The first article in this edition of the newsletter explores the widely replicated

Cognitive development and children’s perceptions of fruit and vegetables

Despite the positive health effects, children’s fruit and vegetable consumption is below the recommendations(1, 2). Intervention studies have shown that their fruit and vegetable consumption can be increased successfully. Increases in intake have been found to range between 0 – 2.5 servings a day. However, most of the changes are due to increased fruit consumption, and long-term changes have rarely been seen(3-5). Therefore, it is important to focus on new approaches. Since preference is the most important determinant of children’s food intake(6-8), we should aim to increase children’s preference for fruit and vegetables. In line with the Ottawa Charter, we should aim for “Make the healthy choice, the tasty choice!”. In the area of food preferences, cognitive development has almost never been taken into account.

Developmental theories show that when children grow up, their cognitive abilities increase: concrete thinking becomes more abstract and logical; information processing becomes more advanced and strategic; centration and egocentrism diminishes; and children’s capacity to employ mental operations and hypothetical thinking increases(9, 10). Since children in distinct cognitive stages think, perceive and understand food topics differently, they may need different approaches to change their food preferences.

In our qualitative study, we investigated how cognitive development is related to children’s food preferences and perceptions. Focus group discussions and duo-interviews were held with children in three age groups: 4-5-years-old, 7-8-years-old and 11-12-years-old. Different topics were discussed and several fruits were tasted (see(11) for details).

It was found that the preferences of children from the three age groups were influenced by different attributes. Young children focused more on appearance and texture, whereas older children focused more on taste. This finding is in line with Rose et al(12). Older children were also more specific about the way the food was prepared, which may indicate that young children may dislike spinach in any form, whereas older children can dislike cooked spinach but like it in an oven dish.

We also found that young children have difficulties in explaining what health means. This concept is too abstract for them, and needs the capacity of long-term thinking. Contrary to the finding that most children link the concept of “healthy foods” with “not tasty”(13, 14), we found that this link was not present in 4-5-year old children. So probably, this link between “healthy” and “not-tasty” develops somehow before the age of 7-8 years.

Another important finding was that parents used different healthyeating strategies in the three age groups, which were in line with children’s cognitive developmental capacities. Also, the emergence of social norms and others’ perspective as children grow up was seen in children’s reasoning about fruit and vegetables.

Taking these findings into account, we would suggest the following actions which can be helpful to encourage children’s fruit and vegetable consumption:

  • Do not use the strategy “You should eat your veggies/fruit, because it is healthy”. Young children do not know what is meant by “healthy” and older children may have developed a link between “healthy” and “distaste”.
  • Be aware that texture and appearance may be more important in younger children. So, finding out which texture and appearance is most attractive to your own child with regard to fruit or vegetables, and preparing it in this way, can increase children’s willingness to taste, and their intake.

In conclusion, it appears that cognitive development plays a role in children’s perceptions of, and preferences for fruit and vegetables. To be effective on the long-term, we should include these developmental aspects in interventions aiming to increase children’s fruit and vegetable intake.

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