Promoting Fruit and Vegetables in Young Children

Fruit and vegetable (FV) intake has been linked to greater micronutrient intakes, lower risk of cardiovascular diseases, lower risk of certain types of cancer, and healthier weight across different age groups. Furthermore, bioactive compounds in FV have been associated with reduced risk of inflammatory responses that are implicated in several conditions, such as metabolic syndrome, diabetes, and dementia. While the benefits of FV intake are well recognized, children’s intakes remain below the current recommendations, with vegetables being particularly problematic due to their less preferred taste. Early years of life are critical for increasing children’s taste preferences for healthy foods and establishing nutrient-dense diets. Unfortunately, caregivers often struggle to successfully promote healthy diets in children, with vegetables being notoriously the least likely foods accepted by young children. Parents have profound influence on children’s dietary intake by serving as physical gatekeepers of the food supply, but also by influencing the social, emotional, and feeding climate that affects children’s eating behaviors. Research suggests that parents with authoritative parenting and feeding styles, characterized by high demandingness and responsiveness (ie, clear rules/expectations while providing warmth and explanations), have children with more favorable dietary and weight outcomes, such as greater FV intakes, compared to parents with indulgent or authoritarian styles. However, pediatricians cannot advise parents to utilize a certain parenting or feeding style, because such advice is too general without any specific practical tips for encouraging children’s FV consumption. This is because parenting styles are relatively stable and changing an individual’s parenting style would require structural shifts within families, which limits the effectiveness of parenting/feeding styles as intervention targets. On the other hand, parenting practices are specific behaviors that parents can utilize as practical ways to achieve a goal within a specific area of the child’s development. Drawing on theoretical work by Darling and Steinberg and Maccoby and Martin, parenting practices, or strategies, represent a more promising target for caregivers to effectively encourage FV-rich diets in young children. Barbarin and Jean-Baptiste recently extended the theoretical premise of parenting practices further to include strategies that teach values and foster attitudes that help children function more effectively within their sociocultural environment (ie, teaching the child about the cultural importance of specific fruit or vegetables). Recently, Baranowski et al and O’Connor et al have built on the existing knowledge of parenting practices and children’s FV consumption in nutrition literature. Baranowski and colleagues created a measure of parenting practices that were reported by parents as effective for increasing vegetable consumption by their young children. O’Connor and colleagues reported on strategies related to FV intakes in 5 different domains of parenting practices. Given that pediatricians have regular contact with parents of young children, they are in a unique position to provide parents with simple nutrition parenting strategies that may effectively increase their young child’s FV intake and contribute to lifelong healthy eating habits.