Obesity Prevention within the Early Childhood Education and Care Setting: A Systematic Review of Dietary Behavior and Physical Activity Policies and Guidelines in High Income Countries

Abstract

As a strategy for early childhood obesity prevention, a variety of dietary behavior and physical activity policies and guidelines published by leading health agencies and early childhood education and care (ECEC) licensing and accreditation bodies exist. Given the potential diversity in recommendations from these policies, this narrative review sought to synthesize, appraise and describe the various policies and guidelines made by organizational and professional bodies to highlight consistent recommendations and identify opportunities to strengthen such policies. An electronic bibliographic search of seven online databases and grey literature sources was undertaken. Records were included if they were policies or guidelines with specific recommendations addressing dietary behavior and/or physical activity practice implementation within the ECEC setting; included children aged >12 months and <6 years and were developed for high income countries. Recommended dietary behavior and physical activity policies and practices were synthesized into broad themes using the Analysis Grid for Environments Linked to Obesity framework, and the quality of included guidelines appraised. Our search identified 38 eligible publications mostly from the US and Australia. Identified guidelines were largely consistent in their recommendation and frequently addressed the physical and sociocultural environment and were well-aligned with research evidence. Broader consideration of policy and economic environments may be needed to increase the impact of such policies and guidelines within the ECEC setting.

Interventions to Improve Child Physical Activity in the Early Childhood Education and Care Setting: An Umbrella Review

“…As such, many governments recommend the implementation of physical activity-promoting practices in this setting. A systematic review conducted by Jackson et al [ 12 ] identified 28 physical activity guidelines for the ECEC sector across high-income countries, spanning over two decades. The recommended physical activity practices contained within these guidelines were summarised into eight broad practices and 44 sub-practices related to promoting physical activity in ECEC settings, providing a comprehensive overview of practice recommendations for the sector.…”

“…This allows for review evidence to be efficiently collated and summarised to provide an overview of the collective findings. An umbrella review of the empirical evidence for physical activity strategies in ECEC mapping to the obesity prevention guidelines as identified by Jackson et al [ 12 ] provides an overview of where there is strong empirical evidence and where there may be gaps, provides opportunities to strengthen recommendations and generates primary evidence to examine this.…”

“…Therefore, the aim of this umbrella review was to (i) gather and synthesise systematic review evidence of the effectiveness of interventions in the ECEC setting on the physical activity levels of children aged 0–6 years and (ii) map the current evidence to the existing recommendations in the sector (as outlined in the review by Jackson et al [ 12 ]).…”

“…Mapping of intervention strategies synthesised in the included reviews to the recommended practices[12].…”

Cooperative planning in childcare centers to improve physical activity: a qualitative investigation of directors’ perspectives

“…Different strategies and interventions for PA promotion have been developed and tested in this setting, and a growing number of best practice guidelines and PA recommendations exist for childcare centers ( Finch et al , 2016 ; Wolfenden et al , 2020 ; Jackson et al , 2021 ). However, there is a lack of evidence to inform the successful implementation of evidence-based policies, practices and programs in childcare centers ( Larson et al , 2011 ; Finch et al , 2016 ; Jones et al , 2017 ; Razak et al , 2019 ; Wolfenden et al , 2020 ).…”