Child care centers might be critical settings for effort to improve children’s eating patterns [1, 2]. In 2007, approximately 55% of children ages 3 to 6 years were enrolled in center-based care . Analyses of dietary intakes of children attending full-time child care centers across the U. S. have shown that children have lower than recommended intake of whole grains, fruits, vegetables, and dairy [2, 4]. On the other hand, children are consuming excessive amounts of added sugar and saturated fat. An important nutrient for children’s health that is commonly underconsumed is dietary fiber, which can be partially attributed to the low intake of high-fiber foods such as whole grains, fruits, vegetables, and legumes [5, 6].
Along with the rise in obesity prevalence, the incidence of children’s snacking has increased [7, 8]. From 1977 to 2006, children increased the consumption of energy from snacks by 168 to approximately 491 calories per day which is approximately 27% of their daily intake . In addition, while most children consume an estimated three snacks per day, there was a decline of food consumption at the primary meals: breakfast, lunch, and dinner. The largest proportion of foods consumed as snacks were known predictors of low diet quality, such as desserts, savory snacks, and sweetened beverages . For instance, between 1977–1978 and 2003–2006, the proportion of calories from snacks that were candy or salty snacks significantly increased from 5.7% to 8.5% and from 8.1% to 15.7%, respectively .
It is well known that children consume suboptimal levels of fruits, vegetables, whole grains, and legumes, although federal nutrition guidance has encouraged consumption of these food groups for several decades. In an effort to increase fiber consumption, the shape of food might be used to increase children’s intake, as data from product marketing towards children indicates a positive effect of shapes to create “fun foods” . In marketing, foods are strategically portrayed as fun either by association or by specific characteristics of those foods. Unfortunately many of these “fun foods” are lacking nutrients and are high in calories, such as carbonated beverages, fast food, and sugary cereals. Fitzhugh and Lobstein completed an analysis of the nutritional quality of foods targeted specifically at children in the United Kingdom . Of 358 food products considered to be marketed toward children, they found that 77% contained high levels of sugar, salt, saturated fat or total fat. Interestingly, these products were often offered in child-oriented product shapes like animals or familiar cartoon characters. In addition, in Canada 89% of 367 products targeted toward children, including foods in child-oriented shapes, were of poor nutritional quality from high sugar, fat, and sodium amounts .
Based on the use of food shapes in marketing toward children, one could assume that offering foods that are shaped to resemble an item a child might be interested in would encourage the consumption of healthy foods, thereby improving the diet quality in children. The Interagency Working Group on Food Marketed to Children, formed by members of the Federal Trade Commission, Centers for Disease Control, Federal Drug Administration and United States Department of Agriculture, found that foods most heavily marketed to children ages 2–17 years were breakfast cereals, snacks foods, and restaurant foods ; costing approximately 70% of food marketing expenditures. The commission proposed a guide for marketing to children and urged companies to market foods that are contributing to a healthful diet. Based on the amount of effort companies are expending on finding ways to make foods attractive to children, one might assume that offering children healthy, shaped foods is an efficient venue to beneficially influence children’s eating behaviors.
Studies on the influence of food shape on the intake of these foods are lacking. One study conducted on the effect of different visual characteristics of foods and suggested that visual appeal had a strong influence of consumption of fruit in children ages 4 to 7 years . Another group of researchers examined the influence of shape in respect to size and flavor on liking and wanting of snacks  and found that children were more likely to repeatedly eat a healthy food product if it was offered in a smaller size. To date, the results of only one study focus specifically on the effect of offering shaped foods on children’s consumption  and there was no significant difference between offering different shaped foods versus foods in their usual shapes. However, the study did not allow children to first acclimate to the food during a run-in period. The present study was designed to improve on previous research on the topic and to evaluate the effect of serving healthy, high-fiber snack foods in normal or shaped form on preschooler’s snack consumption.