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- W4386045903 abstract "Dietary intake during early childhood can have implications on child health and developmental trajectories. Early childhood education and care (ECEC) services are recommended settings to deliver healthy eating interventions as they provide access to many children during this important period. Healthy eating interventions delivered in ECEC settings can include strategies targeting the curriculum (e.g. nutrition education), ethos and environment (e.g. menu modification) and partnerships (e.g. workshops for families). Despite guidelines supporting the delivery of healthy eating interventions in this setting, little is known about their impact on child health.To assess the effectiveness of healthy eating interventions delivered in ECEC settings for improving dietary intake in children aged six months to six years, relative to usual care, no intervention or an alternative, non-dietary intervention. Secondary objectives were to assess the impact of ECEC-based healthy eating interventions on physical outcomes (e.g. child body mass index (BMI), weight, waist circumference), language and cognitive outcomes, social/emotional and quality-of-life outcomes. We also report on cost and adverse consequences of ECEC-based healthy eating interventions.We searched eight electronic databases including CENTRAL, MEDLINE, Embase, CINAHL, PsycINFO, ERIC, Scopus and SportDiscus on 24 February 2022. We searched reference lists of included studies, reference lists of relevant systematic reviews, the World Health Organization International Clinical Trials Registry Platform, ClinicalTrials.gov and Google Scholar, and contacted authors of relevant papers.We included randomised controlled trials (RCTs), including cluster-RCTs, stepped-wedge RCTs, factorial RCTs, multiple baseline RCTs and randomised cross-over trials, of healthy eating interventions targeting children aged six months to six years that were conducted within the ECEC setting. ECEC settings included preschools, nurseries, kindergartens, long day care and family day care. To be included, studies had to include at least one intervention component targeting child diet within the ECEC setting and measure child dietary or physical outcomes, or both.Pairs of review authors independently screened titles and abstracts and extracted study data. We assessed risk of bias for all studies against 12 criteria within RoB 1, which allows for consideration of how selection, performance, attrition, publication and reporting biases impact outcomes. We resolved discrepancies via consensus or by consulting a third review author. Where we identified studies with suitable data and homogeneity, we performed meta-analyses using a random-effects model; otherwise, we described findings using vote-counting approaches and via harvest plots. For measures with similar metrics, we calculated mean differences (MDs) for continuous outcomes and risk ratios (RRs) for dichotomous outcomes. We calculated standardised mean differences (SMDs) for primary and secondary outcomes where studies used different measures. We applied GRADE to assess certainty of evidence for dietary, cost and adverse outcomes.We included 52 studies that investigated 58 interventions (described across 96 articles). All studies were cluster-RCTs. Twenty-nine studies were large (≥ 400 participants) and 23 were small (< 400 participants). Of the 58 interventions, 43 targeted curriculum, 56 targeted ethos and environment, and 50 targeted partnerships. Thirty-eight interventions incorporated all three components. For the primary outcomes (dietary outcomes), we assessed 19 studies as overall high risk of bias, with performance and detection bias being most commonly judged as high risk of bias. ECEC-based healthy eating interventions versus usual practice or no intervention may have a positive effect on child diet quality (SMD 0.34, 95% confidence interval (CI) 0.04 to 0.65; P = 0.03, I2 = 91%; 6 studies, 1973 children) but the evidence is very uncertain. There is moderate-certainty evidence that ECEC-based healthy eating interventions likely increase children's consumption of fruit (SMD 0.11, 95% CI 0.04 to 0.18; P < 0.01, I2 = 0%; 11 studies, 2901 children). The evidence is very uncertain about the effect of ECEC-based healthy eating interventions on children's consumption of vegetables (SMD 0.12, 95% CI -0.01 to 0.25; P =0.08, I2 = 70%; 13 studies, 3335 children). There is moderate-certainty evidence that ECEC-based healthy eating interventions likely result in little to no difference in children's consumption of non-core (i.e. less healthy/discretionary) foods (SMD -0.05, 95% CI -0.17 to 0.08; P = 0.48, I2 = 16%; 7 studies, 1369 children) or consumption of sugar-sweetened beverages (SMD -0.10, 95% CI -0.34 to 0.14; P = 0.41, I2 = 45%; 3 studies, 522 children). Thirty-six studies measured BMI, BMI z-score, weight, overweight and obesity, or waist circumference, or a combination of some or all of these. ECEC-based healthy eating interventions may result in little to no difference in child BMI (MD -0.08, 95% CI -0.23 to 0.07; P = 0.30, I2 = 65%; 15 studies, 3932 children) or in child BMI z-score (MD -0.03, 95% CI -0.09 to 0.03; P = 0.36, I2 = 0%; 17 studies; 4766 children). ECEC-based healthy eating interventions may decrease child weight (MD -0.23, 95% CI -0.49 to 0.03; P = 0.09, I2 = 0%; 9 studies, 2071 children) and risk of overweight and obesity (RR 0.81, 95% CI 0.65 to 1.01; P = 0.07, I2 = 0%; 5 studies, 1070 children). ECEC-based healthy eating interventions may be cost-effective but the evidence is very uncertain (6 studies). ECEC-based healthy eating interventions may have little to no effect on adverse consequences but the evidence is very uncertain (3 studies). Few studies measured language and cognitive skills (n = 2), social/emotional outcomes (n = 2) and quality of life (n = 3).ECEC-based healthy eating interventions may improve child diet quality slightly, but the evidence is very uncertain, and likely increase child fruit consumption slightly. There is uncertainty about the effect of ECEC-based healthy eating interventions on vegetable consumption. ECEC-based healthy eating interventions may result in little to no difference in child consumption of non-core foods and sugar-sweetened beverages. Healthy eating interventions could have favourable effects on child weight and risk of overweight and obesity, although there was little to no difference in BMI and BMI z-scores. Future studies exploring the impact of specific intervention components, and describing cost-effectiveness and adverse outcomes are needed to better understand how to maximise the impact of ECEC-based healthy eating interventions." @default.
- W4386045903 created "2023-08-23" @default.
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- W4386045903 date "2023-08-22" @default.
- W4386045903 modified "2023-10-18" @default.
- W4386045903 title "Healthy eating interventions delivered in early childhood education and care settings for improving the diet of children aged six months to six years" @default.
- W4386045903 cites W1455834090 @default.
- W4386045903 cites W1558753988 @default.
- W4386045903 cites W1576161252 @default.
- W4386045903 cites W1627600591 @default.
- W4386045903 cites W1760226955 @default.
- W4386045903 cites W1847300601 @default.
- W4386045903 cites W1867106587 @default.
- W4386045903 cites W1885624352 @default.
- W4386045903 cites W1907658676 @default.
- W4386045903 cites W1958628458 @default.
- W4386045903 cites W1966380063 @default.
- W4386045903 cites W1966521870 @default.
- W4386045903 cites W1967472090 @default.
- W4386045903 cites W1972321309 @default.
- W4386045903 cites W1972467077 @default.
- W4386045903 cites W1975123213 @default.
- W4386045903 cites W1977132526 @default.
- W4386045903 cites W1980350507 @default.
- W4386045903 cites W1981310893 @default.
- W4386045903 cites W1981418470 @default.
- W4386045903 cites W1984668247 @default.
- W4386045903 cites W1988182496 @default.
- W4386045903 cites W1996675615 @default.
- W4386045903 cites W1998143545 @default.
- W4386045903 cites W1998696286 @default.
- W4386045903 cites W1999044878 @default.
- W4386045903 cites W1999205882 @default.
- W4386045903 cites W1999393270 @default.
- W4386045903 cites W2000281340 @default.
- W4386045903 cites W2000944114 @default.
- W4386045903 cites W2001654835 @default.
- W4386045903 cites W2004400086 @default.
- W4386045903 cites W2007489770 @default.
- W4386045903 cites W2010271589 @default.
- W4386045903 cites W2010660578 @default.
- W4386045903 cites W2011775251 @default.
- W4386045903 cites W2012631923 @default.
- W4386045903 cites W2016860569 @default.
- W4386045903 cites W2020836374 @default.
- W4386045903 cites W2033379556 @default.
- W4386045903 cites W2036441880 @default.
- W4386045903 cites W2036964749 @default.
- W4386045903 cites W2038763743 @default.
- W4386045903 cites W2042564249 @default.
- W4386045903 cites W2053384201 @default.
- W4386045903 cites W2053759535 @default.
- W4386045903 cites W2054783712 @default.
- W4386045903 cites W2055474504 @default.
- W4386045903 cites W2056905638 @default.
- W4386045903 cites W2059378240 @default.
- W4386045903 cites W2073106580 @default.
- W4386045903 cites W2073618991 @default.
- W4386045903 cites W2075360189 @default.
- W4386045903 cites W2080616836 @default.
- W4386045903 cites W2080981943 @default.
- W4386045903 cites W2082665421 @default.
- W4386045903 cites W2085726610 @default.
- W4386045903 cites W2087247956 @default.
- W4386045903 cites W2087554805 @default.
- W4386045903 cites W2090774146 @default.
- W4386045903 cites W2102925803 @default.
- W4386045903 cites W2103438501 @default.
- W4386045903 cites W2104675861 @default.
- W4386045903 cites W2105036621 @default.
- W4386045903 cites W2108875452 @default.
- W4386045903 cites W2113876353 @default.
- W4386045903 cites W2116233720 @default.
- W4386045903 cites W2121254940 @default.
- W4386045903 cites W2123264836 @default.
- W4386045903 cites W2123369745 @default.
- W4386045903 cites W2123516551 @default.
- W4386045903 cites W2124018511 @default.
- W4386045903 cites W2125435699 @default.
- W4386045903 cites W2125921440 @default.
- W4386045903 cites W2127811226 @default.
- W4386045903 cites W2130160211 @default.
- W4386045903 cites W2132702041 @default.
- W4386045903 cites W2135684115 @default.
- W4386045903 cites W2136007347 @default.
- W4386045903 cites W2136435419 @default.