title: Factors influencing obesogenic dietary intake in young children (0-6 years): systematic review of qualitative evidence.
abstract: BACKGROUND
  Obesogenic dietary intake is prevalent in young children and is associated with obesity and other adverse health outcomes in childhood and later in life.
  
  
  OBJECTIVE
  To describe the barriers to and facilitators of obesogenic dietary intake in early childhood, in order to inform interventions and public health policies to prevent obesity.
  
  
  METHODS
  Systematic review of qualitative literature on factors influencing obesogenic diets in children aged 0-6 years.
  
  
  METHODS
  MEDLINE, EMBASE, CINAHL, PsycINFO, Web of Knowledge, British Nursing Index, ASSIA and Sociological Abstracts.
  
  
  METHODS
  Qualitative studies meeting the inclusion criteria were synthesised. Data were analysed by creating a thematic framework, underpinned by the socioecological model, which included familiarisation of data across the studies, indexing, charting, mapping and interpretation.
  
  
  RESULTS
  20 studies from the USA (10), Europe (6) and Australia (4) included the views of 1067 participants (901 parents/caregivers, 37 children, 87 teachers, 15 dieticians and 27 nursery staff). Study designs included focus groups (n=16), individual interviews (n=6) and ethnography (n=1) with some studies using more than one design. Despite wide differences in the study context and focus, several consistent themes emerged. Parental factors increasing young children's obesogenic diets were: negative parent/family/peer modelling, lack of knowledge, time constraints, using food as reward, affordability and concerns about child's health. Child preferences also increased intake. Environmental factors increasing intake include: availability, advertising, societal, cultural and preschool/childcare influences.
  
  
  CONCLUSIONS
  Future intervention strategies should aim to promote modelling of positive behaviours, create home and preschool environments that promote healthy diets, and simultaneously target factors at the family and preschool/childcare levels.
  
  
  BACKGROUND
  This review is one of a series of systematic reviews on the determinants of obesogenic behaviours in young children, registered with the International Prospective Register for Systematic Reviews (PROSPERO), CRD42012002881.
authors.affiliation: Institute of Public Health, University of Cambridge, Cambridge, UK Institute of Child Health, University College London, London, UK.
authors.forename: Veena
authors.initials: V
authors.lastname: Mazarello Paes
authors.affiliation: MRC Epidemiology Unit & UKCRC Centre for Diet and Activity Research (CEDAR), University of Cambridge, Cambridge, UK.
authors.forename: Ken K
authors.identifier: http://orcid.org/0000-0003-4689-7530
authors.initials: KK
authors.lastname: Ong
authors.affiliation: MRC Epidemiology Unit & UKCRC Centre for Diet and Activity Research (CEDAR), University of Cambridge, Cambridge, UK.
authors.forename: Rajalakshmi
authors.identifier: http://orcid.org/0000-0001-6748-5960
authors.initials: R
authors.lastname: Lakshman
mesh_terms: D002664:Child Nutritional Physiological Phenomena; D002675:Child, Preschool; D004032:Diet / Q000009:adverse effects* / Q000523:psychology; D002149:Energy Intake; D005247:Feeding Behavior / Q000523:psychology*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D016487:Parenting / Q000523:psychology*; D010290:Parents / Q000523:psychology*; D063766:Pediatric Obesity / Q000517:prevention & control*; D036301:Qualitative Research
keywords: NUTRITION & DIETETICS; PREVENTIVE MEDICINE