Complementary feeding: Vegetables first, frequently and in variety

Abstract

Diets rich in fruit and vegetables are associated with lower risk of a number of chronic health problems, but the majority of people do not consume enough of these foods. The main predictor of fruit and vegetable intake is enjoyment of these foods, but vegetables are often disliked, especially by children. Food preferences developed in the early years track throughout childhood and beyond and, therefore, it is critical that vegetable liking is promoted at the very earliest opportunity. The start of complementary feeding is a sensitive period for the development of food preferences, as infants will readily accept new foods and quickly learn to like them. Repeated exposure to a variety of vegetables during complementary feeding is an effective way to encourage infants to accept these foods. Recent research has suggested that offering vegetables exclusively for the first few weeks of complementary feeding offers additional benefits, but survey data indicate that this is not yet commonly practised in the UK. Encouraging UK parents to adopt a 'vegetables first, frequently and in variety' approach to complementary feeding is likely to steer children towards a lifelong preference for these foods and all the associated health benefits.

Reaching consensus on a ‘vegetables first’ approach to complementary feeding

“…food likes and dislikes developed in the early years predict food likes and dislikes in later years) but noted that this evidence base is mostly observational (as is the case for most life‐course research) and follow‐up periods do not tend to cover later childhood (>7 years). The majority of this evidence comes from prospective cohort studies [as described by Chambers ()] and includes data from large cohorts such as the Avon Longitudinal Study of Parents and Children ( ALSPAC ) (Coulthard et al . , ) and the Infant Feeding Practices Study II (Grimm et al .…”

“…Round‐table discussions centred on the following ways of introducing vegetables during complementary feeding as there is both experimental and observational evidence that these can increase children's vegetable acceptance in the short and longer term: repeated exposure to vegetables, offering a wide variety of vegetables and introducing vegetables as first foods. The paper by Chambers () described some of the studies in this evidence base but the round‐table participants agreed that a systematic research review is necessary to ensure that all relevant papers are captured and to assess the quality of the studies using standardised criteria.…”

“…, ; Fildes et al . ) (see Chambers ). Discussions at this point turned to the practical implications of recommending vegetable exclusivity at the initiation of complementary feeding.…”

“…A recent narrative review of the scientific infant feeding literature highlighted that introducing ‘vegetables first, frequently and in variety’ during complementary feeding ( i.e . when foods other than milk are first introduced – commonly referred to as weaning) can increase acceptance of vegetables during this period and into later childhood (Chambers ). On 5 May 2016, the British Nutrition Foundation (BNF) invited leading infant feeding experts to discuss and debate the strength of the evidence base and to see whether consensus could be reached on the translation of the science into practical messages for parents/carers.…”

Nutrition in the early years – laying the foundations for healthy eating

“…To make the most of this crucial period when babies are receptive to new foods, it has been suggested that offering vegetables exclusively for the first few weeks of complementary feeding with a ‘vegetables first’ approach enhances liking and facilitates acceptance of these foods (Chambers ; Chambers et al . ).…”