My first in-depth encounter with the topic of understanding children’s attitudes towards food occurred during the pandemic in 2020 when I decided to conduct research among children and their parents to try to determine whether there is a connection between three variables closely related to children’s food choices: parental food shopping, children’s attitudes towards food, and Body Mass Index (BMI).
I presented the results of this research at the EMAC 2021 Annual Conference in Madrid under the title mentioned above, and now I will briefly share the results with you through a short story.
In summary, the aim of the research was to examine children’s implicit and explicit attitudes towards healthy and unhealthy foods, collect children’s BMI values, and find out about parents’ shopping habits. A total of 140 parent-child pairs participated in the study (70 girls and 70 boys aged 6 to 9 years). The results showed differences between children’s implicit and explicit attitudes towards food. Children had positive explicit attitudes towards food, but their implicit attitudes were not strongly expressed. On the other hand, there was no direct link between parental purchasing decisions and children’s BMI, but statistical analysis through hierarchical regression shows that in addition to explicit and implicit attitudes, “parental purchasing decisions” predict BMI for overweight children. The results presented here may seem unclear and confusing, so keep reading to better understand the relationships between these variables.
What we already know is that childhood obesity has reached critical levels in many countries. We also know that both biological and environmental factors contribute to weight gain and obesity in childhood. In this regard, several factors have been identified and linked with children’s unhealthy eating habits: parental food preferences and beliefs, children’s innate preferences, the influence of siblings and peers, and exposure to various media, including food advertising. There is consensus that parental influence is a very important factor in the development of a child’s attitudes towards food, as children generally spend more time with their parents than with anyone else. Parents purchase food, instill eating habits from an early age, and serve as role models and primary determinants in children’s food cognition and preferences. Moreover, it is crucial to understand how parents can positively influence their child’s food preferences, as a child’s eating preferences and attitudes will affect the quality of their diet in adulthood. The role of parents has been examined in several ways: parental intervention in children’s food preferences, parents’ role in children’s understanding of advertising messages, parental influence on children’s consumer socialization, and parental responsibility for mitigating the effects of TV advertising on their children. On the other hand, there is less consensus on understanding the nature of children’s attitudes towards food. To date, only a few studies have investigated both implicit and explicit attitudes towards food in children. Some authors have found that children aged 4 to 12 demonstrated positive implicit associations with vegetables. To address these limitations, the research presented here explored children’s implicit and explicit attitudes towards healthy and unhealthy foods (vegetables and desserts), the relationship between attitudes and their BMI, and parental purchasing decisions.
We know that children are influenced by their parents when choosing food, and it is also known that parental behavior shapes children’s acceptance of food. Furthermore, early exposure to fruits and vegetables or high-energy foods is associated with children’s preferences and consumption of these foods. Parents have the opportunity to improve their children’s food preferences if they choose healthier foods at an early age. To encourage children’s positive attitudes towards healthier foods, parents MUST take a leading role and increase the consumption of healthier foods. Parental modeling of healthy eating, which helps parents teach their children about healthy eating in a “non-coercive” way, is associated with healthier eating for children. When parents have more fruits and vegetables available at home, it improves children’s consumption. Although many scientists believe that parents can shape children’s food preferences, parents often consider a child’s food preferences to be innate traits of the child. It is crucial to determine the relationship between the role of parents and children’s attitudes towards food in order to conclude how a child can make healthier food choices. Children’s attitudes towards food can provide better predictions of what a child will actually consume. Children’s attitudes towards food influence their consumption choices, and both conscious education and passive learning can shape their attitudes! Understanding children’s implicit and explicit attitudes is important for the prevention and management of obesity. Implicit and explicit attitudes significantly influence children’s food choices, and previous research shows that children with low implicit and explicit attitudes towards healthy foods choose the unhealthier option. However, there is little evidence on the relationships between children’s food attitudes, BMI levels, and parental purchasing decisions.
A total of 140 households participated in this study (140 children fully completed the Implicit Association Test, and 140 parents of these same children successfully completed the survey). The study involved 70 girls (50%) and 70 boys (50%) aged 6 to 9 years. The children were tested using Inquisit software, which can assess implicit and explicit attitudes towards healthy food. Socio-demographic indicators, household buying habits, supermarket receipts, and children’s BMI were collected and calculated based on data collected from parents. Written consent was obtained from each parent before data collection to allow their children to participate in the study. The research was conducted in November 2020.
Children’s implicit attitudes towards food
Children completed the Implicit Association Test, adapted for their age, using a touch-sensitive device (tablet). In the test, children categorize stimuli belonging to four categories as quickly as possible using response buttons. The test is based on the principle that it is easier to give the same response to items from categories that are mentally associated than to those that are not. The categories used in the test were vegetables/desserts and tasty/gross. The stimuli for the vegetable category were foods most commonly used in Croatia in the last three months before the study, with data obtained from the largest Croatian food chain (Konzum). Vegetables were represented in the form of images depicting tomatoes, kale, peppers, and lettuce, while the dessert category included images of cake, sweets, cookies, and ice cream. The stimuli for the “tasty” category included the words “delicious,” “tasty,” and “yummy,” while the “gross” category included the words “flavorless,” “yuck,” and “bland.” In this study, children who prefer healthy foods (vegetables = tasty) should find it easier to respond when vegetable images and tasty words are paired together than when dessert images and tasty words are paired together.
Children’s explicit attitudes towards food
Children answered eight questions related to their explicit attitudes towards vegetables, measured on a 4-point Likert scale (ranging from 1 = strongly disagree, 2 = slightly disagree, 3 = slightly agree, 4 = strongly agree).
Parental survey
Parents completed an online survey consisting of 26 questions divided into three parts: (a) socio-demographic data; (b) frequency of consumption of eight foods by children over the past three months; (c) monthly food consumption data were collected, along with the most recent supermarket receipt (minimum amount of 15 EUR). From this receipt, it was possible to calculate how much money was spent on fruits and vegetables and how much on sweets.
Results
Children’s implicit attitudes towards food
The Implicit Association Test generates a so-called D score. Positive scores indicate a stronger association of vegetables = tasty / desserts = gross (upper limit: +2), while negative scores indicate a stronger association of desserts = tasty / vegetables = gross (lower limit: -2). In the conducted study, the D score was 0 (M = -.01; SD = .570), indicating an equally strong association for both combinations. Although the overall D score was very close to 0, observing the separate scores of girls and boys revealed that girls had a slightly stronger association of unhealthy with tasty and healthy with gross (M = -.024), while boys had a slightly stronger association of healthy with tasty and unhealthy with gross (M = 0.01).
Children’s explicit attitudes towards food
The results show that children have a positive attitude towards healthy food with an average value of 2.88 (SD = .54). The maximum value indicating a positive attitude was 4.00, while the minimum value indicating a negative attitude was 1.00.
BMI-related behaviors
To examine the relationship between implicit/explicit food preferences, a three-step multiple hierarchical regression analysis was conducted for four subsamples (girls with normal and overweight BMI, and boys with normal and overweight BMI), with parental shopping behavior observed as an independent variable and children’s BMI as the dependent variable. There is negative regression, meaning that positive implicit attitudes of boys towards vegetables are associated with lower BMI. A similar effect occurs in girls, but their result is not statistically significant. It is important to note that no correlation was found between parental monthly food expenditures and BMI.
The conducted research had several strengths. First, this is the first attempt at empirical research on three environmental variables that contribute to children’s healthy eating: actual food purchase receipts to understand parents’ purchasing behavior, children’s implicit and explicit attitudes, and children’s BMI data. The combination of measuring both implicit and explicit attitudes provides a unique approach to tracking positive changes in their attitudes towards healthy food. The methods used are evidence-based, psychometrically reliable, and sensitive to individual differences. Second, the results of this study showed that parental purchasing decisions do not impact a child’s BMI as a direct consequence of their purchasing behavior, which is consistent with previous research findings. Third, the analysis showed that explicit and implicit attitudes predict BMI for overweight children, even “above” parental purchasing decisions. By using the Implicit Association Test for children, we obtained a reliable scale for assessing children’s implicit attitudes, so we can conclude that this test can be a measurement scale for assessing children’s food preferences when choosing vegetables versus sweets.
However, this research also has certain limitations, which we will now discuss. The first limitation relates to the small sample size. A larger sample would increase the statistical power of the results obtained. The collection of receipts also needs further validation, and they should be gathered over a longer period, preferably through access to loyalty card data. Receipts should be a standardized method for defining different categories of food based on the data collected, providing a much-needed, more objective measure of family food intake. Additionally, in this study, parents reported their child’s height and weight to calculate the child’s Body Mass Index (BMI). In future research, it would be desirable to measure the children directly to obtain primary, more objective data.
This study provides valuable insights into the relationship between parental food shopping behavior, children’s food attitudes, and their BMI. The findings indicate that while parental purchasing decisions do not directly influence a child’s BMI, children’s explicit and implicit attitudes toward food are significant predictors of BMI, especially among overweight children. Positive implicit attitudes towards vegetables are associated with lower BMI in overweight children, highlighting the importance of addressing both implicit and explicit attitudes in interventions aimed at promoting healthier eating habits.
As for practical implications, communication strategies should be developed for specific target groups (children, parents, and teachers) with effective messaging to improve children’s dietary habits. Interventions focused on healthy eating (such as educational workshops) and monitoring children’s attitudes after these interventions could be highly valuable. The results of this study emphasize the need for targeted interventions that shape children’s attitudes towards food from an early age. Specifically, developing strategies that strengthen positive implicit and explicit attitudes towards healthy food could be crucial in the fight against childhood obesity. For practitioners, this means designing educational programs and marketing campaigns that not only inform but also positively influence children’s subconscious and conscious attitudes toward food. Additionally, the study suggests that simply changing parental shopping behavior may not be sufficient; instead, a comprehensive approach is necessary, one that involves modifying children’s attitudes and behaviors toward food.
Given that Croatia has childhood obesity rates similar to global levels, identifying factors that can lead to improved attitudes towards healthy food in Croatia would provide valuable lessons that could be applied to many other countries.
I hope this paper has opened up new horizons for you, and even if you currently have a million questions in your mind, I am available for further discussion and analysis to help you better understand your role in developing your children’s attitudes and preferences in choosing healthy food.