Do hedonic- versus nutrition-based attitudes toward food predict food choices? a cross-sectional study of 6- to 11-year-olds
Marty et al. International Journal of Behavioral Nutrition and Physical Activity
Do hedonic- versus nutrition-based attitudes toward food predict food choices? a cross-sectional study of 6- to 11-year-olds
Lucile Marty 0 1 3
Maud Miguet 0 3
Marie Bournez 0 2 3
Sophie Nicklaus 0 3
Stéphanie Chambaron 0 3
Sandrine Monnery-Patris 0 3
0 Centre des Sciences du Goût et de l'Alimentation, AgroSup Dijon, CNRS, INRA, Univ. Bourgogne Franche-Comté , F-21000 Dijon , France
1 Centre des Sciences du Goût
2 University Hospital of Dijon, Pediatric Unit , Dijon , France
3 Centre des Sciences du Goût et de l'Alimentation, AgroSup Dijon, CNRS, INRA, Univ. Bourgogne Franche-Comté , F-21000 Dijon , France
Background: Implicit and explicit attitudes are potential precursors of food choices and combine affective and cognitive components that can vary in their relative dominance. Yet, the affective and cognitive components of attitudes toward food can lead to distinct predisposition toward a food item and potentially to different food choices. In the food domain, the affective component pertains to the hedonic tone of consumption, while the cognitive component encompasses nutritional value or health consequences of food. The present study investigated whether hedonic- versus nutrition-based implicit and/or explicit attitudes toward food predicts children's healthy versus unhealthy food choices. Methods: A total of 63 children (age range = 6.3-11.5) participated in a 90-min session at 5 pm (i.e., afterschool snack time in France). The children were asked to choose five food items from a buffet featuring five healthy and five unhealthy sweet foods pretested as being highly liked. Children ate what they had chosen. Moreover, their implicit attitudes were assessed with a pairing task in which children were presented with 10 food triplets and asked to choose two food items that “best go together”. For each triplet, foods could be paired according to their hedonic or nutritional characteristics. Explicit attitudes were assessed with a task in which children placed each of 48 food items into one of the following categories: “yummy”, “yucky” (i.e., hedonic categories), “makes you strong”, or “makes you fat” (i.e., nutritional categories). Results: Both implicit and explicit attitudes significantly influenced children's food choices. We observed that children with more hedonic-based implicit or explicit attitudes toward food were more likely to choose healthy food options from the buffet. Conversely, children with both implicit and explicit nutrition-based attitudes chose less healthy foods. Conclusions: Hedonic-based attitudes toward food seem to drive healthier food choices in children compared with nutrition-based attitudes in this particular eating context. These findings suggest that pleasure from eating might be an ally with regard to healthy eating among children. Additional research is needed to understand the etiology of children's attitudes toward food in order to provide insights on how to shape adequate children's attitudes to guide them toward healthy food choices.
Attitudes; Food choices; Children; Nutrition; Hedonic
Pleasure from eating is an innate driver of food
consumption, and food likes and dislikes are strong
predictors of children’s food choices [
children’s food preferences generally do not align with
dietary recommendations: they typically rate
energydense foods as the most liked and vegetables as the least
liked foods [
]. To encourage children to adopt a
healthy diet, parents, caregivers, and national campaigns
display nutritional information . In this context,
children acquire an early awareness about both the
hedonic and nutritional values of food. Five-year-olds are
able to classify food products considering both hedonic
and nutritional perceptions [
]. Interestingly, qualitative
studies have shown that children consider both hedonic
and nutritional perceptions as factors that influence their
food choices [
]. A better understanding of the
factors that underlie healthy or unhealthy eating in children
is of particular importance because eating habits remain
stable from childhood to adulthood [
surprisingly sparse research has examined the relative
influence of hedonic versus nutritional considerations
on children’s food choices [
]. To fill this gap, the
current study investigated the relationship between
children’s attitudes toward food (in particular, the relative
dominance of nutrition- versus hedonic-based attitudes)
and children’s choices of healthy versus unhealthy foods.
Attitudes are commonly viewed as memory associations
between objects and their evaluations that guide behavior
toward these objects [
]. Attitudes combine cognitive
and affective components that can vary in their relative
dominance to form global evaluations of an object [
In the food domain, the affective component pertains to
the sensations, feelings and emotions experienced in
response to a food item (e.g., the hedonic tone of
consumption), whereas the cognitive component encompasses the
positive and negative attributes and beliefs about a food
item (e.g., its nutritional value and health consequences)
]. Importantly, Dubé and Cantin showed that the relative
dominance of affective or cognitive components of attitudes
toward a food item influences eating behavior [
]. In fact,
the affective and cognitive basis of attitudes toward food
can lead to distinct evaluative consequences. The affective
component of attitudes toward a food item (e.g., chips) can
lead to a positive evaluation because it is tasty, whereas the
cognitive component of the attitude can lead to a negative
evaluation because it is unhealthy. One’s global evaluation
of chips may differ depending on whether one favors the
affective or cognitive component. Thus, primarily
hedonicbased (i.e., affect-based) or nutrition-based (i.e.,
cognitivebased) attitudes toward food can lead to different food
In addition, numerous psychology studies have
demonstrated the influence of non-conscious processes on decision
], and the distinction between implicit and
explicit attitudes has emerged [
]. Implicit attitudes likely
operate automatically in a non-conscious fashion, whereas
explicit attitudes are likely retrieved deliberatively under
conscious control [
]. Several attempts have been made to
develop predictive models combining implicit and explicit
attitudes and their influences on behavior [
major models have been proposed in the literature and
tested in a food context by Perugini [
]: (1) additive (the
two types of attitudes explain different proportions of the
variance of behavior), (2) double dissociation (implicit
attitudes predict spontaneous behaviors, whereas explicit
attitudes predict deliberative behaviors), and (3)
multiplicative (implicit and explicit attitudes interact to influence
behavior). Perugini observed that the double dissociation
model of Wilson et al. [
] predicted eating behaviors:
implicit attitudes were significantly related to spontaneous
eating behaviors (namely, the choice of a snack or fruit at
the end of the experiment), whereas a significant
relationship was found between explicit attitudes and deliberative
behavior (namely, the self-reported consumption of snacks
and fruit during an average week) [
]. Interestingly, König
et al. recently showed that both explicit and implicit
attitudes were independent precursors of food choice in a
binary-option choice task. Conversely, in a multiple-option
choice task, the effects of explicit and implicit attitudes were
qualified by an interaction. The participants served
themselves more sweets than fruit when their implicit and explicit
attitudes revealed a consistent preference for sweets, as well
as when one attitude type (i.e., either the implicit or the
explicit one) indicated a preference for sweets while the other
indicated a preference for fruit [
]. Contrary to Perugini’s
], these results support the additive model
using a binary-option food-choice task and suggest a shift
from the additive to the multiplicative predictive model
when multiple food options are offered. In summary,
although both implicit and explicit attitudes influence eating
behaviors, how they interact to predict eating behavior
Only few studies have investigated both implicit and
explicit attitudes toward food in children [
to our knowledge, the relationships between implicit and
explicit attitudes and food choices has never been
investigated in children. In a recent study, a new method was
developed to assess hedonic versus nutritional basis of
implicit and explicit food-related attitudes in children
]. This new method included two tasks appropriate
for use with children from 5 to 11 years old. The implicit
attitudes were assessed with a pairing task, in which
children were presented with food pictures triplets and
asked to choose two food items that “best go together”.
For each triplet, foods could be paired according to their
hedonic or nutritional characteristics. Explicit attitudes
were assessed with a categorization task in which
children placed food items into one of the following
categories: “yummy”, “yucky” (i.e., hedonic categories),
“makes you strong”, or “makes you fat” (i.e., nutritional
categories). For both tasks, for each trial, children had to
choose between a hedonic-based and a nutrition-based
answer. It was assumed that the proportion of
hedonicor nutrition-based answers would reflect the relative
dominance of the hedonic or nutritional basis of implicit
and explicit attitudes. The first study using these two
tasks revealed an increase in implicit hedonic-based
attitudes but a decrease in explicit hedonic-based attitudes
with school level [
]. The tasks were also used to
compare attitudes towards food between children with or
without overweigh [
]. The results showed no
difference in children’s responses in the implicit task based on
their weight status, but children who were overweight
were more likely to make nutrition-based categorizations
than children who were normal-weight.
Following on from these results, the present study
investigated whether the relative dominance of the
nutritional (i.e., cognitive) versus hedonic (i.e., affective)
components of implicit and explicit attitudes toward food
are associated with children’s choices of healthy versus
unhealthy foods. During an experimental session,
children chose five of 10 highly appreciated healthy or
unhealthy sweet food items to compose a snack they had
to eat. Moreover, children’s attitudes toward food were
assessed using the implicit pairing task and the explicit
categorization task developed by Monnery-Patris et al.
]. Based on the literature regarding adults [
we assumed that both implicit and explicit attitudes
would predict the healthiness of children’s food choices.
On one hand, nutritional interventions commonly
assume that knowledge about the nutritional value of
food improves the nutritional quality of children’s diets
]. Based on this perspective, having
nutritionbased attitudes toward food should drive healthier food
choices in children. On the other hand, cross-cultural
studies of adults have highlighted the positive
relationship between hedonic perceptions of food consumption
and overall health status [
]. In addition, some
evidence suggests that emphasizing hedonic considerations
toward food may drive healthy eating behaviors in
]. Thus, it could be assumed that hedonic-based
attitudes toward food would drive healthier food choices
A power calculation to detect a large effect (f2 = 0.35),
assuming three predictors in a linear multiple regression,
led to a sample size of 35 participants for 80% power at
α = 0.05. The expected effect size was based on the
results of König et al. (2016) who investigated the
influence of implicit and explicit attitudes on food choices in
a multiple-option food choice task [
]. A total of 63
children participated in this study (mean ± SD age = 8.99 ± 1.51,
age range = 6.3–11.5 years, mean ± SD BMI (Body Mass
Index) z-score = 1.65 ± 1.92, BMI z-score range = −1.74–
5.74; 31 girls, 32 boys). Children were recruited from 6 to
11 years old because the implicit pairing task and the
explicit categorization task were developed and adapted for this
age range. Moreover, based on the results of a previous
study using the same method [
], children varying in
weight status were recruited to maximize the attitudinal
variability of the sample. Children were recruited from a
population registered in the Chemosens Platform’s
PanelSens database. This database was declared to the
relevant authority (Commission Nationale Informatique et
Libertés; CNIL; n°1,148,039). Children with high
body mass index z-scores (z-BMI) were specifically recruited
from pediatric weight care consultations at a local hospital.
The study was conducted in accordance with the
Declaration of Helsinki and approved by the local ethical
committee (Comité pour la Protection des Personnes EST-1
Burgundy, file number: 2015-A01547–42). Based on a
recruitment questionnaire, children with food allergies were
excluded. Written informed consent was obtained from both
parents before their child’s participation. We certify that all
applicable institutional and governmental regulations
concerning the ethical use of human volunteers were adhered to
throughout this study.
The children and their parents were invited to a 90-min
session after school (i.e., from 5 to 6:30 pm during
weekdays) that occurred in our laboratory. The experiment
was conducted with a maximum of 8 children per
session and a minimum of 3. Children in the same
session did not know each other. Parents were asked not
to give their children a snack during the afternoon
before the experiment. We welcomed the children and
their parents in a waiting room, and only the children
were invited to enter the experimental room. First, the
children were asked to choose five snacks from an
individual buffet and had time to eat what they had chosen.
They made their choices individually but consumed their
five snacks together at the same table. This protocol (i.e.,
first, individual choices, then commensal consumption)
has been selected since it is very close to the meal
proceedings at schools in France, in particular for afternoon
snack. Hidden video cameras recorded the food choices
of the children without their knowledge. Each individual
buffet was separated from the others by two partitions
to avoid interactions between children and to limit peer
influence. Then, we measured the children’s attitudes
toward food by placing them at separated tables. They
performed an implicit and an explicit task on a computer.
The tasks were self-administered, but experimenters
were present to provide the initial instructions and were
available for consultation if needed. Next, children
individually rated their liking and healthiness perception of
the foods offered in the buffet. Finally, the children’s
height and weight were measured. Before leaving, the
children received a certificate of participation, and their
parents received a €20 voucher.
Evaluation of food choices
Ten sweet foods, including 5 healthy foods (red apple,
banana, kiwi, applesauce and strawberries) and 5
unhealthy foods (donut, chocolate cake, Smarties®,
Kinder Bueno® and Gold Bears®) were served to the
children in individual buffets (Table 1). These foods were
selected based on a pre-testing of children’s familiarity with
these foods conducted with a separate group of 61 children
recruited from children’s holiday centers. During
face-toface interviews, the children were presented with pictures
of the foods from the Food4Health pictures base [
reported whether they had ever tried them.
An individual buffet with 20 small plates (two plates of
each food) was prepared for each child in the study
(Fig. 1). The foods were not presented in packets. The
position of the healthy and unhealthy foods was
counterbalanced: two healthy foods at the front and three at the
back of the table, alternatively placed, versus three
unhealthy foods at the front and two at the back of the
table, alternatively placed. Under this predetermined
position, healthy and unhealthy foods were randomly
presented. Hidden video cameras were placed above
each buffet to record the food choices of the children
without their knowledge.
Values are shown as the means ± SD. Energy density was obtained from the
French food composition database [
] or from the food packaging
The video camera began recording before the children
entered the experimental room. When the children
entered, they were given a tray and assigned to their
individual buffet. The children chose five plates to
compose their snack. The children were told: “Today,
we start the session by a snack! Each of you has an
individual buffet prepared. You can choose five food items
from your buffet and keep them on your tray. When you
have made your choices, you can sit at the table with the
other children to eat.” The children were able to choose
two plates of the same food. They chose foods alone
among the foods displayed in their individual buffet.
Then, they ate together around the same table on which
a glass of tap water (200 mL) and a napkin were
available for each of them. They were told that they could
leave some food on the plates if they did not want to eat
anymore. When they finished, they left their tray on a
trolley. After the participants left, the videos were
watched. The number of healthy foods chosen by each
participant was counted, and the time spent choosing
the five food items was recorded.
Characterization of children’s attitudes toward food
Implicit pairing task
Eleven triplets of food item pictures were successively
presented, including an initial training triplet (strawberries,
raspberries and whipped cream) followed by 10 test
triplets (chicken, steak and French fries; baguette, butter
and Nutella; tomatoes, olive oil and mayonnaise; cigarette
cookies, chocolate chip cookies and applesauce; white
bread, baguette and jam; waffle, pancakes and jam; plain
cookies, chocolate chip cookies and applesauce; chicken,
French fries and potato wedges; fruit salad, cigarette cookies
and applesauce; and pasta, rice and steak) presented in a
random order [
]. For each triplet of foods, children were
asked to “choose the two foods that best go together”. The
children were able to perform hedonic associations by
pairing two food items that are typically consumed together
(e.g., steak with fries or chicken with fries) or a nutritional
association by pairing the two nutritionally similar food
items (e.g., steak with chicken because they both belong to
the meat category). The instructions and names of each food
item were read aloud by the tablet computer when the food
pictures appeared on the screen. For each triplet, the
children answered by touching the two pictures on the screen
that they thought matched. This action was recorded by the
program, and no feedback was given. The pairing task
required approximately 5 min. An implicit hedonic score
based on the percentage of hedonic associations was
calculated for each child (range: 0–100%).
Explicit forced-choice categorization task
A total of 51 food pictures were successively presented
on a touch-screen tablet, including 3 for initial training
(banana, lollipop, and rice) followed by 48 randomized
test food item pictures: 9 fruits (red apple, grapefruit,
orange, melon, grapes, pear, kiwi, nectarine, and fruit
salad), 10 vegetables (tomatoes, carrots, cucumber, string
beans, peas, vegetable soup, zucchini, mixed vegetables,
ratatouille and lentils), 6 animal proteins (fish fillet,
salmon steak, beef steak, lamb chop, fried egg, and omelet),
4 cheeses (Gruyere, Camembert, Roquefort, and goat
cheese), 4 high-fat dishes (hamburger, lasagna, pizza, and
French fries), 3 salted snacks (chips, pretzels, and small
quiche), 5 sweet snacks (croissant, plain cookies, candies,
chocolate, and candy bar), and 7 desserts (chocolate éclair,
strawberry ice-lolly, crème caramel, ice cream, apple pie,
chocolate cake, and chocolate pudding). The children chose
whether each food item was “yummy” or “yucky” (poles of
the hedonic dimension) or whether it “makes you strong”
or “makes you fat” (poles of the nutritional dimension) by
touching the corresponding pictogram on the tablet.
Another category, “I don’t know this food”, was also available.
The meaning of each pictogram was provided for the 3 first
food items. The tablet computer read aloud the instructions
and the name of each food item. Their choice was recorded
by the program, and no feedback was provided. This task
lasted approximately 10–15 min. An explicit hedonic score
based on the percentage of hedonic answers (i.e., “yummy”
or “yucky”) for known foods was calculated for each child
Validation of the implicit pairing task and the explicit forced-choice categorization task
To confirm the validity of these measures, a pre-test
with 27 different children (mean age = 8.45 years) was
initially performed to examine whether hedonic (resp.
nutritional) pairings and categorizations actually reflect
hedonic (resp. nutritional) considerations [
Regarding the implicit pairing task, children were interviewed
and their verbatims were collected to ensure that an
association such as steak and chicken (coded as a
nutritional association) was motivated by nutritional
considerations (e.g., “they are both meat”), and that an
association such as chicken and French fries (coded as a
hedonic association) was motivated by hedonic
considerations (e.g., “I like eating chicken with French fries”).
The results of the qualitative analysis of children’s words
led the authors to conclude that hedonic or nutritional
pairings were congruently justified by hedonic or
nutritional justifications, respectively, for all food triplets.
Regarding the explicit categorization task, children were
presented with different pictograms assumed to reflect
the different categories (“yummy”, “yucky”, “makes you
strong”, “makes you fat”, and “I don’t know this food”).
Children were asked to describe each pictogram. Finally,
the pictures that were correctly labeled for the purpose
of the study by at least 95% of the children were
selected. These categories labels were selected by the
authors because they referred to concrete situations
easily conceptualized by young children. They highlighted
that the children preferentially chose concrete answers
such as “makes you fat” or “makes you strong” instead of
more abstract categories such as “good for your health”
or “bad for your health”.
Liking and healthiness perception
During face-to-face interviews, children rated their liking
and health perception of the 10 buffet foods based on
pictures of these foods. Children were presented with the 10
food pictures, one at a time, and rated their liking (i.e.,
“How much do you like this food?”) using a continuous
scale ranging from “I do not like it at all” to “I like it very
much”, which was coded from 0 to 10, respectively. After
they rated their liking for all the foods, they were presented
with the 10 food pictures again and rated their healthiness
perceptions (i.e., “Is this food healthy?”) using a continuous
scale ranging from “It is not healthy at all” to “It is very
healthy”, coded from 0 to 10, respectively.
Weight (kg) was measured to the nearest 0.1 kg using a
digital scale (Soehnle, Benfeld, Germany) while the
children wore light clothes and no shoes; height (cm) was
measured to the nearest 0.1 cm while the children stood
without shoes using a stadiometer (Seca Leicester,
Birmingham, UK). BMI was calculated and transformed
into age- and sex-standardized z-scores (z-BMI) based
on the French reference data [
At the beginning of the session, the children indicated
their hunger on a four-point scale ranging from (1) not
hungry at all to (4) very hungry.
To describe children’s perceptions of the buffet food
assortment, liking and healthiness perception of healthy
versus unhealthy foods were compared using Student’s
T-tests. Multiple linear regression analyses were
conducted to analyze the effect of the explicit and implicit
hedonic scores as well as their interaction with regard to
the (1) number of healthy food choices, (2) time spent to
make the food choices, (3) difference between the liking
ratings of the chosen and non-chosen foods (referred as
Δlikingchosen-non_chosen), (4) difference between the
healthiness ratings of the chosen and non-chosen foods
(referred as Δhealthinesschosen-non_chosen), (5) difference
between the liking ratings of the healthy and unhealthy
foods (referred as Δlikinghealthy-unhealthy), and (6)
difference between the healthiness ratings of the healthy and
unhealthy foods (referred as Δhealthinesshealthy-unhealthy).
We assumed that Δlikingchosen-non_chosen (resp.
Δhealthinesschosen-non_chosen) reflected the use of liking (resp.
healthiness perception) as a criterion for food choice. All
the participants completed the entire protocol, there was
no missing data and the analyses were conducted on the
total sample of 63 children. All of the multiple linear
regression analyses presented in the results section
included three continuous control variables: hunger
level, age, and z-BMI. All statistical analyses were
performed using SAS version 9.3 (SAS Institute, Inc., 2012
SAS® 9.3. Cary, NC). The level of significance was set at
P = 0.05. The results are expressed as means ± SDs.
Perception of the food assortment
The liking and healthiness perception ratings of each
buffet food are presented in Table 2. On average, the
liking of healthy foods was similar to that of unhealthy
foods (Mliking_healthy = 8.4 ± 1.4, Mliking_unhealthy = 7.9 ± 1.5;
t(62) = 1.73, P = 0.09), whereas healthiness perception
significantly differed between healthy and unhealthy
foods (Mhealthiness_healthy = 9.3 ± 0.8, Mhealthiness_unhealthy =
3.7 ± 2.1; t(62) = 21.0, P < 0.0001). In addition, a
Spearman’s correlation revealed that children’s health ratings
were inversely linked with food ED (Spearman’s ρ = −0.68,
P = 0.03). High ED is an indicator of poor nutritional
quality in western countries [
]. Thus, children’s
perception of food healthiness matched an objective indicator
of food nutritional quality. Moreover, no correlation was
found between liking and healthiness for the 10 food items
rated by the children (Spearman’s ρ = 0.12, P = 0.75).
Description of children’s food choices
On average, the children chose 2.2 ± 1.1 healthy foods in
55.9 ± 24.2 s. All of the children ate all the foods that they
chose. The liking ratings of the chosen foods were higher
than those of the non-chosen foods (Mliking_chosen = 9.1 ±
0.87, Mliking_non_chosen = 7.3 ± 1.6; t(62) = 8.33, P < 0.0001),
whereas healthiness perception did not significantly differ
between the chosen and non-chosen foods
(Mhealthiness_chosen = 6.2 ± 1.9, Mhealthiness_non_chosen = 6.8 ± 1.7; t(62) = −1.96,
P = 0.055).
Description of children’s attitudes toward food
On average, children’s implicit attitudes toward food were
primarily hedonic-based (Mimplicit_hedonic_score = 75.7 ±
26.6%), as were their explicit attitudes, to a lesser extent
(Mexplicit_hedonic_score = 56.0 ± 23.4%). The implicit and
explicit hedonic scores were not significantly correlated
with each other (r = 0.09, P = 0.48).
Effect of explicit and implicit attitudes on children’s food
The number of healthy buffet foods chosen significantly
increased as a function of both the implicit hedonic
score (β = 0.04, 95% CI [0.011; 0.061], P = 0.01) and the
explicit hedonic score (β = 0.05, 95% CI [0.015; 0.088], P
= 0.01). The interaction between the explicit and implicit
hedonic scores was also significant (β = −0.001, 95% CI
[−0.001; −0.0001], P = 0.01). Median splits were
performed with regard to the implicit and explicit hedonic
scores to create four groups of children with contrasting
attitudes toward food. As Fig. 2 shows, the children with
both high implicit and explicit hedonic scores chose
more healthy foods, as did the children with either high
implicit or high explicit hedonic scores. Conversely,
children with both low implicit and explicit hedonic scores
chose fewer healthy buffet foods than those from the
Effect of explicit and implicit attitudes on the time spent to make food choices
The time that children took to choose was not related to
their implicit hedonic scores (β = −0.23, 95% CI [−0.85;
0.40], P = 0.47) or their explicit hedonic scores (β = −0.06,
95% CI [−0.96; 0.85], P = 0.90).
Effect of explicit and implicit attitudes on the difference between the liking or healthiness ratings of the chosen and non-chosen foods
To further understand the relationship between the relative
dominance of hedonic versus nutrition-based implicit and
explicit attitudes toward food and children’s food choices,
the effects of the implicit and explicit hedonic scores on
Δlikingchosen-non-chosen and Δhealthinesschosen-non-chosen were
tested. On average, Δlikingchosen-non-chosen = 1.75 ± 1.67 and
significantly differed from zero (P < 0.001), and
Δhealthinesschosen-non-chosen = −0.62 and did not significantly differ
from zero (P = 0.055). The results of the linear regressions
did not show an effect of the implicit (β = 0.02, 95% CI
[−0.03; 0.06], P = 0.50) and explicit (β = 0.03, 95% CI [−0.04;
0.09], P = 0.38) hedonic scores on Δlikingchosen-non-chosen but
a significant effect of both implicit (β = 0.09, 95% CI [0.03;
0.15], P = 0.004) and explicit (β = 0.13, 95% Cs [0.04; 0.22],
P = 0.01) hedonic scores as well as their interaction (β =
−0.001, 95% CI [−0.002; −0.0003], P = 0.01) on
Effect of explicit and implicit attitudes on the difference between the liking or healthiness ratings of the healthy and unhealthy foods
We wondered whether the above results were because the
children with low implicit and explicit hedonic scores liked
healthy foods less than unhealthy foods; this effect might
have led to a greater number of unhealthy food choices
driven by liking. The effects of the implicit and explicit
hedonic scores on Δlikinghealthy-unhealthy were tested. No
significant effect of the implicit (β = 0.05, 95% CI [−0.003;
0.10], P = 0.07) or explicit (β = 0.04, 95% CI [−0.04; 0.11], P
= 0.31) hedonic scores on Δlikinghealthy-unhealthy was found.
In addition, we did not observe a significant effect of the
implicit (β = −0.004, 95% CI [−0.06; 0.05], P = 0.88) or
explicit (β = −0.0003, 95% CI [−0.08; 0.08], P = 0.85)
hedonic scores on Δhealthinesshealthy-unhealthy.
The present study explored the relationship between
children’s implicit and explicit attitudes toward food.
Specifically, we investigated the relative dominance of
hedonic- versus nutrition-based attitudes, and children’s
food choices with regard to a buffet offering highly
appreciated healthy and unhealthy sweet foods. To
assess children’s attitudes toward food, we used two
tasks previously developed by Monnery-Patris et al.
]. The implicit pairing task assessed the
dominance of hedonic versus nutritional associations without
criteria. This task likely assesses implicit attitudes toward
food, which are defined as automatic and spontaneous
]. In fact, implicit attitudes likely result from
associative reasoning and reflect an individual’s level of
exposure to a given association in one’s culture [
assume that the implicit hedonic score from the implicit
pairing task reflects passive learning of the relative
dominance of hedonic versus nutritional considerations
through successive food experiences. The explicit
forced-choice categorization task assessed the
dominance of hedonic versus nutritional categorizations when
explicit classification criteria were given. This task likely
assessed explicit attitudes toward food, which are
defined as non-automatic and deliberative [
this task involved a direct analysis of the potential
benefits of food consumption, either hedonic or nutritional,
the explicit hedonic score may reflect what children are
taught about food. To clearly establish a difference in
the interpretation of the two tasks, we hypothesize that
the implicit hedonic score reflects a passive learning and
appropriation of cultural food values among children,
whereas the explicit hedonic score reflects their
intentional education of the hedonic and nutritional
values of food through family expectations, media
information about nutrition, and health promotion programs.
This study observed that both implicit and explicit
attitudes significantly influenced children’s food choices.
We observed that children with more hedonic-based
implicit or explicit attitudes toward food chose healthier
buffet foods. The influence of implicit and explicit
hedonic scores on food choices was also moderated by a
negative interaction indicating that children who had
both low implicit and explicit hedonic scores were those
who chose the fewest healthy food options. These results
support Rozin et al.’s hypothesis that pleasure-oriented
attitudes toward food are associated with healthier diets
]. On one hand, we showed that the difference in
liking between chosen and non-chosen foods was
significantly positive, and neither implicit nor explicit hedonic
scores affected this difference; in other words, children
primarily chose the foods that they liked regardless of
their attitudes. On the other hand, we showed that the
difference in healthiness perception between the chosen
and non-chosen foods was negative but not significantly
different from zero; furthermore, this difference
increased as a function of both implicit and explicit
hedonic scores. Thus, when their implicit and explicit
hedonic scores decreased, children chose the foods they
perceived as less healthy, even though that they liked the
healthy and unhealthy buffet foods equally.
Children with high hedonic scores chose healthier
food options from a buffet offering similarly liked
healthy and unhealthy foods. In this particular condition,
having hedonic-based attitudes might have driven
healthy food choices. In fact, hedonically oriented
children chose the foods that they liked without considering
the healthiness of foods, leading to a balanced choice of
healthy and unhealthy food items. Conversely, children
with both low implicit and explicit hedonic scores chose
more unhealthy buffet food items and did not report a
higher liking for unhealthy foods. Being unhealthy per se
likely made unhealthy foods more attractive to them. At
first sight, it could be surprising that the children most
motivated to eat unhealthy foods were those with both
implicit and explicit nutrition-based attitudes. Several
hypotheses might explain why such an attitudinal
pattern is associated with unhealthier food choices.
Based on the interpretation of the tasks, having both
implicit and explicit nutrition-based attitudes might
reflect both a passive learning of and an intentional
education about the nutritional value of foods in
]. This effect might be because of particular
nutrition-focused familial contexts associated with
restrictive parental feeding practices that enhanced
children’s motivations to eat unhealthy foods during the
experiment. For instance, children’s desire for a food
increases significantly when its access is prohibited [
and children consume more of a formerly forbidden
food when they are finally allowed to eat it [
Children with both implicit and explicit nutrition-based
attitudes might have a restricted access to unhealthy foods
at home which consequently increased their selection
and intake of these foods in the context of this
experiment. In fact, the experimental session occurred in the
absence of a parent and might have been perceived as
particularly tempting because numerous highly
appreciated sweets were available. Perceived restrictive parental
feeding practices were not recorded in the present study.
Additional research is needed to investigate the
psychological and environmental factors associated with this
nutrition-focused pattern of attitudes toward food in
children. To avoid any potential counter-productive
effect of this nutrition-focused attitudinal pattern, we
suggest that shaping hedonic-based attitudes toward
food by enhancing the attractiveness of healthy foods
using pleasure-based strategies could be efficient to drive
healthy food choices in children [
From a theoretical perspective, the present study was
the first to investigate the ways that both implicit and
explicit attitudes toward food predict children’s food
choices. We found an interaction between implicit and
explicit attitudes with regard to their influence on
children’s buffet food choices, supporting the multiplicative
predictive model [
]. Although the attitudes measures
differed, this result is consistent with König et al. [
who found a negative interaction between the effects of
implicit and explicit attitudes on food choice using a
multiple-option choice task involving the choice of a
meal at a fake foods buffet. These authors specifically
recorded the total amount of self-served sweets and fruit
as well as studied their relationships with implicit and
explicit attitudes toward these foods. König et al.
highlighted a compensatory “one attitude is sufficient”
effect because more sweets than fruit were chosen when
at least one attitude (either implicit or explicit) showed a
preference for sweets over fruit. Similarly, we found that
when either the implicit or explicit hedonic score was
high, children chose more healthy foods.
Strengths and limitations
One strength of this study was its assessment of actual
food choices among children in an ecologically valid
eating situation. In fact, 80% of French 3- to 17-year-olds
have a snack in the afternoon at least 4 times a week
]; thus, snacking is a common practice. A limitation
of the protocol is that the study occurred in a laboratory,
which might have biased children’s food choices.
Nevertheless, the laboratory context allowed us to accurately
control certain environmental parameters. It ensured
that each child made his or her own food choices under
the same conditions so that these choices could be
properly compared. Regarding food assortment, we chose
highly liked healthy and unhealthy foods. Although both
healthy and unhealthy foods were displayed in the buffet
without packaging, certain unhealthy foods might have
been recognized as branded products that may have
influenced children’s food choices. Moreover, this
particular assortment of food questions the generalizability
of our findings. Notably, one may wonder whether
implicit and explicit hedonic scores would have similarly
predicted healthier food choices if the healthy food items
had been less liked (e.g., if we had chosen vegetables
instead of fruit). The answer might be negative. Knowing
that liking was a strong predictor of children’s food
choices independent of their implicit and explicit
hedonic score, offering foods with contrasted liking
could have driven all of the children to the same choice:
they would have chosen the foods they liked (i.e., the
unhealthy options). Thus, offering similarly liked healthy
and unhealthy foods is strength of our experimental
design because it enabled us to observe a fine tuning of
food choices based on attitudes toward food. Moreover,
the age range was quite large and it might have affected
the results. The age of the participants was included
as a control variable in all the statistical analyses
(Additional file 1). However, the effect of age on
children’s food choices was not significant. Thus, the
wide age range strengthens the assumption that food
choices were primarily influenced by children’s
attitudes rather than by their age. The same is also true
for z-BMI, also included as a control variable in all
the statistical analyses (Additional file 1). Finally, in
line with previous studies, we assumed that the
implicit pairing task and the explicit categorization task
measured the implicit and explicit relative dominance
of hedonic- versus nutrition-based attitudes toward
food, respectively [
]. However, the implicit
pairing task is likely to have captured something else
than strictly speaking hedonic or nutritional aspects
of food. In fact, pairing two meats together because
“they are both meats” could reflect nutritional
considerations but also usage (e.g., two meats are
interchangeable within a meal, because they belong to the
same food category). Conversely, pairing two foods
together because they are good together could reflect
hedonic considerations but also habits. However, there
is still an opposition between cognitive associations
(i.e., pairing two similar foods according to their
taxonomic status) and affective associations (i.e., pairing
two complementary foods reflects the anticipation of
food consumption and of pleasure which may derive
Contrary to common belief, our experiment showed
that having hedonic-based attitudes toward food
predicted healthier food choices in children, whereas
consistent implicit and explicit nutrition-based
attitudes were associated with fewer healthy food choices
from a buffet offering highly liked sweets of
contrasting nutritional quality. These findings indicate that
pleasure from eating could be an ally more than a
threat regarding healthy eating in children, at least
when liked healthy foods are available. These results
are of particular interest from a public health
perspective because they indicate that hedonic-based
attitudes might be a lever to enhance healthy eating
behaviors among children. It now appears important
to develop further research to understand the etiology
of children’s attitudes toward foods in order to
provide insights on how to shape adequate children’s
attitudes to guide them toward healthy food choices.
Additional file 1: Complete description of the multiple linear regression
analyses. The Additional file 1 presents the results of the 5 multiple linear
regression analyses including the DF, F-value, P > F, β, 95% CI and P > |t|
for the three variables of interest, namely the implicit score, the explicit
score and the interaction between the scores, and for the three control
variables, namely age, z-BMI and hunger level. (DOCX 26 kb)
z-BMI: Body mass index z-score; ED: Energy density
We thank E Cacaud and F Bouillot for assisting with the recruitment of the
children; V Feyen and E Szleper for their help with the experimental sessions;
and M Friquet for assisting with the data collection.
This work was supported by grants from ANR (ANR-15-CE21–0014); the
Regional Council of Burgundy France (PARI grant); the FEDER (European
Funding for Regional Economic Development); a PhD fellowship to LM from
the Nutrition, Chemical Food Safety and Consumer Behavior Division of INRA
(French National Institute for Agronomical Research, France); and the
Regional Council of Burgundy (France).
Availability of data and materials
The datasets analyzed during the current study are available from the
LM performed the experimental sessions, completed the statistical analysis
and drafted the manuscript. MM performed the experimental sessions. MB
assisted with participant recruitment. All of the authors contributed
significantly to the design of this study, to the interpretation of the findings
and to a critical revision of the manuscript. All of the authors read and
approved the final manuscript.
Ethics approval and consent to participate
The study was conducted in accordance with the Declaration of Helsinki and
approved by the local ethical committee (Comité pour la Protection des Personnes
EST-1 Burgundy, file number: 2015-A01547–42). Written informed consent was
obtained from parents before their child’s participation in the study. We certify that
all applicable institutional and governmental regulations concerning the ethical use
of human volunteers were adhered to during this research study.
Consent for publication
The authors declare that they have no competing interests.
Springer Nature remains neutral with regard to jurisdictional claims in
published maps and institutional affiliations.
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