Food preferences are a primary determinant of dietary intake and behaviors, and they persist from early childhood into later life. As such, establishing preferences for healthy foods from a young age is a promising approach to improving diet quality, a leading contributor to cardiometabolic health. This narrative review first describes the critical period for food preference development starting in utero and continuing through early childhood. Infants’ innate aversion to sour and bitter tastes can lead them to initially reject some healthy foods such as vegetables. Infants can learn to like these foods through exposures to their flavors in utero and through breastmilk. As solid foods are introduced through toddlerhood, children’s food preferences are shaped by parent feeding practices and environmental factors such as food advertising. Next, we discuss two key focus areas to improve diet quality highlighted by the current understanding of food preferences: (1) promoting healthy food preferences through breastfeeding and early exposures to healthy foods and (2) limiting the extent to which innate preferences for sweet and salty tastes lead to poor diet quality. We use an ecological framework to summarize potential points of intervention and provide recommendations for these focus areas, such as worksite benefits that promote breastfeeding, and changes in food retail and service environments. Individuals’ choices around breastfeeding and diet may ultimately be influenced by policy and community-level factors. It is thus crucial to take a multilevel approach to establish healthy food preferences from a young age, which have the potential to translate into lifelong healthy diet.

Authors' contributions: KKD is the principal investigator and is responsible for overall direction and conduct of the study; KKD conceived the study along with co-investigators JMJ, EMT and SH. JM leads the study's participatory process and developed the empowerment measures. SH, the study biostatistician, developed the analytic strategy and will oversee primary data analyses. EMT oversees the assessment of environmental factors affecting intervention outcomes. JB led preparation of this paper, co-developed the Parents Connect for Healthy Living (PConnect) curriculum, and participates in survey preparation, participant recruitment, and data collection. AAT manages the implementation of the study, participates in survey preparation, participant recruitment and data collection, and co-developed the Parents Connect for Healthy Living (PConnect) curriculum. NK oversaw the quality and integrity of the data. KL, CK, and AV oversee day-to-day implementation of the intervention within Head Start and assist with recruitment, data collection, and data processing. AG developed the online Community Resource Guide and participates in survey preparation, participant recruitment, and data collection. RF and BK assisted with the intervention design and participate in survey preparation, participant recruitment, and data collection. RK and RB participated in intervention design and RB designed all intervention artwork. All of the authors have reviewed, edited, and approved the manuscript.

Cardiovascular disease (CVD) is the leading killer of Americans. CVD is understudied among Latinos, who have high levels of CVD risk factors. This study aimed to determine whether access to health care (ie, insurance status and having a usual source of care) is associated with 4 CVD prevention factors (ie, health care utilization, CVD screening, information received from health care providers, and lifestyle factors) among Latino adults and to evaluate whether the associations depended on CVD clinical risk/disease.Data were collected as part of a community-engaged food environment intervention study in East Los Angeles and Boyle Heights, CA. Logistic regressions were fitted with insurance status and usual source of care as predictors of the 4 CVD prevention factors while controlling for demographics. Analyses were repeated with interactions between self-reported CVD clinical risk/disease and access to care measures.Access to health care significantly increased the odds of CVD prevention. Having a usual source of care was associated with all factors of prevention, whereas being insured was only associated with some factors of prevention. CVD clinical risk/disease did not moderate any associations.Although efforts to reduce CVD risk among Latinos through the Affordable Care Act could be impactful, they might have limited impact in curbing CVD among Latinos, via the law's expansion of insurance coverage. CVD prevention efforts must expand beyond the provision of insurance to effectively lower CVD rates.