title: The impact of instrumental feeding on children's responses to taste exposure.
abstract: BACKGROUND
  In a recent study, we showed that nonfood incentives combined with taste exposure increase children's acceptance of vegetables. However, the impact of children's previous experience of receiving food rewards is unknown. The present study investigated whether the experience of food rewards affects responses to an exposure-plus-reward intervention.
  
  
  METHODS
  One hundred and thirty-seven parents of 4-6-year-old children taking part in an exposure-based intervention study completed an instrumental feeding (IF) questionnaire aiming to assess their use of food rewards. Based on these scores, children were categorised as frequently or rarely instrumentally-fed. Intervention groups were given 12 daily tastes of a target vegetable combined with no reward, a tangible reward, (sticker) or a verbal reward (praise). A no-treatment control group received no tastings. Liking and intake of a target vegetable were measured at baseline and post-intervention.
  
  
  RESULTS
  Irrespective of experience of IF, children in all intervention groups increased liking compared to controls (all P < 0.001) and both reward groups increased intake compared to controls (both P < 0.05). However, in the nonrewarded exposure group, only children with a limited experience with food rewards increased consumption (P < 0.05).
  
  
  CONCLUSIONS
  Experience of IF may limit the benefits of 'mere exposure'. However, exposure with nonfood rewards can increase the acceptance of vegetables, regardless of previous experience.
authors.affiliation: Department of Epidemiology and Public Health, Health Behaviour Research Centre, University College London, London, UK.
authors.forename: E
authors.initials: E
authors.lastname: Añez
authors.forename: A
authors.initials: A
authors.lastname: Remington
authors.forename: J
authors.initials: J
authors.lastname: Wardle
authors.forename: L
authors.initials: L
authors.lastname: Cooke
mesh_terms: D002648:Child; D002675:Child, Preschool; D004435:Eating / Q000523:psychology*; D005260:Female; D005518:Food Preferences / Q000523:psychology*; D006801:Humans; D008297:Male; D009042:Motivation; D012201:Reward; D011795:Surveys and Questionnaires; D013649:Taste; D014675:Vegetables