Some preschool children have very restricted diets

The initial findings of a doctoral study aimed at developing ways to reduce fussy eating in preschool children indicate that some of the children taking part in the study eat fewer than ten kinds of food. This is the first study of its kind in Iceland.

Berglind Lilja Guðlaugsdóttir, a PhD student at the School of Education, is working on the research under the supervision of Anna Sigríður Ólafsdóttir, professor of nutrition science at the same School. The study is based on the Taste Bud Training project, developed by Anna Sigríður in collaboration with Sigrún Þorsteinsdóttir, postdoctoral researcher at the School of Education. That project  focused on developing family-centred techniques to tackle fussy eating in children aged 8-12 with and without neurodevelopmental disorders. “Our research is about fussy eating and eating habits in preschool children and using Taste Bud Training to prevent and/or reduce fussy eating, as well as influencing the food environment at home with the aim of increasing dietary variety, particularly the consumption of fruits and vegetables,” explains Berglind.

Berglind also helped with implementing the previous Taste Bud Training project. "That research yielded very positive results, reducing fussy eating, increasing dietary variety and improving challenging behaviour at meal times. That got me thinking about whether it would be possible to use the same methods for preschool-age children, which is the age range when fussy eating is at its peak,” says Berglind.

The early years have a huge impact on future health

Berglind points out that children with fussy eating frequently lack variety in their diets; in particular, they don’t eat enough fruits, vegetables and grains. “Fussy eating can also cause stress and anxiety for parents and children around meal times and parents and preschool staff often lack effective techniques to deal with the issue. Responding to fussy eating in the wrong way can make the problem worse,” says Berglind.

In addition to tackling fussy eating, she plans to investigate whether interventions such as Taste Bud Training can impact long-term childhood growth patterns. This research will be conducted in collaboration with primary healtcare clinics. "The early years of a child's life have a huge impact on future health and development and a varied and healthy diet is absolutely key. So this is a very important age,” argues Berglind, pointing out that there is a lack of research in this area, making it an exciting topic in an international scientific context. 

Methods and learning material developed with preschool staff

Berglind has spent recent semesters carrying out her research in collaboration with four preschools both within and outside the capital area. Taste Bud Training became part of the daily routine for all age groups at these four preschools. “Children spend most of their day in preschool, so it was important to adapt the Taste Bud Training methods to the preschool environment,” explains Berglind, adding that the children’s families were also actively involved in the project and have a key role to play in changing food behaviours.

The methods developed for Taste Bud Training were used to prevent and/or reduce food sensitivity and increase dietary variety among the children. “It’s about training the children systematically to experience food with all their senses. The methods and learning material were developed in collaboration with preschool staff to make sure they were suitable for the preschool environment. Preschool staff were also trained in how to apply the methods. We have named this adapted version of Taste Bud Training for preschools Little Buds,” says Berglind, who hopes that the study will yield similar results to Anna Sigríður and Sigrún’s original study looking at older children. 

Besides Anna Sigríður and Sigrún, Berglind’s doctoral committee also includes Ragnar Grímur Bjarnason, professor and paediatrician. “We also have a strong, multidisciplinary team thanks to experienced domestic and international partners from a range of backgrounds. For example, we have a partnership with the Centre for Development of Icelandic Health Clinics,” explains Berglind. 

Half of participants exhibit some symptoms of fussy eating

The formal data collection stage of the study was completed this autumn, meaning that work on processing the data is still in the early stages. “But we have started looking at the data from the start of the study, before the intervention began. This data shows that around half the children who took part exhibit some symptoms of fussy eating, based on their parents’ survey responses, but the symptoms do vary. For example, the most common foods for children to reject  are bitter or sour. It is rarest for them to reject sweet foods. Some of the children have a very restricted diet as reported by parents, which means that they eat fewer than ten kinds of food and avoid more than one food group – this is a cause for concern. We can also see that foods with a slippery texture, for example sauteed mushrooms and soft boiled or fried eggs, are challenging for children, as well as mixed foods, since that makes it more difficult for them to distinguish the ingredients,” explains Berglind.

This study will create new knowledge and the techniques being developed could benefit a broad section of society. “Very few comparable studies have been conducted abroad and this is the first study of its kind here in Iceland. If we get positive results and the methods prove effective, we aim to develop them further and perhaps even incorporate them into the preschool curriculum. Our findings could also provide valuable support for parents who often don’t know how to respond to their children’s fussy eating. Food education based on training food-related skills, such as Taste Bud Training, is most effective when schools and parents work together and share common goals,” concludes Berglind.