1. ASSOCIATIVE CONDITIONING CAN INCREASE LIKING FOR AND CONSUMPTION OF BRUSSELS SPROUTS IN CHILDREN AGED 3 TO 5 YEARS Created by Ashley Kish, Dietetic Intern

2. Background  > 75% of children aged 2 to 5 years do not meet the recommended intake of vegetables.  Consumption of vegetables is hindered by neophobia (fear of something new), which peaks between ages 2 and 5 years.  Neophobia can be overcome by  Repeated exposure to a food  Given the opportunity to watch parents or peers eat those foods  Associative learning; pairing flavors with nutrients or a preferred flavor

3. Background  Associative Conditioning: changed response to a disliked food by learning to associate it with a liked food. (positive reinforcement).  Ex: pairing vegetables with cream cheese  Exposure: repeatedly presenting a specific food  Ex: presenting vegetables alone

4. Purpose of this Study Compare the effectiveness of associative conditioning to exposure on changing liking for bitter (Brussels sprouts) and nonbitter (cauliflower) vegetable in children.

5. Methods  29 children participated  3 to 5 years of age  13 boys, 16 girls  Parents completed a questionnaire regarding their children’s liking of 11 vegetables  Brussels sprouts and cauliflower were never tried by the majority of children.  Vegetables were boiled and children were served equal amounts of each vegetable during each trial.  3 groups  Brussels sprouts (bitter) paired with sweetened cream cheese and cauliflower (nonbitter) paired with unsweetened cream cheese  Brussels sprouts (bitter) paired with unsweetened cream cheese and cauliflower (nonbitter) paired with sweetened cream cheese  Brussels sprouts and cauliflower with no cream cheese

6. Results

7. Results – Brussels Sprouts  Children liked Brussels sprouts much more when they had been paired with cream cheese than when given without cream cheese.  No significant difference between children who received sweetened vs unsweetened cream cheese

8. Results - Cauliflower  Liking for Cauliflower did not vary by condition  No significant differences between children given sweetened or unsweetened cream cheese

9. Conclusions  Pairing foods with liked flavors repeatedly can increase preferences for those foods.  Associative conditioning can increase liking for Brussels sprouts and perhaps be used to increase consumption of these and other bitter vegetables in children.  Fewer than ¼ of children liked Brussels sprouts when given without cream cheese; 72% of children liked Brussels sprouts when given with cream cheese.  Exposure alone was not successful in increasing liking for a bitter vegetable like Brussels sprouts, but has been successful in increasing preferences for nonbitter foods.  Exposure was sufficient to increase preference for nonbitter cauliflower

10. Sources  Anzman-Frasca, S, Savage, JS, Marini ME, Fisher, J.O., Birch LL. “Repeated exposure and associative conditioning promote preschool children’s liking of vegetables.” Appetite. 2012 Apr;58(2):543-53.  Capaldi-Philips, Elizabeth D. and Devina Wadhera. “Associative Conditioning Can Increase Liking for and Consumption of Brussels Sprouts in Children Aged 3 to 5 Years.” Journal of the Academy of Nutrition and Dietetics. June 27, 2013.  Keller, Kathleen L. “The Use of Repeated Exposure and Associative Conditioning to Increase Vegetable Acceptance in Children: Explaining the Variability Across Studies.” Journal of the Academy of Nutrition and Dietetics. Accepted: April 3, 2014; Published Online: June 10, 2014.