Sweet Rules Project

Rationale: Food preferences are developed from early infancy and can influence later preferences and food choices. Parents have an important role in their children’s food environment and intake. Strategies for parents to help their children develop and maintain healthy food preferences are necessary to achieve a reduction in sugar consumption. One strategy used by parents is to restrict their children’s consumption of sweet foods with mono- and disaccharides (MDS) by imposing restriction rules, such as “no candies”. Although it seems beneficial to restrict children’s sugar consumption, restrictive rules can also have a “backfire” effect, such as overconsumption of sweet foods when the ‘restricted child’ gets the opportunity to eat them without restriction. Studies on the effectiveness of parental restriction are limited and show conflicting results. It is therefore inconclusive if parental restriction for MDS-containing foods contributes to a higher or lower sweetness preference in children and/or contributes to a higher or lower intake of these MDS-containing foods. As the World Health Organization (WHO) called on countries to reduce sugar intake among children (2015), these days, parents seem to be more conscious of the negative health effects of sugar and hence, more restrictive towards the consumption of MDS-containing foods. Therefore, further research is crucial to assess the effects of parental restriction on children’s liking and consumption of sweet products.
Objectives: The primary objective of the current study is to investigate the relationship between parental restriction of MDS-containing foods and the intake of these products and the relationship between parental restriction of MDS-containing foods and sweetness preferences in children aged 4 to 7 years old.
Study design: Cross-sectional study, consisting of two parts: a survey filled out by parents of healthy 4-7-year-old children and a sweetness preference test conducted in a subset of the 4-7-year-old children. The questionnaire will be filled in online via Eye Question and covers four parts: (1) general characteristics of the parent/guardian and the child; (2) the child’s consumption of a variety of MDS-containing foods; (3) level of parental restriction of the consumption of foods with added MDS; and (4) parents’ background ideas and convictions regarding MDS-containing foods and restriction of these products.
Two series of a forced choice, paired comparison tracking test will be used to assess sweetness preferences of the children. A researcher will conduct the preference test with the child at their home. However, if home-visits are not possible, due to the COVID-19 crisis, the parent/guardian will perform the test with online guidance of the researcher and a test handbook. The test will be conducted with five beverages (apple juice/ ‘diksap’) which differ in sweetness (sucrose concentration).
Study population: 245 parents or guardians of healthy, 4-7-year-old children to conduct the online survey and a subset of 56 children from these parents to perform the preference test.

Effect of parental restrictiveness on sweetness preference and intake of sugary foods/drinks of the children

All primary and secondary outcomes will be measured once: Demographics of child and parents, parental restriction, background ideas for restriction rules, consumption pattern of sugar-containing foods by the child via an online survey filled out by the parents. Sweetness preferences of children will be measured at home using a forced choice, paired comparison tracking test.

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