Eyes bigger than the tummy: a comparative evaluation of cooking and drinking preferences vs. healthy cooking and drinking knowledge in childhood

This work is licensed under a Creative Commons Attribution 4.0 International License. You are free to share (copy and redistribute the material in any medium or format) and adapt (remix, transform, and build upon the material) under the following terms:1 - Attribution (you must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use).2 - No additional restrictions (you may not apply legal terms or technological measures that legally restrict others from doing anything the license permits)."Childhood overweight and obesity have been increasing over recent years and, more than ever, we are being called to act, whether as clinicians, parents or educators. The aim of this empirical research is to assess children’s cognitive and emotionally internalized mental representation of a Preferred and Healthy Meal, using drawing as methodological instrument. This is a cross-sectional, exploratory and descriptive study using a qualitative methodology – content analysis. In the present research, conducted in two moments, with 1013 children (aged 4-10 years), from Lisbon metropolitan area, we’ve asked children to draw a Preferred Meal and a Healthy Meal, trying to evaluate the child’s implicit knowledge and habits of drink intake and food cooking methods. 2026 drawings were collected: 1013 representing a Preferred Meal and 1013 a Healthy one. Drawings were evaluated using a content analysis instrument specifically developed for this study, using ATLAS.ti 6. For purposes of obtaining a descriptive analysis, data were treated using the Statistical Package for the Social Sciences (SPSS) 19.0 for Windows. The obtained results on Cooking Methods (sub-categories Meat, Fish and Potatoes) reveal that children, regarding the Preferred Meal, selected both healthier and unhealthier cooking methods like Fried (Meat and Potatoes), Stewed and Grilled (Meat). Representations of healthy cooking methods, on the other hand, show conspicuous disparities by age-group as children aged 4 and 5 years take frying as a healthy meat cooking method, whereas children aged 6 years are virtually unanimous in choosing grilling as the best representation of healthy meat cooking method. As to Potato and Fish healthy cooking methods, most children elect boiling. Regarding the beverages that children included in their Preferred Meals, we found some discrepancies with selection of fresh juices in the age-groups 4YG and 5YG with clear contrast with the dominance of soft drinks (carbonated beverages sweetened with sugar) in the older groups. Regarding healthy drink choices, soft drinks decrease drastically, being consensually replaced by Water in all age groups or by Natural / Fresh Juices in the younger age groups, despite an undeniable presence of soft drinks, disguised of “natural”. The results obtained in the study points out that preferred cooking methods and drinks are internalized during childhood and are connected to early experiences with food and to pathogenic (family and society) nutritional patterns. They also testify to the children’s ability to learn to select healthy cooking methods, despite being an abstract cognitive construct, at a very early age. Despite that knowledge, when it comes to drinks, this study evidences that children’s reveal some erroneous representations influenced by exposure to media, namely related to advertising soft drinks bearing a ‘healthy food’ label. These are the stronger arguments to support the need for developing health education ludic-pedagogic instruments for children.