da Fonseca Pâmela Gracielle, Raposo António, Alqarawi Nada, Alasqah Ibrahim, Pinto Mariana Figueiredo, Martins Tábata Monaliza Marcelino, Gonçalves Viviane Dias, Pereira Simone Cardoso Lisboa, Albaridi Najla A, BinMowyna Mona N, Saraiva Ariana, Guimarães Nathalia Sernizon
Department of Nutrition, Nursing School, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
CBIOS (Research Center for Biosciences and Health Technologies), ECTS (School of Health Sciences and Technologies), Lusófona University, Lisboa, Portugal.
Front Pediatr. 2025 Jul 9;13:1609714. doi: 10.3389/fped.2025.1609714. eCollection 2025.
Feeding difficulties, such as limited appetite, selective eating, and food phobia, affect caregivers' ability to provide adequate nutrition to children. These issues impact 25%-40% of non-neurodivergent children and up 80% of neurodivergent children.
This review examines how family involvement influences the improvement, worsening, or maintenance of feeding difficulties in neurodivergent and non-neurodivergent preschool and school-age children.
An integrative review was conducted using Embase, PubMed, Scopus, Cochrane Library, Lilacs and grey literature (Google Scholar and Connect Papers). The review focused on randomized clinical trials (RCTs) involving parents or caregivers of children aged 2-10 years, assessing lifestyle or psychological interventions.
From 1,257 studies, 885 primary articles were screened. Of the 100 most recent articles on grey literature, 2 met the eligibility criteria after full-text assessment and were therefore included in the review. Thirty-six studies were reviewed in full, leading to 11 RCTs with 630 children aged 1 to 14. Interventions included behavioral education, sensory education, and cooking classes. Findings indicated increased vegetable acceptance in two studies, improved feeding difficulties scores in five, and reduced avoidant/restrictive food intake disorder (ARFID) symptoms in two studies. One study showed no significant differences between control and intervention groups.
Family-involved interventions generally produced positive outcomes in managing feeding difficulties. However, methodological variability and the predominance of studies from high-income countries limit the generalizability of these results. Future research should focus on standardizing diagnostic criteria and developing culturally sensitive interventions.
喂养困难，如食欲有限、挑食和食物恐惧症，会影响照顾者为儿童提供充足营养的能力。这些问题影响25%-40%的非神经发育障碍儿童，以及高达80%的神经发育障碍儿童。
本综述探讨家庭参与如何影响神经发育障碍和非神经发育障碍的学龄前及学龄儿童喂养困难的改善、恶化或维持情况。
使用Embase、PubMed、Scopus、Cochrane图书馆、Lilacs以及灰色文献（谷歌学术和Connect Papers）进行综合综述。该综述聚焦于涉及2至10岁儿童的父母或照顾者的随机临床试验（RCT），评估生活方式或心理干预。
从1257项研究中筛选出885篇主要文章。在100篇最新的灰色文献文章中，经过全文评估后有2篇符合纳入标准，因此被纳入综述。对36项研究进行了全面审查，最终得到11项RCT，涉及630名1至14岁的儿童。干预措施包括行为教育、感官教育和烹饪课程。研究结果表明，两项研究中蔬菜接受度有所提高，五项研究中喂养困难得分有所改善，两项研究中回避/限制型食物摄入障碍（ARFID）症状有所减轻。一项研究显示对照组和干预组之间没有显著差异。
家庭参与的干预措施在管理喂养困难方面通常产生积极效果。然而，方法的变异性以及来自高收入国家的研究占主导地位限制了这些结果的普遍性。未来的研究应侧重于标准化诊断标准并开发具有文化敏感性的干预措施。
