Early childhood education and care-based healthy eating interventions for improving child diet: a systematic review protocol

Jacklyn Jackson,Sze Lin Yoong,Courtney Barnes,Alecia Leonard,Sam Mccrabb,Alice Grady,Alix Hall,Melanie Lum,Nicole Pearson,Luke Wolfenden

doi:10.1186/s13643-020-01440-4

Abstract

IntroductionDiet during infancy and early childhood can have implications on child growth, health, and developmental trajectories. Yet, poor dietary habits are common in young children, who often consume diets that are not aligned with dietary recommendations. Early childhood education and care (ECEC) is a recommended setting to deliver healthy eating interventions as they offer existing infrastructure and access to a large number of children. This protocol aims to describe the methods of a systematic review to assess the effectiveness of healthy eating interventions conducted within the ECEC setting to improve child diet.Methods and analysisEight electronic databases including Cochrane Central Register of Controlled Trials (CENTRAL), Ovid MEDLINE, EMBASE, CINAHL Complete, PsycINFO, ERIC, SCOPUS, and SPORTDiscus will be searched from conception to March 2020. Randomised controlled trials (RCT) of dietary interventions targeting children aged up to 6 years conducted within the ECEC setting (including pre-schools, kindergartens, long day care, and family day care) will be included in the review. The primary review outcome is any measure of child dietary intake. Secondary outcomes include (i) child anthropometrics, (ii) child cognition, (iii) child mental health, (iv) child quality of life, (v) the absolute cost or cost-effectiveness of included interventions, and (vi) any reported adverse effects. Study inclusion, data extraction, and risk of bias assessments will be performed independently by two reviewers. Meta-analyses will be performed if adequate data is available, else review findings will be described narratively.DiscussionThis systematic review seeks to synthesise the effectiveness of healthy eating interventions conducted within the ECEC setting for improving child diet. This review will also seek to describe the effect of ECEC-based healthy eating interventions on a variety of important secondary outcomes (adverse events and cost-effectiveness) that will enhance the public health policy and practice relevance of review findings.Systematic review registrationPROSPERO [ID CRD42020153188]

Highlights

Diet during infancy and early childhood can have implications on child growth, health, and developmental trajectories
This systematic review seeks to synthesise the effectiveness of healthy eating interventions conducted within the Early childhood education and care (ECEC) setting for improving child diet
This review will seek to describe the effect of ECEC-based healthy eating interventions on a variety of important secondary outcomes that will enhance the public health policy and practice relevance of review findings

Summary

Introduction

Diet during infancy and early childhood can have implications on child growth, health, and developmental trajectories. Childhood education and care (ECEC) is a recommended setting to deliver healthy eating interventions as they offer existing infrastructure and access to a large number of children. This protocol aims to describe the methods of a systematic review to assess the effectiveness of healthy eating interventions conducted within the ECEC setting to improve child diet. International data indicates that in infants and young children, approximately 30% of total daily energy intake comes from discretionary (energy-dense, nutrient-poor) foods, and over 90% of this population are not consuming the recommended serves of vegetables [12, 13]. Given that ECEC services represent a captive setting, where children can consume up to two thirds of their recommended daily intake [20], it represents a promising avenue for targeting dietary behaviours in infants and young children [21,22,23]

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Conclusion