Review finds healthy eating programs in ECEC don’t change unhealthy consumption

A comprehensive review of healthy eating programs in early childhood education and care (ECEC) settings has found that while these programs may improve child diet quality, they likely have no impact on consumption of less healthy foods and sugar-sweetened drinks.

 

Healthy eating programs aim to encourage children to eat a healthier diet. They may involve changes to lessons and the culture in ECEC settings, and working with children’s families, teachers and healthcare staff. For example, introducing new fruits and vegetables to children, changing the menu to include healthier options or providing families with information about child healthy eating.

 

The researchers also found that such programs may increase fruit and vegetable consumption, and may also have favourable effects on child weight, reducing the risk of children being overweight or obese.

 

Researchers were unable to conclude that healthy eating interventions saved money, and found little evidence about the impact of such programs being run in low- and middle-income countries, noting that in high-income countries, such interventions may benefit child health. 

 

“We don’t know how to support educators and staff to implement these programs in practice. We need more research about delivering programmes and about their effect in low-income countries,” researchers said. 

 

The findings are significant given the role that poor diet plays in determining the risk of many long-term diseases including heart disease, type 2 diabetes and certain types of cancers. 

 

Research estimates that over 11 million deaths worldwide are caused by having an unhealthy diet. Dietary behaviours and preferences which are established early in life typically persist into adulthood. 

 

To reach their conclusion, the researchers examined studies that compared healthy eating programs against no action, delayed delivery of the program, or a program that did not aim to change child diet.

 

They compared and summarised the results of the studies and rated their confidence in the evidence, based on factors such as study methods and sizes.

 

Researchers found 52 studies that looked at the effects of 58 healthy eating programs in ECEC settings for children aged six months to six years. All studies were published in high and high-middle-income countries. The programs were very different from each other. They:

 

• lasted from four weeks to three years;
• were delivered by a range of people including healthcare providers, ECEC staff, and researchers;
• used different delivery methods (telephone, face-to-face, online, printed materials); and,
• measured results in a variety of ways (e.g. parent or staff surveys, observations of children’s eating, and weighing foods before and after meals). 

 

Overall, the programs aimed to:

 

• change the ECEC environment (e.g. staff demonstrated healthy eating to children, and provided healthier foods); 
• change the curriculum (e.g. they provided lessons about foods and healthy eating); 
• establish partnerships (e.g. they provided educational resources to families); and,
• increase children’s physical activity (e.g. by structured physical activity lessons and encouraging less screen time). 

 

“ECEC-based healthy eating interventions may improve child diet quality slightly, but the evidence is very uncertain,” researchers concluded. 

 

“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.”

 

To progress their findings, the researchers suggest further studies to explore the impact of specific intervention components, to better understand how to maximise the impact of ECEC-based healthy eating interventions.

 

For further context or information, please see here.