Chan Jacqueline, Conroy Patrick, Phongsavan Philayrath, Raubenheimer David, Allman-Farinelli Margaret
Nutrition and Dietetics Group, Sydney Nursing School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia; Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia.
Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia.
Prev Med. 2023 Dec;177:107727. doi: 10.1016/j.ypmed.2023.107727. Epub 2023 Oct 15.
Implementation and sustaining impact of early childhood nutrition interventions in practice remains a challenge. An understanding of the extent to which determinants across multiple levels of the food system are being addressed may improve success. This literature review aimed to synthesise the evidence on interventions targeting dietary intake and eating behaviours in preschool children using a systems approach. Eligible studies included intervention studies targeting the dietary intake of preschool children aged 2-5 years in high income countries, published in English after January 2000. Interventions were categorised to the Determinants of Nutrition and Eating (DONE) framework for children developed and evaluated by experts across multiple fields. The framework maps and ranks 411 factors driving eating behaviours and nutrition and can be used to systematically summarise determinants. DONE ranks each determinant for its perceived research priority. A total of 160 eligible studies were identified. Most interventions targeted interpersonal (n = 101, 63.1%) and individual (n = 85, 53.1%) level determinants, with fewer targeting environmental (n = 55, 34.4%) and policy level (n = 17, 10.6%) determinants. The most frequently addressed determinants were Parental Resources and Risk Factors (n = 85) and Children's Food Knowledge, Skills and Abilities (n = 67). These determinants had a Moderate research priority rating. Home Food Availability and Accessibility at the environmental level is classified as the highest research priority, however, only 15 of 160 interventions addressed this determinant. This review highlights home food availability and accessibility as potential leverage points for future interventions to improve children's dietary intake and eating behaviours.
在实际操作中，幼儿营养干预措施的实施及持续影响仍是一项挑战。了解食品系统多个层面的决定因素在多大程度上得到解决可能会提高成功率。本综述旨在综合运用系统方法，针对学龄前儿童饮食摄入和饮食行为的干预措施的相关证据。符合条件的研究包括2000年1月以后以英文发表的、针对高收入国家2至5岁学龄前儿童饮食摄入的干预研究。干预措施按照由多个领域的专家制定并评估的儿童营养与饮食决定因素（DONE）框架进行分类。该框架对影响饮食行为和营养的411个因素进行了梳理和排序，可用于系统地总结决定因素。DONE根据其感知到的研究优先级对每个决定因素进行排名。共确定了160项符合条件的研究。大多数干预措施针对人际层面（n = 101，63.1%）和个体层面（n = 85，53.1%）的决定因素，针对环境层面（n = 55，34.4%）和政策层面（n = 17，10.6%）决定因素的较少。最常涉及的决定因素是父母资源和风险因素（n = 85）以及儿童的食物知识、技能和能力（n = 67）。这些决定因素的研究优先级评级为中等。环境层面的家庭食物供应和可及性被列为最高研究优先级，然而，160项干预措施中只有15项涉及这一决定因素。本综述强调家庭食物供应和可及性是未来干预措施改善儿童饮食摄入和饮食行为的潜在杠杆点。
