Baby's First Bites: Promoting Vegetable Intake in Infants and Toddlers

NCT ID: NCT03348176

Last Updated: 2020-11-17

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 255 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2016-05-11
• Study Completion Date: 2020-06-30

Brief Summary

Overweight and obesity in preschool children is more and more common and predicts overweight in later childhood and adulthood. A healthy eating pattern with many vegetables decreases the risk to develop overweight. As many food preferences are learned in the first years of life, teaching children to like vegetables from the very start of eating solid foods is essential. Starting baby's first bites of solid foods with vegetables instead of more sweet tastes like fruits may promote vegetable liking. Also, it is important that parents know how to feed their children: e.g., paying attention to whether the child is hungry or full is essential, as is not pressuring them to eat. What is yet unknown is which of these two are more important to promote, to facilitate vegetable liking in young children. Is starting with vegetables most important, or educating parents on their feeding-techniques? And is a combination of both most effective? This study tests which of three interventions is most effective to promote vegetable intake and liking in children up until the age of 3 years: a) a focus on the 'what' (starting with vegetables); b) a focus on the 'how' (listen to your child's cues while feeding); c) a focus on both the 'what' and the 'how'. These three groups will be compared to a control group receiving no advice on how to introduce solid foods on children's vegetable intake and liking.

Detailed Description

The weaning period in infancy is an important time for introducing healthy eating patterns that include vegetables to protect children against the development of overweight. There is evidence that it is important what weaning infants are offered: starting exclusively with vegetables is more successful for the promotion of vegetable acceptance than starting with fruits. There is also evidence that it is important how infants are weaned: responsive feeding characterised by sensitive responses to infant cues during feeding fosters healthy eating. However, the what and the how of infant weaning have never been experimentally tested in the same study to determine their relative importance for fostering vegetable acceptance, nor have they been combined to test whether a focus on both may be superior to each approach separately. This study employs a randomised controlled design testing the effectiveness of (a) a focus on the what in weaning, i.e., a vegetable-exposure intervention; (b) a focus on the how in weaning, i.e., an intervention to enhance responsive feeding; (c) a combined focus on what and how in weaning in an integrated intervention; (d) an attention-control group. Vegetable acceptance will be measured before and directly after the interventions when the child is 18 months of age, and when the child is 24 and 36 months of age. The proposed study is based on a unique integration of expert knowledge from the field of nutrition and the field of parenting, which will provide new insights into the mechanisms underlying the development of vegetable acceptance in infants, and ultimately the prevention of overweight.

Conditions

Vegetable Acceptance in Early Childhood; Childhood Obesity; Childhood Overweight

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: FACTORIAL
• Primary Study Purpose: PREVENTION
• Blinding Strategy: SINGLE

Study Groups

Vegetable exposure

Repeated exposure to a variety of vegetables from the start of complementary feeding

Group Type: EXPERIMENTAL

Vegetable exposure

Intervention Type: OTHER

Repeated exposure to variety of vegetables

VIPP-Feeding Infants

Promotion of responsive feeding practices from the start of complementary feeding

Group Type: EXPERIMENTAL

VIPP-Feeding Infants

Intervention Type: BEHAVIORAL

Promoting responsive feeding practices

Exposure + VIPP-FI

Combination of repeated exposure to vegetables and promotion of responsive feeding practices

Group Type: EXPERIMENTAL

Vegetable exposure

Intervention Type: OTHER

Repeated exposure to variety of vegetables

VIPP-Feeding Infants

Intervention Type: BEHAVIORAL

Promoting responsive feeding practices

Control

Phone calls on development child with no information on complementary feeding

Group Type: SHAM_COMPARATOR

Control

Intervention Type: OTHER

Phone calls with mother about development of child, no advice on complementary feeding

Interventions

Vegetable exposure

Repeated exposure to variety of vegetables

Intervention Type: OTHER

VIPP-Feeding Infants

Promoting responsive feeding practices

Intervention Type: BEHAVIORAL

Control

Phone calls with mother about development of child, no advice on complementary feeding

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

First-time mothers of healthy term infants who report to have good reading and writing skills in the Dutch language

Exclusion Criteria

• Medical problems in the infant that influence the ability to eat
• Major psychiatric problems in the mother, like depression
• Mothers who are not willing to start weaning exclusively with prepared vegetable/fruit purees from the Nutricia brand
• Mothers who are not willing for themselves and/or their infants to be video-taped

• Minimum Eligible Age: 4 Months
• Maximum Eligible Age: 3 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

Wageningen University

OTHER

Sponsor Role: collaborator

Danone Global Research & Innovation Center

INDUSTRY

Sponsor Role: collaborator

Nutricia, Inc.

INDUSTRY

Sponsor Role: collaborator

Universiteit Leiden

OTHER

Sponsor Role: lead

Responsible Party

Judi Mesman

Prof. dr. J. Mesman

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Judi Mesman, PhD

Role: PRINCIPAL_INVESTIGATOR

Leiden University

Locations

Leiden University, Faculty of Social Sciences, Education and Child Studies

Leiden, , Netherlands

Wageningen University, Department of Agrotechnology and Food Sciences

Wageningen, , Netherlands

Countries

Netherlands

References

Mueller C, Mars M, Zeinstra GG, Perenboom C, Forde CG, Jager G. Sowing the Seeds of Taste? A Novel Approach to Investigate the Impact of Early Sweet Exposure on Children's Dietary Taste Patterns from 12 to 36 Mo. J Nutr. 2025 May;155(5):1466-1473. doi: 10.1016/j.tjnut.2025.03.017. Epub 2025 Mar 18.

Reference Type: DERIVED

PMID: 40113172 (View on PubMed)

van Vliet MS, Schultink JM, Jager G, de Vries JHM, Mesman J, de Graaf C, Vereijken CMJL, Weenen H, de Wild VWT, Martens VEG, Houniet H, van der Veek SMC. The Baby's First Bites RCT: Evaluating a Vegetable-Exposure and a Sensitive-Feeding Intervention in Terms of Child Health Outcomes and Maternal Feeding Behavior During Toddlerhood. J Nutr. 2022 Feb 8;152(2):386-398. doi: 10.1093/jn/nxab387.

Reference Type: DERIVED

PMID: 34791320 (View on PubMed)

van der Veek SMC, de Graaf C, de Vries JHM, Jager G, Vereijken CMJL, Weenen H, van Winden N, van Vliet MS, Schultink JM, de Wild VWT, Janssen S, Mesman J. Baby's first bites: a randomized controlled trial to assess the effects of vegetable-exposure and sensitive feeding on vegetable acceptance, eating behavior and weight gain in infants and toddlers. BMC Pediatr. 2019 Aug 1;19(1):266. doi: 10.1186/s12887-019-1627-z.

Reference Type: DERIVED

PMID: 31370830 (View on PubMed)

Related Links

http://babyseerstehapjes.nl/

Trial website, including participant information and possibility to enroll

Other Identifiers

057-14-002

Identifier Type: -

Identifier Source: org_study_id