Healthy Eating in Early Childhood: A Critical Review

This paper provides a critical review of key articles and a report on healthy eating in early childhood, discussing key ideas, evidence, and recommendations.

Running head: EARLY CHILDHOOD
Name of the Student
Name of the University
Author Note

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Introduction:
Early childhood is a phase of early growth and important phase for developing healthy
eating habits as the dietary habit of early childhood can extend to adult and shape children as
adults. Early childhood eating habits are crucial for children since eating habits are related to
the development of certain disease and healthy eating habit in childhood is able to prevent an
array of disease. As discussed by Lo, Cheung, Tam and Keung (2016) the significant rise in
children with obesity has become a public health concern. In Australia, approximately 20% of
children in between 2 to 15 years are obese and a significant number of children are suffering
from a disease associated with obesity. The aim of the paper is to provide a critical review of key
articles and a report (details provided) on healthy eating in early childhood. This paper will
discuss key ideas of the articles, evidence of authors; appraise the best article and rationale
behind it in the following paragraphs.
Discussion:
Methodology:
Methodology section of a peer-reviewed journal document the actions which have been
taken to investigate certain hypothesis and rationale of the applications and specific procedures
used for interpreting the result obtained from the investigations. In the first article, a semi-
structured interview was undertaken by Cole Vidgen and Cleland, P. (2017) regarding the use
of tools , nutritional adequacy, menu planning , guidelines and checklists and identification and
management of unhealthy foods, in order to find the methods , process and strategies that has
been used by early childhood care and education services while identifying the nutritional
adequacy of food provided to the children. The researchers recruited 32 participants as a focus

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group, out of which 22 participants include directors, educators and 12 were cooks at long day
care services. As discussed by Leung (2015), qualitative e research design especially semi-
structured interviews are highlighted as one of the crucial research design since it provides the
researchers with an opportunity to obtain factual as well as emotional data. Moreover, first-
person data in the interview provide the opportunity to identify the perspectives, values, and
beliefs of the researchers. Hence it is appropriate for the study. Considering the second study,
Gerritsen, Dean, Morton, and Wall (2017), conducted an online survey in the three regions of
New Zealand a where a total of 257 services were recruited in the study and each service
uploaded their weekly menu when application. The menus were scored for its compliance with
the guideline for considering the parameters such as quantity, variety, and quality of the foods
that were served for the children. The bivariate and multivariate analysis was done for gaining
the understanding of the association between menu score as well as service characteristics.
According to Goertzen (2017), the survey is highlighted as a quantitative study which provides
the opportunity to investigate the relationship between two variables and establish the numerical
relationship. Survey also represents a large number of population and able to reduce selection
bias. Hence it is appropriate for researchers to make their arguments based on the data collected
from the online survey. Similarly, Lockeridge, Innes-Hughes, Hara, McGill and Rissel (2015),
undertook a program called much and move where they trained the staffs and evaluated the data
based on it. As discussed by Goertzen (2017), experimental study suitable evidence which
provides an opportunity to observe a population and design interventions according to it.
However, limitation of the study is they failed to provide compared data from different sources.

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Key messages of the articles
 The study of Cole, Vidgen and Cleland (2016), tried to find the processes, methods and
strategies used by the early childhood education and care (ECEC) providers while fixing
the nutritional quality of the foods provided to the children in their care home. Authors
of this study mainly tried to evaluate the quality of the strategies of care providers during
the determination of nutritional aspects of foods. As the nutritional quality of the food for
the children is associated with their quality of life, it is very crucial to maintain a proper
quality of food for them.
 The study of Gerritsen, Dean, Morton, and Wall (2017), investigated the childcare
services of New Zealand whether they are maintaining proper guidelines regarding child
nutrition. This guideline includes the quality, quantity and simultaneously variety of
foods. In this study, the authors also tried to find out the service characteristics and
service cost in New Zealand. The quality and variety of foods in New Zealand’s care
centre is associated with the growth of a child, so it is very crucial to maintain a versatile
menus with a good quality and quantity.
 From the study of Gerritsen, Dean, Morton, and Wall (2017), another important finding
was mentioned regarding public health. The poor developmental pattern due to low
quality of nutrition among children promoting the childhood obesities and thus quality of
life and social burden is also increasing regarding childhood obesity.
 The report of Lockeridge et al. (2015), investigated the issue of childhood obesity as this
public health issue is faced by the population of Australia in recent years. This report
emphasized on the healthy eating behaviour among the children in their childhood and
simultaneously suggested that, physical activity and healthy eating behaviour can reduce

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the cases of obesity among the children. The Munch & Move program is a specially
designed program for NSW and this The Munch & Move program influences the child’s
healthy eating and physical activity behaviour of the children and it was observed that,
this initiative under NSW Healthy Eating and Active Living Strategy: Preventing
overweight and obesity in NSW 2013-2018 is implemented by a huge number of children
care services in Australia.
Evidence on which author make their argument
 In the study of Cole, Vidgen and Cleland (2016), a semi-structured interview method
was conducted for collecting the data. In this method, total 22 face to face interview was
conducted at 12 LDCS along with 5 cooks, 7 educators and 13 directors. The study
results showed that none of the LDCS did not use any tools developed by the health
department during their service. However, only 3 LDCS with different sub groups
reported about using tool developed by Nutrition Australia to examine the nutritional
adequacy of foods provided. One of LDCS among all the LDCS used a checklist given by
centre support. In case of foods provided by the caterers, the LDCS completely
dependent on the caterers regarding the nutritional quality of foods. Most of the LDCS
mentioned that, they use common sense and their personal knowledge while deciding the
nutritional adequacy of foods of children.
 In another study by Gerritsen, Dean, Morton, and Wall (2017), conducted their study on
257 childcare services by using online questionnaire and the total survey population was
compared to the survey sample. From the results, it was found that 56.54% (n= 145) of
total child care services provide snacks to the children, 11.3% child care services provide
breakfast. In addition to this, almost 37.8% of child care services provided lunch. From

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the menus of the child care services it was observed that, many menus served a low
amount of grains and milk related products to the children and it is unhealthy diet
practice as it is recommended that in a diet of a child there should be adequate amount of
grains and milk. In case of cost analysis of the services, it was reported that 118 services
provided information about their costs ( Excluding g the cost of food service staff and
kitchen facilities) on per child per day. 21 services reported that their per day costing was
almost NZ$ 10 or more and one third of the total subject population had revised their
prices. From the study, it was recommended that 96% of the service providers met the
recommendation of one fruit/ day, 87% of total service providers provided grains/ meal /
day and 89% service providers served a milk/ meal / day. However, none of the service
providers met the recommendation of vegetable/ meal/ day.
 The study of Lockeridge et al. (2015), showed the effectiveness of Munch & Move
program as a part of the improvement of quality of life among the children. In ordwer to
train the service providers of health care services, workshops were arranged and it was
observed that, almost 89% of staffs were trained in this program. The training program
mainly become very successful in big cities and 88.5% of major city day care staffs were
trained under this program. In NSW, it was observed that, overall 70% or more child
care services adopted this Munch & Move program. In 2012, the amount of day care
services adopted this Munch & Move program was only 36% and in 2015, the amount
was 78% with a significant p value ( p<0.001). The study also found that, with time, the
safety practices among the care providers also enhanced. In 2012, 56.5% of care services
had written physical activity policy and on the other hand, in 2015 that amount increased
to 73.1% after implementation of Munch & Move program. Fundamental movement

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skills of the children also improved from 62.9% in 2012 to 67.1% in 2015.
Evaluate quality of evidence
 In the study of Cole, Vidgen and Cleland (2016), a qualitative study method was used
and as part of this a semi-structured interview was used. As a part of the qualitative
study, interview method can be recommended as a good method (Robinson, 2014). So,
after collecting the information, NVivo qualitative software was used to analyse those
data and case-by-case comparison were executed to perform comparison between themes
and collected data.
 A qualitative approach was used in the study of Gerritsen, Dean, Morton, and Wall
(2017). A large sample size was recruited as a study population in this study and an
online survey was performed. The large sample population of this study can be counted
as good quality of study (Malterud, Siersma, & Guassora, 2016). The variety of foods
along with the quantity and quality was analysed in this study and this can be counted as
good quality of evidence.
 In the report, an observational study method was used and data were collected in between
2012 to 2015. This large time period enhances the range of collected data and as it can be
counted as a good quality of data.
Best resource
The report of Lockeridge et al (2015) is the best resource.

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Features of the best articles
 Presence of huge amount of data
 Presence of pre and post intervention data
 Presence of tabular data
 Presence of future recommendation
 Attractive representation with a whole lot of information.
Conclusion
Therefore, it can be concluded that, the quality and quantity of provided foods to the
children in the care services is very crucial as they directly affect the growth of the children.
Most of the care service providers do not follow the guidelines regarding quality of food. The
quality of food also can affect the health of child and adolescents. Moreover, a healthy eating
behavior can also reduce the burden of obesity among the children.

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References
Cole, A., Vidgen, H., & Cleland, P. (2017). Food provision in early childhood education
and care services: Exploring how staff determine nutritional adequacy. Nutrition &
Dietetics, 74(1), 105-110.doi: 10.1111/1747-0080.12310
Gerritsen, S., Dean, B., Morton, S., & Wall, C. (2017). Do childcare menus meet
nutrition guidelines? Quantity, variety and quality of food provided in New
Zealand Early Childhood Education services. Australian and New Zealand
Journal of Public Health, 41(4), 345-351. doi: 10.1111/1753-6405.12667.
Lockeridge, A., Innes-Hughes, C., O’Hara, B.J., McGill, B., & Rissel, C. (2015) Munch
& Move: Evidence and Evaluation Summary. NSW Ministry of Health. Retrieved:
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unchMoveSummary.pdf
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