A Systematic Review of Interventions to Improve Diet Quality of Children that Included Parents Versus Those Without Parental Involvement

Abstract

Abstract Objectives To determine through systematic review whether parental involvement in interventions to improve eating habits of children was more often associated with positive dietary behavior changes as compared to those with no or low involvement. Methods Web of Science, PsychInfo, PubMed, and EBSCO were searched for studies between 2004–2016 that aimed to change children's (2 to 12 years old) diet quality (diet quality; and 1 or more eating behavior component: fruit (F), vegetables (V), whole grains, lower saturated fat, lower sugar-sweetened beverages (SSB), and intake of calcium-rich foods). Preferred Reporting Items for Systematic Reviews and Meta-Analysis were followed for this review. Parental involvement was classified as low, medium, or high involvement. Diet assessment tools were scored for their reliability and validity. The influence of theoretical framework on outcomes was not included in the current review. Results Of 443 papers, data was extracted from 156 randomized controlled trials, and 26 met inclusion criteria. Most studies focused on the intake of F and/or V or SSB. Most with low parental involvement reported no significant dietary change (12 of 15 diet measures in 8 studies). Half with medium/medium-high involvement found significant diet change (4 of 8 measures, 3 studies). More positive diet change resulted with high parental involvement (13 of 18 measures, 11 studies). All studies with no parental involvement reported significant positive changes except 1 (4 studies, 5 measures); 3 studies incorporated exposure to F&V, 1 aimed to lower SSB. Conclusions Increasing level of parental involvement supports dietary behavior change in children. Without parental involvement, repeated F&V exposure also increases intake. Nutrition professionals should engage parents at multiple time points in child dietary interventions to achieve positive dietary changes. Direct F&V exposure is an option if parental involvement is not feasible. Funding Sources This work was supported by the USDA National Institute of Food and Agriculture through Multistate Hatch Capacity Funds supporting the W-3005 research group and respective universities.