title: Healthy eating in early years settings: a review of current national to local guidance for North West England.
abstract: OBJECTIVE
  To determine the extent to which national and local UK guidelines for the early years sector address key recommendations for encouraging healthy eating based on best available evidence.
  
  
  METHODS
  Phase 1 comprised a literature review to identify new evidence to assess current relevance of the Caroline Walker Trust (CWT) 'Eating well for under-5 s in child care' guidelines. Phase 2 assessed the completeness of seven local to national-level government guidelines by comparison with the 'gold standard' CWT guidelines.
  
  
  METHODS
  Desk-based review using secondary data.
  
  
  METHODS
  Research literature and statutory guidelines on healthy eating in early years settings.
  
  
  RESULTS
  Phase 1 retrieved seventy-five papers, of which sixty were excluded as they addressed compliance with nutritional and food-based standards only. One report examined a social marketing tool and was deemed too narrow. The remaining fourteen documents assessed interventions to encourage healthy eating in early years settings. Following quality assessment, seven documents were included. Nine key recommendations were identified: (i) role of government; (ii) early years setting policy/guidelines; (iii) training; (iv) menu planning; (v) parents; (vi) atmosphere and encouragement; (vii) learning through food; (viii) sustainability; and (ix) equal opportunities. Phase 2 identified that all seven guidelines included the nine key recommendations but sporadic cover of sub-key recommendations.
  
  
  CONCLUSIONS
  More detail is needed on how early years settings can encourage children to eat healthily. Research is required to develop second-layer guidance for interactive materials. Clear processes of communication and support for parents are required. Ways food relates to children's wider learning and social development need further thought, requiring collaboration between the Department of Health and the Department for Education.
authors.affiliation: Department of Health Inequalities, Institute of Psychology, Health and Society, University of Liverpool, Whelan Building, Brownlow Hill, Liverpool L69 3GB, UK. K.S.Bristow@liverpool.ac.uk
authors.forename: Katie
authors.initials: K
authors.lastname: Bristow
authors.forename: Simon
authors.initials: S
authors.lastname: Capewell
authors.forename: Katharine
authors.initials: K
authors.lastname: Abba
authors.forename: Mark
authors.initials: M
authors.lastname: Goodall
authors.forename: Ffion
authors.initials: F
authors.lastname: Lloyd-Williams
mesh_terms: D002664:Child Nutritional Physiological Phenomena; D002675:Child, Preschool; D004739:England; D058870:Food, Organic / Q000592:standards*; D017408:Guidelines as Topic / Q000592:standards*; D006291:Health Policy; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D015596:Nutrition Assessment