The Impact of Picture Books on Children's Intake, Liking, and/or Willingness to Taste Vegetables: Systematic Review.

Abstract

Repeated exposure is effective at increasing preschool children's vegetable acceptance and consumption; however, some parents may find it challenging to expose children to tasting a food the recommended times (> 10). This review examines the evidence for the use of picture books as an alternative strategy to promote preschool-aged children's intake, liking, and/or willingness to taste vegetables. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, a systematic search of four databases was conducted using terms for three concepts: picture/storybook exposure; AND willingness to taste, liking, or consumption of vegetables; AND child. Inclusion criteria included intervention studies examining the impact of at least one picture or storybook on preschool-aged children's intake, liking, and/or willingness to taste vegetables. Two reviewers independently screened titles, abstracts, and full texts. Data from 20% of the included studies were extracted by two authors for consistency; the remaining data were extracted by one author. Quality assessment and risk of bias were assessed using the GRADE approach and Academy of Nutrition and Dietetics Quality Criteria Checklist. The review included 16 studies with a mean sample size of 85, interventions lasting between 3 days and 12 weeks, and child age ranging from 18 months to 6 years. Ten studies found that picture books increased children's vegetable intake, seven increased liking, and three increased willingness to taste vegetables. The evidence from this review demonstrates that picture books are effective at increasing children's intake, liking, and/or willingness to taste vegetables. Future research should include follow-up assessments and larger sample sizes.