • Innate preference for sweetness; foods consumed by the mother can flavour the amniotic environment.
  • Carrot juice in the last trimester led to infants showing enjoyment of carrot flavours after birth.
  • Beauchamp & Mennella (2011) highlight flavour transmission from mother to fetus/newborn and early conditioning of taste preferences.

Early sensory experiences: breast milk vs formula

  • Flavours in breast milk influence infant feeding time; garlic and vanilla can increase feeding time compared with bland formula.
  • Long-term effects are not yet fully known; limited evidence suggests breastfed infants may have greater acceptance of initial solid foods and a broader variety of foods.
  • Formula feeding may involve greater maternal control over intake; breastfeeding may allow the infant greater regulation of intake; long-term implications for hunger/fullness cues are under investigation.

Introducing solid foods: flavours, textures, and neophobia

  • Early exposure to a variety of flavours and textures promotes later acceptance of new foods.
  • Innate preferences: sweet tastes are preferred; bitter tastes are often rejected.
  • Learned preferences: tendencies toward fatty, salty, and sour foods develop with experience.
  • Predisposition toward neophobia: infants are predisposed to reject new foods; arrays of flavours can be learned and associated with eating contexts and consequences.

Repeated exposure and familiarity

  • Crucial principle: 5–10 exposures to a new food are often required for acceptance; neophobia peaks around ages 2-3 years.
  • Early exposure and repeated exposure are critical; familiarity is linked to environmental availability and accessibility of foods.
  • Exposure is multisensory: taste, touch, feel, smell, and visual cues

How much should a child eat?

  • Infants under 3 years eat to satisfy their needs; older children and adults are more influenced by external cues.
  • If an infant stops eating, they are likely full; if they continue eating, they are hungry.
  • Excessive parental control over quantity can reduce a child’s ability to self-regulate intake.

Conditioned preferences and modelling

  • Preferences can develop for foods due to physiological consequences (e.g., fat/sugar when hungry).
  • Social learning: children’s food preferences are influenced by the eaters around them; peer modelling is important.
  • If a child dislikes a vegetable, they may eat more of it and report liking it more when eating with peers who enjoy it.
  • Serving vegetables first and in larger portions can increase intake in some contexts.

UK intervention and the role of modelling

  • A 2003 UK intervention found that exposure over two weeks increased acceptance of vegetables.
  • Parental and family modelling mattered; obesity and disordered eating risks are considerations.
  • Children are more willing to put food in their mouth if their mother is eating it themselves.

Parental influence: feeding method choice and environment

  • Parents influence: feeding method, foods provided/accessible, direct modelling, media exposure, and the interaction style within the food environment (avoiding stress and neophobia).
  • The mother is often the most influential figure in these processes.
  • Availability shapes preference: children may prefer foods that are available to them.

Parental control: restriction and pressure to eat

  • Key elements of influence include restricting or pressuring to eat; “eat your veggies,” “finish your plate,” and “no dessert” messages.
  • Restricting or forbidding foods can sometimes increase a child’s liking for those foods or intake when used as rewards or treats.
  • The way food is presented (home, school, who the child eats with) and the level of stress during eating affect intake; TV/phone distractions also count as part of the food environment.

Food environment and media influence

  • TV advertising and marketing can shape children’s requests for food.
  • Repetition of food ads contributes to preference formation for energy-dense, nutrient-poor foods.
  • Data from cross-country comparisons show variation in advertising exposure across nations; illustrative graphs show ads per hour and types of ads (core vs non-core foods).
  • In Australia and elsewhere, debates about banning food ads on TV or other media for children are ongoing.

Learning activities and practical questions

  • Should food ads be banned from TV? What about social media and sports events?
  • As a nutritionist, what approaches would you recommend regarding junk snacks sold at school?

Gardening interventions and environmental strategies

  • School or community gardens can modestly improve fruit and vegetable intake among children; systematic reviews (Savoie-Roskos et al., 2016) show small positive effects with limited evidence.
  • More education and parental involvement are likely needed; more rigorous randomized controlled trials (RCTs) are required to establish stronger effects.

Adolescence: family meals and social factors

  • Family meal times support socialisation, role modelling, healthful habits, family unity, and connectedness.
  • Regular family dinners are associated with higher fruit and vegetable intake and lower fried foods and soft drink consumption.
  • Family meals are decreasing; more families eat with preteens than with teenagers due to independence and activities.
  • Perceptions: a sizable proportion of adolescents and parents value family meals, but differences exist between adolescent and parent views on the importance and atmosphere of meals.
  • Practical strategies to encourage mealtimes include emphasising pleasure, involving the family in meal preparation, reducing distractions, and planning ahead (location changes, timing adjustments, and normalising mealtime routines).

Adolescents’ attitudes toward junk food vs healthy food

  • Factors influencing choices include parental presence, staying at home, weight/appearance concerns, meals, self-control, peer presence, and being away from home.
  • Strategies encourage making healthy foods more available in shopping and social contexts where teens are active and with friends.

Snack consumption and overall diet context

  • Snacking can occur between meals or instead of meals and has different nutritional implications depending on overall diet composition.
  • Higher energy needs for certain individuals may permit occasional energy-dense snacks as part of a balanced plan.

Across the lifespan: Division of responsibility in feeding

  • Ellyn Satter's framework: division of responsibility between parents and child.
  • Parent responsibilities: what food is served, when it is served, and where it is eaten.
  • Child responsibilities: whether and how much to eat.
  • The approach emphasizes respect for individual differences in food preferences and acceptance; the mantra is "Do as I do" rather than "Do as I say".

Strategies for encouraging healthy eating (practical guidance)

  • Repeated exposure to new foods (tasting, not just smelling or looking).
  • Avoid using food as a reward for eating; avoid pressuring to eat.
  • Present healthy foods in a positive social context.
  • Flavor-flavour learning: pair unfamiliar foods with liked foods (e.g., tomato sauce) to enhance acceptance.
  • Maintain strong parental modelling: eat the same foods as the child.
  • Encourage child involvement in selection, preparation, and even growing foods.
  • Use positive marketing cues: appealing TV advertising, packaging, and even toys attached to healthy foods.

Strategies to decrease intake of occasional foods

  • Reduce exposure to peer influence that promotes unhealthy choices.
  • Avoid banning foods; avoid using them as rewards; model healthy choices and sustainable consumption.
  • Limit advertising exposure to reduce external cues encouraging unhealthy choices.

Case study revisit: The fussy eater (summary)

  • Review questions focus on identifying dietary behaviours to assess and practical strategies to increase fruit and vegetable intake and overall meal consumption in a 4-year-old.

Assessment Task 3: Calcium intake (overview of task structure)

  • Task framework involves national data (NNPAS 2011–2013) and NRV comparisons.
  • Part A: Calcium intake in children (approximately 1400 words).
  • Part B: One-minute audio explaining key findings from Part A.
  • Part C: Reflection (200 words) on the learning plan and assessment process.
  • Documentation: You will review three main documents, use Appendix 2 for NRV values, and Appendix 3 for calcium intake in children; you should understand the methods used in the AHS/NNPAS 2012–13 survey.

Next week

  • Topic 7: Adult years. Prepare for continuity of nutrition considerations into adulthood.

Key numeric and data references to remember

  • Repeated exposure guideline: 5–10 exposures for acceptance; 5-10 exposures.
  • Neophobia peak: around 2-3 years.
  • Energy intake variability: meals ~34 ext{%}, days ~10 ext{%}.
  • Advertising exposure: about 80 ext{%} of food ads show low-nutrient, high-energy products.
  • Family meals: a significant proportion report dinner as a family-wide activity; practical targets include 7 nights per week for family meals in some contexts.
  • Sample size for home food environment study: N=396.
  • Population notes: UK study findings in 2–6 year olds; positive associations with vegetable intake, reduced neophobia and reduced parental control.
  • Cross-cultural/adaptation notes: ads per hour and core vs non-core categories show country-level variation across multiple nations.
  • Division of responsibility: practical framework