Keywords: Exposure to varied foods in early life is important for short- and long-term health and development. Strategically

Overview

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Key numbers

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• intervention to increase 1-year-olds’ acceptance of vegetables
• Food Courage 2.0. The purpose of the current qualitative study was to explore kindergarten teachers’ experience
• verbatim and subjected to thematic analysis. Five main themes were identified: 1) One-year-olds love food and
• renewal of the menus was inspiring; 2) One-year-olds are surprisingly willing to try and accept novel foods; 3) Novel food
• at meals stimulate social interaction; and 4) The Sapere method is a fun and explorative activity for 1-year-olds. These
• teachers. The fifth main theme was: 5) Sustained impact on kindergarten teachers’ practices and beliefs. The
• kindergarten teachers found the intervention easy to implement, and they were surprised by the foods 1-year-
• Trial registration: ISRCTN98064772.
• 1. Background Monnery-Patris, 2018), as food neophobia – children’s natural refusal of
• A varied diet rich in vegetables is crucial for growth and develop­ Halford, 2008). The foods we like and dislike seem to be shaped as early
• ment early in life and for long-term health. Introduction of new foods is as 2–3 years of age (Birch & Anzman, 2010; Maynard et al., 2006;
• essential to enable this. The timing and introduction to varied foods, Skinner, Carruth, Bounds, & Ziegler, 2002) and are predictive of eating
• taste and textures in toddlers are factors that contribute to accepting and habits later in life (Gluckman & Hanson, 2009; Nicklaus, Boggio, Cha­
• liking foods and developing a healthy and varied diet (Schwartz, banet, & Issanchou, 2005; Skinner, Carruth, Bounds, Ziegler, & Reidy,
• Scholtens, Lalanne, Weenen, & Nicklaus, 2011). Children’s natural po­ 2002). Therefore, there is potential for interventions targeting children
• before 2 years of age (Łoboś & Januszewicz, 2019; Nicklaus & phobia. Previous interventions to improve children’s diet and vegetable
• • Corresponding author. Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, University of Agder, PO Box 422, 4604, Kristiansand,
• 0195-6663/© 2021 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
• S.H. Helland et al. Appetite 166 (2021) 105581
• acceptance have typically missed this window of opportunity by starting schoolers’ Food Courage 2.0 (Blomkvist, Helland, Hillesund, & Øverby,
• too late (Hodder, O’Brien, Tzelepis, Wyse, & Wolfenden, 2020). 2018), targeting 1-year-olds in Norwegian kindergartens. The inter­
• (Engel, Barnett, Anders, & Taguma, 2015; OECD, 2017). In Norway, a promote a healthy diet by letting 1-year-olds in kindergarten become
• steadily increasing percentage of 1-year-olds are attending kindergarten familiar with different vegetables and other foods. The study included
• leaders work in teams with assistants to provide for groups of children for 1-year-olds, for example, using a soft toy dog to introduce different
• (The Norwegian Ministry of Education and Research, 2020). Children vegetables. The intervention improved vegetable intake and liking in
• start compulsory school the year they turn six. Most children (93% of 1-year-olds in both intervention groups (evaluation paper under re­
• 1–5-year-olds) spend 7–9 h a day in kindergarten (about 41 h/week), view). The Medical Research Council’s guidelines on evaluating com­
• Education and Research, 2020). mechanisms of impact, i.e., how interventions produce change. One way
• healthy food habits, liking and acceptance (Cardello & Owen, 1982). pants and those who implemented the intervention (Moore et al., 2015).
• fellowship with others, i.e., food pleasure (Haines et al., 2019). In kindergarten teachers’ experience of implementing this intervention
• Directorate of Health, 2012). In most kindergartens where food is
• served, the teachers or assistants prepare the food themselves, and the 2. Methods
• However, these aspects are currently not emphasised in kindergarten 2.1. Design
• healthy eating habits considered a priority (Universities Norway, 2018). The study reported here involved qualitative interviews with
• in promoting healthy eating habits among kindergarten children. The Courage 2.0 project, a Norwegian cluster randomised web-based inter­
• describe meal practices that are influential in shaping kindergarten 1-year-olds in kindergartens (Blomkvist et al., 2018).
• 2015). However, strategies recommended for parents to create a sup­
• portive eating environment can also be applied to employees in kin­ 1. What was kindergarten teachers’ overall experience of taking part in
• dergartens. These strategies include: 1) providing healthy food and the Pre-schoolers’ Food Courage 2.0 project?
• feeding practices; 3) eating together and modelling healthy eating; and intervention on the children and their parents, and on the kinder­
• 4. encouraging pleasure in eating and enjoyable social meals (Haines garten teachers themselves?
• et al., 2019). There may be a need for kindergartens to adjust such 3. What were the key elements of the intervention that kindergarten

Methods (brief)

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