Sprouts: Development of Eating Behaviors in Early Childhood

Eunice Kennedy Shriver National Institute Of Child Health & Human Development

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Abstract

Inadequate intake of whole plant foods and excessive intake of discretionary foods (foods of minimal nutritional value and high energy density) begin in early childhood. Early childhood is a critical period for the development of food preferences and eating behaviors, which in turn influence child growth and adiposity, underscoring the need for research elucidating the influences on intake during this period. Poor diet quality, in particular, excess intake of discretionary foods, may in part be prompted by the propensity to engage in hedonic, or reward-related eating. Critical knowledge gaps remain regarding the development of hedonically-motivated food intake in early childhood and the roles of parental influences, the degree of exposure to highly rewarding foods, and other modifiable family feeding practices that shape the child's food environment. Understanding the influences on hedonically-motivated food intake and its impact on child diet and growth will elucidate the relative importance of individual and environmental factors on eating behaviors and related health indicators and provide critical knowledge to guide future intervention to advance the development of healthful eating habits. The Sprouts study follows the PEAS (Pregnancy Eating Attributes Study) cohort from child age 3 to 7 years to investigate relationships of child eating behaviors and neuro-behavioral responses to food (e.g., eating in the absence of hunger, attentional bias to food cues, food reinforcement value, self-regulation) with maternal dietary intake and food reward-related characteristics, infant feeding practices and eating behaviors, and early life exposure to discretionary foods. Recruitment for Sprouts began in March 2019. In-person data collection was interrupted by the Covid-19 pandemic in early 2020; data collection was continued online to the extent possible until in-person visits resumed in late 2021. Data collection for the final, age 7 years assessment was completed in 2025; data are being prepared for analyses. Findings from the initial waves of data collection highlight the importance of early life food exposures. Infant exposure to fruits and vegetables was associated with higher early childhood diet quality; additionally, this association was stronger in children with higher food avoidance appetitive traits, suggesting a possible sensitive period for these infants. Exposure to discretionary food in the first two years of life was consistently associated with lower diet quality in early childhood regardless of the strength of appetitive traits (i.e., inherent disposition related to food approach and avoidance). Findings suggest that improving child diet quality may require stronger efforts to limit exposure to discretionary foods in infancy (Nansel et al. 2024). Analyses in the current year also reflect advances in measurement development. A latent profile analysis of the 12 subscales of the Comprehensive Feeding Practices Questionnaire yielded three distinct profiles of parent feeding practices, which differed meaningfully in home fruit and vegetable availability and child diet quality. These profiles facilitate examining multiple parent feeding behaviors in combination, thereby providing a comprehensive characterization of parent feeding practices (Channel Doig et al. 2025). A brief version of the Anticipated Effects of Food Scale was developed and evaluated in pooled data from four studies. The abbreviated measure demonstrated good internal consistency and convergent validity with the full measure, and reproduced associations of the full measure with added sugar intake, symptoms of food addiction, eating motives, and ad libitum food intake (Cummings et al 2025).