Factors influencing obesogenic dietary intake in young children (0-6 years): systematic review of qualitative evidence

BMJ Open. 2015 Sep 16;5(9):e007396. doi: 10.1136/bmjopen-2014-007396.


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.

Design: Systematic review of qualitative literature on factors influencing obesogenic diets in children aged 0-6 years.

Data sources: MEDLINE, EMBASE, CINAHL, PsycINFO, Web of Knowledge, British Nursing Index, ASSIA and Sociological Abstracts.

Review 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.

Trial registration number: 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.


Publication types

  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Child Nutritional Physiological Phenomena
  • Child, Preschool
  • Diet / adverse effects*
  • Diet / psychology
  • Energy Intake
  • Feeding Behavior / psychology*
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Infant
  • Infant Nutritional Physiological Phenomena
  • Infant, Newborn
  • Parenting / psychology*
  • Parents / psychology*
  • Pediatric Obesity / prevention & control*
  • Qualitative Research