Family and community factors shaping the eating behaviour of preschool-aged children in low and middle-income countries: A systematic review of interventions.

Low and middle-income countries are experiencing the dual burden of malnutrition which is, at least in part, attributable to changes in eating behaviours of children under age five. Development of food choices is influenced by multiple factors and understanding the interplay of these factors in early childhood in these countries is necessary to promote healthy food choices. We conducted a systematic review to examine the evidence of family and community factors targeted in interventions to influence the eating behaviour of preschool-aged children in low and middle-income countries. A search for peer-reviewed papers was conducted using CINAHL, MEDLINE, PsycINFO, Scopus and ProQuest Health Management published prior to September 2018, in English language including preschool-aged children (PROSPERO registration CRD42018108474). Fourteen studies published between 1994 and 2017 were eligible for inclusion. Factors that were consistently and positively associated with children's healthy food consumption were household food availability, nutritional knowledge of family or caregivers and family income. Unhealthy food consumption in children was inversely associated with family or caregivers' nutritional knowledge. Children's micronutrient intake was positively associated with household food availability, nutritional knowledge of family or caregivers and food availability within the surrounding environment. Findings highlight the importance of targeting nutritional knowledge of family or caregivers to facilitate healthy eating behaviours in children. In addition, creating a supportive family environment via increasing household food availability and family income should be considered when designing interventions to promote healthy eating behaviours in preschool-aged children living in low and middle-income countries.