The What and How in Weaning

The weaning period in infancy is an important time for introducing healthy
eating patterns that include vegetables to protect children against the
development of overweight. Many food preferences, also for vegetables, are
learned early in life and settled by the age of two years.
A high vegetable intake is associated with a lower prevalence of overweight and
obesity. Evidence shows that it is important what weaning infants are offered:
starting exclusively with vegetables is more successful for the promotion of
vegetable acceptance than starting with fruits. There is also evidence that it
is important how infants are weaned: responsive feeding characterised by
sensitive responses to infant cues during feeding fosters healthy eating.
However, the what and the how of infant weaning have never been experimentally
tested in the same study to determine their relative importance for fostering
vegetable acceptance, nor have they been combined to test whether a focus on
both may be superior to each approach separately. Investigation of these
principles his will ultimately contribute to optimizing advise given to parents
concerning the health and development of their child and prevent overweight in
later in life.

The aim of this study is firstly to investigate the effect of repeated
exposure to vegetables or fruit at the start of weaning on short and long term
vegetable intake. A second objective is , to investigate the effect of a
responsive feeding intervention on short and long term vegetable intake and on
parental responsive feeding practices. And finally to investigate the combined
effect of these principles on short and long term vegetable intake.

The present study is a randomized controlled trail to assess the effects of
vegetable exposure and responsive feeding on vegetable acceptance in infants
and toddlers.

Participants are randomly assigned to receive one of three behavioural
interventions aimed at enhancing vegetable intake of infants in the first three
years of life or to the control group.

The risks for the participants are negligible, the study procedures are
non-invasive. Food products used in the study are commercially available and
specifically produced for infants. Furthermore, all other aspects of the
interventions are behavioural. Parents will follow a weaning schedule of 19
days consisting of 1 meal per day. Follow-up measurements will be carried out
when children are 12, 18, 24, 30 and 36 months old during a home-visit. In
addition parents will be asked to complete several questionnaires throughout
the study period. This can be considered time consuming and burdensome.
However, the time investment is divided over the measurement moments in the 2,5
year study period.
The involvement of infants is needed because the first introduction to solid
food is key to our research questions and objectives. Adults have extensive
experience with eating all kinds of foods, and therefore findings in adults
cannot be extrapolated to infants.