![]() At this young age, parents bear primary responsibility for the diet of their children. ![]() Therefore, promoting a healthy diet and healthy eating habits and behavior from infancy is essential. Both children’s food preferences and their ability to self-regulate their energy intake are influenced by their direct environment already in the first two years of life. Poor eating habits, such as consuming too little vegetables and eating in the absence of hunger increase the risk of developing overweight and obesity, and related diseases such as type II diabetes, cardiovascular disease, and certain cancers. ![]() Moreover, a recent experimental study showed that almost 40% of 4 year-olds fail to effectively regulate their own energy intake, showing a tendency to eat even though they are not hungry. In the Netherlands, based on surveys between 20, estimates for the percentage of preschoolers failing to meet daily recommendations for vegetable intake vary from 40% up to an alarming 80%. Children as young as 1–3 years of age already eat too much energy-dense food and too little fruit and vegetables. In light of today’s global obesity epidemic and related diseases, promoting healthy eating habits is essential. Protocol issue date: 1 April 2018 version number 1. The trial was retrospectively registered during inclusion of participants at the Netherlands National Trial Register (identifier NTR6572) and at ( NCT03348176). The results may be used to improve current dietary advice given to parents of their young children on complementary feeding. The outcomes are expected to assess the impact of the interventions and provide new insights into the mechanisms underlying the development of vegetable acceptance, self-regulation and healthy eating patterns in infants and toddlers, as well as the prevention of overweight. Outcomes are assessed before, during and directly after the interventions (child age 18 months), and when children are 24 and 36 months old. Secondary outcomes are child eating behaviors, child anthropometrics and maternal feeding behavior. Primary outcomes are vegetable consumption, vegetable liking and self-regulation of energy intake. All mothers participate in five sessions spread over the first year of eating solid foods (child age 4–16 months). In this trial, we compare the effectiveness of (a) a vegetable-exposure intervention focusing on the what in complementary feeding (b) a sensitive feeding intervention focusing on the how in complementary feeding, (c) a combined intervention focusing on the what and how in complementary feeding (d) an attention-control group. MethodsĪ four-arm randomized controlled trial (Baby’s First Bites (BFB)) was designed for 240 first-time Dutch mothers and their infants, 60 per arm. ![]() In the current project the what and how (and their combination) are tested in one study to determine their relative importance for fostering vegetable acceptance and self-regulation of energy intake in infants. However, the effectiveness of the what and the how of complementary feeding has never been experimentally tested in the same study. ![]() How infants are introduced to solid foods also matters: if parents are sensitive and responsive to infant cues during feeding, this may promote self-regulation of energy intake and a healthy weight. starting exclusively with vegetables is more successful for vegetable acceptance than starting with fruits. Evidence shows that it is important what infants are offered during this first introduction of solid foods: e.g. The start of complementary feeding in infancy plays an essential role in promoting healthy eating habits. ![]()
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