Early Childhood Education and Care (ECEC) settings have a pivotal role in shaping children’s dietary food habits by providing the contextual environment within which they develop these behaviours. This study examines systematic reviews for (1) the effectiveness of interventions to promote healthy eating in children aged 2–5 years attending centre-based childcare; (2) intervention characteristics which are associated with promoting healthy eating and; (3) recommendations for child-health policies and practices. An Umbrella review of systematic reviews was undertaken using a standardized search strategy in ten databases. Twelve systematic reviews were examined using validated critical appraisal and data extraction tools. Children’s dietary food intake and food choices were significantly influenced. Interventions to prevent obesity did not significantly change children’s anthropometric measures or had mixed results. Evidence was more convincing if interventions were multi-component, addressed physical activity and diet, targeted individual-level and environmental-level determinants and engaged parents. Positive outcomes were mostly facilitated by researchers/external experts and these results were not replicated when implemented in centres by ECEC providers without this support. The translation of expert-led interventions into practice warrants further exploration of implementation drivers and barriers. Based on the evidence reviewed, recommendations are made to inform child-health directed practices and policies.

Background: Globally children's diet quality is poor. Parents are primary gatekeepers to children's food intake; however, reaching and engaging parents in nutrition promotion can be challenging. With growth in internet and smartphone use, digital platforms provide potential to disseminate information rapidly to many people. The objectives of this review were to conduct a comprehensive and systematic evaluation of nutrition promotion via websites and apps supporting parents to influence children's nutrition, from three different perspectives: 1) current evidence base, 2) end user (parent) experience and 3) current commercial offerings. Methods: Three systematic reviews were undertaken of (1) studies evaluating the effectiveness for digital platforms for improving nutrition in children and parents, (2) studies conducting user-testing of digital tools with parents, (3) websites and apps providing lunch-provision information to parents. Searches were conducted in five databases for reviews one and two, and systematic search of Google and App Store for review three. Randomised controlled trials, cohort and cross-sectional and qualitative studies (study two only) were included if published in English, from 2013, with the intervention targeted at parents and at least 50% of intervention content focused on nutrition. Search results were double screened, with data extracted into standardised spreadsheets and quality appraisal of included search results. Results: Studies evaluating digital nutrition interventions targeting parents (n = 11) demonstrated effectiveness for improving nutrition outcomes, self-efficacy and knowledge. Six of the included randomised controlled trials reported digital interventions to be equal to, or better than comparison groups. User-testing studies (n = 9) identified that digital platforms should include both informative content and interactive features. Parents wanted evidence-based information from credible sources, practical tools, engaging content and connection with other users and health professionals. Websites targeting lunch provision (n = 15) were developed primarily by credible sources and included information-based content consistent with dietary guidelines and limited interactive features. Lunchbox apps (n = 6), developed mostly by commercial organisations, were more interactive but provided less credible information.(Continued on next page)

Objective:Globally, grandparents are the main informal childcare providers with one-quarter of children aged ≤5 years regularly cared for by grandparents in Australia, the UK and USA. Research is conflicting; many studies claim grandparents provide excessive amounts of discretionary foods (e.g. high in fat/sugar/sodium) while others suggest grandparents can positively influence children’s diet behaviours. The present study aimed to explore the meaning and role of food treats among grandparents who provide regular informal care of young grandchildren.Design:Qualitative methodology utilising a grounded theory approach. Data were collected using semi-structured interviews and focus groups, then thematically analysed.Setting:Participants were recruited through libraries, churches and playgroups in South Australia.Participants:Grandparents (n 12) caring for grandchild/ren aged 1–5 years for 10 h/week or more.Results:Three themes emerged: (i) the functional role of treats (e.g. to reward good behaviour); (ii) grandparent role, responsibility and identity (e.g. the belief that grandparent and parent roles differ); and (iii) the rules regarding food treats (e.g. negotiating differences between own and parental rules). Grandparents favoured core-food over discretionary-food treats. They considered the risks (e.g. dental caries) and rewards (e.g. pleasure) of food treats and balanced their wishes with those of their grandchildren and parents.Conclusions:Food treats play an important role in the grandparent–grandchild relationship and are used judiciously by grandparents to differentiate their identity and relationship from parents and other family members. This research offers an alternative narrative to the dominant discourse regarding grandparents spoiling grandchildren with excessive amounts of discretionary foods.

This multi-strategic intervention was effective in improving the food provided and nutrition practices in childcare settings. Strategies attributed to its success were an inter-sectoral approach and the creation of supportive environments.

Aim:  The study aims to describe the meal time and parent communication practices used in South Australian Long Day Care Centres (LDCCs) and explore whether practices differ by engagement in a nutrition incentive award scheme, Start Right‐Eat Right. Methods:  One hundred eighty‐four staff from South Australian LDCCs (81% response rate) completed a 16‐item telephone survey. Open and closed questions were asked, with multiple unprompted responses accepted for open questions. Differences by Start Right‐Eat Right status (engaged vs not‐engaged) were determined using chi‐square analysis. Results:  Sitting and supervising children while eating (100%), offering meals (98%) and snacks (94%) at regular and predictable intervals, and discussing food served with children (88%) were common mealtime practices. Practices that involved children at mealtimes were also frequent. Engaged centres reported higher frequencies of staff role modelling (80% vs 56%, P= 0.004) and encouraging children to taste foods offered (33% vs 13%, P= 0.021). Centres reported using ‘sometimes foods’ (76%) and food alternatives (42%) to celebrate children's birthdays, with more engaged centres than not‐engaged centres using nutritious foods at celebrations (15% vs 6%, P= 0.045). While 59% of respondents indicated that nutrition can be a sensitive topic to discuss with families, over 90% indicated it is important to communicate with parents about nutrition and felt confident to do so. Conclusion:  Practices employed by South Australian LDCCs to create a positive mealtime environment were consistent with current guidelines, more so when centres are engaged in a nutrition award scheme.