Recipient Organization
WASHINGTON STATE UNIVERSITY
240 FRENCH ADMINISTRATION BLDG
PULLMAN,WA 99164-0001
Performing Department
School of Food Science
Non Technical Summary
Eating is central to healthy development in infants and children, but difficulties in eating can delay the achievement of developmental milestones of motor, language and emotional skills. In typically-developing individuals, oral feeding skills develop from birth, are established by 3-6 years of age, and remain stable throughout adulthood. However, in children with developmental disabilities, development of oral feeding skills is of concern as these children are at an elevated risk of acquiring feeding problems, with up to 80% of children with developmental delays, including Down syndrome, displaying such behavior. These feeding issues often persist into adulthood, with 25-31% of adults with developmental delays experiencing oral feeding difficulties. In children with oral feeding challenges, a common side effect is constipation, which results from a low fiber intake. Constipation reinforces feeding problems by decreasing appetite and willingness to try new foods. In addition, developmental delays have been associated with a delay in the introduction of solid foods, including a prolonged consumption of smooth food, all of which can be deleterious to oral-motor development.Given the lack of research that has been conducted in this area and the number of children with developmental delays, this is an important issue to address proactively to give these children a better opportunity for a healthy childhood. Children that develop healthy eating habits are more likely to extend these habits into adulthood, and healthy adults provide less of a burden to the healthcare system. Research into the area of texture sensitivities will also contribute valuable information to parents and caregivers, and through appropriate outreach, will guide the development of additional resources and tools in caring for children with texture sensitivities. Finally, the development of novel commercial food products with desirable textures and nutrition, including the addition of fiber, will have an agricultural impact.To obtain preliminary data regarding food preferences in children with texture sensitivities and develop and validate the tools necessary for a further research study, a pilot study was completed in August 2015. Texture profiling of 47 commonly consumed and commercially-available products was performed by an experienced sensory panel. A subset of these products was presented to children with and without texture sensitivities. For each product, the reactions of these children were recorded and coded by experienced coders for various behaviors to identify which texture attributes children with texture sensitivities found more acceptable. This coding scheme of children's reactions was developed using input from feeding and speech therapists, as well as industry practitioners. Results showed that the texture of the food product had a significant influence on different behaviors of children - eight products elicited more positive reactions from the children whilst the other four products elicited more negative reactions. The product texture attributes that elicited behaviors generally viewed as more positive included high pastiness, cohesiveness, smoothness and dissolvability; product attributes that elicited more negative reactions included hardness, loose particles, graininess and denseness. These results suggested that the children with texture sensitivities in this study displayed a preference for foods that were more dissolvable and smooth. Such specific findings of the texture preferences of children with texture sensitivities have not previously been reported in the literature.To inform target audiences, results from this research will be disseminated in print in high impact, peer-reviewed journals including Food Quality and Preference and Journal of the American Dietetics Association and via presentations at national and international conferences. To reach parents and practitioners, we will also prepare at least 1 issue of practitioner notes and participate in at least 1 feeding conference specific to children with feeding challenges.The ultimate goal of this project is to develop nutritious products that texture sensitive children find acceptable. The general impact of the grant includes the knowledge contribution to the under-researched area of texture sensitivities in children. From a societal standpoint, this research will help improve the growth, development and quality of life of children with texture sensitivities, along with providing their caregivers with useful resources and tools. Extending beyond children with texture sensitivities, the findings from this research may be transferrable to elderly populations with texture-related eating concerns.
Animal Health Component
60%
Research Effort Categories
Basic
25%
Applied
60%
Developmental
15%
Goals / Objectives
Goal: Ultimately, produce a series of food products, that are accepted by children with food texture sensitivities.Objectives: 1) To evaluate products using a texture-sensitive and texture-insensitive population of children; 2) To evaluate the physical nature of the snack food products using a trained panel and analytical methods. 3) To create a series of food products varying in their texture attributes and evaluate these food products for their textural and nutritional properties.
Project Methods
Objective 1 methods: To evaluate products using a texture-sensitive and texture insensitive population as identified by their caregivers, including a focus on children with Down syndrome. Through a pilot study, we developed a survey tool to identify children (aged 14 months-4 yrs) with and without texture sensitivities. For this study, 60 children identified as texture sensitive and 60 children not found to have texture sensitivities (as a control group) will be identified using the online screening questionnaire. To date, 615 caregivers have completed the pre-screening questionnaire to determine eligibility for this study. Of those screened, 102 participants qualified and we have received completed videos for these 102 children (28% texture sensitive). We need to recruit more texture sensitive children to complete this part of the study. In addition, we have focused on the study of children with Down syndrome and thus are including an additional 120 children with a diagnosis of Down syndrome, 60 with and 60 without texture sensitivities. Since we started our recruiting efforts for children with Down syndrome, 48 caregivers have completed the pre-screening questionnaire.A major challenge of this research has been recruiting participants. We started with the a database of children (Grand Rapids, MI) but were limited by its distribution. With the change in method to a home use test (all exposures at home) and an on-line information session, we opened up recruiting nationwide. In addition to direct contact and advertising on social media, in July 2017, we attended the National Down Syndrome Congress Convention in Sacramento, CA and hosted an exhibit to continue recruiting participants. Once selected for participation, caregivers will view an online information session and products will be sent to the caregivers. As previous research showed that acceptance of new food products requires up to six exposures (Wardle et al., 2003; informal communication with Gerber), children will evaluate each product six times, with their reaction recorded at each exposure. The caregiver will be instructed to feed the child until the child refuses the food product three consecutive times (Blossfeld et al., 2007). At this point, the caregiver will stop feeding the child and interpret the child's liking of the food using a nine-point hedonic scale, as well as his/her own liking (Bovell-Benjamin et al., 1999). Each exposure will be recorded and all videos will be uploaded. The child's reactions to each exposure of the product will be coded by an expert panel, with both intra- and inter-judge reliability measures determined. The taster status of each child will be determined using the 6-n-propylthiouracil (PROP) phenotyping test (Bell and Tepper, 2006) as previous research has shown a relationship between taster status and texture preferences (Bakke and Vickers, 2007). In addition, mouth behavior or how the child manipulates the food in-mouth may differ among the two groups of children (Field et al., 2003).Regarding selection of the products to send out to the participants, 4 different products will be sent out of a total of 16 possible products. These 16 products were separated into 4 flavor groups based upon the sensory profiling of a trained panel which created 4 flavor categories: buttery, cheesy, fruity, and honey/vanilla/caramelized. Each child will be assigned to one of these flavor groups based upon his/her preference (as identified by the screening questionnaire). This control measure minimizes the influence of flavor on overall child perception of products and allows the texture attributes to be the focus.Objective 2 methods: To evaluate the food products using physical methods. The food products being evaluated by the children have already been profiled for appearance, aroma, flavor, taste and texture attributes using a trained sensory evaluation panel. These products will also be evaluated using fracture tests and tribological measurements (Joyner et al., 2014) with a texture analyzer (TA.XT Plus). The three data sets, including trained panel profiling, child acceptance and rheological/tribological data will be analyzed using partial least squares to identify the white space in the product landscape (attribute combinations that are missing from the current product marketplace). These analyses will identify the sensory and mechanical properties that are desired by children with texture sensitivities, with results compared to children without texture sensitivities.Objective 3 methods: To prepare foods with modified texture attributes, food extrusion will be utilized. Extrusion has allowed for quick manufacturing of food products such as breakfast cereals and snack foods. Using this method, high pressure, with or without high temperature, will be applied to the food raw materials, resulting in the production of a food 'puff'. Wheat flour and protein-rich lentil flour will be utilized. To address the constipation that may be observed in children with texture sensitivities (Field et al., 2003), flour will be replaced with bran at varying concentrations (0 to 37%; Fleischman 2016). A co-rotating twin screw extruder (Brabender) housed in the WSU Food Science Pilot Plant will be used to produce the extruded products. To create a variety of textures in the final product, the parameters on the extruder will be adjusted (Ding et al., 2006). A number of parameters of the final extruded product will be examined, including product diameter (an indication of "puff") and weight. A texture analyzer will be used to determine product hardness and tensile strength (Chakraborty et al., 2004). All of the necessary equipment is available for use, either in the School of Food Science or the USDA Wheat Quality Lab. To assess whether the developed products reflect the desired texture attributes, a trained sensory panel will evaluate the products. Future research will involve another home use test in which these products are assessed by children.