Taste Exposure Increases Intake and Nutrition Education Increases Willingness to Try an Unfamiliar Vegetable in Preschool Children: A Cluster Randomized Trial

Background Intake of vegetables in children remains low. Objective To compare taste exposure (TE), nutrition education (NE) and TE+NE together on intake of an unfamiliar vegetable (mooli/daikon radish) in preschool-aged children. Design Children attending 11 preschools in England were randomly assigned by clusters to four intervention conditions using a 2x2 factorial design: TE, NE, TE+NE, and no intervention (control). Participants Two hundred nineteen children aged 2 to 5 years participated from September 2016 to June 2017. Intervention The intervention period was 10 weeks preceded and followed by measurements of raw mooli intake as a snack. Preschools were randomized to receive weekly TE at snack time (n=62 children); NE (n=68) using the PhunkyFoods program; TE+NE (n=55) received both weekly taste exposures at snack and lessons from the PhunkyFoods program; and the control condition (n=34), received NE after the final follow-up measurement. Main outcome measures Individual measured intakes of mooli at Week 1 (baseline), Week 12 (postintervention), and Week 24 and Week 36 (follow-ups). Statistical analysis Differences in intakes were analyzed by cluster. Logistic regressions were conducted to examine odds ratios for intake patterns. Results Data from 140 children with complete mooli intake assessments were analyzed. TE increased intake from 4.7 +/- 1.4 g to 17.0 +/- 2.0 g and this was maintained at both follow-ups. Children assigned to the NE conditions were more likely to eat some of the mooli than children who were not in the NE conditions (odds ratio 6.43, 95% CI 1.5 to 27.8). Combining TE and NE produced no additional benefit to intake beyond TE alone. Conclusions Taste exposures encouraged children to eat more of the unfamiliar vegetable, whereas nutrition education encouraged children who were noneaters to try the vegetable. Both approaches were effective and can be used to produce different outcomes.