Characteristics of Effective Interventions Promoting Healthy Eating for Pre-Schoolers in Childcare Settings: An Umbrella Review.

Louisa Matwiejczyk,Emma Tonkin,Jane Scott,Kaye Mehta,John Coveney

doi:10.3390/nu10030293

Louisa Matwiejczyk, Emma Tonkin + Show 3 more

Open Access

https://doi.org/10.3390/nu10030293

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Journal: Nutrients	Publication Date: Mar 1, 2018
Citations: 100	License type: CC BY 4.0

Affiliation: Flinders University, Curtin University

Abstract

Early Childhood Education and Care (ECEC) settings have a pivotal role in shaping children’s dietary food habits by providing the contextual environment within which they develop these behaviours. This study examines systematic reviews for (1) the effectiveness of interventions to promote healthy eating in children aged 2–5 years attending centre-based childcare; (2) intervention characteristics which are associated with promoting healthy eating and; (3) recommendations for child-health policies and practices. An Umbrella review of systematic reviews was undertaken using a standardized search strategy in ten databases. Twelve systematic reviews were examined using validated critical appraisal and data extraction tools. Children’s dietary food intake and food choices were significantly influenced. Interventions to prevent obesity did not significantly change children’s anthropometric measures or had mixed results. Evidence was more convincing if interventions were multi-component, addressed physical activity and diet, targeted individual-level and environmental-level determinants and engaged parents. Positive outcomes were mostly facilitated by researchers/external experts and these results were not replicated when implemented in centres by ECEC providers without this support. The translation of expert-led interventions into practice warrants further exploration of implementation drivers and barriers. Based on the evidence reviewed, recommendations are made to inform child-health directed practices and policies.

Highlights

Good nutrition in early childhood is essential to ensure children reach their growth and developmental potential [1]
The study selection process is summarised in Figure S1: Preferred Reporting Items for Systematic Reviews (PRISMA) flowchart of the selection process for systematic reviews
After duplicates were removed the title and abstract of 983 citations were screened for relevance and 21 studies were identified for full-text analysis

Summary

Introduction

Good nutrition in early childhood is essential to ensure children reach their growth and developmental potential [1]. Dietary health behaviours and food preferences are learnt early and carry through into adulthood [2,3]. Increasingly in younger populations, poor food choices and overconsumption are associated with a higher risk of developing obesity [4,5]. Excessive weight developed in early childhood is problematic as it is associated with an increased risk of developing physical, social and psychological conditions and earlier onset of non-communicable diseases (NCD) [6,7,8]. Many children carrying extra weight do not outgrow it [9] and childhood-onset obesity is difficult to address in later life [10]. Concern for children’s health, and escalating rates of NCD, have prompted the prioritization of healthy diets for young children globally [11,12]

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