Factors Associated With Food Texture Acceptance in 4- to 36-Month-Old French Children: Findings From a Survey Study

Abstract

Food texture plays an important role in food acceptance by young children, especially during the complementary feeding period. The factors driving infant acceptance of a variety of food textures are not well-known. This study summarizes maternal reports of children's ability to eat foods of different textures (here: acceptance) and associated factors. Mothers of 4- to 36-month-old children (n = 2,999) answered an online survey listing 188 food-texture combinations representing three texture levels: purees (T1), soft small pieces (T2), hard/large pieces, and double textures (T3). For each offered combination, they reported whether it was spat out or eaten with or without difficulty by the child. A global food texture acceptance score (TextAcc) was calculated for each child as an indicator of their ability to eat the offered textured foods. The results were computed by age class from 4–5 to 30–36 months. The ability to eat foods without difficulty increased with age and was ranked as follows: T1> T2 > T3 at all ages. TextAcc was positively associated with exposure to T2 (in the age classes between 6 and 18 months old) and T3 (6–29 months) and negatively associated with exposure to T1 (9–36 months). Children's developmental characteristics, as well as maternal feeding practices and feelings with regard to the introduction of solids, were associated with texture acceptance either directly or indirectly by modulating exposure. Children's ability to eat with their fingers, gagging frequency, and to a lesser extent, dentition as well as maternal feelings with regard to the introduction of solids were the major factors associated with acceptance. This survey provides a detailed description of the development of food texture acceptance over the complementary feeding period, confirms the importance of exposure to a variety of textures and identifies a number of additional person-related associated factors.

Food texture experiences across nine age groups in Indian infants from urban areas

“…The finding that across all AGs, textures such as dissolvable , soft and soupy / liquidy were tried by most infants, while rubbery , hard, and leafy were tried by substantially fewer infants, corroborates other reports ( 1 , 14 , 19 ). Indeed, dal water and rice water, both of soupy / liquidy texture, have been reported as the first complementary foods and are characterised by a thin consistency ( 30 ).…”

“…However, this contrasts with reports indicating that many children under 6 months consume other liquids, such as plain water (10%), other milk (8%), or complementary foods (11%) in addition to breast milk; 96% of the study cohort had a history of breastfeeding, either in the past or at present. This is higher than the 62.9–91% reported for Western populations ( 14 , 19 ). Overall, the proportion of texture-sensitive children in our study was 67%, which is substantially higher than the 23% reported by the US population ( 22 ).…”

“…For example, the food category “vegetables” in one study contains 49 food texture combinations in total ( 13 ). The same authors categorised food texture combinations into three texture levels: texture level 1 “ purees ,” ( soft and rough ), texture level 2 “ small / soft pieces ,” and texture level 3 “ hard / big pieces and double texture .” This illustrates that details of specific textures are easily lost, and only “texture levels” can be related to other factors ( 1 , 14 ). Furthermore, the categorisation of textures in food is not only subjective but also complicated by the fact that food rarely possesses just one texture, of which the several textures reported may depend upon the preferences of the participant.…”

“…The American Academy of Pediatrics has outlined milestones for food texture introduction to ensure that children are safely introduced to a variety of textures ( 18 ). To date, most data on age and food texture introduction are from France and the United States ( 1 , 14 , 19 , 20 ). Moreover, current surveys on the influence of age on texture introduction are limited in the number of textures, including pureed , soft small pieces , hard / large , a combination of textures , lumpy , and dissolvable ( 13 , 21 , 22 ).…”

“…Food refusal in preschool children due to refusal to chew or high food temperatures has been reported ( 29 ). Few studies, predominantly from the United States and France, have explored child behaviours, such as the acceptance of foods based on food texture ( 1 , 14 , 19 ). It is not necessarily possible to generalise these findings to other countries and cultures.…”