To like or not to like: On negotiating taste in children from families with a low socioeconomic position

 Socioeconomic disparities in diet quality continue to prevail, and already emerge in childhood. Children from families with a low socioeconomic position (SEP) consume unhealthier diets than children from families with a higher SEP. However, populations with a low SEP are least reached by interventions to improve diet quality and other lifestyle factors, which paradoxically could result in an increase of the disparity in diet quality and eating behaviors between populations with lower and higher SEPs. Moreover, populations with a low SEP are underrepresented in research. Instead of focusing on reducing the socioeconomic inequalities in health and dietary status, it may be more effective to focus on the health “potential” of populations with a low SEP, and especially children, as they are the ones where the benefits of improved dietary patterns and eating behaviors have the biggest impact.
The research reported in this thesis set out to investigate how health potential could be realized via improving eating behaviors in the everyday life of families with a low SEP. There are differences between populations with low and higher SEPs with regard to food preference, i.e., what they (dis)like, and what they believe is healthy or not, and (not) tasty. Therefore, this thesis aimed to provide insight in how these differences arise, and what the meaning is of “(un)healthy” and (not) “tasty”, and what it means to “like” or “dislike” a food, in the everyday life of families with a low SEP. A multidisciplinary approach was deployed, combining perspectives from nutrition sciences and psychology, diverse theoretical approaches, and quantitative and qualitative research methods.
The range of implicit (i.e., unconscious) and explicit (i.e., conscious) associations between (un)healthiness, (not) tastiness and (dis)liking of foods was mapped in primary school-aged children and parents from families with a low SEP. 37 primary school-aged children and their parents participated in implicit association tests and filled out paper-and-pencil questionnaires. The results showed that children and parents implicitly associated healthy foods and tastiness more strongly with each other than healthy foods and not tasty. In contrast to the hypothesis, this indicated a healthy = tasty intuition. Measures on the explicit level showed a similar result for parents. Children, however, showed mixed results as they rated pictures of unhealthy foods as tastier than pictures of healthy foods, and rated the descriptions “food that is tasty” and “food I like to eat” higher than “food that is healthy for me”, while they also indicated that they did not believe unhealthy foods were tastier than healthy foods. Possible theoretical and methodological explanations are discussed.
Furthermore, a scoping review of the fragmented scientific literature on healthy eating beliefs and the meaning of food in populations with a low SEP was conducted. A systematic search of scientific publication databases identified 35 publications as relevant for inclusion in the scoping review. The thorough review and qualitative synthesis of the literature showed that populations with a low SEP expressed diverse meanings of what they considered to be “healthy” and “good” food. They perceived healthy eating as important. However, they expressed various perceived barriers that indicated perceived limited control over what is eaten, and which may also be interpreted as competing values. Expressed barriers included limited time and money, social influences (such as indulging someone with food they like), desired identities conveyed by the consumption of specific foods, and adhering to traditions. However, participants also expressed a desire to be in control over what is eaten and perceived eating behavior as one’s own responsibility. Furthermore, parents articulated how they used food to coordinate (eating) behavior of their children.
Subsequently, it was explored how children and parents with a low SEP orient to and negotiate food tastiness (i.e., liking and disliking) in conversations during everyday family mealtimes. Video recordings of 79 evening mealtimes of families with a low SEP were analysed deploying discursive psychology and conversation analysis. The analysis revealed that children’s produced “likes” and “dislikes” of food were treated differently by their parents. Children’s food likes were routinely not responded to, agreed with, or further elaborated by parents. Children’s food dislikes, on the other hand, were typically treated as food refusals or as non-genuine claims.
Furthermore, it was explored how children and parents from families with a low SEP orient to and negotiate (un)healthiness of food in conversations during everyday family mealtimes. It was shown that (un)healthy eating and (un)healthiness of food were hardly explicitly oriented to, i.e., were hardly discussed. When they were oriented to, claims about (un)healthiness were produced and designed as identity-centered, food-centered or person-centered claims that accomplished specific actions in the interactional environment in which they were produced. Identity-centered health claims were produced in the interactional environment of managing someone else’s behavior. Parents constructed a desirable prospective identity for their child, typically to overcome food resistance or to reinforce good eating behavior. Food-centered health claims occurred in a variety of contexts where they accomplished actions that accounted for the speaker’s own behavior, such as for eating or providing a particular food. Person-centered health claims accomplished actions in contexts where the referent of the health claim was a food in a hypothetical situation, rather than a food eaten in the present situation.
In sum, this thesis indicated that children and parents with a low SEP oriented to “healthy is tasty” as a normative rather than an intrinsic belief. In addition, it was shown that people with a low SEP encounter competing values as they place a high value on healthy food, but more value on other things. Competing values can hinder, but also enhance healthy eating. Furthermore, this thesis showed that families with a low SEP only trivially oriented to food healthiness and tastiness in everyday conversations during family meals. Finally, it is proposed that a more in-depth connection to populations with a low SEP through mutual understanding and a common language about food, health and taste could be an innovative basis for policy, measures and interventions to improve healthy eating behavior in a way that is rewarding for all involved.