Re-learning by combining mere exposure with variation in sensory aspects of food

Most children in the Netherlands do not meet the recommended daily amount of
vegetable intake. Four- to six-year-olds on average eat about 44 grams of
vegetables per day despite of the recommended amount of 100 to 150 grams. The
percentage of children with inadequate consumption of vegetables is in this age
range close to 100%. Inadequate intake of vegetables may potentially lead to
inadequate eating behavior later in life and is shown to be to related
increased susceptibility for chronic diseases.

It is important to develop strategies to increase children's intake of
vegetables, because of the shown health benefits of long-term intake of
vegetables. The current study aims at a mere exposure to vegetables program of
ten sessions, i.e. two days per week during five consecutive school weeks in
the school groups 1/2 (age of the children: 4 to 6 years), and sustainability
test sessions two months and seven months after the intervention to test
long-term effects of mere exposure.

This study is part of the EU FP7 Medium-Scale Collaborative Project
*Determining factors and critical periods in food habit formation and breaking
in early childhood: a multidisciplinary approach* (HabEat).

The primary objective of the study is to increase the intake of a generally
disliked vegetable by mere exposure in 4-6 year old children and to determine
whether sensory aspects of the vegetable, in this case the shape of the
vegetable, affect intake. The long-term aim is to develop strategies to
increase the intake of vegetables and therewith contribute to health.

Two classes (group 1/2) per school of two schools will participate in the
study, where at each school one class serves as experimental group and the
other as control group.

During a schoolsnack moment the children will be offered a vegetable as snack.
The experimental group will have 10 snack moments (2x per week; 5 weeks); the
control group will have 3 snack moments. The amount vegetables consumed will be
determined by weighing.
A sensory aspect of the vegetable, i.e. shape, will be varied. All children
will receive both shapes (for example cubes and slices) at the same time.
Intake of both shapes will be measured to determine if there is a difference
in amount consumed between the shapes. Two follow-up measurements will take
place after the intervention period, and there will be a one-week period (two
sessions) to familiarize the children with the snackmoment. The parents of the
children will be asked to complete a questionnaire on eating behavior of their
child(ren).

The burden for the subjects is very low. During a school snack moment a
vegetable snack will be offered and the children are not obliged to eat the
snack. In our experience, children like participating in these kind of studies.
The risks are negligibe: commercial available vegetables will be used. Before
the study, parents will be asked for allergies of their child, and in case of
an allergy for the selected vegetable, an alternative will be offered (the data
of that subject will be excluded from the analysis)