Portrayals of Food and Nutrition in Popular US Picture Books.

Abstract

Early experiences shape how children understand food as part of their health, family, and culture. Pediatricians promote picture book reading to support developmental and relational health. We conducted a pediatric-informed content analysis of food and nutrition in US picture books. Using an interdisciplinary content analysis framework, we assessed food and nutrition content within a representative sample of US picture books (N = 159). Coders documented the presence and types of food, mealtimes, and social drivers of nutritional health. We assessed interrater reliability and summarized food-related content within the context of how the book depicted the role and function of food. The κ agreement ranged from 78% to 99% (strong reliability). Most books depicted food in text (67%) or pictures (68%). Fruit (39%) was the most depicted food group, milk the most depicted beverage (15%), and sweet the most depicted flavor (33%). Among books that included meals, snacks were most common (57%), followed by dinner (41%). Characters ate with their families in over half (53%) of books that depicted meals. Food often symbolized a role beyond satiating hunger (eg, rewarding behavior, fostering connection). Specific roles were associated with a higher appearance of certain foods (eg, fruits with pleasure). Picture books, which frequently portray food and reliably capture children's interest, are helpful tools to engage children in conversations about the social, cultural, and nutritional functions of food. Our findings suggest that picture books are a commercial-free early literacy tool that can support integrated interventions addressing both nutritional and relational health.