Children's Introduction to Novel Plant-Based Foods through Varying Repeated Exposure Schedules.

Abstract

To test the effect of different schedules of repeated exposure to a novel food on infants' consumption of the novel food. Fifty-nine infants (mean [SD] age = 11 months [2]; 41% female) caregiver (age = 32 years [4]; 20% Hispanic) dyads were enrolled in the Healthy Starts Study and randomly assigned to 1 of 3 repeated exposure schedules with artichoke as the novel food: (1) 10 exposures over 2 weeks (standard), (2) 5 exposures over 2 weeks, a 2-week break, then 5 more exposures over 2 weeks (take-a-break); or (3) 10 exposures over a 6-week period (extended). Consumption (g) was measured in a laboratory setting at baseline, postintervention, and after a 6-week extinction period. Mixed-effects models tested schedule effect on change in amount consumed between baseline and postintervention, with adjustment for child age and sex. Fifty-four dyads completed all visits (standard = 17, take-a-break = 20, extended = 17; 91% retention). At baseline, consumption did not differ among repeated exposure schedules. At postintervention, consumption in the standard schedule did not change (26.8 g [∼1.8 tbsp] to 22.9 g [∼1.5 tbsp]), whereas infants in the take-a-break and extended schedules significantly increased consumption (P = .024; baseline to postintervention; take-a-break: 21.1 g [∼1.4 tbsp] to 43.6 g [∼3.0 tbsp]; extended: 20.7 g [∼1.4 tbsp] to 33.6 g [∼2.0 tbsp]). Standard, intense exposure did not change consumption, yet less frequent exposure over a longer duration resulted in sustained increases in children's consumption of the novel food. Thus, persistence, rather than intensity of exposure, may offer greater benefit for improving infants' acceptance of novel foods. Healthy Starts Study, ClinicalTrials.gov: NCT05639361.