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      The Environmental and Bitter Taste Endophenotype Determinants of Picky Eating in Australian School-Aged Children 7–12 years—A Cross-Sectional Pilot Study Protocol

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          Abstract

          Caregivers’ perceptions of children’s pickiness are relatively scarce in relation to the five core food groups and their importance in providing a nutritionally balanced diet. Furthermore, there is no validated questionnaire that examines child-reported food preferences in an age-appropriate manner, and the use of terms such as a “picky eater” can be attributed to environmental and genetic factors. Despite potential links between children’s food preferences and endophenotype bitter taste, associations between bitter taste sensitivity and picky eating is relatively unexplored. The proposed cross-sectional study aims to develop and validate a parent-reported core-food Picky Eating Questionnaire (PEQ) and child-reported Food Preference Questionnaire (C-FPQ) and simultaneously investigate environmental and phenotype determinants of picky eating. The study will be conducted in three stages: Phase 1, piloting PEQ and C-FPQ questionnaires (15–20 primary caregivers and their children aged 7–12 years); Phase 2 and 3, validating the revised questionnaires and evaluating the 6-n-propylthiouracil (PROP) bitter taste sensitivity to examine perception to bitter taste (369 primary caregivers and their children). Study findings will generate new validated tools (PEQ, C-FPQ) for use in evidence-based practice and research and explore picky eating as a behavioural issue via the potential genetic-phenotype basis of bitter taste sensitivity.

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          Most cited references34

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          Confirmatory factor analysis of the Child Feeding Questionnaire: a measure of parental attitudes, beliefs and practices about child feeding and obesity proneness.

          The Child Feeding Questionnaire (CFQ) is a self-report measure to assess parental beliefs, attitudes, and practices regarding child feeding, with a focus on obesity proneness in children. Confirmatory factor analysis tested a 7-factor model, which included four factors measuring parental beliefs related to child's obesity proneness, and three factors measuring parental control practices and attitudes regarding child feeding. Using a sample of 394 mothers and fathers, three models were tested, and the third model confirmed an acceptable fit, including correlated factors. Internal consistencies for the seven factors were above 0.70. With minor changes, this same 7-factor model was also confirmed in a second sample of 148 mothers and fathers, and a third sample of 126 Hispanic mothers and fathers. As predicted, four of the seven factors were related to an independent measure of children's weight status, providing initial support for the validity of the instrument. The CFQ can be used to assess aspects of child-feeding perceptions, attitudes, and practices and their relationships to children's developing food acceptance patterns, the controls of food intake, and obesity. The CFQ is designed for use with parents of children ranging in age from about 2 to 11 years of age. Copyright 2000 Academic Press.
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            Derivation and evaluation of a semantic scale of oral sensation magnitude with apparent ratio properties

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              The NOURISH randomised control trial: Positive feeding practices and food preferences in early childhood - a primary prevention program for childhood obesity

              Background Primary prevention of childhood overweight is an international priority. In Australia 20-25% of 2-8 year olds are already overweight. These children are at substantially increased the risk of becoming overweight adults, with attendant increased risk of morbidity and mortality. Early feeding practices determine infant exposure to food (type, amount, frequency) and include responses (eg coercion) to infant feeding behaviour (eg. food refusal). There is correlational evidence linking parenting style and early feeding practices to child eating behaviour and weight status. A focus on early feeding is consistent with the national focus on early childhood as the foundation for life-long health and well being. The NOURISH trial aims to implement and evaluate a community-based intervention to promote early feeding practices that will foster healthy food preferences and intake and preserve the innate capacity to self-regulate food intake in young children. Methods/Design This randomised controlled trial (RCT) aims to recruit 820 first-time mothers and their healthy term infants. A consecutive sample of eligible mothers will be approached postnatally at major maternity hospitals in Brisbane and Adelaide. Initial consent will be for re-contact for full enrolment when the infants are 4-7 months old. Individual mother- infant dyads will be randomised to usual care or the intervention. The intervention will provide anticipatory guidance via two modules of six fortnightly parent education and peer support group sessions, each followed by six months of regular maintenance contact. The modules will commence when the infants are aged 4-7 and 13-16 months to coincide with establishment of solid feeding, and autonomy and independence, respectively. Outcome measures will be assessed at baseline, with follow up at nine and 18 months. These will include infant intake (type and amount of foods), food preferences, feeding behaviour and growth and self-reported maternal feeding practices and parenting practices and efficacy. Covariates will include sociodemographics, infant feeding mode and temperament, maternal weight status and weight concern and child care exposure. Discussion Despite the strong rationale to focus on parents' early feeding practices as a key determinant of child food preferences, intake and self-regulatory capacity, prospective longitudinal and intervention studies are rare. This trial will be amongst to provide Level II evidence regarding the impact of an intervention (commencing prior to age 12 months) on children's eating patterns and behaviours. Trial Registration ACTRN12608000056392
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                Author and article information

                Journal
                Int J Environ Res Public Health
                Int J Environ Res Public Health
                ijerph
                International Journal of Environmental Research and Public Health
                MDPI
                1661-7827
                1660-4601
                29 February 2020
                March 2020
                : 17
                : 5
                : 1573
                Affiliations
                [1 ]Department of Nutrition and Dietetics, Faculty of Health, University of Canberra, Canberra 2617, Australia; Cathy.Knight-Agarwal@ 123456canberra.edu.au (C.A.); Nenad.Naumovski@ 123456canberra.edu.au (N.N.)
                [2 ]School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane 4001, Australia; ra.byrne@ 123456qut.edu.au
                [3 ]School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Victoria 3216, Australia; penny.love@ 123456deakin.edu.au
                [4 ]Department of Arts & Communication, School of Design and the Built Environment, Faculty of Arts and Design, University of Canberra, Canberra 2617, Australia; Fanke.Peng@ 123456canberra.edu.au
                [5 ]Department of Nutrition and Dietetics, School of Health Sciences, International Medical University, Kuala Lumpur 57000, Malaysia; waiyew_yang@ 123456imu.edu.my
                [6 ]Department of Nutrition and Dietetics, School of Health Science & Education, Harokopio University, 17676 Athens, Greece; dbpanag@ 123456hua.gr
                Author notes
                [* ]Correspondence: Rati.Jani@ 123456canberra.edu.au ; Tel.: +61-6201-2745
                Author information
                https://orcid.org/0000-0003-0915-4420
                https://orcid.org/0000-0002-0096-3320
                https://orcid.org/0000-0002-1244-3947
                https://orcid.org/0000-0001-8583-153X
                https://orcid.org/0000-0002-2841-4497
                Article
                ijerph-17-01573
                10.3390/ijerph17051573
                7084323
                32121357
                8fccb26a-ac1b-4c65-9ef2-2bf8c2a1970e
                © 2020 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 28 November 2019
                : 26 February 2020
                Categories
                Protocol

                Public health
                picky eating,endophenotype,6-n-propylthiouracil (prop),bitter taste sensitivity,food preferences

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