Eficácia de intervenções educativas realizadas em creches para melhorar as práticas de alimentação complementar em crianças entre 4 e 36 meses de idade: uma revisão sistemática

Abstract

Healthy eating habits reflect on the growth and development of children. It starts with the introduction of food at home and school. In this context, the families and the professionals in childcare services are fundamental for healthy eating habits. Educational actions carried out at school for children starting to eat, involving families and professionals working in the first years of early childhood education can improve complementary feeding practices. This study aims to analyze scientific evidence on the effectiveness of educational interventions in daycare centers to improve complementary feeding practices in children between 4 and 36 months of age. This study was a systematic review, the protocol was registered on the PROSPERO CRD42022384704. The search was conducted in PubMed, EMBASE, BIREME, Scopus, The Cochrane Library, CINAHL, and ProQuest databases, without date or language limitations to respond. The research question was “How effective are educational interventions carried out in daycare centers to improve complementary feeding practices in children between 4 and 36 months of age?”. The selection of studies was carried out by independent reviewers in two stages, first screening titles and abstracts and, subsequently, full reading to identify studies that met the inclusion criteria. The findings were systematized using RevMan (Review Manager, 2020) and the GRADEpro-GDT© tool and reported in a systematic review supported by tables and charts. Out of 3,385 studies were screened in addition to the citation search. A total of three cluster-type Randomized Clinical Trials from Australia, Spain, and Norway were included, which corresponded to 83 daycare centers and 688 children evaluated. The review result indicated that educational interventions in daycare centers improved complementary feeding, and vegetable consumption (mean RD 0.17, 95% CI: 0.05 to 0.30; 2 studies, 106 children; evidence low quality). There was insufficient evidence to conclude whether they affect fruit, dairy, and meat consumption. The participation of various social stakeholders presented opportunities for conducting educational interventions. Well-trained staff equipped with knowledge of children's feed and nutrition, recipe preparation, and educational tools, such as games, manuals, menus, videos, and website materials, were the primary resources to be considered for carrying out educational interventions. Given the social and cultural variations that impact children's nutrition and childcare on a global scale, future research could explore cultural and social factors to enhance the acceptance and implementation of recommended dietary practices in childcare centers, especially in vulnerable settings.