By Nara Schoenberg, Tribune Newspapers
8:11 PM EDT, July 25, 2012
When your child is a picky eater, everyone has advice: Cook with your kids! Eat like a French person! Roast those Brussels sprouts!
Jessica Seinfeld, wife of the comedian Jerry, advocates pureeing, say, butternut squash or cauliflower, and sneaking it into a familiar food such as mac and cheese.
Nancy Tringali Piho, author of the book "My Two-Year-Old Eats Octopus: Raising Children Who Love to Eat Everything" thinks it would be great if you could introduce your child to a wide range of exquisitely prepared foods from around the world, preferably before he's out of the high chair.
You could easily spend all day and a sizable trust fund following the most popular recommendations — and still see your young child spit a seemingly harmless food (homemade chicken nuggets, sliced cucumber) right on the plate. That is, if you are lucky enough to achieve that one precious second of mouth-to-food contact.
So what's a busy parent to do? Like many parents of the young and the picky, I'm basically concerned with increasing vegetable consumption — not, say, with impressing the other restaurant patrons with my kid's passion for octopus. I also place a pretty high value on my own time and effort. So, with those factors in mind, I redirected my efforts: I resolved that I would continue to try new techniques for promoting vegetable consumption, but not only those that had proven effective in large studies published in respected scientific journals.
That, as it turned out, left me with surprisingly few options.
"The vast majority of scientific research has been through repeat exposure," says Terence M. Dovey, a lecturer at the Centre for Research into Eating Disorders at Loughborough University.
"You show (the food) once. You show it again. You show it again. You show it again. And at no point do you force the child to eat it. Eventually, the vast majority of children will accept the food."
There's plenty that researchers don't know about picky eaters, starting with the basics, such as how many there are. Estimates vary widely, from 8 to 50 percent of kids, with researchers differing on how to define the term. Some allow parents or caregivers to define pickiness, others look at how many foods kids actually eat, and some look at average kids during some or all of the peak pickiness years: ages 2 to 6.
"The research is a bit hampered by that," says Lucy Cooke, a senior research associate at the Health Behaviour Research Centre at University College London.
"The definition of picky eating is a very wishy-washy one; it's hard to tell what people mean."
Even in the case of the relatively well-tested repeat exposure, the evidence of effectiveness is "pretty good" as opposed to very good, says Dovey. The difficulties, he says, lie in the studies' focus on single foods such as kidney beans (but not popular combined foods such as chili) and in the fact that many of the studies take place in schools, where, scientists suspect, kids tend to be more flexible and obedient than they are on their home turf. (If scientists need any parents to vouch for that, I'm available.)
Still the evidence for repeat exposure keeps piling up; a 2007 review of scientific studies by Cooke in the Journal of Human Nutrition and Dietetics found repeated exposure can increase liking and consumption.
And in the past 10 years, scientists have begun to venture into the ultimate picky-eating battleground — yep, the home — with a few large, well-structured experiments and promising, if occasionally contradictory, results.
In a 2003 study published in the journal Appetite, a team of British researchers divided 143 kids ages 2 to 6 into three groups. The parents in one group got nutritional information, the parents in the second (control) group didn't get any extra assistance, and the parents in the third group were asked to offer their kids a taste of a single moderately disliked vegetable every day for 14 days.
The kids in the "14 tastes" group showed greater increases in consumption and "liking" of the despised vegetable than the other kids, and the tasting group was the only one to show significant increases across all three of the measures used (liking, consumption and "ranking" of the vegetable relative to other vegetables.)
Parents complained about the number of tastes required, but of the 10 parents in the "14 tastes" group who did follow-up interviews, seven felt that the experiment had had a lasting effect on their child's opinion of the test vegetable. "It is his favorite, and he would not touch it before," one parent was quoted as saying.
Many of the parents in the study said their children had actually enjoyed the tastings. "Afterwards, he kept asking to try other things," a parent was quoted as saying.
Cooke, a co-author of the study, says that it makes sense, when you think about it, that repeat tastings can affect a child's experience of a food. An adult who's learning to drink tea or coffee without sugar will often miss the sweetness — at first.
"Over time, over repeated exposures to a taste, we can become accustomed to it and like it more," she says.
"That's not to say that every child will grow to like every vegetable because we all have our own idiosyncratic likes and dislikes, and we would never advocate pursuing this beyond the 14 tastes mark. If a child's not responsive, we suggest that a parent move on to something else. But we have had tremendous positive feedback from parents who have done this."
Repeat after me
Lucy Cooke, co-author of a large 2003 study that found repeated tastings increased a child's acceptance of a vegetable, says she can't guarantee that parents will get the same results she did, but the technique does look "very promising."
Here's the basic procedure: Every day for 14 days, the parent would offer the child small pieces of a single "moderately disliked" target vegetable (either carrot, celery, tomato, red pepper, green pepper or cucumber, depending on the child's tastes). The vegetable was served raw and the kid could eat as much or as little as she liked. A parent might say, "You don't have to eat it, just taste it" or "I've (tried) it, can you do it too?"
At the end of the 14 days, the children were consuming more of their target vegetables, and reporting that they liked them more.
Not all kids are willing to even try a disliked vegetable, Cooke acknowledges, but she says a small nonfood incentive can tip the balance. In two subsequent studies that she co-authored, kids were offered stickers for tasting the target vegetable, with good results. All of the kids were willing to try the moderately disliked vegetable when the sticker incentive was added, she says.
Cooke doesn't advise continuing the daily tastings after 14 tries, and she says that, under some circumstances, 10 tries are probably enough.
"The evidence is pretty good that 10 (tries) will do the trick — 15 is optimal, but we do fully understand that it's just beyond the patience of many parents to persevere that long — especially if the child doesn't appear to be responding," she says.
"I think that I would feel that if a child doesn't respond at all by 10, I would give up (on that vegetable) and start with something else."
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