A systems approach to improving healthy eating in early childhood

Abstract

Despite public health efforts, children continue to fall short of meeting dietary guidelines. A systems-based approach is needed to address the complex network of determinants that influence the diets of young children. Centre-based childcare is an important setting to shape children’s diets. However, implementation challenges may inhibit the success of healthy eating interventions. The aim of this thesis was to identify key leverage points to intervene in the food system and inform recommendations for strengthening action in the early childhood education and care setting to improve children’s diets.

A scoping review was conducted to determine: (i) what determinants have been addressed by existing early childhood nutrition interventions, and (ii) which determinants respond to intervention to improve dietary intake. A total of 193 studies were included in the review. Findings highlighted the need for policy level action to enhance home food availability and accessibility, strengthen implementation in the early childhood education and care (ECEC) setting and regulate food marketing directed at children.

Two qualitative studies were conducted to understand how system-level factors influence implementation of healthy eating policies and practices in the ECEC setting from the perspectives of directors and educators and cooks. Findings highlighted the need to strengthen systems-level action to support implementation and ensure success of healthy eating policies and practices. There remain opportunities to strengthen multisectoral partnerships to address fragmented systems of support, foster partnerships with parents and the community, improve access to professional development and industry networks for educators and cooks, and increase investment in the ECEC sector to address current staffing and funding challenges. Together, this research informed recommendations for policy and practice as part of a systems approach to improve the diets of young children.