Children are not consuming sufficient amounts of fruits and vegetables in their habitual diet. Methods derived from associative learning theories could be effective at promoting vegetable intake in pre-school children. The objective of the present study was to compare the effectiveness of different learning strategies in promoting the intake of a novel vegetable. Children aged between 9 and 38 months were recruited from UK nurseries. The children (n 72) were randomly assigned to one of three conditions (repeated exposure, flavourflavour learning or flavour -nutrient learning). Each child was offered ten exposures to their respective version of a novel vegetable (artichoke). Pre-and post-intervention measures of artichoke purée and carrot purée (control vegetable) intake were taken. At pre-intervention, carrot intake was significantly higher than artichoke intake (P, 0·05). Intake of both vegetables increased over time (P,0·001); however, when changes in intake were investigated, artichoke intake increased significantly more than carrot intake (P,0·001). Artichoke intake increased to the same extent in all three conditions, and this effect was persistent up to 5 weeks post-intervention. Five exposures were sufficient to increase intake compared to the first exposure (P,0·001). Repeated exposure to three variants of a novel vegetable was sufficient to increase intake of this vegetable, regardless of the addition of a familiar taste or energy. Repetition is therefore a critical factor for promoting novel vegetable intake in pre-school children.

This review considers papers published in the last decade in relation to tracking between early food habits (here, habits acquired before 10 years) and later eating patterns. This review analyzes first how later eating patterns may be associated with the mode of milk feeding (formula vs. breast feeding; type of formula) and with the way complementary feeding is conducted (timing and type/variety of foods offered). Beyond the first year, this review focuses on the tracking of food preferences, food variety, portion size, dietary intake and eating traits. Most studies revealed moderate but significant associations between mode of milk feeding and complementary feeding practices and later eating patterns. When the baseline period is beyond 1 year, a moderate level of tracking is also observed for most eating behaviors reported (food preferences; food variety; dietary intake; eating traits), revealing a consistency over time in eating behavior; however eating behavior is likely to evolve when children grow older.

Vegetable intake is generally low among children, who appear to be especially fussy during the pre-school years. Repeated exposure is known to enhance intake of a novel vegetable in early life but individual differences in response to familiarisation have emerged from recent studies. In order to understand the factors which predict different responses to repeated exposure, data from the same experiment conducted in three groups of children from three countries (n = 332) aged 4–38 m (18.9±9.9 m) were combined and modelled. During the intervention period each child was given between 5 and 10 exposures to a novel vegetable (artichoke puree) in one of three versions (basic, sweet or added energy). Intake of basic artichoke puree was measured both before and after the exposure period. Overall, younger children consumed more artichoke than older children. Four distinct patterns of eating behaviour during the exposure period were defined. Most children were “learners” (40%) who increased intake over time. 21% consumed more than 75% of what was offered each time and were labelled “plate-clearers”. 16% were considered “non-eaters” eating less than 10 g by the 5th exposure and the remainder were classified as “others” (23%) since their pattern was highly variable. Age was a significant predictor of eating pattern, with older pre-school children more likely to be non-eaters. Plate-clearers had higher enjoyment of food and lower satiety responsiveness than non-eaters who scored highest on food fussiness. Children in the added energy condition showed the smallest change in intake over time, compared to those in the basic or sweetened artichoke condition. Clearly whilst repeated exposure familiarises children with a novel food, alternative strategies that focus on encouraging initial tastes of the target food might be needed for the fussier and older pre-school children.