# Do children allocated to different methods of complementary feeding introduction have distinct food preferences and flavor acceptance in the first years of life? A randomized clinical trial

## TL;DR

This study found that children introduced to solid foods using different methods may have varying taste preferences, but differences were not consistently significant after adjustments.

## Contribution

The study introduces a randomized clinical trial comparing three complementary feeding methods and their impact on early food preferences and flavor acceptance.

## Key findings

- Children in the Mixed group showed higher unadjusted preference for sour-taste foods compared to Parent-Led Weaning.
- Preferences for bitter tastes were linked to bitter solution acceptance in unadjusted analysis but not after adjustment.
- Strong associations were found between taste preferences and acceptance of corresponding flavor solutions for sweet, sour, salty, and umami.

## Abstract

This study aimed to analyze the food preferences and flavor acceptance among children allocated to different methods of complementary feeding (CF) introduction in the first years of life. This randomized clinical trial (RCT) involved three distinct groups of children regarding the method of CF introduction: Parent-Led Weaning (PLW); Baby-Led Introduction to SolidS (BLISS); and Mixed (both PLW and BLISS methods). The intervention occurred at 5.5 months old, and food preferences were analyzed between the ages of 12–35 months using the Food Preferences Questionnaire and the Taste Acceptance Test. The analysis was performed by intention-to-treat, using Pearson’s chi-square test, Mann-Whitney test and Poisson regression. A d irected a cyclic g raph (DAG) was used to define the covariates. A total of 140 mother-infant pairs were randomized for the study (PLW n = 45; BLISS: n = 48; and Mixed: n = 47). Of them, 132 completed the Food Preferences Questionnaire, and 92 attended the Taste Acceptance Test. In unadjusted analysis, the prevalence of preferences for foods with a predominant sour taste was higher in the Mixed method compared to the PLW [Crude prevalence ratio (PR): 1.23; 95% CI: 1.03–1.47; p = 0.020]. However, after adjusting for covariates, this association did not remain statistically significant (Adjusted PR: 1.15; 95% CI: 0.94–1.41; p = 0.173). There was a significant association between the consumption of the solutions and their respective hedonic reactions in most of the offered tastes (sweet: p < 0.001; sour: p = 0.029; salty: p = 0.005; umami: p = 0.026). In addition, food preferences related to the bitter taste were associated with the higher acceptance of the solution with the same taste in unadjusted analysis (Crude PR: 1.12; 95% CI: 1.1–1.25, p = 0.046), but this association did not remain significant in the adjusted analysis (Adjusted PR: 1.16; 95% CI: 0.99–1.37; p = 0.069). In conclusion, infants in the Mixed group showed higher sour taste preference than PLW, though not significant after adjustment.