College Nursing and Health Sciences, Flinders University, Adelaide, SA 5000, Australia.
School of Public Health, Curtin University, Perth, WA 6845, Australia.
Nutrients. 2018 Mar 1;10(3):293. doi: 10.3390/nu10030293.
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.
早期儿童教育和保育（ECEC）环境通过提供儿童发展这些行为的背景环境，在塑造儿童的饮食食物习惯方面发挥着关键作用。本研究通过考察系统评价来检验：（1）促进 2-5 岁入托儿童健康饮食的干预措施的有效性；（2）与促进健康饮食相关的干预特征；以及（3）儿童健康政策和实践的建议。采用标准化检索策略，在 10 个数据库中进行了系统综述的伞式评价。使用经过验证的批判性评估和数据提取工具对 12 项系统评价进行了检查。儿童的饮食食物摄入量和食物选择受到显著影响。预防肥胖的干预措施并未显著改变儿童的人体测量指标，或者结果喜忧参半。如果干预措施是多方面的、针对身体活动和饮食、针对个体和环境层面的决定因素以及吸引家长的话，证据就更有说服力。如果由研究人员/外部专家来推动积极的结果，那么这些结果在没有这种支持的情况下由 ECEC 服务提供商在中心实施时就无法复制。将专家主导的干预措施转化为实践需要进一步探讨实施的驱动因素和障碍。根据审查的证据，提出了建议，以告知针对儿童健康的实践和政策。
