The science behind the French approach to kids food

Various bloggers have asked about the scientific basis for the French approach to kids’ food.

Good question!

The issue of children’s food–and children’s health more generally–became a scientific concern in the 19th century, when infant mortality rates in France were the highest in Europe (and high rates of maternal mortality during childbirth were also a serious issue). In response, the French developed the science of ‘puériculture‘ (literally – the science of infant and child health and hygiene); for example, they invented one of the first modern incubators (the ‘Lion’ incubator, named after Alexandre Lion, was the model first used in US hospitals). Historians generally point to the Hôpital des Enfants Malades (Hospital for Sick Children) in Paris as the world’s first paediatric hospital (opened in 1802, it still exists today, as part of the famous Necker hospital). This gradually became a worldwide trend; the first paediatric hospitals opened in the US in Philadelphia (1855) and Boston (1869).

From the outset, French scientists were particularly interested in children’s eating habits, given that good food is one of the core values of French culture. Their research–much of which I cite in my forthcoming book–is fascinating. Some of the best-known researchers are Dr. Claude Fischler (a sociologist with CNRS, who has worked with Dr Paul Rozin at the University of Pennsylvania), Dr. Natalie Rigal (a specialist in developmental child psychology at the University of Paris/Nanterre), and  French oenologist and “taste philosopher” Dr. Jacques Puisais, who created the Institut du Goûtin 1976, and initially developed some of the “taste-training” ideas that are now used in French classrooms. There are many other researchers studying children’s food in France, notably those working at the Institut du Goût in Paris, and the Centre des Sciences du Goût et de l’Alimentation in Dijon.

A few years ago, these researchers did a comparative study of French and American parental feeding practices, and effects on children’s eating habits (de Lauzon-Guillain 2009, full reference below). They were motivated by the fact that no cross-cultural studies of children’s eating habits have been done between France and US (as opposed to cross-cultural studies of adults). They were also motivated by the fact that the differences in rates of obesity and overweight were striking: in 2000, 6.4% of 6–9 year old French children were obese (95th percentile for weight) and 20.6% were overweight (85th percentile), whereas 15.3% of 6–11 year old children in the United States were obese and 30.3% were overweight. (Obesity rates for French children have since stayed stable, or even declined slightly, whereas they have continued to increase in the US).

So, what did the researchers find? Here’s a quote: “US parents (mothers and fathers) reported higher levels of allowing children control over their own food intake, using food to regulate the child’s emotions, and using food as a reward for behavior than French parents. American mothers reported higher levels of teaching their child about nutrition and encouragement of balance and variety. In contrast, French mothers and fathers both reported higher monitoring and higher restriction of their child’s food intake for weight control than US parents, and French fathers reported greater modeling of healthy eating than US fathers.” French parents exerted more control over their children’s food choices (for example: only allowing one snack per day). More research is required to fully understand the links between culture, parenting practices, children’s eating behaviours, and outcomes like weight status–but this study is suggestive of some important issues, such as the use of food as a reward.

There are also many interesting studies on the French approach to fostering a love of variety and new foods in the children–even before they are a year old. Let’s look at the results of one study, published in 2007 in the peer-reviewed (and leading) journal ‘Appetite’ (Maier et al 2007; full reference below). It compared French and German mothers, and found that:

In the first month of weaning, French mothers typically gave their infants 6 different vegetables (the Germans gave 3).

More than 40% of French infants were exposed to between 7 and 12 vegetables, but none of the German infants were given more than six.

During the 28 day study, the French mothers made 18 or more changes in the vegetables they offered from day-to-day. Some made as many as 27 changes. But in Germany, more than 80% of the mothers made fewer than 7 vegetable changes during the course of the study. None made more than 13 changes.

When asked to explain why they choose their particular feeding strategy, the French mothers mentioned taste development (which is prioritized by French paediatricians and parenting books), whereas the German mothers talked about food allergies. But the prevalence of food allergies in infants in Germany and France (and indeed in the US) is the same: somewhere between 5 and 8%.

The take-home message? The French approach focuses on developing a love of a wide range of foods in children before they arrive at that near-universal ‘no’ stage at around the age of two. Their approach suggests that we should be thinking more about taste development and less about food allergies.

These studies illustrate a key point: the French approach children’s food is a set of codified common sense rules and routines that parents can easily follow, but it is based on over 200 years of scientific research–which governments have transmitted to French parents through extensive outreach (e.g. the first modern network of what would now be called ‘maternal and child health’ centres). We don’t need to accept everything they do unquestioningly, but it is an interesting example that we could learn from. And, the results of French research correspond with emerging American research–a topic I’ll blog about in a future post.

Finally, I should note that no approach to kids’ food is perfect. There is a lot of conflicting information out there, from different sources. And even scientists take different approaches; sociologists and psychologists study children’s eating habits from a different perspective than medical researchers, for example. The key is to inform yourself about a variety of perspectives, and then to make an informed choice.

The studies referenced above are:
Blandine de Lauzon-Guillain PhD, Dara Musher-Eizenman PhD, Emeline Leporc MSc, Shayla Holub PhD and Marie Aline Charles MD. (2009) Parental Feeding Practices in the United States and in France: Relationships with Child’s Characteristics and Parent’s Eating Behavior. Journal of the American Dietetic Association. 109(6), 1064-1066; and Maier, A., C. Chabanet, B. Schaal, P. Leathwood, and S. Issanchou. 2007. “Food-Related Sensory Experience From Birth Through Weaning: Contrasted Patterns in Two Nearby European Regions.” Appetite 49: 429-40.

For a cross-cultural study in English, see:

  • Dara R. Musher-Eizenman, Blandine de Lauzon-Guillain, Shayla Holub, et al., “Child and Parent Characteristics Related to Parental Feeding Practices: A Cross-Cultural Examination in the US and France,” Appetite 52 (2009): 89–95.

Some references to scientific studies by French researchers (mostly in French, unfortunately!):

  • Official historical website of French paediatric hospitals: http://www.aphp.fr/site/histoire/1901_hopitaux_pediatriques.htm
  • Claude FISCHLER L’Homnivore. Le goût, la cuisine et le corps, Paris, Odile Jacob, 1990.
  • Claude FISCHLER Manger. Français, Européens et Américains face à l’alimentation, with Estelle Masson, Paris, Odile Jacob, 2008.
  • Lyon MURARD et Patrick ZYLBERMAN, L’Hygiène dans la République, 1870-1918, Paris, Fayard, 1996.
  • Jacques PUISAIS Le goût chez les enfants (Paris: Flammarion, 2000
  • Natalie RIGAL La naissance du goût: comment donner aux enfants le plaisir de manger Paris: Agnès Viénot, 2000.
  • Gaston VARIOT, Projet d’un Institut de Puériculture aux Enfants-Assistés, Paris, Imprimerie A. Davy, 1908.
  • Paul STRAUSS, Dépopulation et puériculture, Paris, Bibliothèque Charpentier, Eugène Fasquelle éditeur, 1901.

For those of you interested in more discussions about the science of food, visit Dr Dina Rose’s blog: It’s Not About Nutrition. Lots of great information and resources here!

17 thoughts on “The science behind the French approach to kids food

  1. Pingback: Yummy, healthy food for kids isn’t fancy….but fun! How to re-think your approach to kids’ meals, French style | Karen Le Billon

  2. Thanks for reaching out. Have you read French Kids Eat Everything? It explains the 10 ‘Food Rules’ (which are really common sense eating routines) that French families use to teach their children to eat well. The rules focus on ‘how’ to eat as well as ‘what’ to eat–not manners, but rather habits. Some readers have had really good results: http://karenlebillon.com/comments-from-readers/. If you do decide to try this approach, I’d love to hear how it goes!

  3. I have a 9 year old who is a very picky eater and wish I had read all about the French approach to eating earlier. Any suggestions books to read or Watson which I can start shifting and changing his bad eating habits and lack of food choices?

  4. Can anyone offer instructions on how to start introducing solids to infants at 4-6 months of age? I’d like to start with introducing a vegetable puree/soup in my baby’s bottle but I need more specific instructions on how to do this (what vegetables, in what amounts, how often, etc.). I’ve downloaded the INPES, La Sante vient en mangeant et en bougeant: Le guide nutrition des infants but I’d love to have more examples of instructions as well.

    Merci!

  5. To answer to Julia’s question.

    I can only describe the way I did (but many of my friends did the same way).

    As soon as my boys started with diversification, when they were about 6 months old, I cooked them purées with all vegetables I could find : green beams, cauliflowers, carrots, zucchinis, leeks, artichokes, brocolis, pumpkins, potatoes, sweet potatoes, chicories, etc. I added a small potato and some “Kiri” cheese in my purées, to make them sweeter.

    We I introduced mixed fish or meat, I did the same, especially for fish, and gave them the habbit to eat more often fish than meat (and a wide range of fishes).

    I had long working days, and cooked during the week end, and then freezed the meals.

    Around 2 years old, the “no” phase started with my boys. My pediatrician told me to be firm (not easy everyday …). What helped a lot were the routines : as the kids never had French fries for lunch, for instance, but always that kind of meal : cuncumber salad, green beams, steamed salmon, orange, they never thought of asking French fries for lunch.

    After this period, that was something like 6 months to one year, the “no” phase ended, and they ate like adults.

    I think the French parents train their kids early to eat like adults, and use to reach this goal routines, a large choice of food, and the obligation to taste. If a kid doesn’t like something, it’s not a big deal, he will not have to eat it. But he’s compelled to try. One of my son (13 years old) still hates yoghourts, it’s OK. His brother (10 years old) hates cheese and butter, and it’s also OK. Both of them like all fruits, vegetables, fishes, world food and even things that may seem weird to American people (snails, frog legs, rabbit, octopus, …)etc.

    The point is that none of us would spontaneously, and moreover kids, choose zucchinis instead of a good chocolate cake. But we can learn not to always choose the cake, and we can also learn to appreciate zucchinis. Except if we have been taught that we can always choose the chocolate cake.

    I also read in many contributions here how much American people are attached to proteins, carbs, starchy food. They think they are are necessary. And they do are. But we are more and more mothers that think in France that they are not necessary in the same quantity. That eating too much proteins (more than a piece of meat or fish per day) not only is not good for health, but also bad. That slow sugars that are in starchy food are important for lunch, but not for dinner, before going to bed.

    And that true that we are very directive concerning food. My kids never had the right when they were young to open the fridge or the cupboard and to take something to eat. They had to ask me for it. Today, they could help themselves. It would not be a problem. But they kept the habbit not to eat between one of their four meals (breakfast, lunch, gouter and dinner).

  6. Pingback: Top Tips for Picky Eaters, from “French Kids Eat Everything” | Karen Le Billon

  7. Great – looking forward to your thoughts on the book!

    Thanks for pointing out the lack of clarity. That discussion of obesity/overweight was confusing. I was citing a study that compared four different definitions of obesity/overweight with actual prevalence in a sample of French children. The point of the article was that (unsurprisingly) different standards in France versus the US make direct comparisons more difficult. “Four references were used to define grades of nutritional status: (1) the French references to define thinness and overweight (3rd and 97th percentiles respectively); (2) the Must et al references to define thinness, overweight and obesity (5th, 85th and 95th percentiles respectively); (3) the International Obesity Task Force cut-offs to define overweight and obesity; and (4) the Center for Disease Control 2000 references to define thinness, overweight and obesity (5th, 85th and 95th percentiles respectively).” Source: Rolland-Cachera et al., 2002 M.F. Rolland-Cachera, K. Castetbon, N. Arnault, F. Bellisle, M.C. Romano, Y. Lehingue, M.L. Frelut, S. Hercberg Body mass index in 7–9 year old French children: frequency of obesity, overweight and thinness. International Journal of Obesity, 26 (2002), pp. 1610–1616

    To make it simpler, I’ve simply updated my post to cite the (internationally standardized) International Obesity Task Force results. The differences between the US and France remain striking.

  8. Thanks for the article, I think I will order your book! I have a 10 month old who until two weeks ago was gagging and vomiting with most purees and anything with texture other than completely smooth. It’s finally started to resolve itself (I think), but because of the issues I have been proceeding cautiously. I think I need to continue with caution but start to introduce more variety! Quick question though on one of your points:
    “6.4% of 6–9 year old French children were obese (95th percentile for weight) and 20.6% were overweight (85th percentile), whereas 15.3% of 6–11 year old children in the United States were obese and 30.3% were overweight.”
    Why is obesity defined as a percentile of the population (I’m assuming maybe based on BMI?), and relatedly, how can 6.4% be in the greatest 5% percentile? I don’t think that definition makes sense unless I’m missing something. Unless the population is the world or developed country population, but that doesn’t make sense either as obesity should really be defined as a comparison to BMI and not to other kids.

  9. Pingback: The Art of the Gourmandise: eating (well) in France | The Cultural Sponge

  10. Thanks Julia. Great point regarding the difference between the French and American approaches. Your question is really interesting, as both French parents and teachers actually teach children about food. The book goes into this in quite some detail! But I’ll try to blog about this next week, on at least one topic.

  11. Thanks for your comment Julia! You’re right: the French believe that eating (and liking a variety of foods) is something you learn. Just like reading or math. So it is also a skill to be practised, and parents are crucial in this. Of course, they recognize that kids’ preferences for some foods (which are pretty universal –like sugar) are innate, but believe that this is something parents (and teachers) should help kids grow out of. That’s why ‘taste training’ is part of the school curriculum in France.

    The book tells the story of how our family went through ‘taste training’, and what we learned from spending a year in France. There’s a lot to say! Particularly because there is a scientific aspect as well as a social aspect. But I’ll try to blog about one or two examples in the coming weeks. Thanks for the suggestion!

    ________________________________

  12. From this article and others you’ve written, it seems like French parents recognize that children have to be taught to eat properly and most American parents think that children have predetermined food preferences that have to be catered to. I would be really interested to read a post on what French parents try to teach their children about food, and how they teach it. You have a great site and I’m eager to read your book once it comes out.

  13. Great observation. I think that the ‘control’ issue is culturally framed. Those who favour individual autonomy (probably mostly American parents) will tend to give children more control; but those who favour obedience and conformity with social norms (probably mostly French parents) will tend to give children less control. I hadn’t thought about the American approach being conflicting, but I do think it could place a huge burden on young children: because they aren’t really informed enough or developmentally ready to choose well, but then may feel badly if they’ve chosen badly. I think it does set up the possibility for more tension at the family table. Whether or not that’s good or bad in the long run well…I don’t think researchers have a definitive answer. But I know what most French moms would say!

  14. Really interesting comparison. I believe the research on early exposure to variety is sound and makes plenty of common sense, too. I don’t see that encouraged often enough in the popular parenting literature in the U.S. I think we also see a bit emphasis on fruits and veggies as early foods and not enough on protein sources, fats, dairy, etc. The Lauzon-Guillain 2009 findings are especially fascinating – that American parents report giving their kids more control over what they eat (which I think has to be a good thing, as long as the choices are largely limited to healthy foods) but also to attach more emotion to eating, rewards, etc. I think these things are conflicting. It’s like saying, “Sure, eat whatever you want, as much as you want, but then let me tell you that you should eat more veggies and not quite as much cheese and a big high five for eating all your peas!”

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