Historically, the concept of children ‘eating well’ for parents around the world has been straightforward: Growth in terms of height and weight, whether they are at a healthy body mass index (BMI), how large is the portion size they are eating, and whether they are finishing their meals to get enough calories.
But according to new research from the Duke-National University of Singapore (NUS) Medical School, this may actually not be sufficient to really determine whether a child is developing the right, positive relationship with food that they need.
“Height, weight, BMI and calorie intake are indicators that are familiar and reassuring, but the fact is that fullness and healthy growth cannot only be measured by an empty plate,” said study lead author Duke-NUS Assistant Professor Elaine Quah, who is also Senior Research Fellow at the KK Women’s and Children’s Hospital division of obstetrics and gynaecology.
“The paradox is that a child may appear to be growing well, with a healthy BMI, yet mealtimes can still be a daily struggle. We are seeing issues such as being overweight increasing among school-aged children, as well as the emergence of the double burden of malnutrition, where children are overweight or obese yet still have hidden nutritional deficiencies, placing them at greater risk of future cardiometabolic disease.”
In short, solely judging healthy growth to be indicated by weight or calorie intake equals an increased risk of overlooking unhealthy eating behaviours that can have massive impacts on later life.
Asst Prof Quah was speaking at our Growth Asia Summit 2026. She believes that the key to developing sustainable, healthy eating behaviours lies in how children are being fed and not how much they are being fed, and this in turn is based on four key domains.
“These four key domains are: Variety (what type of food children are exposed to), Autonomy (the control the child can exert over their eating); Setting (the environment around meals), and Timing (when the eating happens),” she said.
“Together, these form the easy-to-remember acronym, VAST. These eating behaviors do not function in isolation but instead work together, highlighting the need for a structured, multi-component approach.”
How can food industry contribute to healthier diets for kids?
Within these four domains, there is an immensely important role food brands can play when it comes to improving variety for children while also helping to make mealtimes easier for parents or caregivers.
This holds particularly true in urban markets where many parents are busy working individuals, hence in need of options that can smoothly entice children to eat or drink without endless cajoling.
And when it comes to kids, the look of a product can be just as important as its taste in order to attract them to even try it.
Case in point with Australian synbiotic flavoured waters brand Tummy Buddies, which focused a lot of effort on getting its products brightly-coloured in order to minimize this initial resistance.
“The product looks like a fun juice with bright colours and fun logos. This means it looks tasty instead of ‘healthy’, and reduces any pushback from the children, so they can easily drink their biotics as part of the meal,” Tummy Buddies co-founder Rita Sellars said.
“There is also that key need to reduce sugar use and optimise mouthfeel while making sure all the colours, whether red, green or blue, were bright and enticing.”
This is just one example of a brand attempting to innovate for children, but in reality the potential in this sector is endless. Many foods targeting children today are either snack biscuits, puree or gruel-based, and there is a wide open market here for brands that innovate for this demographic by moving away from these tried-and-known formats rather than trying to reinvent the wheel.
Habit-building at home
Of course, the building of healthy food relationships also depends heavily on the other three pillars of Autonomy, Setting and Timing, and all of these need to be set for children in the home or school setting.
“Caregiver feeding practices play a critical role in shaping children’s eating behaviours, particularly during the formative years of infancy and early childhood, when habits are rapidly being established,” Asst Prof Quah added.
“This influence continues across development and ultimately contributes to long-term outcomes such as healthier eating patterns and better self-regulation around food.”
“[In terms of introducing variety], it is important to expose children to a wide variety of tastes and textures early in life to encourage acceptance of different foods and ensure they are exposed to all essential food groups. [This is an area that] the food sector can help with as well, to ensure there are more options for caregivers to choose.”
Promoting dietary variety, in practice
- Introduce a range of textures early, progressing from smooth purées to mashed and finger foods within the first year
- Consider a vegetables-1st approach. Introducing vegetables early can help shape taste preferences and improve acceptance of less sweet foods
- Be patient — repeated exposure is key. Children often need to try a new food 10 or more times before accepting it, so the goal is familiarity, not immediate success
- Finally, avoid adding any salt before 12 months or exposing them to sugary beverages, including fruit juice, before 2 years of age
As for Autonomy, the key is to prevent trying to micromanage how the child eats.
“The caregiver’s role here is to guide their food choices, model healthy eating and respond to their hunger and fullness cues — not to dictate the child’s portion sizes or pace of eating, as that should be decided by them on their own,” she said.
“If caregivers consistently override the child’s cues, the child may gradually lose this ability to self-regulate, which can increase the risk of overeating over time.”
Unsurprisingly, determining the eating Setting involves prioritizing meal times as family times when everyone eats together in a calm, distraction-free environment, including making these screen-free events for both parent and child.
“However, what is actually happening in practice is concerning: Local Singapore research shows that just 5% of infants were exposed to screens during meals but by toddlerhood, this figure rises sharply to 30%, which is a six‑fold increase in screen use during mealtimes within just the first two years of life,” she said.
“This pattern shows that while families may start with good intentions, distractions quickly creep into the mealtime environment during the very early years when children are learning how to engage with food — and screens can disrupt that process.”
As for eating Timing, the advice is to align with biological rhythms, crucially in terms of avoiding nighttime eating.
“As children’s circadian rhythms develop, we need to move them from irregular around-the-clock feeding to daytime feeding by 12 months of age in order to align,” Asst Prof Quah added.
“In early infancy, post-midnight feeding is almost universal which is expected, but the issue is that we found that almost 40% of all children continue to receive night feeds even well into toddlerhood, so these timing practices remain misaligned with their biological rhythms.”
What needs to improve?
The study overall revealed that there are many gaps to be addressed when it comes to children’s diets, and also that there are many more roles for both food industry and caregivers to play in this regard.
“From the caregiver front, we realized there was a real gap in real-world feeding practices for young kids and a need for clear guidance, so KKH developed the Singapore Guidelines for Feeding and Eating in Infants and Young Children,” she said.
“There are many areas for players in the food and nutrition ecosystem] to consider in this regard, focusing on how to support caregivers in balancing convenience and nutrition, creating opportunities for interventions to improve suboptimal feeding practices, and developing strategies to help reduce mealtime struggles.”
